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Sample records for hospital medicine summit

  1. Rehabilitation medicine summit: building research capacity Executive Summary

    Directory of Open Access Journals (Sweden)

    Kemp John D

    2006-01-01

    Full Text Available Abstract The general objective of the "Rehabilitation Medicine Summit: Building Research Capacity" was to advance and promote research in medical rehabilitation by making recommendations to expand research capacity. The five elements of research capacity that guided the discussions were: 1 researchers; 2 research culture, environment, and infrastructure; 3 funding; 4 partnerships; and 5 metrics. The 100 participants included representatives of professional organizations, consumer groups, academic departments, researchers, governmental funding agencies, and the private sector. The small group discussions and plenary sessions generated an array of problems, possible solutions, and recommended actions. A post-Summit, multi-organizational initiative is called to pursue the agendas outlined in this report (see Additional File 1. Additional File 1 A table outlining the Final Action Plan of the Rehabilitation Medicine Summit: Building Research Capacity held on April 28–29, 2005 in Washington, DC. Click here for file

  2. The First National Pain Medicine Summit--final summary report.

    Science.gov (United States)

    Lippe, Philipp M; Brock, Charles; David, Jose; Crossno, Ronald; Gitlow, Stuart

    2010-10-01

    Pain is ubiquitous. At some point in time it affects everyone. For many millions pain becomes chronic, a scourge that impacts every facet of life-work, hobbies, family relations, social fabric, finances, happiness, mood, and even the very essence of identity. According to the National Institutes of Health (NIH), pain is one of our most important national public health problems, a silent epidemic. In 1998, NIH reported that the annual amount spent on health care, compensation, and litigation related to pain had reached one hundred billion dollars ($100,000,000,000). Considering that health care costs have doubled since then, it is not unreasonable to assume that the costs related to pain care have doubled as well. Millions of patients suffer needlessly with acute pain, with cancer pain, and with chronic pain. The ineffective management of pain results in an escalating cascade of health care issues. Acute pain that is not treated adequately and promptly results in persistent pain that eventually causes irreversible changes in the nervous system. This translates into progressive bio-psycho-social epiphenomena resulting in further pain and disability. It creates a vicious cycle transforming a functional human being into an invalid who becomes a burden to family, to society, and to oneself. In the face of adequate medical science, adequate technical skills, and adequate resources the reality of delayed and inadequate pain care is paradoxical. This dilemma deserves close scrutiny and effective remediation. The American Medical Association (AMA), long dedicated to the need to improve pain care in this country, has been faced with this reality. It was from this vision that the idea of holding a Pain Medicine Summit was conceived. Resolution 321 (A-08) set in motion a process that would bring together a diverse group of stakeholders for the purpose of discussing the present and future status of pain care; a process that culminated in a broad-based coalition of physicians

  3. Erratum: Report on the summit on the future ofacademic medicine in ...

    African Journals Online (AJOL)

    The prescribed forms should be completed. 8. The ethical rules should be complied with at all times. 7. Die voorgeskrewe vorms moet voltooi word. 8. Die etiese reels moet te alle tye nagekom word. Erratum: Report on the summit on the future ofacademic medicine in SA. Please npte that this repon, which was published on ...

  4. Executive Summary from the 2017 Emergency Medicine Resident Wellness Consensus Summit.

    Science.gov (United States)

    Battaglioli, Nicole; Ankel, Felix; Doty, Christopher I; Chung, Arlene; Lin, Michelle

    2018-03-01

    Physician wellness has recently become a popular topic of conversation and publication within the house of medicine and specifically within emergency medicine (EM). Through a joint collaboration involving Academic Life in Emergency Medicine's (ALiEM) Wellness Think Tank, Essentials of Emergency Medicine (EEM), and the Emergency Medicine Residents' Association (EMRA), a one-day Resident Wellness Consensus Summit (RWCS) was organized. The RWCS was held on May 15, 2017, as a pre-day event prior to the 2017 EEM conference in Las Vegas, Nevada. Seven months before the RWCS event, pre-work began in the ALiEM Wellness Think Tank, which was launched in October 2016. The Wellness Think Tank is a virtual community of practice involving EM residents from the U.S. and Canada, hosted on the Slack digital-messaging platform. A working group was formed for each of the four predetermined themes: wellness curriculum development; educator toolkit resources for specific wellness topics; programmatic innovations; and wellness-targeted technologies. Pre-work for RWCS included 142 residents from 100 different training programs in the Wellness Think Tank. Participants in the actual RWCS event included 44 EM residents, five EM attendings who participated as facilitators, and three EM attendings who acted as participants. The four working groups ultimately reached a consensus on their specific objectives to improve resident wellness on both the individual and program level. The Resident Wellness Consensus Summit was a unique and novel consensus meeting, involving residents as the primary stakeholders. The summit demonstrated that it is possible to galvanize a large group of stakeholders in a relatively short time by creating robust trust, communication, and online learning networks to create resources that support resident wellness.

  5. Executive Summary from the 2017 Emergency Medicine Resident Wellness Consensus Summit

    Directory of Open Access Journals (Sweden)

    Felix Ankel

    2018-02-01

    Full Text Available Introduction: Physician wellness has recently become a popular topic of conversation and publication within the house of medicine and specifically within emergency medicine (EM. Through a joint collaboration involving Academic Life in Emergency Medicine’s (ALiEM Wellness Think Tank, Essentials of Emergency Medicine (EEM, and the Emergency Medicine Residents’ Association (EMRA, a one-day Resident Wellness Consensus Summit (RWCS was organized. Methods: The RWCS was held on May 15, 2017, as a pre-day event prior to the 2017 EEM conference in Las Vegas, Nevada. Seven months before the RWCS event, pre-work began in the ALiEM Wellness Think Tank, which was launched in October 2016. The Wellness Think Tank is a virtual community of practice involving EM residents from the U.S. and Canada, hosted on the Slack digital-messaging platform. A working group was formed for each of the four predetermined themes: wellness curriculum development; educator toolkit resources for specific wellness topics; programmatic innovations; and wellness-targeted technologies. Results: Pre-work for RWCS included 142 residents from 100 different training programs in the Wellness Think Tank. Participants in the actual RWCS event included 44 EM residents, five EM attendings who participated as facilitators, and three EM attendings who acted as participants. The four working groups ultimately reached a consensus on their specific objectives to improve resident wellness on both the individual and program level. Conclusion: The Resident Wellness Consensus Summit was a unique and novel consensus meeting, involving residents as the primary stakeholders. The summit demonstrated that it is possible to galvanize a large group of stakeholders in a relatively short time by creating robust trust, communication, and online learning networks to create resources that support resident wellness.

  6. The World Summit of Harmonization on Traditional, Alternative and Complementary Medicine (TACM in Lima, Peru

    Directory of Open Access Journals (Sweden)

    Gustavo F. Gonzales

    2010-01-01

    Full Text Available The World Summit of Harmonization on Traditional, Alternative and Complementary Medicine (TACM was held in Lima, Peru, November 7–11, 2007, with almost 600 worldwide participants. This meeting was organized by Peruvian Medical College, the institution that affiliates and authorizes all physicians to practice medicine in Peru. The meeting included seven sections starting with an overview on the current status of the TACM. The second section included experiences from different countries on regulations and quality control in products and services used in the TACM. The worldwide experience of education and training in TACM was a very important part of the meeting in which speakers from Spain, Germany, Argentina, Italy, Brazil, Cuba and Peru shared their experience. The meeting included topics on homeopathy, acupuncture, mind–body medicine, neural therapy, chiropraxis, among others. Two final sessions were related to the ways of linking Traditional medicine to the national Health Systems in the Latin America countries and also the association between bio-commerce and TACM including intellectual properties and bio-piracy.

  7. Hospital Medicine Resident Training Tracks: Developing the Hospital Medicine Pipeline.

    Science.gov (United States)

    Sweigart, Joseph R; Tad-Y, Darlene; Kneeland, Patrick; Williams, Mark V; Glasheen, Jeffrey J

    2017-03-01

    Hospital medicine (HM) is rapidly evolving into new clinical and nonclinical roles. Traditional internal medicine (IM) residency training likely does not optimally prepare residents for success in HM. Hospital medicine residency training tracks may offer a preferred method for specialized HM education. Internet searches and professional networks were used to identify HM training tracks. Information was gathered from program websites and discussions with track directors. The 11 HM tracks at academic medical centers across the United States focus mostly on senior residents. Track structure and curricular content are determined largely by the structure and curricula of the IM residency programs in which they exist. Almost all tracks feature experiential quality improvement projects. Content on healthcare economics and value is common, and numerous track leaders report this content is expanding from HM tracks into entire residency programs. Tracks also provide opportunities for scholarship and professional development, such as workshops on abstract creation and job procurement skills. Almost all tracks include HM preceptorships as well as rotations within various disciplines of HM. HM residency training tracks focus largely on quality improvement, health care economics, and professional development. The structures and curricula of these tracks are tightly linked to opportunities within IM residency programs. As HM continues to evolve, these tracks likely will expand to bridge clinical and extra-clinical gaps between traditional IM training and contemporary HM practice. Journal of Hospital Medicine 2017;12:173-176. © 2017 Society of Hospital Medicine

  8. Nigerian Quarterly Journal of Hospital Medicine: Submissions

    African Journals Online (AJOL)

    Nigerian Quarterly Journal of Hospital Medicine: Submissions. Journal Home > About the Journal > Nigerian Quarterly Journal of Hospital Medicine: Submissions. Log in or Register to get access to full text downloads.

  9. The market for hospital medicine in Denmark

    Directory of Open Access Journals (Sweden)

    Gisela Hostenkamp

    2011-11-01

    Full Text Available Pharmaceutical expenditure growth has outpaced GDP and healthcare expenditure growth rates in Denmark as in most OECD countries for the last decade. A major part of this increase was due to high growth rates in specialist areas that are typically located in hospital settings. Yet the market for hospital medicines and their procurement are still poorly understood. The present paper characterises the market for hospital medicines in Denmark in terms of its organisation and developments between 2005 and 2009. In Denmark hospital medicines are publicly financed and procurement is centrally organised. 98% of all medicines administered at Danish public hospitals are purchased through a public procurement agency by means of public tenders. Using data on actual contract prices we decompose pharmaceutical expenditure growth into the contributions from newly introduced medicines, price and volume increases and use summary statistics to compare market performance in both sectors. The market for hospital medicine is more concentrated than the pharmaceutical retail sector and the share of generics and parallel imported products is significantly lower. Between 2005 and 2009 expenditures for hospital medicines more than doubled -accounting for almost 40% of the total Danish pharmaceutical market in 2009. Price increases however - although positive and higher than in the pharmaceutical retail sector - were only moderate. The majority of the expenditure growth was due to an increase in utilisation and the introduction of new medicines in the hospital sector. Centralised tendering may therefore have important implications for competition and industry structure in the long run.

  10. The Market for Hospital Medicine in Denmark

    DEFF Research Database (Denmark)

    Hostenkamp, Gisela

    2012-01-01

    Pharmaceutical expenditure growth has outpaced GDP and healthcare expenditure growth rates in Denmark as in most OECD countries for the last decade. A major part of this increase was due to high growth rates in specialist areas that are typically located in hospital settings. Yet the market...... for hospital medicines and their procurement are still poorly understood. The present paper characterises the market for hospital medicines in Denmark in terms of its organisation and developments between 2005 and 2009. In Denmark hospital medicines are publicly financed and procurement is centrally organised....... 98% of all medicines administered at Danish public hospitals are purchased through a public procurement agency by means of public tenders. Using data on actual contract prices we decompose pharmaceutical expenditure growth into the contributions from newly introduced medicines, price and volume...

  11. TECTONIC VERSUS VOLCANIC ORIGIN OF THE SUMMIT DEPRESSION AT MEDICINE LAKE VOLCANO, CALIFORNIA

    Energy Technology Data Exchange (ETDEWEB)

    Mark Leon Gwynn

    2010-05-01

    Medicine Lake Volcano is a Quaternary shield volcano located in a tectonically complex and active zone at the transition between the Basin and Range Province and the Cascade Range of the Pacific Province. The volcano is topped by a 7x12 km elliptical depression surrounded by a discontinuous constructional ring of basaltic to rhyolitic lava flows. This thesis explores the possibility that the depression may have formed due to regional extension (rift basin) or dextral shear (pull-apart basin) rather than through caldera collapse and examines the relationship between regional tectonics and localized volcanism. Existing data consisting of temperature and magnetotelluric surveys, alteration mineral studies, and core logging were compiled and supplemented with additional core logging, field observations, and fault striae studies in paleomagnetically oriented core samples. These results were then synthesized with regional fault data from existing maps and databases. Faulting patterns near the caldera, extension directions derived from fault striae P and T axes, and three-dimensional temperature and alteration mineral models are consistent with slip across arcuate ring faults related to magma chamber deflation during flank eruptions and/or a pyroclastic eruption at about 180 ka. These results are not consistent with a rift or pull-apart basin. Limited subsidence can be attributed to the relatively small volume of ash-flow tuff released by the only known major pyroclastic eruption and is inconsistent with the observed topographic relief. The additional relief can be explained by constructional volcanism. Striae from unoriented and oriented core, augmented by striae measurements in outcrop suggest that Walker Lane dextral shear, which can be reasonably projected from the southeast, has probably propagated into the Medicine Lake area. Most volcanic vents across Medicine Lake Volcano strike north-south, suggesting they are controlled by crustal weakness related to Basin and

  12. Tectonic versus volcanic origin of the summit depression at Medicine Lake Volcano, California

    Energy Technology Data Exchange (ETDEWEB)

    Mark Leon Gwynn

    2010-05-01

    Medicine Lake Volcano is a Quaternary shield volcano located in a tectonically complex and active zone at the transition between the Basin and Range Province and the Cascade Range of the Pacific Province. The volcano is topped by a 7x12 km elliptical depression surrounded by a discontinuous constructional ring of basaltic to rhyolitic lava flows. This thesis explores the possibility that the depression may have formed due to regional extension (rift basin) or dextral shear (pull-apart basin) rather than through caldera collapse and examines the relationship between regional tectonics and localized volcanism. Existing data consisting of temperature and magnetotelluric surveys, alteration mineral studies, and core logging were compiled and supplemented with additional core logging, field observations, and fault striae studies in paleomagnetically oriented core samples. These results were then synthesized with regional fault data from existing maps and databases. Faulting patterns near the caldera, extension directions derived from fault striae P and T axes, and three-dimensional temperature and alteration mineral models are consistent with slip across arcuate ring faults related to magma chamber deflation during flank eruptions and/or a pyroclastic eruption at about 180 ka. These results are not consistent with a rift or pull-apart basin. Limited subsidence can be attributed to the relatively small volume of ash-flow tuff released by the only known major pyroclastic eruption and is inconsistent with the observed topographic relief. The additional relief can be explained by constructional volcanism. Striae from unoriented and oriented core, augmented by striae measurements in outcrop suggest that Walker Lane dextral shear, which can be reasonably projected from the southeast, has probably propagated into the Medicine Lake area. Most volcanic vents across Medicine Lake Volcano strike north-south, suggesting they are controlled by crustal weakness related to Basin and

  13. The business of pediatric hospital medicine.

    Science.gov (United States)

    Percelay, Jack M; Zipes, David G

    2014-07-01

    Pediatric hospital medicine (PHM) programs are mission driven, not margin driven. Very rarely do professional fee revenues exceed physician billing collections. In general, inpatient hospital care codes reimburse less than procedures, payer mix is poor, and pediatric inpatient care is inherently time-consuming. Using traditional accounting principles, almost all PHM programs will have a negative bottom line in the narrow sense of program costs and revenues generated. However, well-run PHM programs contribute positively to the bottom line of the system as a whole through the value-added services hospitalists provide and hospitalists' ability to improve overall system efficiency and productivity. This article provides an overview of the business of hospital medicine with emphasis on the basics of designing and maintaining a program that attends carefully to physician staffing (the major cost component of a program) and physician charges (the major revenue component of the program). Outside of these traditional calculations, resource stewardship is discussed as a way to reduce hospital costs in a capitated or diagnosis-related group reimbursement model and further improve profit-or at least limit losses. Shortening length of stay creates bed capacity for a program already running at capacity. The article concludes with a discussion of how hospitalists add value to the system by making other providers and other parts of the hospital more efficient and productive. Copyright 2014, SLACK Incorporated.

  14. IRSN's expertise about nuclear medicine hospital effluents

    International Nuclear Information System (INIS)

    2009-01-01

    This brief note aims at presenting the radioactivity follow up of hospital effluents performed by the French Institute of Radiation Protection and Nuclear Safety (IRSN). This follow up concerns the radioactive compounds and radiopharmaceuticals used in nuclear medicine, and principally technetium 99 and iodine 131. The IRSN has developed a network of remote measurement systems for the monitoring of sewers and waste water cleaning facilities. Data are compiled in a data base for analysis and subsequent expertise. (J.S.)

  15. Hospital Intranet and Extranet in nuclear medicine

    International Nuclear Information System (INIS)

    Gambini, D.J.; Baum, T.P.; Spector, M.; Dumas, F.; Elgard, M.C.; Collington, M.A.; Barritault, L.

    1997-01-01

    Since two years ago nuclear medicine service of Laennec Hospital has implemented transmission and distribution networks of scintigraphic images. A new stage was reached at present by developing an Intranet and Extranet system for nursing units and other services of nuclear medicine. The Intranet link to the services of Laennec Hospital and AP HP is based on a image server connected to the service gamma camera and, after a possible post-processing, the images are transmitted in PCX format by e-mail, attached to the medical record. For communication between nuclear medicine services, a heavier procedure making use of a program for image processing under inter-file standards has been implemented. To achieve the Extranet link with services and physicians of town, exterior to AP HP, a procedure was installed which allows reaching any nursing unit or town physicians having at their disposal e-mail on a secured network. This procedure will be generalized when the Health secured network, linking the medical bodies to Health insurance institutions, will be operational. The interactive tele-medicine will be achieved by means of a procedure based on Internet cooperative tools (wild cards, video- and vision-conferences) which will permits in all situations an interactive work on all the transmitted patient files

  16. [Strive, plan and reach the "Summit": the Faculty Development Program at the Ruth & Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology].

    Science.gov (United States)

    Castel, Orit Cohen; Nave, Rachel; Ganor, Margalit; Hasson-Gilad, Dalia R; Brika, Riva

    2010-04-01

    In recent years, faculty development has turned into a central component of medical education and a primary instrument in qualifying physicians to be teachers and educators. The faculty development program at the Ruth & Bruce Rappaport Faculty of Medicine ("Summit" program) was established in order to improve teaching of the clinical professions, to create a community of medical teachers and educators and to develop leadership in medical education within the Faculty of Medicine. This article aims to describe the design, implementation and evaluation of the faculty development program in the Technion's Faculty of Medicine. The program was designed for a group of 20 clinical teachers, of various clinical professions, who had gained at least one year of undergraduate teaching experience and wished to develop a career in medical education. The program included seven monthly, eight-hour meetings throughout the academic year. Learning was based on small group discussions, interactive exercises, role-plays and simulations, self-directed reading and reflective writing. At the end of the final meeting, participants completed an evaluation form. Seventeen of the 20 participants (85%) graduated and received certificates. Learners' overall satisfaction was high. Graduates expressed high motivation to practice medical education within the Faculty of Medicine and reported that they gained new knowledge in medical education and skills regarding various aspects of teaching and learning, such as formulation of learning objectives, designing role plays, and providing effective feedback. The "Summit" program is an innovative initiative in the field of medical education in Israel. The program had a significant impact on participants' knowledge, teaching skills and attitudes. In order to ensure implementation of the acquired tools and skills, its shortterm and long-term effects on teaching behavior and the learning climate have yet to be demonstrated. In addition, it is necessary to

  17. Dinosaurs, Hospital Ecosystems, and the Future of Family Medicine

    Science.gov (United States)

    Glazner, Cherie

    2008-01-01

    The continued presence of the family physician within hospital systems is key to family medicine remaining an attractive, viable specialty in the ever-evolving world of medicine. One physician muses about her place in this complex ecosystem and believes that family physicians lose their voice and thus risk their own extinction when they opt out of hospital practice. PMID:18626038

  18. Optimizing the Internal Medicine Clinic at Evans Army Community Hospital

    National Research Council Canada - National Science Library

    Bonilla, Jose

    2003-01-01

    ...) 2002, the Internal Medicine (IM) clinic at Evans Army Community Hospital, Fort Carson, Colorado, failed to meet access to care standards for routine appointments, and was only marginally successful in meeting standards for urgent appointments...

  19. Summit surprises.

    Science.gov (United States)

    Myers, N

    1994-01-01

    A New Delhi Population Summit, organized by the Royal Society, the US National Academy of Sciences, the Royal Swedish Academy of Sciences, and the Indian National Science Academy, was convened with representation of 120 (only 10% women) scientists from 50 countries and about 12 disciplines and 43 national scientific academies. Despite the common assumption that scientists never agree, a 3000 word statement was signed by 50 prominent national figures and supported by 25 professional papers on diverse subjects. The statement proclaimed that stable world population and "prodigious planning efforts" are required for dealing with global social, economic, and environmental problems. The target should be zero population growth by the next generation. The statement, although containing many uncompromising assertions, was not as strong as a statement by the Royal Society and the US National Academy of Sciences released last year: that, in the future, science and technology may not be able to prevent "irreversible degradation of the environment and continued poverty," and that the capacity to sustain life on the planet may be permanently jeopardized. The Delhi statement was backed by professional papers highlighting several important issues. Dr Mahmoud Fathalla of the Rockefeller Foundation claimed that the 500,000 annual maternal deaths worldwide, of which perhaps 33% are due to "coathanger" abortions, are given far less attention than a one-day political event of 500 deaths would receive. Although biologically women have been given a greater survival advantage, which is associated with their reproductive capacity, socially disadvantaged females are relegated to low status. There is poorer nutrition and overall health care for females, female infanticide, and female fetuses are increasingly aborted in China, India, and other countries. The sex ratio in developed countries is 95-97 males to every 100 females, but in developing Asian countries the ratio is 105 males to 100

  20. Hospital medicine (Part 2): what would improve acute hospital care?

    LENUS (Irish Health Repository)

    Kellett, John

    2009-09-01

    There are so many obvious delays and inefficiencies in our traditional system of acute hospital care; it is clear that if outcomes are to be improved prompt accurate assessment immediately followed by competent and efficient treatment is essential. Early warning scores (EWS) help detect acutely ill patients who are seriously ill and likely to deteriorate. However, it is not known if any EWS has universal applicability to all patient populations. The benefit of Rapid Response Systems (RRS) such as Medical Emergency Teams has yet to be proven, possibly because doctors and nurses are reluctant to call the RRS for help. Reconfiguration of care delivery in an Acute Medical Assessment Unit has been suggested as a "proactive" alternative to the "reactive" approach of RRS. This method ensures every patient is in an appropriate and safe environment from the moment of first contact with the hospital. Further research is needed into what interventions are most effective in preventing the deterioration and\\/or resuscitating seriously ill patients. Although physicians expert in hospital care decrease the cost and length of hospitalization without compromising outcomes hospital care will continue to be both expensive and potentially dangerous.

  1. Education in geriatric medicine for community hospital staff.

    LENUS (Irish Health Repository)

    O'Hanlon, Shane

    2010-12-01

    Community hospitals provide many services for older people. They are mainly managed by nursing staff, with some specialist input. Little is known about education provided in these facilities. Most education in geriatric medicine is provided in hospitals, despite most elderly care being provided in the community. The authors surveyed senior nursing staff in Irish community hospitals to examine this area in more detail. Staff in all 18hospitals in the Health Service Executive (South) area were invited to participate. The response rate was 100%. Sixteen of the 18 respondents (89%) felt staff did not have enough education in geriatric medicine. Just over half of hospitals had regular staff education sessions in the area, with a minority of sessions led by a geriatrician, and none by GPs. Geriatrician visits were valued, but were requested only every 1-3 months. Staff identified challenging behaviour and dementia care as the areas that posed most difficulty.

  2. Patient's medicines brought to hospital: an overlooked resource?

    Science.gov (United States)

    Ware, G J

    1993-10-27

    To quantify potential cost advantages and identify practical safeguards required for utilising patients own medicines while in hospital, and returning them on discharge. All medicines brought in by patients in two wards of a geriatric assessment and rehabilitation unit at Auckland Hospital were examined by the pharmacist, and their suitability for re-issue assessed. Medicines were regarded as suitable for use where they could be positively identified, had been dispensed within 3 months of admission, or if packed in foil, provided the expiry date and manufacturer identification were on the foil. Medicines (260 items) totalling $2,976, assessed over a 6 month period, were regarded as suitable for use by the patient, with a mean value of $11.36 per patient. Patients own medicines used within the hospital with a unit-of-issue distribution system, and taken home by them on discharge, would provide appreciable savings for the hospital medicine budget and reduction in waste of the overall health dollar.

  3. Pediatric hospital medicine core competencies: development and methodology.

    Science.gov (United States)

    Stucky, Erin R; Ottolini, Mary C; Maniscalco, Jennifer

    2010-01-01

    Pediatric hospital medicine is the most rapidly growing site-based pediatric specialty. There are over 2500 unique members in the three core societies in which pediatric hospitalists are members: the American Academy of Pediatrics (AAP), the Academic Pediatric Association (APA) and the Society of Hospital Medicine (SHM). Pediatric hospitalists are fulfilling both clinical and system improvement roles within varied hospital systems. Defined expectations and competencies for pediatric hospitalists are needed. In 2005, SHM's Pediatric Core Curriculum Task Force initiated the project and formed the editorial board. Over the subsequent four years, multiple pediatric hospitalists belonging to the AAP, APA, or SHM contributed to the content of and guided the development of the project. Editors and collaborators created a framework for identifying appropriate competency content areas. Content experts from both within and outside of pediatric hospital medicine participated as contributors. A number of selected national organizations and societies provided valuable feedback on chapters. The final product was validated by formal review from the AAP, APA, and SHM. The Pediatric Hospital Medicine Core Competencies were created. They include 54 chapters divided into four sections: Common Clinical Diagnoses and Conditions, Core Skills, Specialized Clinical Services, and Healthcare Systems: Supporting and Advancing Child Health. Each chapter can be used independently of the others. Chapters follow the knowledge, skills, and attitudes educational curriculum format, and have an additional section on systems organization and improvement to reflect the pediatric hospitalist's responsibility to advance systems of care. These competencies provide a foundation for the creation of pediatric hospital medicine curricula and serve to standardize and improve inpatient training practices. (c) 2010 Society of Hospital Medicine.

  4. The VCU Pressure Ulcer Summit: Collaboration to Operationalize Hospital-Acquired Pressure Ulcer Prevention Best Practice Recommendations.

    Science.gov (United States)

    Brindle, C Tod; Creehan, Sue; Black, Joyce; Zimmermann, Deb

    2015-01-01

    This executive summary reports outcomes of an interprofessional collaboration between experts in pressure ulcer prevention, bedside clinicians, regulatory agencies, quality improvement, informatics experts, and professional nursing organizations. The goal of the collaboration was to develop a framework to assist facilities to operationalize best practice recommendations to sustain organizational culture change in hospital-acquired pressure ulcer prevention, to develop a hospital-acquired pressure ulcer severity score, and to address topics related to the unavoidable pressure ulcer.

  5. [Day hospital in internal medicine: A chance for ambulatory care].

    Science.gov (United States)

    Grasland, A; Mortier, E

    2018-04-16

    Internal medicine is an in-hospital speciality. Along with its expertise in rare diseases, it shares with general medicine the global care of patients but its place in the ambulatory shift has yet to be defined. The objective of our work was to evaluate the benefits of an internal medicine day-hospital devoted to general medicine. Named "Centre Vi'TAL" to underline the link between the city and the hospital, this novel activity was implemented in order to respond quickly to general practitioners having difficulties to synthesize their complex patients or facing diagnostic or therapeutic problems. Using preferentially email for communication, the general practitioners can contact an internist who is committed to respond on the same day and take over the patient within 7 days if day-hospital is appropriate for his condition. The other patients are directed either to the emergency department, consultation or full hospitalization. In 14 months, the center has received 213 (144 women, 69 men) patients, mean age 53.6, addressed by 88 general practitioners for 282 day-hospital sessions. Requests included problem diagnoses (n=105), synthesis reviews for complex patients (n=65), and treatment (n=43). In the ambulatory shift advocated by the authorities, this experience shows that internal medicine should engage in the recognition of day-hospital as a place for diagnosis and synthesis reviews connected with the city while leaving the general practitioners coordinator of their patient care. This activity of synthesis in day-hospital is useful for the patients and efficient for our healthcare system. Copyright © 2018 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  6. Selection of medicines in Chilean public hospitals: an exploratory study

    Directory of Open Access Journals (Sweden)

    Collao Juan F

    2013-01-01

    Full Text Available Abstract Background There is a growing interest in high income countries to control expenditure on medicines by improving the rationale for their selection. However, in middle income countries with differing priorities and needs, little attention has been paid to this issue. In this paper we explore the policies and processes for the selection and use of medicines in a group of hospitals in Chile, a middle income country which has recently joined the OECD. Methods A combination of qualitative and quantitative methods was used. A national survey questionnaire was distributed to investigate the role and operation of PTCs (Pharmacy and Therapeutics Committees. Interviews were conducted with key actors in the selection of medicines in large urban public hospitals. Results The national survey had an overall response rate of 42% (83 out of 196, whilst 7 out of 14 hospitals participated in the qualitative study. High complexity hospitals are large urban hospitals; all of which claim to have a working PTC. The pharmacy offices are mainly involved in dispensing medicines with little involvement in clinical duties. The interviews conducted suggest that the formulary of all the hospitals visited is no more than a stock list. PTCs are unable to influence the prescribing practices of doctors. Members do not feel prepared to challenge the opinions of specialists requesting a certain drug, and decisions are based primarily on costs. The inclusion of medicines in the clinical practice of hospitals is as a result of doctors bypassing the PTC and requesting the purchase of exceptional items, some of which are included in the formulary if they are widely used. Conclusions There is an urgent need to develop medicine policies in hospitals in Chile. The procedures used to purchase medicines need to be revised. Central guidance for PTCs could help ensure a more rational use of medicines. PTCs need to be empowered to design formularies which cover all the clinical

  7. Selection of medicines in Chilean public hospitals: an exploratory study.

    Science.gov (United States)

    Collao, Juan F; Smith, Felicity; Barber, Nick

    2013-01-07

    There is a growing interest in high income countries to control expenditure on medicines by improving the rationale for their selection. However, in middle income countries with differing priorities and needs, little attention has been paid to this issue. In this paper we explore the policies and processes for the selection and use of medicines in a group of hospitals in Chile, a middle income country which has recently joined the OECD. A combination of qualitative and quantitative methods was used. A national survey questionnaire was distributed to investigate the role and operation of PTCs (Pharmacy and Therapeutics Committees). Interviews were conducted with key actors in the selection of medicines in large urban public hospitals. The national survey had an overall response rate of 42% (83 out of 196), whilst 7 out of 14 hospitals participated in the qualitative study. High complexity hospitals are large urban hospitals; all of which claim to have a working PTC. The pharmacy offices are mainly involved in dispensing medicines with little involvement in clinical duties.The interviews conducted suggest that the formulary of all the hospitals visited is no more than a stock list. PTCs are unable to influence the prescribing practices of doctors. Members do not feel prepared to challenge the opinions of specialists requesting a certain drug, and decisions are based primarily on costs. The inclusion of medicines in the clinical practice of hospitals is as a result of doctors bypassing the PTC and requesting the purchase of exceptional items, some of which are included in the formulary if they are widely used. There is an urgent need to develop medicine policies in hospitals in Chile. The procedures used to purchase medicines need to be revised. Central guidance for PTCs could help ensure a more rational use of medicines. PTCs need to be empowered to design formularies which cover all the clinical needs of doctors, training members in the analysis of scientific

  8. Use of complementary and alternative medicine within Norwegian hospitals.

    Science.gov (United States)

    Jacobsen, R; Fønnebø, V M; Foss, N; Kristoffersen, A E

    2015-08-13

    Over the recent decades complementary and alternative medicine (CAM) use within and outside of the public health care system in Norway has increased. The aim of this study is to describe to what extent CAM is offered in Norwegian hospitals in 2013 and investigate possible changes since 2008. In January 2013 a one-page questionnaire was sent to the medical director of all included hospitals (n = 80). He/she was asked to report whether or not one or more specific CAM therapies were offered in the hospital. Fifty-nine (73.8%) hospitals responded and form the basis for the analyses. CAM was offered in 64.4% of the responding hospitals. No major differences were found between public and private, or between somatic and psychiatric, hospitals. Acupuncture was the most frequent CAM method offered, followed by art- and expression therapy and massage. The proportion of hospitals offering CAM has increased from 50.5% in 2008 to 64.4% in 2013 (p = 0.089). The largest increase was found in psychiatric hospitals where 76.5% of hospitals offered CAM in 2013 compared to 28.6% in 2008 (p = 0.003). A small decrease was found in the proportion of hospitals offering acupuncture between 2008 (41.4%) and 2013 (37.3%). A majority of Norwegian hospitals offer some sort of CAM. The largest increase since 2008 was found in psychiatric hospitals. Psychiatric hospitals seem to have established a practice of offering CAM to their patients similar to the practice in somatic hospitals. This could indicate a shift in the attitude with regard to CAM in psychiatric hospitals.

  9. Use of complementary and alternative medicine within Norwegian hospitals

    OpenAIRE

    Jacobsen, Renate; Fønnebø, Vinjar; Foss, Nina; Kristoffersen, Agnete Egilsdatter

    2015-01-01

    Background: Over the recent decades complementary and alternative medicine (CAM) use within and outside of the public health care system in Norway has increased. The aim of this study is to describe to what extent CAM is offered in Norwegian hospitals in 2013 and investigate possible changes since 2008. Methods: In January 2013 a one-page questionnaire was sent to the medical director of all included hospitals (n = 80). He/she was asked to report whether or not one or more specifi...

  10. Radioprotection in nuclear medicine department of 'Porto Alegre Clinical Hospital'

    International Nuclear Information System (INIS)

    Dias, T.M.; Pinto, A.L.; Bacelar, A.L.; Dytz, A.S.; Bernasiuk, M.E.; Baptista, I.S.

    1996-01-01

    The use of ionizing radiation in medicine allows great benefits. Nuclear Medicine uses ionizing radiation for medical diagnostic, such as: tumor, cancer, and dysfunctions location. However the use of ionizing radiation must be controlled in order to avoid likely biological effects in human beings. In order to extremely minimize that these effects appear, the Medical Physics Department of the Porto Alegre Clinical Hospital has implemented some procedures to assure that handling and use of radioactive material are in a safe way. This preoccupation is considered in all the places of nuclear medicine sector since the moment when the radioactive material is brought into including its manipulation and retirement, the exam process being accompanied. (authors). 4 refs

  11. Summary of the 2015 International Paediatric Heart Failure Summit of Johns Hopkins All Children's Heart Institute.

    Science.gov (United States)

    Jacobs, Jeffrey P; Quintessenza, James A; Karl, Tom R; Asante-Korang, Alfred; Everett, Allen D; Collins, Susan B; Ramirez-Correa, Genaro A; Burns, Kristin M; Cohen, Mitchell; Colan, Steven D; Costello, John M; Daly, Kevin P; Franklin, Rodney C G; Fraser, Charles D; Hill, Kevin D; Huhta, James C; Kaushal, Sunjay; Law, Yuk M; Lipshultz, Steven E; Murphy, Anne M; Pasquali, Sara K; Payne, Mark R; Rossano, Joseph; Shirali, Girish; Ware, Stephanie M; Xu, Mingguo; Jacobs, Marshall L

    2015-08-01

    In the United States alone, ∼14,000 children are hospitalised annually with acute heart failure. The science and art of caring for these patients continues to evolve. The International Pediatric Heart Failure Summit of Johns Hopkins All Children's Heart Institute was held on February 4 and 5, 2015. The 2015 International Pediatric Heart Failure Summit of Johns Hopkins All Children's Heart Institute was funded through the Andrews/Daicoff Cardiovascular Program Endowment, a philanthropic collaboration between All Children's Hospital and the Morsani College of Medicine at the University of South Florida (USF). Sponsored by All Children's Hospital Andrews/Daicoff Cardiovascular Program, the International Pediatric Heart Failure Summit assembled leaders in clinical and scientific disciplines related to paediatric heart failure and created a multi-disciplinary "think-tank". The purpose of this manuscript is to summarise the lessons from the 2015 International Pediatric Heart Failure Summit of Johns Hopkins All Children's Heart Institute, to describe the "state of the art" of the treatment of paediatric cardiac failure, and to discuss future directions for research in the domain of paediatric cardiac failure.

  12. Hospital Medicine (Part 1): what is wrong with acute hospital care?

    LENUS (Irish Health Repository)

    Kellett, John

    2009-09-01

    Modern hospitals are facing several challenges and, over the last decade in particular, many of these institutions have become dysfunctional. Paradoxically as medicine has become more successful the demand for acute hospital care has increased, yet there is no consensus on what conditions or complaints require hospital admission and there is wide variation in the mortality rates, length of stay and possibly standards of care between different units. Most acutely ill patients are elderly and instead of one straightforward diagnosis are more likely to have a complex combination of multiple co-morbid conditions. Any elderly patient admitted to hospital is at considerable risk which must be balanced against the possible benefits. Although most of the patients in hospital die from only approximately ten diagnoses, obvious life saving treatment is often delayed by a junior doctor in-training first performing an exhaustive complete history and physical, and then ordering a number of investigations before consulting a senior colleague. Following this traditional hierarchy delays care with several "futile cycles" of clinical activity thoughtlessly directed at the patient without any benefit being delivered. If acute hospital medicine is to be improved changes in traditional assumptions, attitudes, beliefs and practices are needed.

  13. Hospital discharge summary scorecard: a quality improvement tool used in a tertiary hospital general medicine service.

    Science.gov (United States)

    Singh, G; Harvey, R; Dyne, A; Said, A; Scott, I

    2015-12-01

    We assessed the impact of completion and feedback of discharge summary scorecards on the quality of discharge summaries written by interns in a general medicine service of a tertiary hospital. The scorecards significantly improved summary quality in the first three rotations of the intern year and could be readily adopted by other units as a quality improvement intervention for optimizing clinical handover to primary care providers. © 2015 Royal Australasian College of Physicians.

  14. Cost of Treatment of Hospitalized Patients with Diabetes in Prenda Hospital Medicine Service, Angola

    Directory of Open Access Journals (Sweden)

    António Zangulo

    2017-07-01

    Full Text Available Introduction: Diabetes has a major impact on morbidity and mortality today. It is estimated that by 2040, about 642 million people are affected worldwide, of which, 34.2 million are from sub-Saharan countries. The direct annual cost of diabetes health care worldwide is estimated at about 153 billion dollars. These patients represent 30% to 40% of all admissions to emergency services, leading to high values of hospital expenditure. We aim to evaluate the cost of treatment of patients with diabetes admitted to Prenda Hospital Medicine Service in 2012. Methods: Retrospective analytical observational study, with data collected from the clinical processes of medical service (age and gender, length of hospitalization, resources consumed, cost of treatment per patient and discharge. Results: Out of 121 patients, the majority was female (n = 70, 57.9%. The age group of 36 to 45 years old was the most frequent among these patients (n = 26, 21.5%. November was the month that recorded the largest number of admissions (n = 17, 14%. About 45.5% were hospitalized during five to eight days, on average for nine days. The majority (76.9% was discharged due to health condition improvement. The price of materials used for treatment of the disease had high variation, and 31 550.15 kwanzas was spent to acquire them. The direct cost per patient per day was 4170.11 kwanzas and the estimated annual cost of care of diabetic patients admitted to Prenda Hospital was 45 525 490.9 kwanzas in 2012. Discussion and Conclusion: These results are in accordance with other studies, indicating a relevant cost of treatment of diabetic patients admitted to Prenda Hospital Medicine Service in 2012.

  15. PFAS National Leadership Summit Materials

    Science.gov (United States)

    U.S. Environmental Protection Agency (EPA) will be hosting a National Leadership Summit in Washington, D.C. to take action on Per- and Polyfluoroalkyl Substances (PFAS) in the environment. Below are the meeting materials for the Summit.

  16. Medicinal plants used with Thai Traditional Medicine in modern healthcare services: a case study in Kabchoeng Hospital, Surin Province, Thailand.

    Science.gov (United States)

    Chotchoungchatchai, Somtanuek; Saralamp, Promchit; Jenjittikul, Thaya; Pornsiripongse, Saowapa; Prathanturarug, Sompop

    2012-05-07

    Thai Traditional Medicine (TTM) is available in many modern hospitals in Thailand. However, there have been difficulties in integrating TTM, particularly the practices of the use of herbal medicines, into modern healthcare services. Kabchoeng Hospital is one hospital that has been able to overcome these difficulties. Thus, this study aimed to document the successful utilization of herbal medicine at Kabchoeng Hospital. The documentation focused on both the knowledge of medicinal plants and the success factors that facilitated the utilization of herbal medicine in the context of a modern hospital in Thailand. Kabchoeng Hospital was intentionally selected for this case study. Participatory observation was used for the data collection. There were six groups of key informants: three applied Thai Traditional Medicine practitioners (ATTMPs), a pharmacist, two physicians, two folk healers, the head of an herbal cultivation and collection group, and 190 patients. The plant specimens were collected and identified based on the botanical literature and a comparison with authentic specimens; these identifications were assisted by microscopic and thin layer chromatography (TLC) techniques. Eighty-nine medicinal plants were used for the herbal preparations. The ATTMPs used these plants to prepare 29 standard herbal preparations and occasional extemporaneous preparations. Moreover, in this hospital, seven herbal preparations were purchased from herbal medicine manufacturers. In total, 36 preparations were used for 10 groups of symptoms, such as the treatment of respiratory system disorders, musculo-skeletal system disorders, and digestive system disorders. Four success factors that facilitated the utilization of herbal medicine at Kabchoeng Hospital were determined. These factors included a proper understanding of the uses of herbal medicines, the successful integration of the modern and TTM healthcare teams, the support of an herbal cultivation and collection group, and the

  17. Passive Dosimetry Of Nuclear Medicine Service Staff, Ibn Sina Hospital

    International Nuclear Information System (INIS)

    Sebihi, R.; Talsmat, K.; Cherkaoui, R.; Ben Rais, N.

    2010-01-01

    Full text: Since the implementation of Law No. 00571 of 21 Chaabane 1391 on protection against ionizing radiation and its decrees 2: 2-97-30 and 2-97-132 28 October 1997, surveillance of workers has the subject of major regulatory developments in Morocco, including individual registration delayed for dosimetry. As part of optimizing the protection of medical personnel, a dosimetric study was performed for the first time at the national level, the Nuclear Medicine Service of the Ibn Sina hospital in collaboration with the National Center for Energy Sciences and Nuclear Techniques (CNESTEN). Dosimetric monitoring was conducted for 2 weeks with the use of passive thermoluminescent dosimeters, (GR200A), covering all categories of staff. The administration of samarium (β emitter with energy substantially higher than the energies encountered in conventional nuclear medicine) has been studied, given his first service. Other cases of people concerned our study: a pregnant woman doctor, whose exposure of the unborn child must be reduced as much as possible, and a woman from a private company, working without dosimeter, handles maintenance of premises. To control the conditions imposed on all activities requiring exposure to ionizing radiation, we evaluated the dose at the extremities of operators with the use of ring dosimeters (GR200A) and the dose on the ambient environment of staff (dosimeters ALNOR). This experiment has shown exposure levels below legal limits, without been negligible for certain post. The evaluation results equivalent doses manipulators justify the wearing of dosimeter rings as a complementary dosimeter in Nuclear Medicine service and a way of controlling the normal working conditions. Finally Monitoring ambient dosimetry showed that the environment is low radiation doses. Lessons learned from this study, for the protection of personnel are as follows: from the simple awareness of staff and means of optimizing radiation can maintain a dosimetry annual

  18. Introduction to the 2015 Supplement to Cardiology in the Young: Proceedings of the 2015 International Pediatric Heart Failure Summit of Johns Hopkins All Children's Heart Institute.

    Science.gov (United States)

    Jacobs, Jeffrey P

    2015-08-01

    In the United States of America alone, ~14,000 children are hospitalised annually with acute heart failure. The science and art of caring for these patients continues to evolve. The International Pediatric Heart Failure Summit of Johns Hopkins All Children's Heart Institute was held on 4 and 5 February, 2015. The 2015 International Pediatric Heart Failure Summit of Johns Hopkins All Children's Heart Institute was funded through the Andrews/Daicoff Cardiovascular Program Endowment, a philanthropic collaboration between All Children's Hospital and the Morsani College of Medicine at the University of South Florida (USF). Sponsored by All Children's Hospital Andrews/Daicoff Cardiovascular Program, the Johns Hopkins All Children's Heart Institute International Pediatric Heart Failure Summit assembled leaders in clinical and scientific disciplines related to paediatric heart failure and created a multi-disciplinary "think-tank". Information about George R. Daicoff, MD, and Ed and Sarainne Andrews is provided in this introductory manuscript to the 2015 Supplement to Cardiology in the Young entitled: "Proceedings of the 2015 International Pediatric Heart Failure Summit of Johns Hopkins All Children's Heart Institute". Dr Daicoff founded the All Children's Hospital Pediatric Heart Surgery programme and directed this programme for over two decades. Sarainne Andrews made her generous bequest to All Children's Hospital in honour of her husband Ed and his friendship with Dr Daicoff in order to support cardiovascular surgery research efforts.

  19. Climate Summit in Copenhagen

    DEFF Research Database (Denmark)

    Delman, Jørgen

      Together with the United States, China has moved to centre stage in the running up to the Climate Summit in Copenhagen 7-18 December 2009. To make the Summit a success, the two countries have started signalling positive commitment to formulation of quantitative targets and engage constructively...... in elaborating a reasonably ambitious, yet realistic framework for the implementation of a new global post-Kyoto regime that will have to take effect from 2012. China's leadership has already acknowledged that climate change may exacerbate an exceedingly unsustainable development path over the next decades...... if action is not taken to change its course dramatically. The challenges are formidable, yet the window of opportunity to take action is quite narrow. For these reasons and due to international pressure, China's position on climate change has been made gradually clearer as the climate negotiations have...

  20. Zolpidem prescribing and adverse drug reactions in hospitalized general medicine patients at a Veterans Affairs hospital.

    Science.gov (United States)

    Mahoney, Jane E; Webb, Melissa J; Gray, Shelly L

    2004-03-01

    Zolpidem is prescribed for sleep disruption in hospitalized patients, but data on the incidence of adverse drug reactions (ADRs) are based largely on outpatient studies. Thus, the incidence of ADRs in hospitalized patients may be much higher. The goal of this study was to describe prescribing patterns of zolpidem for hospitalized medical patients aged 50 years, the incidence of ADRs possibly and probably associated with its use, and the factors associated with central nervous system (CNS) ADRs. This case series was conducted in 4 general medicine wards at a Veterans Affairs hospital and was a consecutive sample of patients aged 50 years who were hospitalized between 1993 and 1997 and received zolpidem as a hypnotic during hospitalization, but had not received it in the previous 3 months. Chart review was conducted by 2 evaluators. Data extracted from the medical records included admission demographic characteristics, medications, comorbidities, and levels of function in performing basic and instrumental activities of daily living. The main outcome measure was ADRs possibly or probably related to zolpidem use. The association between zolpidem and the occurrence of CNS ADRs (eg, confusion, dizziness, daytime somnolence) was analyzed separately. The review included 119 medical patients aged > or =50 years who had newly received zolpidem for sleep disruption during hospitalization. The median age of the population was 70 years; 86 (72.3%) patients were aged 65 years. The initial zolpidem dose was 5 mg in 42 patients (35.3%) and 10 mg in 77 patients (64.7%). Twenty-three patients had a respective 16 and 10 ADRs possibly and probably related to zolpidem use (19.3% incidence). Of a total of 26 ADRs, 21 (80.8%) were CNS ADRs, occurring with both zolpidem 5 mg (10.8% of users) and 10 mg (18.3% of users). On univariate analyses, the only factor significantly associated with a CNS ADR was functional impairment at baseline (P = 0.003). Zolpidem was discontinued in 38.8% of

  1. Establishment of research-oriented hospital: an important way for translational medicine development in China

    Directory of Open Access Journals (Sweden)

    MEINA LI

    2015-06-01

    Full Text Available Globally, one of the major trends is the development of translational medicine. The traditional hospital structure could not meet the demands of translational medicine development any longer and to explore a novel hospital structure is imperative. Following the times, China proposed and implemented a development strategy for a first-class modern research-oriented hospital. To establish a research-oriented hospital has become an important strategy to guide the scientific development of high-quality medical institutions and to advance translational medicine development. To facilitate translational medicine by developing research-oriented hospital, the Chinese Research Hospital Association (CRHA has been established, which provides service of medicine, talents cultivation, scientific research and clinical teaching and covers areas of theoretical research, academic exchange, translational medicine, talents training and practice guiding. On the whole, research-oriented hospital facilitated translational medicine by developing interdisciplinary platform, training core competencies in clinical and translational research, providing financial support of translational research, and hosting journals on translational medicine, etc.

  2. Medicine procurement in hospital pharmacies of Nepal: A qualitative study based on the Basel Statements

    Science.gov (United States)

    Ranjit, Eurek

    2018-01-01

    Background Accessibility and affordability of evidence-based medicines are issues of global concern. For low-income countries like Nepal, it is crucial to have easy and reliable access to affordable, good-quality, evidence-based medicines, especially in the aftermath of natural or manmade disasters. Availability of affordable and evidence-based high quality medicines depends on the medicine procurement procedure, which makes it an important aspect of healthcare delivery. In this study, we aimed to investigate medicine procurement practices in hospital pharmacies of Nepal within the framework of International Pharmaceutical Federation [FIP] hospital pharmacy guidelines “the Basel Statements”. Method We conducted semi-structured interviews with hospital pharmacists or procurement officers in hospital pharmacies of four major regions in Nepal to explore procurement practices. Data were collected until saturation of themes, analysed using the framework approach, and organised around the statements within the procurement theme of the Basel Statements. Results Interviews conducted with 53 participants revealed that the procurement guidelines of the Basel Statements were adopted to a certain extent in hospital pharmacies of Nepal. It was found that the majority of hospital pharmacies in Nepal reported using an expensive direct-procurement model for purchasing medicines. Most had no formulary and procured medicines solely based on doctors’ prescriptions, which were heavily influenced by pharmaceutical companies’ marketing strategies. Whilst most procured only registered medicines, a minority reported purchasing unregistered medicines through unauthorised supply-chains. And although the majority of hospital pharmacies had some contingency plans for managing medicine shortages, a few had none. Conclusions Procurement guidelines of the Basel Statements were thus found to be partially adopted; however, there is room for improvement in current procurement practices in

  3. Medicine procurement in hospital pharmacies of Nepal: A qualitative study based on the Basel Statements.

    Directory of Open Access Journals (Sweden)

    Mina Shrestha

    Full Text Available Accessibility and affordability of evidence-based medicines are issues of global concern. For low-income countries like Nepal, it is crucial to have easy and reliable access to affordable, good-quality, evidence-based medicines, especially in the aftermath of natural or manmade disasters. Availability of affordable and evidence-based high quality medicines depends on the medicine procurement procedure, which makes it an important aspect of healthcare delivery. In this study, we aimed to investigate medicine procurement practices in hospital pharmacies of Nepal within the framework of International Pharmaceutical Federation [FIP] hospital pharmacy guidelines "the Basel Statements".We conducted semi-structured interviews with hospital pharmacists or procurement officers in hospital pharmacies of four major regions in Nepal to explore procurement practices. Data were collected until saturation of themes, analysed using the framework approach, and organised around the statements within the procurement theme of the Basel Statements.Interviews conducted with 53 participants revealed that the procurement guidelines of the Basel Statements were adopted to a certain extent in hospital pharmacies of Nepal. It was found that the majority of hospital pharmacies in Nepal reported using an expensive direct-procurement model for purchasing medicines. Most had no formulary and procured medicines solely based on doctors' prescriptions, which were heavily influenced by pharmaceutical companies' marketing strategies. Whilst most procured only registered medicines, a minority reported purchasing unregistered medicines through unauthorised supply-chains. And although the majority of hospital pharmacies had some contingency plans for managing medicine shortages, a few had none.Procurement guidelines of the Basel Statements were thus found to be partially adopted; however, there is room for improvement in current procurement practices in hospital pharmacies of Nepal

  4. Medicine procurement in hospital pharmacies of Nepal: A qualitative study based on the Basel Statements.

    Science.gov (United States)

    Shrestha, Mina; Moles, Rebekah; Ranjit, Eurek; Chaar, Betty

    2018-01-01

    Accessibility and affordability of evidence-based medicines are issues of global concern. For low-income countries like Nepal, it is crucial to have easy and reliable access to affordable, good-quality, evidence-based medicines, especially in the aftermath of natural or manmade disasters. Availability of affordable and evidence-based high quality medicines depends on the medicine procurement procedure, which makes it an important aspect of healthcare delivery. In this study, we aimed to investigate medicine procurement practices in hospital pharmacies of Nepal within the framework of International Pharmaceutical Federation [FIP] hospital pharmacy guidelines "the Basel Statements". We conducted semi-structured interviews with hospital pharmacists or procurement officers in hospital pharmacies of four major regions in Nepal to explore procurement practices. Data were collected until saturation of themes, analysed using the framework approach, and organised around the statements within the procurement theme of the Basel Statements. Interviews conducted with 53 participants revealed that the procurement guidelines of the Basel Statements were adopted to a certain extent in hospital pharmacies of Nepal. It was found that the majority of hospital pharmacies in Nepal reported using an expensive direct-procurement model for purchasing medicines. Most had no formulary and procured medicines solely based on doctors' prescriptions, which were heavily influenced by pharmaceutical companies' marketing strategies. Whilst most procured only registered medicines, a minority reported purchasing unregistered medicines through unauthorised supply-chains. And although the majority of hospital pharmacies had some contingency plans for managing medicine shortages, a few had none. Procurement guidelines of the Basel Statements were thus found to be partially adopted; however, there is room for improvement in current procurement practices in hospital pharmacies of Nepal. Adoption and

  5. Necessity of Internal Monitoring for Nuclear Medicine Staff in a Large Specialized Chinese Hospital.

    Science.gov (United States)

    Wang, Hong-Bo; Zhang, Qing-Zhao; Zhang, Zhen; Hou, Chang-Song; Li, Wen-Liang; Yang, Hui; Sun, Quan-Fu

    2016-04-12

    This work intends to quantify the risk of internal contaminations in the nuclear medicine staff of one hospital in Henan province, China. For this purpose, the criteria proposed by the International Atomic Energy Agency (IAEA) to determine whether it is necessary to conduct internal individual monitoring was applied to all of the 18 nuclear medicine staff members who handled radionuclides. The activity of different radionuclides used during a whole calendar year and the protection measures adopted were collected for each staff member, and the decision as to whether nuclear medicine staff in the hospital should be subjected to internal monitoring was made on the basis of the criteria proposed by IAEA. It is concluded that for all 18 members of the nuclear medicine staff in the hospital, internal monitoring is required. Internal exposure received by nuclear medicine staff should not be ignored, and it is necessary to implement internal monitoring for nuclear medicine staff routinely.

  6. Getting it RITE: Impact of a Dedicated Hospital Medicine Curriculum for Residents.

    Science.gov (United States)

    Lin, Doris; Shah, Chirayu; Campbell, Steffanie; Bates, Jeffrey T; Lescinskas, Erica

    2018-01-01

    The goal of this study was to improve resident confidence in inpatient care and knowledge in hospital medicine topics with a newly developed rotation and curriculum called the Resident Inpatient Training Experience. This study was a prospective observational study completed by postgraduate year-2 (PGY-2) internal medicine residents in two affiliated hospitals. Forty-six PGY-2 residents each rotated on the Resident Inpatient Training Experience service for 1 month and completed a pre- and postrotation confidential online survey. Primary outcomes included confidence in managing hospitalized patients, knowledge regarding hospital medicine topics, and interest in pursuing hospital medicine as a career. Thirty-three PGY-2 residents completed both the pre- and postrotation survey (72% response rate). After completing the rotation, the residents' confidence level (measured on a 5-point Likert scale, with 1 = strongly disagree and 5 = strongly agree) rose significantly in managing hospitalized patients, from 3.82 to 4.33 ( P = 0.003) and in leading a ward team, from 3.76 to 4.21 ( P = 0.020). Knowledge level (measured on a 5-point Likert scale with 1 = very poor and 5 = excellent) improved significantly in transitions of care, from 3.45 to 3.79 ( P = 0.023); cost-conscious care, from 3.00 to 3.42 ( P = 0.016); physician billing/coding, from 2.55 to 3.03 ( P = 0.007); hospital metrics, from 2.39 to 2.94 ( P = 0.002); and hospital reimbursement, from 2.48 to 3.09 ( P = 0.001). Interest in pursuing hospital medicine as a career also increased. Resident independence in managing patients and training in hospital medicine topics has not kept up with evolving need. Dedicated hospital medicine rotation and curriculum are effective ways to alleviate the deficiencies in resident education.

  7. The Case of the Suzhou Hospital of National Medicine (1939-41): War, Medicine, and Eastern Civilization.

    Science.gov (United States)

    Daidoji, Keiko; Karchmer, Eric I

    2017-06-01

    This article explores the founding of the Suzhou Hospital of National Medicine in 1939 during the Japanese occupation of Suzhou. We argue that the hospital was the culmination of a period of rich intellectual exchange between traditional Chinese and Japanese physicians in the early twentieth century and provides important insights into the modern development of medicine in both countries. The founding of this hospital was followed closely by leading Japanese Kampo physicians. As the Japanese empire expanded into East Asia, they hoped that they could revitalize their profession at home by disseminating their unique interpretations of the famous Treatise on Cold Damage abroad. The Chinese doctors that founded the Suzhou Hospital of National Medicine were close readers of Japanese scholarship on the Treatise and were inspired to experiment with a Japanese approach to diagnosis, based on new interpretations of the concept of "presentation" ( shō / zheng ). Unfortunately, the Sino-Japanese War cut short this fascinating dialogue on reforming medicine and set the traditional medicine professions in both countries on new nationalist trajectories.

  8. Introduction to the role of model of value-based medicine in the development of private hospitals

    Directory of Open Access Journals (Sweden)

    Shou-ping CHEN

    2014-01-01

    Full Text Available Value-based medicine is the tendency of modern medicine.This paper elaborated the properties of value-based medicine,analyzed the role of model of value-based medicine in modern medicine,and put forward ideas and related measures with the model of value-based medicine to promote the development of private hospitals, which provided some reference for development of private hospitals

  9. Introduction to the role of model of value-based medicine in the development of private hospitals

    OpenAIRE

    Shou-ping CHEN

    2014-01-01

    Value-based medicine is the tendency of modern medicine.This paper elaborated the properties of value-based medicine,analyzed the role of model of value-based medicine in modern medicine,and put forward ideas and related measures with the model of value-based medicine to promote the development of private hospitals, which provided some reference for development of private hospitals

  10. Vienna Summit Declaration

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2006-06-21

    The leaders of the European Union (EU) and the United States of America (USA) met June 2006 in Vienna to respond to the concerns of their citizens for peace, security, stability and prosperity in an increasingly globalised world. They welcome that over the past year the Transatlantic Partnership has delivered real results as shown by the political and economic Progress Reports issued during the summit (http://www.eu2006.at/en/The{sub C}ouncil{sub P}residency/EU-USSummit/index.html). They remain committed to finding common or complementary lines of action in many areas. Over the last year there have been many examples of how productive the relationship is, in the Middle East, Iran, the Western Balkans, Belarus, on the frozen conflicts, and Sudan, as well as in the efforts to promote transatlantic trade and investment under last Summit's Economic Initiative. They have decided to further strengthen the strategic Partnership by adopting a number of priority actions to support cooperation in the following four areas: Promoting peace, human rights and democracy worldwide; Confronting global challenges, including security; Fostering prosperity and opportunity; and Promoting strategic cooperation on energy and energy security, climate change and sustainable development.

  11. Vienna Summit Declaration

    International Nuclear Information System (INIS)

    2006-01-01

    The leaders of the European Union (EU) and the United States of America (USA) met June 2006 in Vienna to respond to the concerns of their citizens for peace, security, stability and prosperity in an increasingly globalised world. They welcome that over the past year the Transatlantic Partnership has delivered real results as shown by the political and economic Progress Reports issued during the summit (http://www.eu2006.at/en/The_Council_Presidency/EU-USSummit/index.html). They remain committed to finding common or complementary lines of action in many areas. Over the last year there have been many examples of how productive the relationship is, in the Middle East, Iran, the Western Balkans, Belarus, on the frozen conflicts, and Sudan, as well as in the efforts to promote transatlantic trade and investment under last Summit's Economic Initiative. They have decided to further strengthen the strategic Partnership by adopting a number of priority actions to support cooperation in the following four areas: Promoting peace, human rights and democracy worldwide; Confronting global challenges, including security; Fostering prosperity and opportunity; and Promoting strategic cooperation on energy and energy security, climate change and sustainable development

  12. Ebook Summit: Our Ebook Challenge

    Science.gov (United States)

    Library Journal, 2010

    2010-01-01

    Over 2000 participants made the daylong programming at the "Library Journal"/"School Library Journal" Virtual Ebook Summit, September 29, a robust conversation and not just within the summit interface but also in tweets with the #ebooksummit hashtag (and beyond) and in libraries across the country where participants logged in to take part. The…

  13. [The implementation of strategy of medicinal support in multi-type hospital].

    Science.gov (United States)

    Ludupova, E Yu

    2016-01-01

    The article presents brief review of implementation of strategy of medicinal support of population of the Russian Federation and experience of application of at the level of regional hospital. The necessity and importance of implementation into practice of hospitals of methodology of pharmaco-economical management of medicinal care using modern technologies of XYZ-, ABC and VEN-analysis is demonstrated. The stages of development and implementation of process of medicinal support of multifield hospital applying principles of system of quality management (processing and systemic approaches, risk management) on the basis of standards ISO 9001 are described. The significance of monitoring of results ofprocess of medicinal support of the basis of implementation of priority target programs (prevention of venous thrombo-embolic complications, system od control of anti-bacterial therapy) are demonstrated in relation to multi-field hospital using technique of ATC/DDD-analysis for evaluating indices of effectiveness and efficiency.

  14. Practical radiation protection in hospitals. A view at the nuclear medicine departement of the University Hospital of Cologne

    International Nuclear Information System (INIS)

    Sudbrock, Ferdinand

    2011-01-01

    Radiation protection plays a predominant role in nuclear medicine departments as they are installations dealing with open radioactive substances. Many experts in radiation protection who are not directly involved in nuclear medicine may only have a vague insight into the daily routine of such installations. This contribution would like to give an impression by making a virtual tour through the nuclear medicine department of the University Hospital of Cologne - a department that covers a large part of the ability spectrum of this discipline. This tour will show some specialities concerning radiation protection in diagnostic and therapeutic procedures. (orig.)

  15. Evaluation of the physicians‘ of n hospital opinion on clinical trials of medicinal products

    OpenAIRE

    Videikaitė, Lina

    2014-01-01

    Aim of the research. To evaluate the physicians‘ of N Hospital opinion on clinical trials of medicinal products. Objectives. To evaluate the factors affecting physicians' motivation to perform clinical trials of medicinal products as well as those that prevent the physicians getting involved in the trials. To assess physicians' attitude towards clinical trials of medicinal products. To compare the opinions of physicians who have and have’nt participated in clinical trials. Methods of...

  16. From hospitals to herbalists: Rx herbal medicines | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2011-02-03

    Feb 3, 2011 ... "Equally important, their services are inexpensive — in fact, herbal medicines ... There's also a strong cultural attachment to this form of health care. ... "People and associations of traditional healers now have home gardens of ...

  17. Herbal medicine for hospitalized patients with severe depressive episode: a retrospective controlled study.

    Science.gov (United States)

    Liu, Lan-Ying; Feng, Bin; Chen, Jiong; Tan, Qing-Rong; Chen, Zheng-Xin; Chen, Wen-Song; Wang, Pei-Rong; Zhang, Zhang-Jin

    2015-01-01

    Herbal medicine is increasingly used in depressed patients. The purpose of this retrospective controlled study was to evaluate the efficacy and safety of herbal medicine treatment of severe depressive episode. A total of 146 severely depressed subjects were selected from patients who were admitted to the Department of Psychosomatics of Tongde Hospital at Hangzhou, China between 1st September 2009 and 30th November 2013. While all were medicated with psychotropic drugs, 78 received additional individualized herbal medicine. The severity of depressive symptoms was measured using 24-item Hamilton Rating Scale for Depression (HAMD-24) at admission and thereafter once weekly during hospital stay. The proportion of patients achieving clinical response and remission and incidence of adverse events were compared. The two groups had similar average length of hospital stay for approximately 28 days and were not different in the use of psychotropic medications. Survival analysis revealed that patients with herbal medicine had significantly higher chance of achieving clinical response [relative risk (RR)=2.179, Pherbal medicine. Patients with herbal medicine experienced remarkably fewer incidences of physical tiredness, headache, palpitation, dry mouth and constipation, but had a significantly higher incidence of digestive discomfort compared to patients without herbal medicine. These results indicate that additional treatment with individualized herbal medicine enhances antidepressant response and reduces certain side effects associated with psychotropic medications. Herbal medicine is an effective and relatively safe therapy for severe depressive episode (Trial Registration: ChiCTR-OCH-13003864). Copyright © 2014 Elsevier B.V. All rights reserved.

  18. Nurse practitioners and physician assistants: preparing new providers for hospital medicine at the mayo clinic.

    Science.gov (United States)

    Spychalla, Megan T; Heathman, Joanne H; Pearson, Katherine A; Herber, Andrew J; Newman, James S

    2014-01-01

    Hospital medicine is a growing field with an increasing demand for additional healthcare providers, especially in the face of an aging population. Reductions in resident duty hours, coupled with a continued deficit of medical school graduates to appropriately meet the demand, require an additional workforce to counter the shortage. A major dilemma of incorporating nonphysician providers such as nurse practitioners and physician assistants (NPPAs) into a hospital medicine practice is their varying academic backgrounds and inpatient care experiences. Medical institutions seeking to add NPPAs to their hospital medicine practice need a structured orientation program and ongoing NPPA educational support. This article outlines an NPPA orientation and training program within the Division of Hospital Internal Medicine (HIM) at the Mayo Clinic in Rochester, MN. In addition to a practical orientation program that other institutions can model and implement, the division of HIM also developed supplemental learning modalities to maintain ongoing NPPA competencies and fill learning gaps, including a formal NPPA hospital medicine continuing medical education (CME) course, an NPPA simulation-based boot camp, and the first hospital-based NPPA grand rounds offering CME credit. Since the NPPA orientation and training program was implemented, NPPAs within the division of HIM have gained a reputation for possessing a strong clinical skill set coupled with a depth of knowledge in hospital medicine. The NPPA-physician model serves as an alternative care practice, and we believe that with the institution of modalities, including a structured orientation program, didactic support, hands-on learning, and professional growth opportunities, NPPAs are capable of fulfilling the gap created by provider shortages and resident duty hour restrictions. Additionally, the use of NPPAs in hospital medicine allows for patient care continuity that is otherwise missing with resident practice models.

  19. Prevalence of delirium in hospitalized internal medicine and surgical adult patients in Shohadaye ashayer hospital of Khoram abad

    Directory of Open Access Journals (Sweden)

    raheleh Asaee

    2008-10-01

    Full Text Available Asaee R1, Nasari H2,Hoseini S3 1. Assistant professor, Department of Physiology, Faculty of Medicine, Lorestanl University of Medical Sciences, Khorramabad, Iran 1. Assistant professor, Department of Psychiatry, Faculty of Medicine, Lorestanl University of Medical Sciences, Khorramabad, Iran 2. G.P, Khorramabad, Iran Abstract Background: Delirium is common in elderly persons and in hospitalized patients especially after surgical procedures. But many of them are undetected and don’t receive treatment so they involve with increased mortality and morbidity, adverse outcomes, length of hospital stay and mental disability sequels. Unfortunetly , despite the importance of this syndrom , physicians and staff are able to diagnose only one thirth of the patients. Material and methods: In this cross sectional study, 240 inpatiants (120 from surgery ward and 120 from miernal medicine ward from Shohadaye Ashayer hospital of Khorramabad were selected randomly. The diagnostic criteria for delirium were Mini-Mental state examination (MMSE questionnaire, and patients daily examination for 4 days by MMSE. Results: Delirium was observed in 37 (30.8% of the patients of internal medicine ward and 25 (20.8% of the patients of surgery ward. 27 (22.5% of the patients of internal medicine ward and 37 (30.8% of the patients of surgery ward were suspicious for delirium. In age group of 58-77 years in surgery ward and patients over 77 years in internal medicine ward had the most frequency of delirium. There was significant relationship (p=0.01 between two sex in surgery ward. But there was not significant difference (p=0.92 between two sex in internal medicine ward for delirium. Conclusion: Reading the results of this study and frequency of delirum in surgery and internal medicine wards, presence of a psychiatrist in mentioned wards is necessary of early diagnosis and control of delirium.

  20. [Highlights of hospital-based internal medicine in 2010: chief residents' perspective].

    Science.gov (United States)

    Uhlmann, Marc; Burnard, Jérôme; Cosma Rochat, Monica; Gabus, Vincent; Micheloud, Valérie Geiser; Gobin, Niels; Laurent, Jean-Christophe; Marino, Laura; Méan, Marie; Merz, Laurent; Regamey, Julien; Stadelmann, Raphaël

    2011-02-02

    Applying knowledge acquired from recent medical studies to patient care poses a daily challenge to physicians. Chief residents from the Department of Internal Medicine at the University Hospital of Lausanne carried out a review of some of the issues they considered important. The conclusions of these various publications may have a significant impact on the daily practice of hospital-based internal medicine. Modern medicine based on scientific studies is a reminder that in spite of the essential importance of clinical experience, it is crucial to confront it with the results of relevant publications from the medical literature.

  1. Networking Hospital ePrescribing: A Systemic View of Digitalization of Medicines' Use in England.

    Science.gov (United States)

    Lichtner, Valentina; Hibberd, Ralph; Cornford, Tony

    2016-01-01

    Medicine management is at the core of hospital care and digitalization of prescribing and administration of medicines is often the focus of attention of health IT programs. This may be conveyed to the public in terms of the elimination of paper-based drug charts and increased readability of doctors' prescriptions. Based on analysis of documents about hospital medicines supply and use (including systems' implementation) in the UK, in this conceptual paper electronic prescribing and administration are repositioned as only one aspect of an important wider transformation in medicine management in hospital settings, involving, for example, procurement, dispensing, auditing, waste management, research and safety vigilance. Approaching digitalization from a systemic perspective has the potential to uncover the wider implications of this transformation for patients, the organization and the wider health care system.

  2. Medicine utilization review at a university teaching hospital in New Delhi

    Directory of Open Access Journals (Sweden)

    M Aqil

    2012-01-01

    Full Text Available Objective: A prospective medicine usage evaluation based on prescription monitoring was conducted in the medicine OPD of our university teaching hospital to know prescribing trends of different categories of medicines. Materials and Methods: A total of 600 patients were included in the study comprising of 339 (56.5% males and 261 (43.5% females. The data were recorded within the OPD by a registered pharmacist on a medicine usage evaluation form, approved by The University Institutional Review Board (IRB. Results: A total of 2365 medicines were prescribed to 600 patients during the 3 months study period. The mean number of medicines per prescription were found to be 3.94. Medicines were most frequently prescribed as solid dosage forms (85.62%, especially tablets (70.82%, and liquid formulations (14.12%. Oral route (96.17% was the most preferred mode of administration, followed by topical (2.11% and parenteral (1.60% routes. Combination therapy (94.33% was more prevalent than monotherapy (5.66%. An overwhelming tendency for prescribing medicines by brand names (99% was observed by the physicians. The most frequently prescribed class of medicines were antimicrobials > analgesics > cardiovascular > gastrointestinal agents. The most prescribed individual medicines among various therapeutic classes included isoniazid (antimicrobial, amlodipine (cardiovascular, metformin (hypoglycemic, cetirizine (antiallergic, rabeprazole (GI medicine, atorvastatin (hypolipidemic, dextromethorphan (respiratory medicine, alprazolam (sedative-hypnotic, paracetamol (analgesic. Conclusions: There is a considerable scope of improvement in the existing prescribing practice, especially prescribing by generic names, needs to be encouraged and a hospital formulary has to be developed for the purpose. The number of medicines to be included per prescription should be judged rationally and polypharmacy ought to be curbed. Use of antimicrobial also needs to be rationalized as over

  3. The Practice of Medicine at a District Hospital Emergency Room ...

    African Journals Online (AJOL)

    To remain in touch with the changing environment of medicine, one has to keep on learning and sometimes attend refresher courses far away from the place of work. The rewarding part of the practice is that many junior doctors benefit from the experience of the senior colleagues, who teach them basic skills. A practitioner ...

  4. National Tribal Building Codes Summit

    Science.gov (United States)

    National Tribal Building Codes summit statement developed to support tribes interested in adopting green and culturally-appropriate building systems to ensure safe, sustainable, affordable, and culturally-appropriate buildings on tribal lands.

  5. Port Stakeholder Summit - April 2014

    Science.gov (United States)

    EPA's National Port Stakeholders Summit, Advancing More Sustainable Ports, focused on actions to protect air quality while reducing climate risk and supporting economic growth, making ports more environmentally sustainable.

  6. Defensive medicine among obstetricians and gynecologists in tertiary hospitals.

    Directory of Open Access Journals (Sweden)

    Elad Asher

    Full Text Available OBJECTIVE: To describe the daily work practice under the threat of defensive medicine among obstetricians and gynecologists. STUDY DESIGN: A prospective cross-sectional survey of obstetricians and gynecologists working at tertiary medical centers in Israel. RESULTS: Among the 117 obstetricians and gynecologists who participated in the survey, representing 10% of the obstetricians and gynecologists registered by the Israel Medical Association, 113 (97% felt that their daily work practice is influenced by concern about being sued for medical negligence and not only by genuine medical considerations. As a result, 102 (87% physicians are more likely to offer the cesarean section option, even in the absence of a clear medical indication, 70 (60% follow court rulings concerning medical practices, and 85 (73% physicians mentioned that discussions about medical negligence court rulings are included in their departments' meetings. CONCLUSIONS: Defensive medicine is a well-embedded phenomenon affecting the medical decision process of obstetricians and gynecologists.

  7. Revisiting Primary Care's Critical Role in Achieving Health Equity: Pisacano Scholars' Reflections from Starfield Summit II.

    Science.gov (United States)

    Park, Brian; Coutinho, Anastasia J; Doohan, Noemi; Jimenez, Jonathan; Martin, Sara; Romano, Max; Wohler, Diana; DeVoe, Jennifer

    2018-01-01

    The second Starfield Summit was held in Portland, Oregon, in April 2017. The Summit addressed the role of primary care in advancing health equity by focusing on 4 key domains: social determinants of health in primary care, vulnerable populations, economics and policy, and social accountability. Invited participants represented an interdisciplinary group of primary care clinicians, researchers, educators, policymakers, community leaders, and trainees. The Pisacano Leadership Foundation was one of the Summit sponsors and held its annual leadership symposium in conjunction with the Summit, enabling several Pisacano Scholars to attend the Summit. After the Summit, a small group of current and former Pisacano Scholars formed a writing group to highlight key themes and implications for action discussed at the Summit. The Summit resonated as a call to action for primary care to move beyond identifying existing health inequities and toward the development of interventions that advance health equity, through education, research, and enhanced community partnerships. In doing so, the Summit aimed to build on the foundational work of Dr. Starfield, challenging us to explore the significant role of primary care in truly achieving health equity. © Copyright 2018 by the American Board of Family Medicine.

  8. Do follow-on therapeutic substitutes induce price competition between hospital medicines? Evidence from the Danish hospital sector

    DEFF Research Database (Denmark)

    Hostenkamp, Gisela

    2013-01-01

    Objective The pricing of follow-on drugs, that offer only limited health benefits over existing therapeutic alternatives, is a recurring health policy debate. This study investigates whether follow-on therapeutic substitutes create price competition between branded hospital medicines. Methods New...... pioneer products were significantly reduced as a reaction to competition from follow-on drugs. Conclusion Competition between patented therapeutic substitutes did not seem to increase price competition and containment of pharmaceutical expenditures in the Danish hospital market. Strengthening hospitals......’ incentives to consider the price of alternative treatment options paired with a more active formulary management may increase price competition between therapeutic substitutes in the Danish hospital sector in the future....

  9. An investigation Into Traditional Chinese Medicine Hospitals in China: Development Trend and Medical Service Innovation

    Directory of Open Access Journals (Sweden)

    Liang Wang

    2017-01-01

    Full Text Available Background This paper aims to investigate the development trend of traditional Chinese medicine (TCM hospitals in China and explore their medical service innovations, with special reference to the changing co-existence with western medicine (WM at TCM hospitals. Methods Quantitative data at macro level was collected from official databases of China Health Statistical Yearbook and Extracts of Traditional Chinese Medicine Statistics. Qualitative data at micro level was gathered through interviews and second-hand material collection at two of the top-level TCM hospitals. Results In both outpatient and inpatient sectors of TCM hospitals, drug fees accounted for the biggest part of hospital revenue. Application of WM medical exanimation increased in both outpatient and inpatient services. Even though the demand for WM drugs was much higher in inpatient care, TCM drugs was the winner in the outpatient. Also qualitative evidence showed that TCM dominated the outpatient hospital service with WM incorporated in the assisting role. However, it was in the inpatient medical care that WM prevailed over TCM which was mostly applied to the rehabilitation of patients. Conclusion By drawing on WM while keeping it active in supporting and strengthening the TCM operation in the TCM hospital, the current system accommodates the overriding objective which is for TCM to evolve into a fully informed and more viable medical field.

  10. The design of diagnostic imaging and nuclear medicine facilities in a major new teaching hospital

    International Nuclear Information System (INIS)

    Causer, D.A.

    2010-01-01

    Full text: The design of the layout and radiation shielding for diagnostic imaging and nuclear medicine facilities in a modern teaching hospital requires the collaboration of persons from a number of professions including architects, engineers, radiologists, nuclear medicine physi cians, medical imaging technologists and medical physicists. This paper discusses the design of such facilities, including PET/CT and T-131 ablation therapy suites for a major new tertiary hospital in Perth. The importance of involving physicists on the planning team from the earliest stages of the design process is stressed, design plans presented, and some of the problems which may present themselves and their solutions are illustrated.

  11. Integrating biomedical and herbal medicine in Ghana - experiences from the Kumasi South Hospital: a qualitative study.

    Science.gov (United States)

    Boateng, Millicent Addai; Danso-Appiah, Anthony; Turkson, Bernard Kofi; Tersbøl, Britt Pinkowski

    2016-07-07

    Over the past decade there has been growing interest in the use of herbal medicine both in developed and developing countries. Given the high proportion of patients using herbal medicine in Ghana, some health facilities have initiated implementation of herbal medicine as a component of their healthcare delivery. However, the extent to which herbal medicine has been integrated in Ghanaian health facilities, how integration is implemented and perceived by different stakeholders has not been documented. The study sought to explore these critical issues at the Kumasi South Hospital (KSH) and outline the challenges and motivations of the integration process. Qualitative phenomenological exploratory study design involving fieldwork observations, focus group discussion, in-depth interviews and key informants' interviews was employed to collect data. Policies and protocols outlining the definition, process and goals of integration were lacking, with respondents sharing different views about the purpose and value of integration of herbal medicine within public health facilities. Key informants were supportive of the initiative. Whilst biomedical health workers perceived the system to be parallel than integrated, health personnel providing herbal medicine perceived the system as integrated. Most patients were not aware of the herbal clinic in the hospital but those who had utilized services of the herbal clinic viewed the clinic as part of the hospital. The lack of a regulatory policy and protocol for the integration seemed to have led to the different perception of the integration. Policy and protocol to guide the integration are key recommendations.

  12. Knowledge sharing in Chinese hospitals identifying sharing barriers in traditional Chinese and Western medicine collaboration

    CERN Document Server

    Zhou, Lihong

    2015-01-01

    This book aims to identify, understand and qualify barriers to the patient-centred knowledge sharing (KS) in interprofessional practice of Traditional Chinese Medicine (TCM) and Western Medicine (WM) healthcare professionals in Chinese hospitals.  This collaboration is particularly crucial and unique to China since, contrary to Western practice, these two types of professionals actually work together complimentary in the same hospital. This study adopted a Grounded Theory approach as the overarching methodology to guide the analysis of the data collected in a single case-study design.  A public hospital in central China was selected as the case-study site, at which 49 informants were interviewed by using semi-structured and evolving interview scripts.  The research findings point to five categories of KS barriers: contextual influences, hospital management, philosophical divergence, Chinese healthcare education and interprofessional training.  Further conceptualising the research findings, it is identifie...

  13. [What is new in 2016 for the specialist in hospital internal medicine?

    Science.gov (United States)

    Mraihi, Hamza; Chevaux, Fabienne; Castoni, Julien; Aebischer, Oriane; Christou, Foetini; Jaccard, Evrim; Benmachiche, Malik; Tasheva, Plamena; Giroud, Sabine; Kraege, Vanessa; Lamy, Olivier

    2017-01-18

    The year 2016 was rich in significant advances in all areas of internal medicine. Many of them have an impact on our daily practice in general internal medicine. From the treatment of NSTEMI in population older than 80, to new sepsis and septic shock criteria to antidotes of new oral anticoagulants, this selection offers to the readers a brief overview of the major advances. The chief residents in the Service of internal medicine of the Lausanne University hospital are pleased to share their readings.

  14. Auditing Safety of Compounding and Reconstituting of Intravenous Medicines on Hospital Wards in Finland.

    Science.gov (United States)

    Suvikas-Peltonen, Eeva; Palmgren, Joni; Häggman, Verner; Celikkayalar, Ercan; Manninen, Raija; Airaksinen, Marja

    2017-01-01

    On the hospital wards in Finland, nurses generally reconstitute intravenous medicines, such as antibiotics, analgesics, and antiemetics prescribed by doctors. Medicine reconstitution is prone to many errors. Therefore, it is important to identify incorrect practices in the reconstitution of medicine to improve patient safety in hospitals. The aim of this study was to audit the compounding and reconstituting of intravenous medicines on hospital wards in a secondary-care hospital in Finland by using an assessment tool and microbiological testing for identifying issues posing patient safety risks. A hospital pharmacist conducted an external audit by using a validated 65-item assessment tool for safe-medicine compounding practices on 20 wards of the selected hospital. Also, three different microbiological samples were collected to assure the aseptics. Practices were evaluated using a four-point rating scale of "never performed," "rarely performed," "often performed," and "always performed," and were based on observation and interviews with nurses or ward pharmacists. In addition, glove-, settle plate-, and media fill-tests were collected. Associations between microbial sample results and audit-tool results were discussed. Altogether, only six out of the 65 items were fully implemented in all wards; these were related to logistic practices and quality assurance. More than half of the wards used incorrect practices ("rarely performed" or "never performed") for five items. Most of these obviated practices related to aseptic practices. All media-fill tests were clean but the number of colony forming units in glove samples and settle- plate samples varied from 0 to >100. More contamination was found in wards where environmental conditions were inadequate or the use of gloves was incorrect. Compounding practices were [mostly] quite well adapted, but the aseptic practices needed improvement. Attention should have been directed particularly to good aseptic techniques and

  15. Use of complementary and alternative medicine at Norwegian and Danish hospitals

    Science.gov (United States)

    2011-01-01

    Background Several studies have found that a high proportion of the population in western countries use complementary and alternative medicine (CAM). However, little is known about whether CAM is offered in hospitals. The aim of this study was to describe to what extent CAM is offered in Norwegian and Danish hospitals and investigate possible changes in Norway since 2001. Methods A one-page questionnaire was sent to all included hospitals in both countries. The questionnaire was sent to the person responsible for the clinical activity, typically the medical director. 99 hospitals in the authority (85%) in Norway and 126 in Denmark (97%) responded. Given contact persons were interviewed. Results CAM is presently offered in about 50% of Norwegian hospitals and one-third of Danish hospitals. In Norway CAM was offered in 50 hospitals, 40 of which involved acupuncture. 19 hospitals gave other alternative therapies like biofeedback, hypnosis, cupping, ear-acupuncture, herbal medicine, art therapy, homeopathy, reflexology, thought field therapy, gestalt therapy, aromatherapy, tai chi, acupressure, yoga, pilates and other. 9 hospitals offered more than one therapy form. In Denmark 38 hospitals offered acupuncture and one Eye Movement Desensitization and Reprocessing Light Therapy. The most commonly reported reason for offering CAM was scientific evidence in Denmark. In Norway it was the interest of a hospital employee, except for acupuncture where the introduction is more often initiated by the leadership and is more based on scientific evidence of effect. All persons (except one) responsible for the alternative treatment had a medical or allied health professional background and their education/training in CAM treatment varied substantially. Conclusions The extent of CAM being offered has increased substantially in Norway during the first decade of the 21st century. This might indicate a shift in attitude regarding CAM within the conventional health care system. PMID

  16. Use of complementary and alternative medicine at Norwegian and Danish hospitals

    Directory of Open Access Journals (Sweden)

    Launsø Laila

    2011-01-01

    Full Text Available Abstract Background Several studies have found that a high proportion of the population in western countries use complementary and alternative medicine (CAM. However, little is known about whether CAM is offered in hospitals. The aim of this study was to describe to what extent CAM is offered in Norwegian and Danish hospitals and investigate possible changes in Norway since 2001. Methods A one-page questionnaire was sent to all included hospitals in both countries. The questionnaire was sent to the person responsible for the clinical activity, typically the medical director. 99 hospitals in the authority (85% in Norway and 126 in Denmark (97% responded. Given contact persons were interviewed. Results CAM is presently offered in about 50% of Norwegian hospitals and one-third of Danish hospitals. In Norway CAM was offered in 50 hospitals, 40 of which involved acupuncture. 19 hospitals gave other alternative therapies like biofeedback, hypnosis, cupping, ear-acupuncture, herbal medicine, art therapy, homeopathy, reflexology, thought field therapy, gestalt therapy, aromatherapy, tai chi, acupressure, yoga, pilates and other. 9 hospitals offered more than one therapy form. In Denmark 38 hospitals offered acupuncture and one Eye Movement Desensitization and Reprocessing Light Therapy. The most commonly reported reason for offering CAM was scientific evidence in Denmark. In Norway it was the interest of a hospital employee, except for acupuncture where the introduction is more often initiated by the leadership and is more based on scientific evidence of effect. All persons (except one responsible for the alternative treatment had a medical or allied health professional background and their education/training in CAM treatment varied substantially. Conclusions The extent of CAM being offered has increased substantially in Norway during the first decade of the 21st century. This might indicate a shift in attitude regarding CAM within the conventional

  17. Fiftieth Anniversary at the summit

    CERN Multimedia

    2005-01-01

    Neither fear of heights nor the cold succeeded in cooling the ardour of four brave climbers from CERN who celebrated CERN's 50th Anniversary at the summit of Mount Kilimanjaro (5,895 metres). On the way back from the summit, Miguel Cerqueira Bastos (AB/PO), David Collados Polidura (IT/GM), Sandra Sequeira Tavares (PH/CMI) and Daniel Cano Ott (n_TOF) raised the official CERN Jubilee flag at 4750 metres altitude. How long will it be before a CERN flag is planted on the moon?

  18. Summit Station Skiway Cost Analysis

    Science.gov (United States)

    2016-07-01

    of fuel delivered to Summit via LC-130 at a price of $32/gal. (Lever et al. 2016), the cost for constructing and maintaining the skiway for the 2014...CRREL TR-16-9 18 The costs associated with the Twin Otter include a day rate plus an hourly mission rate, a per passenger rate, airport fees, fuel, a...ER D C/ CR RE L TR -1 6- 9 Engineering for Polar Operations, Logistics, and Research (EPOLAR) Summit Station Skiway Cost Analysis Co ld

  19. Earth Summit Science, policy discussed

    Science.gov (United States)

    Leath, Audrey T.

    The United Nations Conference on Environment and Development, the “Earth Summit,” convenes in Rio de Janeiro on June 3. President Bush has pledged to attend part of the 2-week conference. The highlight of the summit will be the signing of an international framework convention to reduce emissions of greenhouse gases. The final elements of the agreement were negotiated in New York last week by representative of 143 countries. In anticipation of the Rio conference, the Senate Committee on Energy and Natural Resources held two standing-roomonly hearings, reviewing the scientific basis for global warming due to greenhouse gases and discussing the details of the proposed convention.

  20. Pharmaceutical policies and access to medicines : a hospital-pharmacy perspective from Ghana

    NARCIS (Netherlands)

    Ankrah, D.

    2017-01-01

    Access to quality medicines is a universal human right which featured prominently on the agenda of the World Health Organisation (WHO) over the past decades. Hospital pharmacists play a pivotal role in ensuring that treatment outcomes are optimal. This thesis studied pharmaceutical policies and

  1. Preparing tomorrow's transportation workforce : a Midwest summit.

    Science.gov (United States)

    2010-08-01

    Preparing Tomorrows Transportation Workforce: A Midwest Summit, held April 2728, 2010, in Ames, Iowa, was one of several : regional transportation workforce development summits held across the United States in 2009 and 2010 as part of a coordin...

  2. Giving Medicine Through Intravenous Towards Incident of Phlebitis to Hospitalized Patient in Hospital

    OpenAIRE

    Iradiyanti, Winda Pratama; Kurnia, Erlin

    2013-01-01

    Phlebitis incident is a reflection of the character of health care. The sign of phlebitis include an increase of skin temperature on the veins, pain, and some cases of redness in the site of insertion or along the vein line. The purpose of this research to study the phlebitis caused. The design used was cross sectional. Population of this research was all patients hospitalized at inpatient ward Kediri Baptist Hospital and all the nurses who provided medication through an intravenous tube a...

  3. When Reducing Low-Value Care in Hospital Medicine Saves Money, Who Benefits ?

    Science.gov (United States)

    Liao, Joshua M; Navathe, Amol S; Schapira, Marilyn M; Weissman, Arlene; Mitra, Nandita; Asch, David A

    2018-01-01

    One emerging policy solution for deterring low-value care is to financially penalize physicians who prescribe it. However, physicians' willingness to support such policies may depend on whether they perceive that benefits accrue to patients or to insurers and hospitals. We surveyed physicians practicing hospital medicine to evaluate the association between policy support and physician beliefs about who benefits from the money saved through reducing low-value services in hospital medicine. Overall, physicians believed that more of any money saved would go to profits and leadership salaries for insurance companies and hospitals and/or health systems rather than to patients. These beliefs were associated with policy support: 66% of those supporting physician penalties were more likely to believe that benefits accrue to patients or physicians, compared to 39% of those not supporting policies (P benefits accrue to corporate or organizational interests. Effective physician penalties will likely need to address the belief that insurers and provider organizations stand to gain more than patients when low-value care services are reduced. © 2017 Society of Hospital Medicine.

  4. A practical guide to manuscript writing with particular relevance to the field of pediatric hospital medicine.

    Science.gov (United States)

    Teufel, Ronald J; Andrews, Anne L; Williams, Derek J

    2014-11-01

    Publishing manuscripts in peer-reviewed journals, such as Hospital Pediatrics, is critical for both the academic development of practitioners in pediatric hospital medicine and the scientific advancement of our field. Understanding the purpose of scientific writing and developing a structured approach to the writing process is essential. Doing so will improve the clarity of your work and likely the ease at which your research is published and disseminated throughout the scientific community. The purposes of this article are to detail the structure of a scientific manuscript, to highlight specific writing strategies, and to provide writing tips that may help or hinder publication. Our ultimate goal is to advance the field of pediatric hospital medicine and its growing membership by promoting the dissemination of high-quality research. Copyright © 2014 by the American Academy of Pediatrics.

  5. Forensic medicine experts' opinion on medico-legal autopsies in hospital deaths: a questionnaire survey.

    Science.gov (United States)

    D'Souza, Deepak Herald; Pant, Sadip; Menezes, Ritesh George

    2013-10-01

    Medico-legal autopsy is conducted routinely in some countries and selectively in others in hospital deaths. This study was conducted to evaluate the views of the forensic medicine experts regarding this matter. A questionnaire pro forma was sent to sixty-five forensic medicine experts practicing in different medical institutions all around India. Designations and experiences of the participants were noted by requests in the same questionnaire. Their specific experience in conducting medico-legal autopsy in hospital deaths was also requested for. Responses were charted in frequency distribution tables and analyzed using SPSS, version 17.0. One-third of the participants felt that a medico-legal autopsy was necessary in all the hospital death cases as defined in the present study. Ten percent of the participants opined that a medico-legal autopsy was unnecessary in hospital deaths. The majority of the experts mentioned finding the cause of death, followed by finding the manner of death and collecting the evidentiary materials, as the reasons for medico-legal autopsy in hospital deaths. Twenty percent of the participants felt that internal findings at autopsy poorly matched with the case records. All the experts agreed that external autopsy findings matched with the hospital case records. Nearly two-third of the participants felt that it was difficult in some cases to interpret the autopsy findings without case records from the hospital where the deceased was treated. Our findings suggest that the exercise of carrying out medico-legal autopsy routinely in every hospital death as evident in the Indian framework is often unnecessary as per the experts' opinion. Autopsy findings in hospital deaths often correlate with hospital case records.

  6. 2014 Mid-Atlantic Telehealth Resource Center Annual Summit

    Directory of Open Access Journals (Sweden)

    Katharine Hsu Wibberly

    2013-12-01

    Full Text Available The Mid-Atlantic Resource Center (MATRC; http://www.matrc.org/ advances the adoption and utilization of telehealth within the MATRC region and works collaboratively with the other federally funded Telehealth Resource Centers to accomplish the same nationally. MATRC offers technical assistance and other resources within the following mid-Atlantic states: Delaware, District of Columbia, Kentucky, Maryland, North Carolina, Pennsylvania, Virginia and West Virginia.   The 2014 MATRC Summit “Adding Value through Sustainable Telehealth” will be held March 30-April 1, 2014, at the Fredericksburg Expo & Conference Center, Fredericksburg, VA. The Summit will explore how telehealth adds value to patients, practitioners, hospitals, health systems, and other facilities. Participants will experience a highly interactive program built around the case history of “Mr. Doe” as he progresses through the primary care, inpatient hospitalization, and post-discharge environments. The Summit will conclude with a session on financial and business models for providing sustainable telehealth services.   For further information and registration, visit: http://matrc.org/component/content/article/2-uncategorised/80-mid-atlantic-telehealth-resource-summit-2014    

  7. Higher Ambitions Summit. Rapporteur Report

    Science.gov (United States)

    Nash, Ian

    2014-01-01

    The Sutton Trust and Pearson two-day summit on higher ambitions in apprenticeships and vocational education drew more than 120 leaders in education, training and employment, policy makers, academics, and researchers to London. Delegates heard from political leaders stressing the importance they attach to high-quality apprenticeships. Presentations…

  8. Clostridial collagenase ointment and medicinal honey utilization for pressure ulcers in US hospitals.

    Science.gov (United States)

    Dreyfus, Jill; Delhougne, Gary; James, Roberta; Gayle, Julie; Waycaster, Curtis

    2018-04-01

    To describe the utilization of clostridial collagenase ointment (CCO) and medicinal honey debridement methods in real-world inpatient and outpatient hospital settings among pressure ulcer (PU) patients and compare the frequency of healthcare re-encounters between CCO- and medicinal honey-treated patients. De-identified hospital discharge records for patients receiving CCO or medicinal honey methods of debridement and having an ICD-9 code for PU were extracted from the US Premier Healthcare Database. Multivariable analysis was used to compare the frequency of inpatient and outpatient revisits up to 6 months after an index encounter for CCO- vs medicinal honey-treated PUs. The study identified 48,267 inpatients and 2,599 outpatients with PUs treated with CCO or medicinal honeys. Among study inpatients, n = 44,725 (93%) were treated with CCO, and n = 3,542 (7%) with medicinal honeys. CCO and medicinal honeys accounted for 1,826 (70%) and 773 (30%), respectively, of study outpatients. In adjusted models, those treated with CCO had lower odds for inpatient readmissions (OR = 0.86, 95% CI = 0.80-0.94) after inpatient index visits, and outpatient re-encounters both after inpatient (OR = 0.73, 95% CI = 0.67-0.79) and outpatient (OR = 0.78, 95% CI = 0.64-0.95) index visits in 6 months of follow-up. The study was observational in nature, and did not adjust for reasons why patients were hospitalized initially, or why they returned to the facility. Although the study adjusted for differences in a variety of demographic, clinical, and hospital characteristics between the treatments, we are not able to rule out selection bias. Patients with CCO-treated PUs returned to inpatient and outpatient hospital settings less often compared with medicinal honey-treated PUs. These results from real-world administrative data help to gain a better understanding of the clinical characteristics of patients with PUs treated with these two debridement methods and

  9. Women in hospital medicine in the United Kingdom: glass ceiling, preference, prejudice or cohort effect?

    Science.gov (United States)

    McManus, I C; Sproston, K A

    2000-01-01

    To assess from official statistics whether there is evidence that the careers of women doctors in hospitals do not progress in the same way as those of men. The proportions of female hospital doctors overall (1963-96), and in the specialties of medicine, surgery, obstetrics and gynaecology, pathology, radiology/radiotherapy, anaesthetics and psychiatry (1974-1996) were examined. Additionally data were examined on career preferences and intentions from pre-registration house officers, final year medical students, and medical school applicants (1966-1991). Data were analysed according to cohort of entry to medical school to assess the extent of disproportionate promotion. The proportion of women in hospital career posts was largely explained by the rapidly increasing proportion of women entering medical school during the past three decades. In general there was little evidence for disproportionate promotion of women in hospital careers, although in surgery, hospital medicine and obstetrics and gynaecology, fewer women seemed to progress beyond the SHO grade, and in anaesthetics there were deficits of women at each career stage. Analyses of career preferences and intentions suggest that disproportionate promotion cannot readily be explained as differential choice by women. Although there is no evidence as such of a "glass ceiling" for women doctors in hospital careers, and the current paucity of women consultants primarily reflects historical trends in the numbers of women entering medical school, there is evidence in some cases of disproportionate promotion that is best interpreted as direct or indirect discrimination.

  10. An investigation Into Traditional Chinese Medicine Hospitals in China: Development Trend and Medical Service Innovation.

    Science.gov (United States)

    Wang, Liang; Suo, Sizhuo; Li, Jian; Hu, Yuanjia; Li, Peng; Wang, Yitao; Hu, Hao

    2016-06-07

    This paper aims to investigate the development trend of traditional Chinese medicine (TCM) hospitals in China and explore their medical service innovations, with special reference to the changing co-existence with western medicine (WM) at TCM hospitals. Quantitative data at macro level was collected from official databases of China Health Statistical Yearbook and Extracts of Traditional Chinese Medicine Statistics. Qualitative data at micro level was gathered through interviews and second-hand material collection at two of the top-level TCM hospitals. In both outpatient and inpatient sectors of TCM hospitals, drug fees accounted for the biggest part of hospital revenue. Application of WM medical exanimation increased in both outpatient and inpatient services. Even though the demand for WM drugs was much higher in inpatient care, TCM drugs was the winner in the outpatient. Also qualitative evidence showed that TCM dominated the outpatient hospital service with WM incorporated in the assisting role. However, it was in the inpatient medical care that WM prevailed over TCM which was mostly applied to the rehabilitation of patients. By drawing on WM while keeping it active in supporting and strengthening the TCM operation in the TCM hospital, the current system accommodates the overriding objective which is for TCM to evolve into a fully informed and more viable medical field. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  11. [Susceptibility of yeasts to antifungal agents in Kaunas University of Medicine Hospital].

    Science.gov (United States)

    Skrodeniene, Erika; Dambrauskiene, Asta; Vitkauskiene, Astra

    2006-01-01

    The aim of this study was to determine the species of yeast and their susceptibility to antifungal agents isolated from clinical specimens of patients treated in Kaunas University of Medicine Hospital. A total of 142 yeasts isolated from various clinical specimens of patients hospitalized in Kaunas University of Medicine Hospital were included in this study. All yeasts were cultivated on Sabouraud dextrose agar and identified using either CHROM agar or API 20C AUX system. The minimum inhibitory concentrations of fluconazole, itraconazole, and amphotericin B were determined by the ATB FUNGUS 2 agar microdilution test. In all clinical specimens except blood, Candida albicans was the most frequently isolated yeast (65.5%, pyeast strains showed resistance to fluconazole. Nearly one-fourth of Candida albicans strains (24.7%) and 23.2% of all isolated yeast strains showed resistance to itraconazole. Almost all of fluconazole-resistant (93.3%) and 12.6% of fluconazole-susceptible yeast were found to be resistant to itraconazole (pyeast strains were susceptible to amphotericin B. Candida albicans strains were significantly frequently resistant to fluconazole than non-albicans Candida species (15.1% and 4.1%, respectively, pyeast isolated in Kaunas University of Medicine Hospital. There was determined that yeasts resistant to fluconazole were commonly resistant to itraconazole too. All isolated yeast strains were susceptible to amphotericin B.

  12. Hospital Medicine and Fellowship Program in Rural North Dakota - A Multifaceted Success Story.

    Science.gov (United States)

    Hyder, S S; Amundson, Mary

    2017-11-01

    Recruitment of hospitalists and primary care physicians for Critical Access Hospitals and tertiary care hospitals in North Dakota is difficult. To address this challenge, 2 programs were implemented in Bismarck, North Dakota. St. Alexius Medical Center created a hospitalist fellowship training program in collaboration with the University of North Dakota School of Medicine and Health Sciences and physicians willing to work in Critical Access Hospitals were offered a joint appointment to teach hospitalist fellows and obtain a clinical academic appointment at the university. Since it was created in 2012, 84 physicians have applied for 13 fellowships. Of the 11 fellows who have completed the program, 64% (7/11) remained in North Dakota to practice. Physicians are more likely to work in a rural Critical Access Hospital if they spend time working at a tertiary care center and have clinical academic appointments. Where recruitment is challenging, hospitalist fellowship programs are helpful in meeting the health care workforce demand.

  13. Assessment of readability, understandability, and completeness of pediatric hospital medicine discharge instructions.

    Science.gov (United States)

    Unaka, Ndidi I; Statile, Angela; Haney, Julianne; Beck, Andrew F; Brady, Patrick W; Jerardi, Karen E

    2017-02-01

    The average American adult reads at an 8th-grade level. Discharge instructions written above this level might increase the risk of adverse outcomes for children as they transition from hospital to home. We conducted a cross-sectional study at a large urban academic children's hospital to describe readability levels, understandability scores, and completeness of written instructions given to families at hospital discharge. Two hundred charts for patients discharged from the hospital medicine service were randomly selected for review. Written discharge instructions were extracted and scored for readability (Fry Readability Scale [FRS]), understandability (Patient Education Materials Assessment Tool [PEMAT]), and completeness (5 criteria determined by consensus). Descriptive statistics enumerated the distribution of readability, understandability, and completeness of written discharge instructions. Of the patients included in the study, 51% were publicly insured. Median age was 3.1 years, and median length of stay was 2.0 days. The median readability score corresponded to a 10th-grade reading level (interquartile range, 8-12; range, 1-13). Median PEMAT score was 73% (interquartile range, 64%-82%; range, 45%-100%); 36% of instructions scored below 70%, correlating with suboptimal understandability. The diagnosis was described in only 33% of the instructions. Although explicit warning signs were listed in most instructions, 38% of the instructions did not include information on the person to contact if warning signs developed. Overall, the readability, understandability, and completeness of discharge instructions were subpar. Efforts to improve the content of discharge instructions may promote safe and effective transitions home. Journal of Hospital Medicine 2017;12:98-101. © 2017 Society of Hospital Medicine.

  14. Consultation clinics for complementary and alternative medicine at Japanese university hospitals: An analysis at Tokushima University Hospital

    Science.gov (United States)

    YANAGAWA, HIROAKI; TERAO, JUNJI; TAKEDA, EIJI; TAKAISHI, YOSHIHISA; KASHIWADA, YOSHIKI; KAWAZOE, KAZUYOSHI; FUSHITANI, SHUJI; TSUCHIYA, KOICHIRO; YAMAUCHI, AIKO; SATO, CHIHO; IRAHARA, MINORU

    2010-01-01

    Here, we report on a Consultation Clinic for Complementary and Alternative Medicine (CAM) which we established at Tokushima University Hospital in July of 2007 with the aim of providing person-to-person information on CAM, though not CAM therapy itself. In December of 2008, we received 55 applications for consultation, 37% concerning health foods, 37% Japanese herbal medicine (Kampo), and 26% various other topics. The consultants (nutritionists and pharmacists) communicated individually with 38 applicants; malignancies (26%) and cardiovascular disease (24%) were the main underlying concerns. To promote the quality of consultation, data was collected by means of focus group interviews concerning the perspective of the consultants. Safe and effective use of CAM requires a network of communication linking individuals, consultation teams, physicians, primary care institutions and university hospitals. To advance this goal, we plan to broaden the efforts described herein. Our findings indicate that the specific role of the consultation clinic in promoting the scientific use of CAM merits further study. PMID:22993564

  15. Quality of communication about medicines in United States hospitals: A national retrospective study.

    Science.gov (United States)

    Mullings, Lauren; Sankaranarayanan, Jayashri

    Despite the benefits of improving transitions across care, literature is very limited on inpatient "Communication about Medicines" (ComMed) by staff across United States (U.S.) hospitals. To evaluate ComMed quality variations by hospital characteristics. In a cross-sectional, retrospective study of publicly available U.S. Medicare's Hospital Consumer Assessment of Health Care Plans Survey (HCAHPS) data (January 2013-September 2014), ComMed quality (high = above average/excellent vs. low = average/below average/poor star ratings) of 3125 hospitals were compared across region, rural-urban location, and health information technology (HIT) infrastructure giving providers access to patients' electronic medical records. Multivariate logistic regression analysis was conducted with adjusting for confounders (hospital - bed size, ownership, type, ED services, the number of completed HCAHPS surveys). After adjusting for other characteristics, Midwest versus Western region hospitals (OR = 1.55, 95% CI: 1.21-1.98, p=quality. Hospitals' small bed-size, physician/non-profit ownership, critical-access type, absent ED services, and 100-299 HCAHPS completed surveys were more likely to be associated with high ComMed quality. One of the first national studies found significant variations in ComMed quality across U.S. hospitals by location (high in Midwest and low in Northeast regions and urban areas) and by access to HIT infrastructure (high) after controlling for other hospital characteristics. With this baseline data, hospital providers and policymakers can design, implement, and evaluate service programs with pharmacists and HIT to enhance ComMed quality in the future delivery of patient-centered care. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Multidisciplinary education in geriatric medicine. Continuing experience at the Middlesex Hospital.

    Science.gov (United States)

    Beynon, G P; Croker, J

    1983-01-01

    The unique feature about the course in teaching geriatric medicine to undergraduates at the Middlesex Hospital is its multidisciplinary nature. The course lasts for three weeks during the first or second clinical year and involves medical students together with student physiotherapists, nurses and occupational therapists. All take part in seminars, ward rounds and multidisciplinary case presentations. A full-time course organizer funded by the School of Nursing manages the course. Assessment includes MCQ and course evaluation questionnaire and an essay.

  17. Pediatric hospital medicine: a strategic planning roundtable to chart the future.

    Science.gov (United States)

    Rauch, Daniel A; Lye, Patricia S; Carlson, Douglas; Daru, Jennifer A; Narang, Steve; Srivastava, Rajendu; Melzer, Sanford; Conway, Patrick H

    2012-04-01

    Given the growing field of Pediatric Hospital Medicine (PHM) and the need to define strategic direction, the Society of Hospital Medicine, the American Academy of Pediatrics, and the Academic Pediatric Association sponsored a roundtable to discuss the future of the field. Twenty-one leaders were invited plus a facilitator utilizing established health care strategic planning methods. A "vision statement" was developed. Specific initiatives in 4 domains (clinical practice, quality of care, research, and workforce) were identified that would advance PHM with a plan to complete each initiative. Review of the current issues demonstrated gaps between the current state of affairs and the full vision of the potential impact of PHM. Clinical initiatives were to develop an educational plan supporting the PHM Core Competencies and a clinical practice monitoring dashboard template. Quality initiatives included an environmental assessment of PHM participation on key committees, societies, and agencies to ensure appropriate PHM representation. Three QI collaboratives are underway. A Research Leadership Task Force was created and the Pediatric Research in Inpatient Settings (PRIS) network was refocused, defining a strategic framework for PRIS, and developing a funding strategy. Workforce initiatives were to develop a descriptive statement that can be used by any PHM physician, a communications tool describing "value added" of PHM; and a tool to assess career satisfaction among PHM physicians. We believe the Roundtable was successful in describing the current state of PHM and laying a course for the near future. Copyright © 2011 Society of Hospital Medicine.

  18. A modified Elixhauser score for predicting in-hospital mortality in internal medicine admissions.

    Science.gov (United States)

    Fabbian, Fabio; De Giorgi, Alfredo; Maietti, Elisa; Gallerani, Massimo; Pala, Marco; Cappadona, Rosaria; Manfredini, Roberto; Fedeli, Ugo

    2017-05-01

    In-hospital mortality (IHM) is an indicator of the quality of care provided. The two most widely used scores for predicting IHM by International Classification of Diseases (ICD) codes are the Elixhauser (EI) and the Charlson Comorbidity indexes. Our aim was to obtain new measures based on internal medicine ICD codes for the original EI, to detect risk for IHM. This single-center retrospective study included hospital admissions for any cause in the department of internal medicine between January 1, 2000, and December 31, 2013, recorded in the hospital database. The EI was calculated for evaluation of comorbidity, then we added age, gender and diagnosis of ischemic heart disease. IHM was our outcome. Only predictors positively associated with IHM were taken into consideration and the Sullivan's method was applied in order to modify the parameter estimates of the regression model into an index. We analyzed 75,586 admissions (53.4% females) and mean age was 72.7±16.3years. IHM was 7.9% and mean score was 12.1±7.6. The points assigned to each condition ranged from 0 to 16, and the possible range of the score varied between 0 and 89. In our population the score ranged from 0 to 54, and it was higher in the deceased group. Receiver operating characteristic curve of the new score was 0.721 (95% CI 0.714-0.727, pInternal Medicine. Published by Elsevier B.V. All rights reserved.

  19. Hospital structure and technical efficiency in the production of nuclear medicine. Doctoral thesis

    International Nuclear Information System (INIS)

    Wilson, G.W.

    1976-01-01

    The relationship of hospital structure to production efficiency is explored. The hospital subindustry on which this research centers is nuclear medicine. The hypotheses generated were that technical efficiency is reduced by increased competitive intensity, by a lack of profit incentive, by a broader service range, and by in-house training of technical personnel. Most data employed in the study were gathered from the American College of Radiology and the Energy Research and Development Administration Census of Nuclear Medicine. More specific information came from questionnaires sent to 2,050 short-term general hospitals known to have a nuclear medicine facility. Of the responses 1,362 were usable for the study. A major study finding was that over half of the variations observed in technical efficiency were attributable to the structural elements being studied. The research indicated that competition for staff physicians has a role in reducing technical efficiency; that the output effect of in-house manpower training was relatively unimportant; and that profit incentives do have a significant impact. It is suggested that increased technical efficiency could be achieved through reduced competitive intensity, stronger profit orientation, and reduced service range. A bibliography is included

  20. Supporting Faculty Development in Hospital Medicine: Design and Implementation of a Personalized Structured Mentoring Program.

    Science.gov (United States)

    Nagarur, Amulya; O'Neill, Regina M; Lawton, Donna; Greenwald, Jeffrey L

    2018-02-01

    The guidance of a mentor can have a tremendous influence on the careers of academic physicians. The lack of mentorship in the relatively young field of hospital medicine has been documented, but the efficacy of formalized mentorship programs has not been well studied. We implemented and evaluated a structured mentorship program for junior faculty at a large academic medical center. Of the 16 mentees who participated in the mentorship program, 14 (88%) completed preintervention surveys and 10 (63%) completed postintervention surveys. After completing the program, there was a statistically significant improvement in overall satisfaction within 5 specific domains: career planning, professional connectedness, self-reflection, research skills, and mentoring skills. All mentees reported that they would recommend that all hospital medicine faculty participate in similar mentorship programs. In this small, single-center pilot study, we found that the addition of a structured mentorship program based on training sessions that focus on best practices in mentoring was feasible and led to increased satisfaction in certain career domains among early-career hospitalists. Larger prospective studies with a longer follow-up are needed to assess the generalizability and durability of our findings. © 2017 Society of Hospital Medicine.

  1. Paramedics' experiences of financial medicine practices in the pre-hospital environment. A pilot study

    Directory of Open Access Journals (Sweden)

    Craig Vincent-Lambert

    2016-10-01

    Objectives: This qualitative pilot study explored and described the experiences of South African Paramedics with regard to the practicing of financial medicine in the local pre-hospital emergency care environment. Method: A sample of South African Paramedics were interviewed either face-to-face or telephonically. The interviews were audio recorded and transcripts produced. Content analysis was conducted to explore, document and describe the participants' experiences with regard to financial medicine practices in the local pre-hospital environment. Results: It emerged that all of the participants had experienced a number of financial medicine practices and associated unethical conduct. Examples included Over-servicing, Selective Patient Treatment, Fraudulent Billing Practices, Eliciting of kickbacks, incentives or benefits and Deliberate Time Wasting. Conclusion: The results of this study are concerning as the actions of service providers described by the participants constitute gross violations of the ethical and professional guidelines for health care professionals. The authors recommend additional studies be conducted to further explore these findings and to establish the reasons for, and ways of, limiting financial medicine practices in the South African emergency care environment.

  2. Stenotrophomonas maltophilia in a university hospital of traditional Chinese medicine: molecular epidemiology and antimicrobial resistance.

    Science.gov (United States)

    Zhao, S; Yang, L; Liu, H; Gao, F

    2017-07-01

    Stenotrophomona maltophilia has emerged as an important opportunistic pathogen that is highly antibiotic resistant. Analysis of antibiotic susceptibilities, drug-resistant gene profiles and molecular typing of S. maltophilia was undertaken in a university hospital of traditional Chinese medicine in East China. Resistance to sulphamethoxazole (SXT) was found to be an indicator of multi-drug resistance. SXT resistance was mediated by sul and dfrA genes in integrons, especially class 1. Some evidence of clonal dissemination was found, indicating the occurrence of cross-transmission of antibiotic-resistant strains within the hospital. This underscores the need for effective control and prevention measures in hospitals. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  3. [Assessing research productivity in Department of Internal Medicine, University of Zagreb, School of Medicine and University Hospital Centre Zagreb].

    Science.gov (United States)

    Petrak, Jelka; Sember, Marijan; Granić, Davorka

    2012-01-01

    Bibliometric analysis may give an objective information about publishing activity, citation rate and collaboration patterns of individuals, groups and institutions. The publication productivity of the present medical staff (79 with specialist degree and 22 residents) in Department of Internal Medicine, University of Zagreb School of Medicine in University Hospital Centre Zagreb was measured by the number of papers indexed by Medline, their impact was measured by the number of times these papers had subsequently been cited in the medical literature, while the collaboration pattern was estimated by the authors' addresses listed in the papers. PubMed database was a source for verifying the bibliographic data, and the citation data were searched via Thomson Web of Scence (WoS) platform. There were a total of 1182 papers, published from 1974 to date. The number of papers per author ranged from 0 to 252. Sixty of papers were published in English, and 39% in Croatian language. The roughly equal share was published in local and foreign journals. The RCT studies and practice guidelines were among the most cited papers and were at the same time published by the highly ranked journals. The collaboration analysis confirmed the extensive involment in the international multicentric clinical trials as well as in the development of international/local practice guidelines.

  4. Use of herbal medicine among pregnant women on antenatal care at nekemte hospital, Western ethiopia.

    Science.gov (United States)

    Bayisa, Bodena; Tatiparthi, Ramanjireddy; Mulisa, Eshetu

    2014-11-01

    Investigations across the world confirm dramatic increment in the use of complementary and alternative medicine in pregnant women. The most important aspect is lack of awareness of pregnant women about potential effects of using traditional medicine on fetus; some herbal products may be teratogenic in human and animal models. In this area, so far, no research has been conducted in Ethiopia to assess traditional medicine use in pregnant women. Therefore, the main objective of this study was to investigate the prevalence and use of herbal drugs among pregnant women attending Nekemte Hospital to provide baseline information for future studies. A cross-sectional descriptive study was conducted by quantitative and qualitative approaches to identify the prevalence of using herbal medicines among pregnant women. About 50.4% of study participants used herbal drugs during their pregnancy. The proportion of herbal drug usage was gradually decreased along with the first, second and third trimesters of pregnancy. The most and least commonly used herbs were ginger (44.36%) and tenaadam (9.15 %), respectively. The common indications of herbal remedies use during pregnancy were nausea (23.90%) and morning sickness (21.05%). The result of the present study confirmed wide use of herbal drugs use during pregnancy that need to report the safety concerns of these drugs during pregnancy. To achieve the requirements of pregnant women, it is vital for health care workers to be familiar with the effect of herbal medicine in pregnancy.

  5. Women in hospital medicine in the United Kingdom: glass ceiling, preference, prejudice or cohort effect?

    Science.gov (United States)

    McManus, I; Sproston, K

    2000-01-01

    OBJECTIVE—To assess from official statistics whether there is evidence that the careers of women doctors in hospitals do not progress in the same way as those of men.
DESIGN—The proportions of female hospital doctors overall (1963-96), and in the specialties of medicine, surgery, obstetrics and gynaecology, pathology, radiology/radiotherapy, anaesthetics and psychiatry (1974-1996) were examined. Additionally data were examined on career preferences and intentions from pre-registration house officers, final year medical students, and medical school applicants (1966-1991).
ANALYSIS—Data were analysed according to cohort of entry to medical school to assess the extent of disproportionate promotion.
RESULTS—The proportion of women in hospital career posts was largely explained by the rapidly increasing proportion of women entering medical school during the past three decades. In general there was little evidence for disproportionate promotion of women in hospital careers, although in surgery, hospital medicine and obstetrics and gynaecology, fewer women seemed to progress beyond the SHO grade, and in anaesthetics there were deficits of women at each career stage. Analyses of career preferences and intentions suggest that disproportionate promotion cannot readily be explained as differential choice by women.
CONCLUSIONS—Although there is no evidence as such of a "glass ceiling" for women doctors in hospital careers, and the current paucity of women consultants primarily reflects historical trends in the numbers of women entering medical school, there is evidence in some cases of disproportionate promotion that is best interpreted as direct or indirect discrimination.

 PMID:10692956

  6. Pharmacovigilance study of Ayurvedic medicine in Ayurvedic Teaching Hospital: A prospective survey study.

    Science.gov (United States)

    Ajanal, Manjunath N; Nayak, Shradda U; Kadam, Avinash P; Prasad, B S

    2015-01-01

    Though Ayurveda is practiced in the Indian subcontinent since centuries, there is a paucity of systematic documentation related to the occurrence of adverse drug reactions (ADR) and other issues regarding the safety of Ayurveda medicines. To monitor and analyze the pattern and frequency of ADR to Ayurvedic medicines in an Ayurvedic hospital setup. In this prospective study, ADR monitoring was done in KLE Ayurveda Secondary Care Hospital, Belgaum, Karnataka, India by spontaneous and intensive monitoring technique for a span of 1-year (June 2010 to May 2011). Data pertaining to patient demography, drug and reaction characteristics, organ system involved and reaction outcomes were collected and evaluated. The reaction severity and predisposing factors were also assessed. In a span of one year, 84 adverse drug events were reported out of which 52 confirmed as ADR. The overall incidence of ADR in the patient population was 1.14%, out of which 23 (44.23%) were related to Panchakarma (detoxification process), 13 (25.00%) related to the herbal formulations and 06 (11.53%) were of Rasa Aushadhi (mineral or herbo-mineral formulations). The commonly affected organ systems were gastrointestinal system 24 (46.15%) and skin 15 (28.84%). The majority of the reactions were moderate 30 (57.69%) to mild 20 (38.46%) in severity. Most patients recovered from the incidence. The present work has documented the incidence and characteristic of ADR to Ayurvedic medicine in a typical Ayurveda hospital setup. This will help in developing various strategies for boosting pharmacovigilance in Ayurveda, thereby ensuring safer use of Ayurveda medicines.

  7. Drug utilization pattern of Chinese herbal medicines in a general hospital in Taiwan.

    Science.gov (United States)

    Chen, L C; Wang, B R; Chou, Y C; Tien, J H

    2005-09-01

    Drug utilization studies are important for the optimization of drug therapy and have received a great attention in recent years. Most of the information on drug use patterns has been derived from studies in modern Western medicines; however, studies regarding the drug utilization of traditional Chinese medicine (CM) are few. The present study was the first clinical research to evaluate the drug utilization patterns of Chinese herbal medicines in a general hospital in Taiwan. Data were collected prospectively from the patients attending the Traditional Medicine Center of Taipei Veteran General Hospital under CM drug treatments. The study was carried out over a period of 1 year, from January 2002 to December 2002. Core drug use indicators, such as the average number of drugs per prescriptions, the dosing frequency of prescriptions, and the most common prescribed CM herbs and formulae were evaluated. The primary diagnosis and the CM drugs prescribed for were also revealed. All data were analyzed by descriptive statistics. A total of 10 737 patients, representing 52 255 CM drugs, were screened during the study period. Regarding the prescriptions, the average number of drugs per prescription was 4.87 and 37.21% of prescriptions were composed by five drugs. Most of prescriptions (91.38%) were prescribed for three times a day. The most often prescribed Chinese herb was Hong-Hwa (5.76%) and the most common Chinese herbal formula was Jia-Wey-Shiau-Yau-San (3.80%). The most frequent main diagnosis was insomnia (15.58%), followed by menopause (5.22%) and constipation (5.09%). The survey revealed the drug use pattern of CMs in a general hospital. The majority of CM prescriptions were composed by 3-6 drugs and often prescribed for three times a day. Generally, the rational drug uses of CM drugs were provided with respect to the various diagnoses. (c) 2005 John Wiley & Sons, Ltd.

  8. Road map to a patient-centered research agenda at the intersection of hospital medicine and geriatric medicine.

    Science.gov (United States)

    Wald, Heidi L; Leykum, Luci K; Mattison, Melissa L P; Vasilevskis, Eduard E; Meltzer, David O

    2014-06-01

    As the United States ages, the patient population in acute care hospitals is increasingly older and more medically complex. Despite evidence of a high burden of disease, high costs, and often poor outcomes of care, there is limited understanding of the presentation, diagnostic strategies, and management of acute illness in older adults. In this paper, we present a strategy for the development of a research agenda at the intersection of hospital and geriatric medicine. This approach is informed by the Patient-Centered Outcomes Research Institute (PCORI) framework for identification and prioritization of research areas, emphasizing input from patients and caregivers. The framework's four components are: 1) Topic generation, 2) Gap Analysis in Systematic Review, 3) Value of information (VOI) analysis, and 4) Peer Review. An inclusive process for topic generation requiring the systematic engagement of multiple stakeholders, especially patients, is emphasized. In subsequent steps, researchers and stakeholders prioritize research topics in order to identify areas that optimize patient-centeredness, population impact, impact on clinical decision making, ease of implementation, and durability. Finally, next steps for dissemination of the research agenda and evaluation of the impact of the patient-centered research prioritization process are described.

  9. "A Paradox Persists When the Paradigm Is Wrong": Pisacano Scholars' Reflections from the Inaugural Starfield Summit.

    Science.gov (United States)

    Doohan, Noemi; Coutinho, Anastasia J; Lochner, Jennifer; Wohler, Diana; DeVoe, Jennifer

    The inaugural Starfield Summit was hosted in April 2016 by the Robert Graham Center for Policy Studies in Family Medicine and Primary Care with additional partners and sponsors, including the Pisacano Leadership Foundation (PLF). The Summit addressed critical topics in primary care and health care delivery, including payment, measurement, and team-based care. Invited participants included an interdisciplinary group of pediatricians, family physicians, internists, behaviorists, trainees, researchers, and advocates. Among the family physicians invited were both current and past PLF (Pisacano) scholars. After the Summit, a small group of current and past Pisacano scholars formed a writing group to reflect on and summarize key lessons and conclusions from the Summit. A Summit participant's statement, "a paradox persists when the paradigm is wrong," became a repeated theme regarding the paradox of primary care within the context of the health care system in the United States. The Summit energized participants to renew their commitment to Dr. Starfield's 4 C's of Primary Care (first contact access, continuity, comprehensiveness, and care coordination) and to the Quadruple Aim (quality, value, and patient and physician satisfaction) and to continue to explore how primary care can best shape the future of the nation's health care system. © Copyright 2016 by the American Board of Family Medicine.

  10. National Farmers Market Summit Proceedings Report

    OpenAIRE

    Tropp, Debra; Barham, James

    2008-01-01

    The USDA Agricultural Marketing Service (AMS), in partnership with the Farmers Market Consortium, hosted the National Farmers Market Summit November 7–9, 2007, in Baltimore, MD. The Summit assembled key stakeholders from the farmers market community to convene a national conversation on issues and challenges facing today’s farmers markets. The National Farmers Market Summit had three broad objectives: (1) Identify farmers market needs and existing gaps in assistance, (2) Prioritize future res...

  11. Development of pediatric emergency medicine at Addis Ababa University/Tikuranbessa Specialized Hospital, Ethiopia.

    Science.gov (United States)

    Tefera, Muluwork; Bacha, Tigist; Butteris, Sabrina; Teshome, Getachew; Ross, Joshua; Hagen, Scott; Svenson, Jim; Busse, Heidi; Tefera, Girma

    2014-07-01

    In the world emergencies occur everywhere, and each day they consume ressources regardless of whether there are systems capable of achieving good outcomes. Low-income countries suffer the most highest rates of every category of injury--from traffic and the highest rates of acute complications of communicable diseases including tuberculosis, malaria and HIV. To describe the development of pediatrics emergency medicine at Tikur Anbesa Specialized Hospital A twinning partnership model was used in developing a pediatric emergency medicine training program helps in development of pediatrics emergency system. Strengthening the capacity of Addis Ababa University (AAU), Tikur Anbessa Hospital (TASH) to provide pediatric emergency medical services through improved organization of the pediatrics emergency department and strengthening of continuing education opportunities for faculty and staff capacity building by this improving quality of care in pediatrics patients in the country. The Addis Ababa University, University of Wiscosin and People to People partners intend to continue working together to strengthening and developing effetive systems to deliver quality pediatrics emergency medicine care troughout all regions of Ethiopia.

  12. Attitudes toward integration of complementary and alternative medicine with hospital-based care.

    Science.gov (United States)

    Lewis, D; Paterson, M; Beckerman, S; Sandilands, C

    2001-12-01

    To characterize those who have used, expect to use, or are opposed to the use of holistic therapies, especially in a conventional medical (hospital) setting. SAMPLE DESCRIPTION AND METHODS: Cross-sectional survey of a random sample of Hamilton-Wentworth residents between March and June 1998 (n = 416; response rate, 63%); analysis used logistic regression. Thirty-seven percent (37%) used at least one holistic therapy in the previous year: the three most common were chiropractic, massage, and herbal/phytology. The three most common reasons for use were general health, fatigue, and arthritis. Thirty-three percent (33%) would use holistic therapy in the future. Barriers to use were lack of information, perceived ineffectiveness, and cost; approximately 40% agreed they would only use holistic therapies with medical advice. Approximately 13% were opposed to holistic therapy and objected to its use in hospitals. Younger age, preference for holistic therapy over conventional medicine, and prior use of holism independently predicted high likelihood for future use. Lower income and high self-perceived health were associated with negative attitude toward use of holistic therapies in hospital. Most respondents would accept integration of holistic techniques into a hospital; therapies would be more acceptable if there were clear evidence of their efficacy. A few might find their opinion of a sponsoring hospital lowered by such integration.

  13. Medicine and management: looking inside the box of changing hospital governance.

    Science.gov (United States)

    Kuhlmann, Ellen; Rangnitt, Ylva; von Knorring, Mia

    2016-05-24

    Health policy has strengthened the demand for coordination between clinicians and managers and introduced new medical manager roles in hospitals to better connect medicine and management. These developments have created a scholarly debate of concepts and an increasing 'hybridization' of tasks and roles, yet the organizational effects are not well researched. This research introduces a multi-level governance approach and aims to explore the organizational needs of doctors using Sweden as a case study. We apply an assessment framework focusing on macro-meso levels and managerial-professional modes of hospital governance (using document analysis, secondary sources, and expert information) and expand the analysis towards the micro-level. Qualitative explorative empirical material gathered in two different studies in Swedish hospitals serves to pilot research into actor-centred perceptions of clinical management from the viewpoint of the 'managed' and the 'managing' doctors in an organization. Sweden has developed a model of integrated hospital governance with complex structural coordination between medicine and management on the level of the organization. In terms of formal requirements, the professional background is less relevant for many management positions but in everyday work, medical managers are perceived primarily as colleagues and not as experts advising on managerial problems. The managers themselves seem to rely more on personal strength and medical knowledge than on management tools. Bringing doctors into management may hybridize formal roles and concepts, but it does not necessarily change the perceptions of doctors and improve managerial-professional coordination at the micro-level of the organization. This study brings gaps in hospital governance into view that may create organizational weaknesses and unmet management needs, thereby constraining more coordinated and integrated medical management.

  14. 11. International Oil Summit 2010

    International Nuclear Information System (INIS)

    Anon.

    2010-01-01

    In his introduction at the 11. international oil summit 2010, Mr N. Ait-Laoussine (President of Nalcosa and past Energy Minister in Algeria) has summarized the main points which will be approached during the meeting: 1)after the crisis of 2008, what will be the challenges of the petroleum industry? the environmental constraints? the availability of the new technologies? Will the prices volatility be permanent? 2)what will be the strategy at middle/long term of the national petroleum companies, of the international petroleum companies and of the service companies (partnership, research and innovation,....)? (O.M.)

  15. Consensus in Guidelines for Evaluation of DSD by the Texas Children's Hospital Multidisciplinary Gender Medicine Team

    Directory of Open Access Journals (Sweden)

    Macias CharlesG

    2010-08-01

    Full Text Available The Gender Medicine Team (GMT, comprised of members with expertise in endocrinology, ethics, genetics, gynecology, pediatric surgery, psychology, and urology, at Texas Children's Hospital and Baylor College of Medicine formed a task force to formulate a consensus statement on practice guidelines for managing disorders of sexual differentiation (DSD and for making sex assignments. The GMT task force reviewed published evidence and incorporated findings from clinical experience. Grading of Recommendations, Assessment, Development, and Evaluation (GRADE was used to assess the quality of evidence presented in the literature for establishing evidence-based guidelines. The task force presents a consensus statement regarding specific diagnostic and therapeutic issues in the management of individuals who present with DSD. The consensus statement includes recommendations for (1 laboratory workup, (2 acute management, (3 sex assignment in an ethical framework that includes education and involvement of the parents, and (4 surgical management.

  16. Will there be room for the teaching of internal medicine in a university hospital?

    Science.gov (United States)

    Junod, Alain F

    2002-01-12

    To answer the question addressed, two working groups, one made of the staff of a University clinic, the other one composed of practising general internists, have discussed the assets and weaknesses of a University service of Internal Medicine for postgraduate training. The groups agreed on a number of points: patients' characteristics (complexity and co-morbidities), quality of teaching, method acquisition for clinical reasoning, as well as absence of exposure to ambulatory patients and of follow-up. The groups differed in their views related to the lack of training in psychiatry and psychosocial problems or to hospital dysfunctions. Opening of internal medicine to primary care appears to be necessary at the same time as individual qualities among the senior staff are to be developed, such as critical analysis and self-questioning.

  17. Evidence-based medicine and hospital reform: tracing origins back to Florence Nightingale.

    Science.gov (United States)

    Aravind, Maya; Chung, Kevin C

    2010-01-01

    The use of reliable evidence to evaluate health care interventions has gained strong support within the medical community and in the field of plastic surgery in particular. Evidence-based medicine aims to improve health care and reduce costs through the use of sound clinical evidence in evaluating treatments, procedures, and outcomes. The field is hardly new, however, and most trace its origins back to the work of Cochrane in the 1970s and Sackett in the 1990s. Though she wouldn't know it, Florence Nightingale was applying the concepts of evidence-based reform to the medical profession more than a century before. She used medical statistics to reveal the nature of infection in hospitals and on the battlefield. Moreover, Nightingale marshaled data and evidence to establish guidelines for health care reform. Tracing the origins of evidence-based medicine back to Nightingale underscores how critical this movement is to improving the quality and effectiveness of patient care today.

  18. Causes of prolonged hospitalization among general internal medicine patients of a tertiary care center.

    Science.gov (United States)

    Ruangkriengsin, Darat; Phisalprapa, Pochamana

    2014-03-01

    Unnecessary days of prolonged hospitalization may lead to the increase in hospital-related complications and costs, especially in tertiary care center Currently, there have not been many studies about the causes of prolonged hospitalization. Some identified causes could, however, be prevented and improved. To identify the prevalence, causes, predictive factors, prognosis, and economic burden of prolonged hospitalization in patients who had been in general internal medicine wards of the tertiary care center for 7 days or more. Retrospective chart review study was conducted among all patients who were admitted for 7 days or more in general internal medicine wards of Siriraj Hospital, the largest tertiary care center in Thailand. The period of this study was from 1 August 2012 to 30 September 2012. Demographic data, principle diagnosis, comorbid diseases, complications, discharge status, total costs of admission and percentage of reimbursement were collected. The causes of prolonged hospitalization at day 7, 14, 30, and 90 were assessed. Five hundred and sixty-two charts were reviewed. The average length of stay was 25.9 days. The two most common causes of prolonged admission at day 7 were treatment of main diagnosed disease with stable condition (27.6%) and waiting for completion of intravenous antibiotics administration with stable condition (19.5%). The causes of prolonged hospitalization at day 14 were unstable condition from complications (22.6%) and those waiting for completion of intravenous antibiotics administration with stable condition (15.8%). The causes of prolonged admission at day 30 were unstable conditions from complications (25.6%), difficulty weaning or ventilator dependence (17.6%), and caregiver problems (15.2%). The causes of prolonged hospitalization at day 90 were unstable condition from complications (30.0%), caregiver problems (30.0%), and palliative care (25.0%). Poor outcomes were shown in the patients admitted more than 90 days. Percentage

  19. Impact of Family Medicine Implementation in outpatient admissions in an Education and Research Hospital

    Directory of Open Access Journals (Sweden)

    Abdülkadir Aydın

    2017-12-01

    Full Text Available Aim: With the health transformation program in Turkey, the Family Medicine Implementation (FMI was started across the nation in the end of 2010. This study attempted to assess the influence of the FMI on outpatient applications to a third level state hospital.Methods: The number of outpatient applications from 2007 to 2014 was screened through an automation system. Eight clinics were examined including the clinics which Ministry of Health, the Board of Medical Specialties assigned as a part of obligatory rotation within the scope of Family Medicine assistant training, and emergency service. The year 2011 was taken as beginning year of the Family Medicine system. The period from 2007 to 2010 was taken as the pre-FMI period while the term from 2010 to 2014 was taken as the post-FMI period. The outpatient application rates of the selected clinics were compared by periods in correlation with population changes in the Anatolian site of İstanbul. In the analysis of the data, descriptive statistics, mean and standard deviation for continuous variables, Mann Whitney U Test for abnormal distribution comparisons of measured values were used. Significance was assessed at p<0,01 and p<0,05 levels.Results: It was found that no significant increase occurred in the number of patients who applied to the clinics of chest diseases and cardiology in parallel to population growth. In other clinics, the number of applications increased in correlation with population growth.Conclusion: The family medicine implementation made positive effects on the third level hospital in the beginning phase. We are of the opinion that, in order for these positive effects to be improved further, patients should be encouraged to apply to family physicians, and a health referral chain should be implemented with sufficient numbers of primary care personnel.

  20. Estimation of Internal Radiation Dose to Nuclear Medicine Workers at Siriraj Hospital

    International Nuclear Information System (INIS)

    Asawarattanapakdee, J.; Sritongkul, N.; Chaudakshetrin, P.; Kanchanaphiboon, P.; Tuntawiroon, M.

    2012-01-01

    Every type of work performed in a nuclear medicine department will make a contribution to both external and internal exposure of the worker. The purpose of this study is to evaluate the potential risks of internal contamination to staff members during nuclear medicine practices and to conclude about the requirement of a routine internal monitoring. Following the method describes in the ICRP Publication 78 and the IAEA Safety Standard Series No. RS- G-1.2, in vivo thyroid bioassays using NaI(Tl) thyroid probe were performed to determine the intake estimates on 7 groups of nuclear medicine personnel working with I-131 and Tc-99m, based on working conditions and amount of radionuclides being handled. Frequency of measurements was between 7 and 14 days. These include (1) physicians and physicists, (2) radiochemists (3) technologists, (4) nurses and assistant nurses, (5) imaging room assistants, (6) hot lab workers and (7) hospital ward housekeepers/cleaners. Among all workers, the intake estimates of I-131 in the thyroid ranged from 0 to 76.7 kBq and of the technetium-99m from 0 to 35.4 MBq. The mean committed effective dose equivalent (CEDE) from both I-131 and Tc-99m were 0.63, 1.44 0.53, 0.57, 0.73, 0.98, and 1.36, mSv, for group 1 through group 7 respectively. However, the highest mean CEDE of 1.44 (max. 1.75) and 1.36 (max. 2.11) mSv observed in groups of radiochemists and hospital ward housekeepers were within the permissible level. Our results showed that CEDE for internal exposure in this study were less than investigate level of 5 mSv according to the ICRP Publication 78 and the IAEA Basic Safety Standards. However, the mean CEDE for radiochemists and hospital ward housekeepers were considered in exceed of the limits of recording level (1 mSv).The increasing use of I-131 and Tc-99m in nuclear medicine poses significant risks of internal exposure to the staff. This study suggests that a routine monitoring program for internal exposures should be implemented for

  1. Designing HIGH-COST medicine: hospital surveys, health planning, and the paradox of progressive reform.

    Science.gov (United States)

    Perkins, Barbara Bridgman

    2010-02-01

    Inspired by social medicine, some progressive US health reforms have paradoxically reinforced a business model of high-cost medical delivery that does not match social needs. In analyzing the financial status of their areas' hospitals, for example, city-wide hospital surveys of the 1910s through 1930s sought to direct capital investments and, in so doing, control competition and markets. The 2 national health planning programs that ran from the mid-1960s to the mid-1980s continued similar strategies of economic organization and management, as did the so-called market reforms that followed. Consequently, these reforms promoted large, extremely specialized, capital-intensive institutions and systems at the expense of less complex (and less costly) primary and chronic care. The current capital crisis may expose the lack of sustainability of such a model and open up new ideas and new ways to build health care designed to meet people's health needs.

  2. [Undesirable effects of medicine in the Internal Medicine Service of the University Hospital Center du Point G].

    Science.gov (United States)

    Soukho-Kaya, A; Minta, D K; Diarra, M T; Konaté, A; Diallo, B; Sidibé, A T; Dembélé, M; Bah, M; Doumbia, A A; Dao, K; Tolo, N; Camara, B D; Sy, D; Maiga, M Y; Traoré, H A

    2010-01-01

    The aim of this study was to determine the frequency of adverse reactions to drugs, the WHO grade, describe the clinical features and identify the drug responsible. This was a descriptive cross-sectional study which took place from February 2005 to January 2006 in the Internal Medicine Department at the hospital point G. Were included in this study, all patients hospitalized during the study period, which presented adverse drug reactions (ADRs) that the relation of cause and effect was certain or likely. Thus, 47 ADRs were identified in 39 patients of 426 admitted during the same period a frequency of 9.2%. The average age of our patients was 48.5 ± 16.5 years. The sex-ratio was 1.6 for women. Eighty-two percent of our patients had an ADR and 18% more than one. The WHO grade 1 was the most met or 36.2%, followed by grades 4 and 2 respectively 27.7% and 25.5%. Antidiabetics were responsible for adverse reactions in 46.8% and 21.3% in TB. Adverse events were neurological in 53.2% and type of manifestations of hypoglycemia 46.8% (22/47 cases), polyneuritis 6.4% (3 / 47 cases) and 29.8% in digestive cases dominated by vomiting 12.8% (6 / 47 cases), the epigastria pain 6.4% (3 / 47 cases). The outcome was favorable in 87.2% of cases, however, 3 cases of death among those over 60 years all grade 4 WHO. ADRs deserve special attention to this high death rate (6.4% 3/47 cases) where the interest to search systematically for all patients under medical treatment with a good clinical examination and questioning some thoroughly.

  3. Caregivers’ knowledge and acceptance of complementary and alternative medicine in a tertiary care pediatric hospital

    Directory of Open Access Journals (Sweden)

    Trifa M

    2018-03-01

    Full Text Available Mehdi Trifa,1,2 Dmitry Tumin,1,3 Hina Walia,1 Kathleen L Lemanek,4 Joseph D Tobias,1,3 Tarun Bhalla1,3 1Department of Anesthesiology and Pain Medicine, Nationwide Children’s Hospital, Columbus, OH, USA; 2Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia; 3Department of Anesthesiology and Pain Medicine, The Ohio State University College of Medicine, Columbus, OH, USA; 4Department of Pediatric Psychology and Neuropsychology, Nationwide Children’s Hospital, Columbus, OH, USA Background: The use of complementary and alternative medicine (CAM therapies has increased in children, especially in those with chronic health conditions. However, this increase may not translate into acceptance of CAM in the perioperative setting. We surveyed caregivers of patients undergoing surgery to determine their knowledge and acceptance of hypnotherapy, acupuncture, and music therapy as alternatives to standard medication in the perioperative period. Materials and methods: An anonymous, 12-question survey was administered to caregivers of children undergoing procedures under general anesthesia. Caregivers reported their knowledge about hypnotherapy, music therapy, and acupuncture and interest in one of these methods during the perioperative period. CAM acceptance was defined as interest in one or more CAM methods.Results: Data from 164 caregivers were analyzed. The majority of caregivers were 20–40 years of age (68% and mothers of the patient (82%. Caregivers were most familiar with acupuncture (70%, followed by music therapy (60% and hypnotherapy (38%. Overall CAM acceptance was 51%. The acceptance of specific CAM modalities was highest for music therapy (50%, followed by hypnotherapy (17% and acupuncture (13%. In multivariable logistic regression, familiarity with music therapy was associated with greater odds of CAM acceptance (odds ratio=3.36; 95% CI: 1.46, 7.74; P=0.004.Conclusion: Overall CAM acceptance among caregivers of children

  4. Relationship between Personality Profiles and Suicide Attempt via Medicine Poisoning among Hospitalized Patients: A Case-Control Study

    OpenAIRE

    Shafiee-Kandjani, Ali Reza; Amiri, Shahrokh; Arfaie, Asghar; Ahmadi, Azadeh; Farvareshi, Mahmoud

    2014-01-01

    Objectives. Inflexible personality traits play an important role in the development of maladaptive behaviors among patients who attempt suicide. This study was conducted to investigate the relationship between personality profiles and suicide attempt via medicine poisoning among the patients hospitalized in a public hospital. Materials and Methods. Fifty-nine patients who attempted suicide for the first time and hospitalized in the poisoning ward were selected as the experimental group. Sixty...

  5. On the first occupational medicine initiatives in Mexico: The Real del Monte miners’ hospital.

    Science.gov (United States)

    Gómez, José Luis; Rodríguez-Paz, Carlos Agustín

    2018-01-01

    Despite the legislation of Otto von Bismarck (1815-1898) on social security rights formulated in 1883 in Germany where it is stated that it is the duty of the State to promote the welfare of all members of society, particularly the weakest and most needy, using the means available to them, and the proposals of laws against accidents issued on April 30, 1904 in the State of Mexico in 1904, in the Mexico of the Porfirio Díaz era, providing workers with formal medical care was not contemplated, except in the case of some railway companies, hospitals for the care of patients with occupational diseases were not built. One of these exceptions was the Hospital del Mineral del Real del Monte de Pachuca, founded in the late nineteenth century and after the mining company passed to the Americans in 1906, it was agreed that the company acquired the hospital and equated it with the medical and surgical advances of the time for immediate care of injuries, especially of the orthopedic type, which enabled not only the healing of wounds, but also rehabilitation. This hospital is one of the oldest in Mexico with regard to three disciplines: orthopedics, occupational medicine and rehabilitation. It ceased to operate in 1982, and currently it is a museum with a rich collection of documents and instruments related to the aforementioned disciplines. Copyright: © 2018 SecretarÍa de Salud.

  6. Does medicine still show an unresolved discrimination against women? Experience in two European university hospitals.

    Science.gov (United States)

    Santamaría, A; Merino, A; Viñas, O; Arrizabalaga, P

    2009-02-01

    Have invisible barriers for women been broken in 2007, or do we still have to break through medicine's glass ceiling? Data from two of the most prestigious university hospitals in Barcelona with 700-800 beds, Hospital Clínic (HC) and Hospital de la Santa Creu i Sant Pau (HSCSP) address this issue. In the HSCSP, 87% of the department chairs are men and 85% of the department unit chiefs are also men. With respect to women, only 5 (13%) are in the top position (department chair) and 4 (15%) are department unit chiefs. Similar statistics are also found at the HC: 87% of the department chairs and 89% of the department unit chiefs are men. Currently, only 6 women (13%) are in the top position and 6 (11%) are department unit chiefs. Analysis of the 2002 data of internal promotions in HC showed that for the first level (senior specialist) sex distribution was similar. Nevertheless, for the second level (consultant) only 25% were women, and for the top level (senior consultant) only 8% were women. These proportions have not changed in 2007 in spite of a 10% increase in leadership positions during this period. Similar proportions were found in HSCSP where 68% of the top promotions were held by men. The data obtained from these two different medical institutions in Barcelona are probably representative of other hospitals in Spain. It would be ethically desirable to have males and females in leadership positions in the medical profession.

  7. World Summit embraces Open Access, libraries

    CERN Multimedia

    Kaser, D

    2004-01-01

    "The long-anticipated "first phase" meeting of the World Summit on the Information Society (WSIS), held in Geneva in December, was supposed to have been about equal access. It turned out being equally about open access as leading scientific organizations pushed their open-access initiative onto the World Summit agenda" (1 page)

  8. [History of the 4th Department of Internal Medicine of the First Faculty of Medicine at Charles University and the General University Hospital in Prague].

    Science.gov (United States)

    Bartůněk, Petr

    In 2015, the doctors and nurses of the 4th Department of Internal Medicine of the First Faculty of Medicine, Charles University and the General University Hospital in Prague celebrated the 70th anniversary of its founding. The article summarizes the clinics contribution to the field of internal medicine, and particularly to angiology, hepatogastroenterology and lipidology. It comments the clinics current activities and the possibilities of its further development. Attention is also paid to the tradition of high ethical and professional standards of medical care in accordance with the norms established by the clinic's founder, prof. MUDr. Bohumil Prusík.

  9. Cross-sectional survey of patients' need for information and support with medicines after discharge from hospital.

    Science.gov (United States)

    Mackridge, Adam J; Rodgers, Ruth; Lee, Dan; Morecroft, Charles W; Krska, Janet

    2017-11-20

    Most patients experience changes to prescribed medicines during a hospital stay. Ensuring they understand such changes is important for preventing adverse events post-discharge and optimising patient understanding. However, little work has explored the information that patients receive about medicines or their perceived needs for information and support after discharge. To determine information that hospital inpatients who experience medicine changes receive about their medicines during admission and their needs and preferences for, and use of, post-discharge support. Cross-sectional survey with adult medical inpatients experiencing medicine changes in six English hospitals, with telephone follow-up 2-3 weeks post-discharge. A total of 444 inpatients completed surveys, and 99 of these were followed up post-discharge. Of the 444, 44 (10%) were unaware of changes to medicines and 65 (16%) did not recall discussing them with a health professional, but 305 (77%) reported understanding the changes. Type of information provided and patients' perceived need for post-discharge support differed between hospitals. Information about changes was most frequently provided by consultant medical staff (157; 39%) with pharmacists providing information least often (71; 17%). One third of patients surveyed considered community pharmacists as potential sources of information about medicines and associated support post-discharge. Post-discharge, just 5% had spoken to a pharmacist, although 35% reported medicine-related problems. In north-west England, patient inclusion in treatment decisions could be improved, but provision of information prior to discharge is reasonable. There is scope to develop hospital and community pharmacists' role in medicine optimisation to maximise safety and effectiveness of care. © 2017 Royal Pharmaceutical Society.

  10. Patient characteristics, resource use and outcomes associated with general internal medicine hospital care: the General Medicine Inpatient Initiative (GEMINI) retrospective cohort study.

    Science.gov (United States)

    Verma, Amol A; Guo, Yishan; Kwan, Janice L; Lapointe-Shaw, Lauren; Rawal, Shail; Tang, Terence; Weinerman, Adina; Cram, Peter; Dhalla, Irfan A; Hwang, Stephen W; Laupacis, Andreas; Mamdani, Muhammad M; Shadowitz, Steven; Upshur, Ross; Reid, Robert J; Razak, Fahad

    2017-12-11

    The precise scope of hospital care delivered under general internal medicine services remains poorly quantified. The purpose of this study was to describe the demographic characteristics, medical conditions, health outcomes and resource use of patients admitted to general internal medicine at 7 hospital sites in the Greater Toronto Area. This was a retrospective cohort study involving all patients who were admitted to or discharged from general internal medicine at the study sites between Apr. 1, 2010, and Mar. 31, 2015. Clinical data from hospital electronic information systems were linked to administrative data from each hospital. We examined trends in resource use and patient characteristics over the study period. There were 136 208 admissions to general internal medicine involving 88 121 unique patients over the study period. General internal medicine admissions accounted for 38.8% of all admissions from the emergency department and 23.7% of all hospital bed-days. Over the study period, the number of admissions to general internal medicine increased by 32.4%; there was no meaningful change in the median length of stay or cost per hospital stay. The median patient age was 73 (interquartile range [IQR] 57-84) years, and the median number of coexisting conditions was 6 (IQR 3-9). The median acute length of stay was 4.6 (IQR 2.5-8.6) days, and the median total cost per hospital stay was $5850 (IQR $3915-$10 061). Patients received at least 1 computed tomography scan in 52.2% of admissions. The most common primary discharge diagnoses were pneumonia (5.0% of admissions), heart failure (4.7%), chronic obstructive pulmonary disease (4.1%), urinary tract infection (4.0%) and stroke (3.6%). Patients admitted to general internal medicine services represent a large, heterogeneous, resource-intensive and growing population. Understanding and improving general internal medicine care is essential to promote a high-quality, sustainable health care system. Copyright 2017

  11. [Supply prescription filling and out-of-pocket expenditures on medicines in public hospitals in Mexico in 2009].

    Science.gov (United States)

    Sesma-Vázquez, Sergio; Gómez-Dantés, Octavio; Wirtz, Veronika J; Castro-Tinoco, Manuel

    2011-01-01

    To analyze the availability of drugs in public hospitals, the prescription-filling patterns for in-patients when they are discharged and their out-of-pocket expenditure during their hospitalization. Using the National Satisfaction and Responsiveness Survey (ENSATA) 2009, which includes a representative sample of public hospitals in Mexico in 2009, the availability of 83 essential medicines in the hospital pharmacies at the day of visit, the proportion of prescriptions completely filled for patients when they are discharged and their out-of-pocket expenditure during their hospitalization were analyzed. A total of 26 271 patients in 160 public hospitals were interviewed. The mean availability of drugs was 82% for all hospitals, with the lowest availability for the Ministry of Health (SESA) hospitals (77%, with a range of 30 to 96%). Patients discharged at social security hospitals received in 97% of cases a complete prescription filling, while in SESA hospitals the average was only 56.2%, with a large variance among states (13 to 94%). The median inpatient spending was 150 pesos in national currency (1% spent over 10 000 pesos). The lack of medicines in public hospitals may increase in-patient morbidity and mortality and has an economic impact on household spending, particularly in those with scarce resources.

  12. Associations between teaching effectiveness scores and characteristics of presentations in hospital medicine continuing education.

    Science.gov (United States)

    Ratelle, John T; Wittich, Christopher M; Yu, Roger C; Newman, James S; Jenkins, Sarah M; Beckman, Thomas J

    2015-09-01

    There is little research regarding characteristics of effective continuing medical education (CME) presentations in hospital medicine (HM). Therefore, we sought to identify associations between validated CME teaching effectiveness scores and characteristics of CME presentations in the field of HM. This was a cross-sectional study of participants and didactic presentations from a national HM CME course in 2014. Participants provided CME teaching effectiveness (CMETE) ratings using an instrument with known validity evidence. Overall CMETE scores (5-point scale: 1 = strongly disagree; 5 = strongly agree) were averaged for each presentation, and associations between scores and presentation characteristics were determined using the Kruskal-Wallis test. The threshold for statistical significance was set at P teaching effectiveness scores and characteristics of effective CME presentations in HM. Our findings, which support previous research in other fields, indicate that CME presentations may be improved by increasing interactivity through the use of audience response systems and allowing longer presentations. © 2015 Society of Hospital Medicine.

  13. Measuring Value in Internal Medicine Residency Training Hospitals Using Publicly Reported Measures.

    Science.gov (United States)

    Schickedanz, Adam; Gupta, Reshma; Arora, Vineet M; Braddock, Clarence H

    2018-03-01

    Graduate medical education (GME) lacks measures of resident preparation for high-quality, cost-conscious practice. The authors used publicly reported teaching hospital value measures to compare internal medicine residency programs on high-value care training and to validate these measures against program director perceptions of value. Program-level value training scores were constructed using Centers for Medicare & Medicaid Services Value-Based Purchasing (VBP) Program hospital quality and cost-efficiency data. Correlations with Association of Program Directors in Internal Medicine Annual Survey high-value care training measures were examined using logistic regression. For every point increase in program-level VBP score, residency directors were more likely to agree that GME programs have a responsibility to contain health care costs (adjusted odds ratio [aOR] 1.18, P = .04), their faculty model high-value care (aOR 1.07, P = .03), and residents are prepared to make high-value medical decisions (aOR 1.07, P = .09). Publicly reported clinical data offer valid measures of GME value training.

  14. Medicines

    Science.gov (United States)

    Medicines can treat diseases and improve your health. If you are like most people, you need to take medicine at some point in your life. You may need to take medicine every day, or you may only need to ...

  15. The future of emergency medicine.

    Science.gov (United States)

    Schneider, Sandra M; Gardner, Angela F; Weiss, Larry D; Wood, Joseph P; Ybarra, Michael; Beck, Dennis M; Stauffer, Arlen R; Wilkerson, Dean; Brabson, Thomas; Jennings, Anthony; Mitchell, Mark; McGrath, Roland B; Christopher, Theodore A; King, Brent; Muelleman, Robert L; Wagner, Mary J; Char, Douglas M; McGee, Douglas L; Pilgrim, Randy L; Moskovitz, Joshua B; Zinkel, Andrew R; Byers, Michelle; Briggs, William T; Hobgood, Cherri D; Kupas, Douglas F; Krueger, Jennifer; Stratford, Cary J; Jouriles, Nicholas J

    2010-08-01

    The specialty of emergency medicine (EM) continues to experience a significant workforce shortage in the face of increasing demand for emergency care. In July 2009, representatives of the leading EM organizations met in Dallas for the Future of Emergency Medicine Summit. Attendees at the Future of Emergency Medicine Summit agreed on the following: 1) Emergency medical care is an essential community service that should be available to all; 2) An insufficient emergency physician workforce also represents a potential threat to patient safety; 3) Accreditation Council for Graduate Medical Education/American Osteopathic Association (AOA)-accredited EM residency training and American Board of Medical Specialties/AOA EM board certification is the recognized standard for physician providers currently entering a career in emergency care; 4) Physician supply shortages in all fields contribute to-and will continue to contribute to-a situation in which providers with other levels of training may be a necessary part of the workforce for the foreseeable future; 5) A maldistribution of EM residency-trained physicians persists, with few pursuing practice in small hospital or rural settings; 6) Assuring that the public receives high quality emergency care while continuing to produce highly skilled EM specialists through EM training programs is the challenge for EM's future; 7) It is important that all providers of emergency care receive continuing postgraduate education. Copyright 2010. Published by Elsevier Inc.

  16. System for radiation emergency medicine. Activities of tertiary radiation emergency hospitals

    International Nuclear Information System (INIS)

    Kamiya, Kenji; Tanigawa, Koichi; Hosoi, Yoshio

    2011-01-01

    Japanese system for radiation emergency medicine is primarily built up by Cabinet Nuclear Safety Commission in 2001 based on previous Tokai JCO Accident (1999) and is composed from the primary, secondary and tertiary medical organizations. This paper describes mainly about roles and actions of the tertiary facilities at Fukushima Nuclear Power Plant Accident and tasks to be improved in future. The primary and secondary organizations in the system above are set up in the prefectures with or neighboring the nuclear facility, and tertiary ones, in two parts of western and eastern Japan. The western organization is in Hiroshima University having its cooperating 7 hospitals, and is responsible for such patients as exposed to high dose external radiation, having serious complication, and difficult to treat in the primary/secondary hospitals. The eastern is in National Institute of Radiological Sciences (NIRS) with 6 cooperating hospitals and responsible for patients with internal radiation exposure difficult to treat, with contaminated body surface with difficulty in decontamination and/or with causable of secondary contamination, and difficult to treat in the secondary hospitals. The tertiary organizations have made efforts for the education and training of medical staff, for network construction among the primary, secondary and other medicare facilities, for establishment of transferring system of patients, and for participation to the international network by global organizations like Response Assistance Network (RANET) in International Atomic Energy Agency (IAEA), and Radiation Emergency Preparedness and Network (REMPAN) in World Health Organization (WHO). At the Fukushima Accident, staffs of the two tertiary hospitals began to conduct medicare on site (Mar. 12-) and learned following tasks to be improved in future: the early definition of medicare and its network system, and Emergency Planning Zone (EPZ); urgent evacuation of residents weak to disaster like elderly

  17. First, keep it safe: Integration of a complementary medicine service within a hospital.

    Science.gov (United States)

    Schiff, Elad; Levy, Ilana; Arnon, Zahi; Ben-Arye, Eran; Attias, Samuel

    2018-05-01

    This paper sought to explore risk/safety considerations associated with the integration of a complementary medicine (CM) service within a public academic medical centre in Israel. We reviewed various sources pertaining to the CM service (interviews with CM staff, patients' electronic charts, service guidelines, correspondence with hospital administration) and conducted a thematic analysis to evaluate safety-related incidents during the 7 years of operation. In addition, we systematically assessed the charts for reports of treatment-associated adverse effects, which were documented in an obligatory field on treatment reports. After reviewing transcripts of interviews with 12 CM practitioners and with the director and vice-director of the CM service as well as transcripts of 8560 consultations that included 7383 treatments, we categorised 3 major domains of CM safety management: (i) prevention of safety-related incidents by appropriate selection of CM practitioners and modalities, (ii) actual adverse incidents and (iii) prevention of their recurrence using both hospital and CM service safety protocols. CM staff reported 5 categories of adverse incidents, most of which were minor. Twenty-nine adverse incidents were documented in the 7383 treatment sessions (0.4%). Safety management needs to be addressed both before introducing CM services in hospitals and throughout their integration. Important considerations for the safe integration of CM practices in the hospital include communication between CM and conventional practitioners, adherence to hospital safety rules, implementing a systematic approach for detecting and reporting safety-related incidents and continuous adaptation of the CM service safety protocols. © 2018 John Wiley & Sons Ltd.

  18. [The department budget, in the context of the hospital global budget. Initial results in general medicine].

    Science.gov (United States)

    Besançon, F

    1984-02-23

    In a general hospital (Hôtel-Dieu, in the center of Paris), run with a global budget, budgets determined for each unit were introduced as an experiment in 1980. Physicians were in charge of certain expenses, mainly: linen, drugs, transportation of patients to and from other hospitals within Paris, and blood fractions. The whole does not exceed 4% of the turnover (FF 20 millions in 1980) of a 67 bed internal medicine unit. Other accounts deal with the stays, admissions, prescriptions of technical acts, laboratory analyses, and X-rays. In 1980, expenses were 11% more than budgeted, but the increase in stays and particularly in admissions was significantly greater. The resulting savings were 8.8% and 18.7% for stays and admissions respectively. Psychic reactions were variable. The subsequent budgets followed the fluctuations of recorded expenses, which were fairly important in both directions. The unit budget may be an advance or a regression, in a restrictive and past-perpetuating context. The coherence between the unit budget and the global hospital budget is questionable. Physicians were willing to take part in accounting and saving. They have good reason for not enlarging their financial responsibilities. Conversely, they may give more attention to diseases of public opinion.

  19. The Creation of a Pediatric Hospital Medicine Dashboard: Performance Assessment for Improvement.

    Science.gov (United States)

    Fox, Lindsay Anne; Walsh, Kathleen E; Schainker, Elisabeth G

    2016-07-01

    Leaders of pediatric hospital medicine (PHM) recommended a clinical dashboard to monitor clinical practice and make improvements. To date, however, no programs report implementing a dashboard including the proposed broad range of metrics across multiple sites. We sought to (1) develop and populate a clinical dashboard to demonstrate productivity, quality, group sustainability, and value added for an academic division of PHM across 4 inpatient sites; (2) share dashboard data with division members and administrations to improve performance and guide program development; and (3) revise the dashboard to optimize its utility. Division members proposed a dashboard based on PHM recommendations. We assessed feasibility of data collection and defined and modified metrics to enable collection of comparable data across sites. We gathered data and shared the results with division members and administrations. We collected quarterly and annual data from October 2011 to September 2013. We found comparable metrics across all sites for descriptive, productivity, group sustainability, and value-added domains; only 72% of all quality metrics were tracked in a comparable fashion. After sharing the data, we saw increased timeliness of nursery discharges and an increase in hospital committee participation and grant funding. PHM dashboards have the potential to guide program development, mobilize faculty to improve care, and demonstrate program value to stakeholders. Dashboard implementation at other institutions and data sharing across sites may help to better define and strengthen the field of PHM by creating benchmarks and help improve the quality of pediatric hospital care. Copyright © 2016 by the American Academy of Pediatrics.

  20. Nurses Caring and Patient’s Satisfaction at Internal Medicine Unit of Dr. Soetomo Hospital, Surabaya

    Directory of Open Access Journals (Sweden)

    Nur Hasanah

    2017-06-01

    Full Text Available Patient’s satisfaction is crucial for a hospital, and nursing as an integral part of health care in hospitals also determine the level of patient’s satisfaction. At the order of the clinic nurses deal directly with the public as their client. A direct relationship between the nurse and the client need a behaviour that can be accepted by the whole society. Caring as one of the basic values of nursing, is a phenomenon that affects the way to think, feel and relate to others. This study aimed to analyze the relationship between the nurses caring with patient’s satisfaction by using cross sectional design. Population of this study was patients who were treated in Internal Medicine Unit of Dr. Soetomo Hospital in November 2015. The sample size was 75 people, who were selected  by simple random sampling technique. Data collection was done by filling out the questionnaire, then anayzed by using Chi-square test. Results showed 57.33% of the patients gave judgment of satisfactory to nurse caring behaviour and 42.67% gave a good assessment. 62.67% of the patients said they were satisfied with the caring services. There was a significant relationship between nurses caring with patient satisfaction.

  1. Internal Medicine Residents' Perceived Responsibility for Patients at Hospital Discharge: A National Survey.

    Science.gov (United States)

    Young, Eric; Stickrath, Chad; McNulty, Monica C; Calderon, Aaron J; Chapman, Elizabeth; Gonzalo, Jed D; Kuperman, Ethan F; Lopez, Max; Smith, Christopher J; Sweigart, Joseph R; Theobald, Cecelia N; Burke, Robert E

    2016-12-01

    Medical residents are routinely entrusted with transitions of care, yet little is known about the duration or content of their perceived responsibility for patients they discharge from the hospital. To examine the duration and content of internal medicine residents' perceived responsibility for patients they discharge from the hospital. The secondary objective was to determine whether specific individual experiences and characteristics correlate with perceived responsibility. Multi-site, cross-sectional 24-question survey delivered via email or paper-based form. Internal medicine residents (post-graduate years 1-3) at nine university and community-based internal medicine training programs in the United States. Perceived responsibility for patients after discharge as measured by a previously developed single-item tool for duration of responsibility and novel domain-specific questions assessing attitudes towards specific transition of care behaviors. Of 817 residents surveyed, 469 responded (57.4 %). One quarter of residents (26.1 %) indicated that their responsibility for patients ended at discharge, while 19.3 % reported perceived responsibility extending beyond 2 weeks. Perceived duration of responsibility did not correlate with level of training (P = 0.57), program type (P = 0.28), career path (P = 0.12), or presence of burnout (P = 0.59). The majority of residents indicated they were responsible for six of eight transitional care tasks (85.1-99.3 % strongly agree or agree). Approximately half of residents (57 %) indicated that it was their responsibility to directly contact patients' primary care providers at discharge. and 21.6 % indicated that it was their responsibility to ensure that patients attended their follow-up appointments. Internal medicine residents demonstrate variability in perceived duration of responsibility for recently discharged patients. Neither the duration nor the content of residents' perceived responsibility was

  2. Best Practices for Interdisciplinary Care Management by Hospital Glycemic Teams: Results of a Society of Hospital Medicine Survey Among 19 U.S. Hospitals

    Science.gov (United States)

    Magee, Michelle; Ramos, Pedro; Seley, Jane Jeffrie; Nolan, Ann; Kulasa, Kristen; Caudell, Kathryn Ann; Lamb, Aimee; MacIndoe, John; Maynard, Greg

    2014-01-01

    Abstract Objective. The Society for Hospital Medicine (SHM) conducted a survey of U.S. hospital systems to determine how nonphysician providers (NPPs) are utilized in interdisciplinary glucose management teams. Methods. An online survey grouped 50 questions into broad categories related to team functions. Queries addressed strategies that had proven successful, as well as challenges encountered. Fifty surveys were electronically distributed with an invitation to respond. A subset of seven respondents identified as having active glycemic committees that met at least every other month also participated in an in-depth telephone interview conducted by an SHM Glycemic Advisory Panel physician and NPP to obtain further details. The survey and interviews were conducted from May to July 2012. Results. Nineteen hospital/hospital system teams completed the survey (38% response rate). Most of the teams (52%) had existed for 1–5 years and served 90–100% of noncritical care, medical critical care, and surgical units. All of the glycemic control teams were supported by the use of protocols for insulin infusion, basal-bolus subcutaneous insulin orders, and hypoglycemia management. However, > 20% did not have protocols for discontinuation of oral hypoglycemic agents on admission or for transition from intravenous to subcutaneous insulin infusion. About 30% lacked protocols assessing A1C during the admission or providing guidance for insulin pump management. One-third reported that glycemic triggers led to preauthorized consultation or assumption of care for hyperglycemia. Institutional knowledge assessment programs were common for nurses (85%); intermediate for pharmacists, nutritionists, residents, and students (40–45%); and uncommon for fellows (25%) and attending physicians (20%). Many institutions were not monitoring appropriate use of insulin, oral agents, or insulin protocol utilization. Although the majority of teams had a process in place for post-discharge referrals

  3. The Hospitalist Huddle: a 1-year experience of teaching Hospital Medicine utilizing the concept of peer teaching in medical education.

    Science.gov (United States)

    Elhassan, Mohammed

    2017-01-01

    The relatively new specialty of Hospital Medicine in the USA is one of the fastest growing fields in internal medicine. Academic hospitalists are largely involved in the medical education of postgraduate residents and medical students. Little is known about the effectiveness of peer-to-peer teaching in internal medicine residency training programs and how the medical residents perceive its educational value in learning Hospital Medicine. The Hospitalist Huddle is a weekly educational activity newly established by our Hospitalist Division to facilitate the concept of peer-to-peer teaching. It requires medical residents to teach and educate their peers about the clinical topics related to Hospital Medicine. Faculty hospitalists serve as facilitators during the teaching sessions. A survey disseminated at the end of the first year of its implementation examined the residents' perception of the educational value of this new teaching activity. Most residents reported that they see the Huddle as a useful educational forum which may improve their skills in teaching, create a better educational and learning environment during their inpatient rotation, and improve their understanding of Hospital Medicine. Most residents also prefer that their peers, rather than faculty hospitalists, run the activity and do the teaching. The survey results support the notion that teaching and learning with flat hierarchies can be an appealing educational method to medical residents to help them understand Hospital Medicine during their medical wards rotation. Some areas need to be improved and others need to be continued and emphasized in order to make this novel educational activity grow and flourish in terms of its educational value and residents' satisfaction.

  4. Prognostic importance of glycaemic variability on hospital mortality in patients hospitalised in Internal Medicine Departments.

    Science.gov (United States)

    Sáenz-Abad, D; Gimeno-Orna, J A; Pérez-Calvo, J I

    2015-12-01

    The objective was to assess the prognostic importance of various glycaemic control measures on hospital mortality. Retrospective, analytical cohort study that included patients hospitalised in internal medicine departments with a diagnosis related to diabetes mellitus (DM), excluding acute decompensations. The clinical endpoint was hospital mortality. We recorded clinical, analytical and glycaemic control-related variables (scheduled insulin administration, plasma glycaemia at admission, HbA1c, mean glycaemia (MG) and in-hospital glycaemic variability and hypoglycaemia). The measurement of hospital mortality predictors was performed using univariate and multivariate logistic regression. A total of 384 patients (50.3% men) were included. The mean age was 78.5 (SD, 10.3) years. The DM-related diagnoses were type 2 diabetes (83.6%) and stress hyperglycaemia (6.8%). Thirty-one (8.1%) patients died while in hospital. In the multivariate analysis, the best model for predicting mortality (R(2)=0.326; P<.0001) consisted, in order of importance, of age (χ(2)=8.19; OR=1.094; 95% CI 1.020-1.174; P=.004), Charlson index (χ(2)=7.28; OR=1.48; 95% CI 1.11-1.99; P=.007), initial glycaemia (χ(2)=6.05; OR=1.007; 95% CI 1.001-1.014; P=.014), HbA1c (χ(2)=5.76; OR=0.59; 95% CI 0.33-1; P=.016), glycaemic variability (χ(2)=4.41; OR=1.031; 95% CI 1-1.062; P=.036), need for corticosteroid treatment (χ(2)=4.03; OR=3.1; 95% CI 1-9.64; P=.045), administration of scheduled insulin (χ(2)=3.98; OR=0.26; 95% CI 0.066-1; P=.046) and systolic blood pressure (χ(2)=2.92; OR=0.985; 95% CI 0.97-1.003; P=.088). An increase in initial glycaemia and in-hospital glycaemic variability predict the risk of mortality for hospitalised patients with DM. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Medicina Interna (SEMI). All rights reserved.

  5. Experience of an eating disorders out-patient program in an internal medicine hospital.

    Science.gov (United States)

    García-García, Eduardo; Rocha-Velis, Ingrid; Vázquez-Velázquez, Verónica; Kaufer-Horwitz, Martha; Reynoso, Ricardo; Méndez, Juan Pablo

    2013-12-01

    The aim of this study was to develop a successful low budget out-patient program, in an internal medicine hospital, for patients presenting eating disorders in an emerging nation. A total of 144 patients were included in a 6 month intervention centered in medical support, with fortnightly medical consultations, monthly counseling by a nutritionist and by a psychiatrist and three psycho-educational courses. The Three Factor Eating Questionnaire and the Eating Disorders Inventory-2 were performed at the beginning and at the end of the study. After 6 months, more than half of the patients who completed the intervention were on remission. Substantial improvement was observed regarding the scores of both instruments after completion of the program. The outcome of this study compares favorably to previous published data of more intensive programs. These results were obtained having little infrastructure, a low budget and limited human resources, making this a suitable eating disorders program for emerging nations.

  6. Concurrent Use of Herbal and Orthodox Medicines among Residents of Tamale, Northern Ghana, Who Patronize Hospitals and Herbal Clinics

    Science.gov (United States)

    Ibrahim, Mohammed; Ibrahim, Halimatu-Sadia; Habib, Rabiatu Hamisu; Gbedema, Stephen Yao

    2018-01-01

    Despite the development of more researched and formulated orthodox medicines, herbal medicines continue to be well patronized for persons across the world with some patrons concurrently using both forms, oblivious of the unwanted effects that may occur. Using a multistage sampling procedure, a semistructured questionnaire was used to collect data in April 2016 from 240 informants from three selected hospitals and three herbal clinics in Tamale, a city in northern Ghana. Using Statistical Package for the Social Sciences, binary logistic regression was used to determine sociodemographic predictors of concurrent use of herbal and orthodox medicines. Orthodox medicines were the drug of choice for 54.2% and 49.2% of patrons of hospitals and herbal clinics, respectively. Also, 67.5% of herbal clinic patrons used orthodox medicines, while 25.0% of hospital attendees used herbal medications prior to their visit to the health facilities. Up to 17.9% of respondents concurrently used herbal and orthodox medicines for their prevailing ailment with age, less than 30 years being the only predictor of this habit (p = 0.015; 95% CI, 1.183–4.793; cOR = 2.4). All health professionals including those in herbal clinics should therefore be interested in the drug history of their clients. PMID:29743917

  7. Comparison of Patient Costs in Internal Medicine and Anaesthesiology Intensive Care Units in a Tertiary University Hospital.

    Science.gov (United States)

    Kara, İskender; Yıldırım, Fatma; Başak, Dilek Yumuş; Küçük, Hamit; Türkoğlu, Melda; Aygencel, Gülbin; Katı, İsmail; Karabıyık, Lale

    2015-06-01

    The allocation of the Gross Domestic Product (GDP) to health is limited, therefore it has made a need for professional management of health business. Hospital managers as well as employees are required to have sufficient knowledge about the hospital costs. Hospital facilities like intensive care units that require specialization and advanced technology have an important part in costs. For this purpose, cost analysis studies should be done in the general health business and special units separately. In this study we aimed to compare the costs of anaesthesiology and internal medicine intensive care units (ICU) roughly. After approval of this study by Gazi University Faculty of Medicine Ethics Committee, the costs of 855 patients that were hospitalized, examined and treated for at least 24 hours in internal medicine and anaesthesiology ICUs between January 2012-August 2013 (20 months period) were taken and analyzed from chief staff of the Department of Information Technology, Gazi University Hospital. At the end of the study, we observed clear differences between internal medicine and anaesthesiology ICUs arising from transactions and patient characteristics of units. We stated that these differences should be considered by Social Security Institution (SSI) for the reimbursement of the services. Further, we revealed that SSI payments do not meet the intensive care expenditure.

  8. Residents examine factors associated with 30-day, same-cause hospital readmissions on an internal medicine service.

    Science.gov (United States)

    Moran, Jennifer; Colbert, Colleen Y; Song, Juhee; Hull, Joshua; Rajan, Sabitha; Varghees, Sunita; Arroliga, Alejandro C; Reddy, Santosh P

    2013-01-01

    In recent years, there has been increased interest in stemming the tide of hospital readmissions in an attempt to improve quality of care. This study presents the Phase I results of a resident-led quality improvement initiative to determine the percentage of and risk factors for same-cause readmissions (SCRs; defined as hospital readmission within 30 days of hospital discharge for treatment of the same condition) to the internal medicine service of a multispecialty teaching hospital in central Texas. Results indicate that patients diagnosed with chronic obstructive pulmonary disease/asthma or anemia may be at increased risk for SCRs. Those patients who are insured by Medicaid and those who require assistance from social services also demonstrated an increased risk for SCRs. This study appears to be the first resident-led initiative in the field to examine 30-day SCRs to an internal medicine service for demographic and clinical risk factors.

  9. Enlargement Issues at NATO's Bucharest Summit

    National Research Council Canada - National Science Library

    Gallis, Paul; Belkin, Paul; Ek, Carl; Kim, Julie; Nichol, Jim; Woehrel, Steven

    2008-01-01

    NATO will hold a summit in Bucharest on April 2-4, 2008, and a principal issue will be the consideration of the candidacies for membership of Albania, Croatia, and the Former Yugoslav Republic of Macedonia...

  10. Global Summit on Student Affairs and Services

    African Journals Online (AJOL)

    introduced to the 3rd Global Summit on Student Affairs and Services that was hosted by Stellenbosch University (SU) in Cape Town, South Africa, this past .... students to act as partners and change agents in their educational experience.

  11. Corporate and Hospital Profiteering in Emergency Medicine: Problems of the Past, Present, and Future.

    Science.gov (United States)

    Derlet, Robert W; McNamara, Robert M; Plantz, Scott H; Organ, Matthew K; Richards, John R

    2016-06-01

    Health care delivery in the United States has evolved in many ways over the past century, including the development of the specialty of Emergency Medicine (EM). With the creation of this specialty, many positive changes have occurred within hospital emergency departments (EDs) to improve access and quality of care of the nation's de facto "safety net." The specialty of EM has been further defined and held to high standards with regard to board certification, sub-specialization, maintenance of skills, and research. Despite these advances, problems remain. This review discusses the history and evolution of for-profit corporate influence on EM, emergency physicians, finance, and demise of democratic group practice. The review also explores federal and state health care financing issues pertinent to EM and discusses potential solutions. The monopolistic growth of large corporate contract management groups and hospital ownership of vertically integrated physician groups has resulted in the elimination of many local democratic emergency physician groups. Potential downsides of this trend include unfair or unlawful termination of emergency physicians, restrictive covenants, quotas for productivity, admissions, testing, patient satisfaction, and the rising cost of health care. Other problems impact the financial outlook for EM and include falling federal, state, and private insurance reimbursement for emergency care, balance-billing, up-coding, unnecessary testing, and admissions. Emergency physicians should be aware of the many changes happening to the specialty and practice of EM resulting from corporate control, influence, and changing federal and state health care financing issues. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. A qualitative study of patient involvement in medicines management after hospital discharge: an under-recognised source of systems resilience.

    Science.gov (United States)

    Fylan, Beth; Armitage, Gerry; Naylor, Deirdre; Blenkinsopp, Alison

    2017-11-16

    There are risks to the safety of medicines management when patient care is transferred between healthcare organisations, for example, when a patient is discharged from hospital. Using the theoretical concept of resilience in healthcare, this study aimed to better understand the proactive role that patients can play in creating safer, resilient medicines management at a common transition of care. Qualitative interviews with 60 cardiology patients 6 weeks after their discharge from 2 UK hospitals explored patients' experiences with their discharge medicines. Data were initially subjected to an inductive thematic analysis and a subsequent theory-guided deductive analysis. During interviews 23 patients described medicines management resilience strategies in two main themes: identifying system vulnerabilities; and establishing self-management strategies. Patients could anticipate problems in the system that supplied them with medicines and took specific actions to prevent them. They also identified when errors had occurred both before and after medicines had been supplied and took corrective action to avoid harm. Some reported how they had not foreseen problems or experienced patient safety incidents. Patients recounted how they ensured information about medicines changes was correctly communicated and acted upon, and described their strategies to enhance their own reliability in adherence and resource management. Patients experience the impact of vulnerabilities in the medicines management system across the secondary-primary care transition but many are able to enhance system resilience through developing strategies to reduce the risk of medicines errors occurring. Consequently, there are opportunities-with caveats-to elicit, develop and formalise patients' capabilities which would contribute to safer patient care and more effective medicines management. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights

  13. Promoting mobility and reducing length of stay in hospitalized general medicine patients: A quality-improvement project.

    Science.gov (United States)

    Hoyer, Erik H; Friedman, Michael; Lavezza, Annette; Wagner-Kosmakos, Kathleen; Lewis-Cherry, Robin; Skolnik, Judy L; Byers, Sherrie P; Atanelov, Levan; Colantuoni, Elizabeth; Brotman, Daniel J; Needham, Dale M

    2016-05-01

    To determine whether a multidisciplinary mobility promotion quality-improvement (QI) project would increase patient mobility and reduce hospital length of stay (LOS). Implemented using a structured QI model, the project took place between March 1, 2013 and March 1, 2014 on 2 general medicine units in a large academic medical center. There were 3352 patients admitted during the QI project period. The Johns Hopkins Highest Level of Mobility (JH-HLM) scale, an 8-point ordinal scale ranging from bed rest (score = 1) to ambulating ≥250 feet (score = 8), was used to quantify mobility. Changes in JH-HLM scores were compared for the first 4 months of the project (ramp-up phase) versus 4 months after project completion (post-QI phase) using generalized estimating equations. We compared the relative change in median LOS for the project months versus 12 months prior among the QI units, using multivariable linear regression analysis adjusting for 7 demographic and clinically relevant variables. Comparing the ramp-up versus post-QI phases, patients reaching JH-HLM's ambulation status increased from 43% to 70% (P mobility scores between admission and discharge increased from 32% to 45% (P 7 days), were associated with a significantly greater adjusted median reduction in LOS of 1.11 (95% CI: -1.53 to -0.65, P mobility was not associated with an increase in injurious falls compared to 12 months prior on the QI units (P = 0.73). Active prevention of a decline in physical function that commonly occurs during hospitalization may be achieved with a structured QI approach. In an adult medicine population, our QI project was associated with improved mobility, and this may have contributed to a reduction in LOS, particularly for more complex patients with longer expected hospital stay. Journal of Hospital Medicine 2016. © 2016 Society of Hospital Medicine. © 2016 Society of Hospital Medicine.

  14. Is laboratory medicine ready for the era of personalized medicine? A survey addressed to laboratory directors of hospitals/academic schools of medicine in Europe

    DEFF Research Database (Denmark)

    Malentacchi, F.; Mancini, I.; Brandslund, I.

    2015-01-01

    Society of Pharmacogenomics and Personalised Therapy (ESPT). The answers of the participating laboratory medicine professionals indicate that they are aware that personalized medicine can represent a new and promising health model, and that laboratory medicine should play a key role in supporting...

  15. The medicine selection process in four large university hospitals in Brazil: Does the DTC have a role?

    Directory of Open Access Journals (Sweden)

    Elisangela da Costa Lima-Dellamora

    2015-03-01

    Full Text Available Knowledge about evidence-based medicine selection and the role of the Drug and Therapeutics Committee (DTC is an important topic in the literature but is scarcely discussed in Brazil. Our objective, using a qualitative design, was to analyze the medicine selection process performed in four large university hospitals in the state of Rio de Janeiro. Information was collected from documents, interviews with key informants and direct observations. Two dimensions were analyzed: the structural and organizational aspects of the selection process and the criteria and methods used in medicine selection. The findings showed that the DTC was active in two hospitals. The structure for decision-making was weak. DTC members had little experience in evidence-based selection, and their everyday functions did not influence their participation in DTC activities. The methods used to evaluate evidence were inadequate. The uncritical adoption of new medicines in these complex hospital facilities may be hampering pharmaceutical services, with consequences for the entire health system. Although the qualitative approach considerably limits the extent to which the results can be extrapolated, we believe that our findings may be relevant to other university hospitals in the country.

  16. Hospital doctors' self-rated skills in and use of evidence-based medicine - a questionnaire survey

    DEFF Research Database (Denmark)

    Oliveri, Roberto S; Gluud, Christian; Wille-Jørgensen, Peer A

    2004-01-01

    Problems in understanding basic aspects of evidence-based medicine (EBM) may form barriers to its implementation into clinical practice. We examined hospital doctors' skills in EBM terms and related these skills to their use of information sources, critical appraisal, and implementation of EBM...

  17. Prevalence of potential drug–drug interactions among internal medicine ward in University of Gondar Teaching Hospital, Ethiopia

    Directory of Open Access Journals (Sweden)

    Akshaya Srikanth Bhagavathula

    2014-05-01

    Conclusion: We have recorded a high rate of prevalence of potential DDI in the internal medicine ward of UOG hospital and a high number of clinically significant DDIs which the most prevalent DDI were of moderate severity. Careful selection of drugs and active pharmaceutical care is encouraged in order to avoid negative consequences of these interactions.

  18. News from the Breath Analysis Summit 2011.

    Science.gov (United States)

    Corradi, Massimo; Mutti, Antonio

    2012-06-01

    (oxygen, nitrogen, water vapour and CO(2)) in patient respiratory monitoring have served as a platform for technological growth in clinical breath-testing applications. A few exhaled breath tests have demonstrated clinical utility and are in widespread use, and several FDA-approved devices are available. These widely used exhaled breath tests include detection of blood alcohol concentration and exhaled CO(2). Other clinical applications of exhaled breath analysis include testing for H. pylori infection, lactose intolerance, heart transplant rejection and, more recently, monitoring of airway inflammation by means of exhaled NO. Examination of exhaled breath has the potential to change the existing routine approaches in human medicine. The rapidly developing new analytical and computer technologies along with novel, unorthodox ideas are prerequisites for future advances in this field. Scientists who participated in the Breath Analysis Summit 2011 were invited to submit a full length paper to the Journal of Breath Research and this issue includes eight articles which describe the different applications of breath analysis. We thank all the authors for their valuable contribution and we trust that this collection will provide useful information and an update to this rapidly evolving field, giving an example of integration among scientists who address the same topic-breath analysis-from different and complementary perspectives, from basic to clinical research.

  19. Supporting 'medicine at a distance' for delivery of hospital services in war-torn Somalia: how well are we doing?

    Science.gov (United States)

    Maalim, Abdisalan M; Zachariah, Rony; Khogali, Mohamed; Van Griensven, Johan; Van den Bergh, Rafael; Tayler-Smith, Katherine; Kizito, Walter; Baruani, Bienvenu; Osoble, Abdirahman; Abdirahman, Faiza; Ayada, Latifa; Mohamed, Abdinoor H

    2014-03-01

    We describe an innovative strategy implemented to support national staff at Istarlin Hospital in the conflict setting of Somalia; and report on inpatient morbidities, mortality and adverse hospital exit outcomes. This was a retrospective analysis of hospital data for 2011. Of 8584 admitted patients, the largest numbers were for lower respiratory tract infections (LRTI) (2114; 25%), normal deliveries (1355; 16%) and diarrhoeal diseases (715; 8%). The highest contributors to mortality were gunshot wounds in surgery (18/30; 60%), LRTIs in internal medicine (6/32; 19%) and malnutrition in paediatrics (30/81; 37%). Adverse hospital exit outcomes (deaths and absconded) were well within thresholds set by Médecins Sans Frontières. With a support package, satisfactory standards of care were met for hospital care in Somalia.

  20. Surveillance of psychosomatic disorders in internal medicine in Cipto Mangunkusumo Hospital, Jakarta, Indonesia.

    Science.gov (United States)

    Shatri, Hamzah; Mudjaddid, E; Lapau, Buchari

    2004-01-01

    to examine certain characteristics of patients who suffer from psychosomatic disorders. We called data through medical report outpatient clinic of the Psychosomatic Division, Department of internal medicine, Cipto Mangunkusumo Central General Hospital/Faculty of Medicine of the University of Indonesia (FKUI/RSUPN-CM), Jakarta, Indonesia, in 1996. The data was processed manually and by computer from which table and graphic were obtained. The descriptive analysis was performed to the objective the study. the FPD patients consisted of those with vegetative imbalance (multiple psychosomatic syndrome) (30.2%), dyspepsia (20.8%), functional heart disease (11.3%) and others 1%-6%. All of SPD consisted of chronic disease, such as hypertension (38.3%), diabetes mellitus (29.8%), bronchial asthma (10.6%), coronary artery disease (6.4%), and others 2%-5%. According to DSM IV, among the psychosomatic patients, 52.7% met the criteria for anxiety, 29.3% for depression, 14.2% for mixed anxiety and depression, and 3.8% unclear. The psychosocial stressor groups were family problems (38%), physical conditions (16%), work-related problems (13.4%), marriage problems (8.4%) and others (1%-4%). The most common physical symptoms of psychosomatic disorders were functional. Common functional psychosomatic disorders were multiple psychosomatic syndrome, dyspepsia and functional heart disease. Structural disorders found were chronic diseases. There was no difference in prevalence between males and females. The most frequent functional disorders were more commonly found among those under 40 years of age, while those with structural disorders were more common among patients 40 years of age or more. The psychological diagnoses were anxiety and depression. The most frequent psychological stressors were family problems, medical conditions, work-related problems and marriage problems.

  1. Pulmonary tuberculosis among diabetic patients in internal medicine at point g hospital, bamako - mali.

    Science.gov (United States)

    Sidibé, At; Dembélé, M; Diarra, As; Cissé, I; Bocoum, A; Traoré, Ak; Traoré, Ha

    2005-01-01

    Summary The depression of cellular immunity among diabetic patients exposes them to tuberculosis considered as one of the major diseases of immune-depressive people. The purpose of our study was to evaluate the frequency, gravity, treatment and evolution of pulmonary tuberculosis among our patients affected with diabetes. For that purpose, two descriptive retrospective and prospective studies were undertaken from January 1982 to December 1992 in the Internal Medicine (Internal medicine) department of Hospital of Point G, the national hospital. Thus, 54 diabetics patients hospitalised out of 1 365 had tuberculosis at a frequency rate of 3,95%. The average age of our patients was 49 years +/- 12 and the sex ratio was 2,18 in favour of men. The infection was also more frequent in diabetes type 1 (51,9%) then in type 2 (48,1%), and concerned mainly men (68.51%) who were more than 37 years old (57.41%). Clinically, the common signs to both affections were prevalent namely asthenia: 85,2%, anorexia: 53,7%, weight loss: 66,7%, associated to cough: 81,5% and to dyspnea: 29,6%. However, for a third of the patients (22,2%), tuberculosis was discovered during a systematic check up. All the patients had a glycemia higher than 8mmol/l, with extremes up to 8mmol/l and 32mmol/l, 63% of patient had a febricula. The intradermo cutaneous reaction to tuberculosis (IDR) was negative in 44,4%. The bacilloscopy during direct testing or through the liquid obtained by casing was positive in 64,82%. Tubercular lesions were localised at the top: 91,8%, with an equal attack of the two lungs. During the treatment six products were mainly used comprising Rifampicine (R) isoniazid (INH or H), Streptomycine (S), Ethambutol (E), Thiacetazone (T), and Pyrazinamide (Z). Insulin treatment was done on all patients until tuberculosis was cured. The evolution was favourable after 2 to 3 months of treatment for 48 patients (88,88%) among whom 4: (8,33%) fell sick again. Six patients out of 54 died, i

  2. Hospital Audit as a Useful Tool in the Process of Introducing Falsified Medicines Directive (FMD into Hospital Pharmacy Settings—A Pilot Study

    Directory of Open Access Journals (Sweden)

    Urszula Religioni

    2017-11-01

    Full Text Available Background: Recently, the European Union has introduced the Falsified Medicines Directive (FMD. Additionally, in early 2016, a Delegated Act (DA related to the FMD was published. The main objective of this study was to evaluate the usefulness of external audits in the context of implementing new regulations provided by the FMD in the secondary care environment. Methods: The external, in-person workflow audits were performed by an authentication company in three Polish hospital pharmacies. Each audit consisted of a combination of supervision (non-participant observation, secondary data analysis, and expert interviews with the use of an independently designed authorial Diagnostic Questionnaire. The questionnaire included information about hospital drug distribution procedures, data concerning drug usage, IT systems, medication order systems, the processes of medication dispensing, and the preparation and administration of hazardous drugs. Data analysis included a thorough examination of hospital documentation in regard to drug management. All data were subjected to qualitative analysis, with the aim of generating meaningful information through inductive inference. Results: Only one dispensing location in the Polish hospitals studied has the potential to be a primary authentication area. In the audited hospitals, an Automated Drug Dispensing System and unit dose were not identified during the study. Hospital wards contained an enclosed place within the department dedicated to drug storage under the direct supervision of senior nursing staff. An electronic order system was not available. In the largest center, unused medications are re-dispensed to different hospital departments, or may be sold to various institutions. Additionally, in one hospital pharmacy, pharmacists prepared parenteral nutrition and chemotherapeutic drugs for patients admitted to the hospital. Conclusions: External audits might prove beneficial in the course of introducing new

  3. Hospitability of ornamental and medicinal plants to root-knot nematode (Meloidogyne incognita race 2

    Directory of Open Access Journals (Sweden)

    Francisco José Carvalho Moreira

    2017-10-01

    Full Text Available The correct identification of species and genus of nematodes that affect a particular culture is of great importance to form a quantity of information that will be useful to laboratories for diagnosis and control of these pathogens. Because of the increase in the production of ornamental and medicinal plants in the of Cear. á State, the agricultural importance of the genus Meloidogyne and the scarcity of information on the hospitability this pathogen in these species, in that it was to evaluate the susceptibility testing of 30 species, and 20 ornamental (Antirrhimum majus, Gazania ringens, Carthamus tinctorius, Bryophyllum cayicinum, Ceasalpinia pulcherrima, Thumbergia alata, Petunia hibryda, Exacum affine, Catharanthus roseus, Opuntia sp., Sansevieria trifasciata, Asparagus densiflorus, Hibiscus mutabilis-roreus, Impatiens balsamiana, Celosia spicata, Antirrhimum sp., Dianthus chinensis, Zinnia elegans, Tagetes patula, Capsicum annuum and 10 medicinal (Peumus boldus, Ocimum gratissimum, Mentha arvensis var. piperascens, Mentha x Vilosa, Plectranthus amboinicus, Ocimum bassilicum, Rosmarinus officinalis, Cymbopogon citratus, Lippia alba, Cymbopogon winterianus. The test was conducted in a greenhouse, of the Phytosanitary Sector, Department of Plant Science, Federal University of Ceará. The inoculation was conducted with 4,000 eggs/J2 for pot. Evaluation of the plants gave to 60 days after inoculation. Evaluated is the reaction of the plants, measuring up: number of galls and eggs, egg mass index, reproduction factor and reduce the reproduction factor. From these variables it was classified the reaction of plants to the nematode by means of five criterions. Of ownership of the results, it was verified that of the ornamental plants only species T. patula didn’t presented galls in your root system. Concerning medicinal species M. vilosa, C. citrates, L. alba, C. winterianus and P. boldus showed no galls in their root systems. Thus, concluded

  4. [Laboratory medicine in the obligatory postgraduate clinical training system--common clinical training program in the department of laboratory medicine in our prefectural medical university hospital].

    Science.gov (United States)

    Okamoto, Yasuyuki

    2003-04-01

    I propose a postgraduate common clinical training program to be provided by the department of laboratory medicine in our prefectural medical university hospital. The program has three purposes: first, mastering basic laboratory tests; second, developing the skills necessary to accurately interpret laboratory data; third, learning specific techniques in the field of laboratory medicine. For the first purpose, it is important that medical trainees perform testing of their own patients at bedside or in the central clinical laboratory. When testing at the central clinical laboratory, instruction by expert laboratory technicians is helpful. The teaching doctors in the department of laboratory medicine are asked to advise the trainees on the interpretation of data. Consultation will be received via interview or e-mail. In addition, the trainees can participate in various conferences, seminars, and meetings held at the central clinical laboratory. Finally, in order to learn specific techniques in the field of laboratory medicine, several special courses lasting a few months will be prepared. I think this program should be closely linked to the training program in internal medicine.

  5. Overspecialized and undertrained? Patient diversity encountered by medical students during their internal medicine clerkship at a university hospital.

    Science.gov (United States)

    Melderis, Simon; Gutowski, Jan-Philipp; Harendza, Sigrid

    2015-03-31

    During the four-month internal medicine clerkship in their final year, undergraduate medical students are closely involved in patient care. Little is known about what constitutes their typical learning experiences with respect to patient diversity within the different subspecialties of internal medicine and during on call hours. 25 final year medical students (16 female, 9 male) on their internal medicine clerkship participated in this observational single-center study. To detail the patient diversity encountered by medical students at a university hospital during their 16-week internal medicine clerkship, all participants self-reported their patient contacts in the different subspecialties and during on call hours on patient encounter cards. Patients' chief complaint, suspected main diagnosis, planned diagnostic investigations, and therapy in seven different internal medicine subspecialties and the on call medicine service were documented. 496 PECs were analysed in total. The greatest diversity of chief complaints (CC) and suspected main diagnoses (SMD) was observed in patients encountered on call, with the combined frequencies of the three most common CCs or SMDs accounting for only 23% and 25%, respectively. Combined, the three most commonly encountered CC/SMD accounted for high percentages (82%/63%), i.e. less diversity, in oncology and low percentages (37%/32%), i.e. high diversity, in nephrology. The percentage of all diagnostic investigations and therapies that were classified as "basic" differed between the subspecialties from 82%/94% (on call) to 37%/50% (pulmonology/oncology). The only subspecialty with no significant difference compared with on call was nephrology for diagnostic investigations. With respect to therapy, nephrology and infectious diseases showed no significant differences compared with on call. Internal medicine clerkships at a university hospital provide students with a very limited patient diversity in most internal medicine

  6. Relationship between Personality Profiles and Suicide Attempt via Medicine Poisoning among Hospitalized Patients: A Case-Control Study.

    Science.gov (United States)

    Shafiee-Kandjani, Ali Reza; Amiri, Shahrokh; Arfaie, Asghar; Ahmadi, Azadeh; Farvareshi, Mahmoud

    2014-01-01

    Objectives. Inflexible personality traits play an important role in the development of maladaptive behaviors among patients who attempt suicide. This study was conducted to investigate the relationship between personality profiles and suicide attempt via medicine poisoning among the patients hospitalized in a public hospital. Materials and Methods. Fifty-nine patients who attempted suicide for the first time and hospitalized in the poisoning ward were selected as the experimental group. Sixty-three patients hospitalized in the other wards for a variety of reasons were selected as the adjusted control group. Millon Clinical Multiaxial Personality Inventory, 3rd version (MCMI-III) was used to assess the personality profiles. Results. The majority of the suicide attempters were low-level graduates (67.8% versus 47.1%, OR = 2.36). 79.7% of the suicide attempters were suffering from at least one maladaptive personality profile. The most common maladaptive personality profiles among the suicide attempters were depressive personality disorder (40.7%) and histrionic personality disorder (32.2%). Among the syndromes the most common ones were anxiety clinical syndrome (23.7%) and major depression (23.7%). Conclusion. Major depression clinical syndrome, histrionic personality disorder, anxiety clinical syndrome, and depressive personality disorder are among the predicators of first suicide attempts for the patients hospitalized in the public hospital due to the medicine poisoning.

  7. Social deprivation, population dependency ratio and an extended hospital episode - Insights from acute medicine.

    Science.gov (United States)

    Cournane, Seán; Dalton, Ann; Byrne, Declan; Conway, Richard; O'Riordan, Deirdre; Coveney, Seamus; Silke, Bernard

    2015-11-01

    Patients from deprived backgrounds have a higher in-patient mortality following an emergency medical admission; this study aimed to investigate the extent to which Deprivation status and the population Dependency Ratio influenced extended hospital episodes. All Emergency Medical admissions (75,018 episodes of 41,728 patients) over 12 years (2002-2013) categorized by quintile of Deprivation Index and Population Dependency Rates (proportion of non-working/working) were evaluated against length of stay (LOS). Patients with an Extended LOS (ELOS), >30 days, were investigated, by Deprivation status, Illness Severity and Co-morbidity status. Univariate and multi-variable risk estimates (Odds Rates or Incidence Rate Ratios) were calculated, using truncated Poisson regression. Hospital episodes with ELOS had a frequency of 11.5%; their median LOS (IQR) was 55.0 (38.8, 97.6) days utilizing 57.6% of all bed days by all 75,018 emergency medical admissions. The Deprivation Index independently predicted the rate of such ELOS admissions; these increased approximately five-fold (rate/1000 population) over the Deprivation Quintiles with model adjusted predicted admission rates of for Q1 0.93 (95% CI: 0.86, 0.99), Q22.63 (95% CI: 2.55, 2.71), Q3 3.84 (95% CI: 3.77, 3.91), Q4 3.42 (95% CI: 3.37, 3.48) and Q5 4.38 (95% CI: 4.22, 4.54). Similarly the Population Dependency Ratio Quintiles (dependent to working structure of the population by small area units) independently predicted extended LOS admissions. The admission of patients with an ELOS is strongly influenced by the Deprivation status and the population Dependency Ratio of the catchment area. These factors interact, with both high deprivation and Dependency cohorts having a major influence on the numbers of emergency medical admission patients with an extended hospital episode. Copyright © 2015 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  8. Environmental iodine intake and pattern of thyroid diseases: experience at nuclear medicine centre, Mayo Hospital (abstract)

    International Nuclear Information System (INIS)

    Elahi, S.; Khan, M.; Rasool, S.; Khalid, A.; Tasneem, A.

    2011-01-01

    To know level of iodine intake in women residing in Lahore and correlate it with pattern of thyroid diseases found in women referred to Centre for Nuclear Medicine (CENUM), Mayo Hospital. Iodine intake status was determined by urinary iodine (UI) excretion by Sandell-Kolthoff reaction. Thyroid related hormones (FT4, FT3 and TSH) were measured by radioimmunoassay. In 110 non-pregnant euthyroid women (age 20-36 year) average iodine intake was 66.3 +- 14.4 mu g/L (range: 30-98 mu g/dL). All women were iodine deficient (UI 22.0 pmol/L and TSH greater or equal to 0.1mIU/L) was detected in 580(10.8%) women and hypothyroidism (FT4 0.4mIU/L) was found in 271(5.1%) women. Thus incidence of hyperthyroidism was almost double than that of hypothyroidism. Low iodine intake is manifested as increased incidence of hyperthyroidism. (author)

  9. Association between Internet addiction and depression in Thai medical students at Faculty of Medicine, Ramathibodi Hospital.

    Science.gov (United States)

    Boonvisudhi, Thummaporn; Kuladee, Sanchai

    2017-01-01

    To study the extent of Internet addiction (IA) and its association with depression in Thai medical students. A cross-sectional study was conducted at Faculty of Medicine, Ramathibodi Hospital. Participants were first- to fifth-year medical students who agreed to participate in this study. Demographic characteristics and stress-related factors were derived from self-rated questionnaires. Depression was assessed using the Thai version of Patient Health Questionnaire (PHQ-9). A total score of five or greater derived from the Thai version of Young Diagnostic Questionnaire for Internet Addiction was classified as "possible IA". Then chi-square test and logistic regression were used to evaluate the associations between possible IA, depression and associated factors. From 705 participants, 24.4% had possible IA and 28.8% had depression. There was statistically significant association between possible IA and depression (odds ratio (OR) 1.92, 95% confidence interval (CI): 1.34-2.77, P-value depression in possible IA group was 1.58 times of the group of normal Internet use (95% CI: 1.04-2.38, P-value = 0.031). Academic problems were found to be a significant predictor of both possible IA and depression. IA was likely to be a common psychiatric problem among Thai medical students. The research has also shown that possible IA was associated with depression and academic problems. We suggest that surveillance of IA should be considered in medical schools.

  10. Preparing for the aged in investigative medicine in a General Hospital setting

    International Nuclear Information System (INIS)

    Richards, P.A.C.

    1998-01-01

    Full text: The inequalities which exist today between the health of various sectors of society have grown partly out of the different rates of improvement experienced during the 18th, 19th and 20th Centuries. This is especially so for social class, racial and regional differences. Differential health problems between various age groups and disease groups have probably arisen for other reasons. People can now expect to live well into their 70s or early 80s. Many things have contributed to these health gains, including improved public health measures, high quality clinical treatment services, social and environmental conditions and lifestyle changes. The purpose of this paper is to highlight the major health problems of the community served by the Department of Nuclear Medicine at the Launceston General Hospital (Northern Regional Health) with the following perspectives: (i) How an ageing population is impacting in the level of service; (ii) How the aged are to be managed during investigation, after care and follow-up; and (iii) Major areas of investigations and age group analysis

  11. A matter of priorities? Exploring the persistent gender pay gap in hospital medicine.

    Science.gov (United States)

    Weaver, A Charlotta; Wetterneck, Tosha B; Whelan, Chad T; Hinami, Keiki

    2015-08-01

    Gender earnings disparities among physicians exist even after considering differences in specialty, part-time status, and practice type. Little is known about the role of job satisfaction priorities on earnings differences. To examine gender differences in work characteristics and job satisfaction priorities, and their relationship with gender earnings disparities among hospitalists. Observational cross-sectional survey study. US hospitalists in 2010. Self-reported income, work characteristics, and priorities among job satisfaction domains. On average, women compared to men hospitalists were younger, less likely to be leaders, worked fewer full-time equivalents, worked more nights, reported fewer daily billable encounters, more were pediatricians, worked in university settings, worked in the Western United States, and were divorced. More hospitalists of both genders prioritized optimal workload among the satisfaction domains. However, substantial pay ranked second in prevalence by men and fourth by women. Women hospitalists earned $14,581 less than their male peers in an analysis adjusting for these differences. The gender earnings gap persists among hospitalists. A portion of the disparity is explained by the fewer women hospitalists compared to men who prioritize pay. © 2015 Society of Hospital Medicine.

  12. 50th Year Anniversary of Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University.

    Science.gov (United States)

    Lertakyamanee, Jariya

    2016-05-01

    Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, has started to be a formal anesthesia division, divided from division of Surgery in 1965; hence our 50th year anniversary in 2015. Research is now a priority and mandatory mission, according to the vision of Mahidol University. Second mission is to teach and train, and we produce the highest number of states-of-the-art anesthesiologists and anesthetic nurses each year Curriculum and training are being continuously improved. From a small unit, now it is one of the largest departments and extends the service, our third mission, to more than only in the operating theaters. We look after pre-anesthesia assessment, inside and outside operating room anesthesia, post-operative pain relief Intensive Care Unit, and chronic pain management. The number of patients and their diseases increase; so do the complexities of surgeries. There are tremendous changes in drugs and equipment. There is the fourth mission on administration, IT and resource management. And the fifth mission which is corporate social responsibility. However, we still believe that compassion, responsibility and integrity are most important. We have taught and tried to live by the teaching of HRH the King's Father. And these will contribute to our progress and shine in the next 50 years.

  13. Allocation of Internal Medicine Resident Time in a Swiss Hospital: A Time and Motion Study of Day and Evening Shifts.

    Science.gov (United States)

    Wenger, Nathalie; Méan, Marie; Castioni, Julien; Marques-Vidal, Pedro; Waeber, Gérard; Garnier, Antoine

    2017-04-18

    Little current evidence documents how internal medicine residents spend their time at work, particularly with regard to the proportions of time spent in direct patient care versus using computers. To describe how residents allocate their time during day and evening hospital shifts. Time and motion study. Internal medicine residency at a university hospital in Switzerland, May to July 2015. 36 internal medicine residents with an average of 29 months of postgraduate training. Trained observers recorded the residents' activities using a tablet-based application. Twenty-two activities were categorized as directly related to patients, indirectly related to patients, communication, academic, nonmedical tasks, and transition. In addition, the presence of a patient or colleague and use of a computer or telephone during each activity was recorded. Residents were observed for a total of 696.7 hours. Day shifts lasted 11.6 hours (1.6 hours more than scheduled). During these shifts, activities indirectly related to patients accounted for 52.4% of the time, and activities directly related to patients accounted for 28.0%. Residents spent an average of 1.7 hours with patients, 5.2 hours using computers, and 13 minutes doing both. Time spent using a computer was scattered throughout the day, with the heaviest use after 6:00 p.m. The study involved a small sample from 1 institution. At this Swiss teaching hospital, internal medicine residents spent more time at work than scheduled. Activities indirectly related to patients predominated, and about half the workday was spent using a computer. Information Technology Department and Department of Internal Medicine of Lausanne University Hospital.

  14. Reasons given by hypertensive patients for concurrently using traditional and Western medicine at Natalspruit Hospital in the Gauteng Province, South Africa

    Science.gov (United States)

    Mabuza, Langalibalele H.; Okonta, Henry I.

    2013-01-01

    Abstract Background In 2007, a large number of hypertensive patients seen at Natalspruit Hospital had poor adherent to their anti-hypertension treatment which manifested itself through poor blood pressure control. On enquiry, they revealed that they were also taking traditional medicines. Objectives To explore the reasons given by hypertensive patients for concurrently using traditional and Western medicine. Methods A qualitative study was conducted amongst nine purposefully selected participants attending treatment at the hospital. Interviews were conducted in the Southern Sotho and IsiZulu languages and were audio-taped. The exploratory question was: ‘Would you tell us why you are taking traditional medicine together with the antihypertensive medicine your are receiving at this hospital?’ The transcribed and translated transcriptions were analysed using the ‘cut and paste’ method to identify themes. Results Themes that emerged were that traditional medicine was readily accessible; traditional healers displayed knowledge and confidence in their medicine; traditional medicine was perceived to counteract the side-effects of western medicine; the two streams were perceived to complement each other and both streams could lead to a ‘cure’. Patients were disappointed at the perceived bad attitude of the hospital staff. Conclusion The reasons given by hypertensive patients for their concurrent use of traditional and Western medicine centred around patients’ relatively favourable perception of traditional medicine and its practitioners. Western medicine health care practitioners should continue health education on antihypertensive medication in a manner acceptable to patients.

  15. Report on World Homoeopathy Summit organized by Global Homeopathy Foundation

    Directory of Open Access Journals (Sweden)

    Eswara Das

    2015-01-01

    Full Text Available The Global Homeopathy Foundation (GHF organized the World Homoeopathy Summit (WHS at Birla Matoshree Sabhaghar, Mumbai, 400020, India on 11-12 April, 2015. Ministry of AYUSH, Central Council for Research in Homoeopathy, Central Council of Homoeopathy and Homoeopathic Pharmacopeia Laboratory were the institutional collaborators. Homoeopathic Medical Association of India, Indian Homoeopathic Medical Association and the Indian Chapter of Liga Medicorum Homeopathica Internationalis supported the event. The WHS was aimed at enhancing research aptitudes of young homoeopaths, increasing clinical proficiency of practitioners, encouraging scientists from pure and applied sciences to associate in fundamental research and also inviting government as well as non government institutions to patronize research in Homoeopathy. About 800 delegates from across the country, mainly practitioners, teaching faculties, postgraduate students, Ph.D. scholars and scientists attended the summit. Scientific sessions on nature of homoeopathic medicine, Evidence and Mechanism of its action were presented by molecular biologists, engineers, physicists, immunologists, pharmacologists, chemists, nano-technologists, zoologists, homeopaths and conventional doctors from some of the premium Universities. The conference ended with panel discussion moderated by Dr. Raj K. Manchanda and Dr. Rajesh Shah. It was recommended to encourage more scientific research and better documentation in Homoeopathy and to review the existing approaches in practice.

  16. The subjectively perceived quality of postgraduate medical training in integrative medicine within the public healthcare systems of Germany and Switzerland: the example of anthroposophic hospitals

    OpenAIRE

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

    2014-01-01

    Background Integrative medicine (IM) integrates evidence-based Complementary and Alternative Medicine (CAM) with conventional medicine (CON). Medical schools offer basic CAM electives but in postgraduate medical training (PGMT) little has been done for the integration of CAM. An exception to this is anthroposophic medicine (AM), a western form of CAM based on CON, offering an individualized holistic IM approach. AM hospitals are part of the public healthcare systems in Germany and Switzerland...

  17. Working towards implementation of a nuclear medicine accreditation program in a South African teaching hospital

    International Nuclear Information System (INIS)

    Eiselen, T.; Ellmann, A.

    2004-01-01

    Full text: Introduction: Quality assurance in Nuclear Medicine is of utmost importance in order to ensure optimal scintigraphic results and correct patient management and care. The implementation of a good quality assurance program should address all factors that playa role in the optimal functioning of a department. It should be developed by scientific findings as well as national and international guidelines. Aim: To develop a tailor made program that can be managed according to the individual needs and requirements of a Nuclear Medicine department in a teaching hospital. This program is aimed at international accreditation of the department. Materials and methods: Auditing of the following aspects was conducted: organizational, clinical and technical, personnel satisfaction, patient experience and satisfaction, referring physicians experience and satisfaction. Information was collected by means of questionnaires to groups and individuals for opinion polls; one-to-one interviews with personnel and patients; technical evaluation of equipment according to manufacturer's specifications and international standards; laboratory equipment evaluation according to precompiled guidelines and investigation of laboratory procedures for standardization and radiation safety. Existing procedure protocols were measured against international guidelines and evaluated for possible shortcomings of technical as well as cosmetic details, and data storage facilities were evaluated in terms of user friendliness, viability and cost effectiveness. A number of international accreditation experts were also visited to establish the validity of our results. Results: Patient questionnaires indicated overall satisfaction with personal service providing, but provision of written and understandable information, long waiting periods and equipment must receive attention. Staff questionnaires indicated a general lack of communication between different professional groups and the need for

  18. The Pipeline From Abstract Presentation to Publication in Pediatric Hospital Medicine.

    Science.gov (United States)

    Herrmann, Lisa E; Hall, Matthew; Kyler, Kathryn; Cochran, Joseph; Andrews, Annie L; Williams, Derek J; Wilson, Karen M; Shah, Samir S

    2018-02-01

    The annual Pediatric Hospital Medicine (PHM) conference serves as a venue for the dissemination of research in this rapidly growing discipline. A measure of research validity is subsequent publication in peer-reviewed journals. To identify the publication rate of abstracts submitted to the 2014 PHM conference and determine whether presentation format was associated with subsequent journal publication or time to publication. We identified abstracts submitted to the 2014 PHM conference. Presentation formats included rejected abstracts and poster and oral presentations. Abstracts subsequently published in journals were identified by searching the author and abstract title in PubMed, MedEdPORTAL, and Google Scholar. We used logistic regression and Cox proportional hazards models to determine if presentation format was associated with publication, time to publication, and publishing journal impact factor. Of 226 submitted abstracts, 19.0% were rejected, 68.0% were selected for posters, and 12.8% were selected for oral presentations; 36.3% were subsequently published within 30 months after the conference. Abstracts accepted for oral presentation had more than 7-fold greater odds of publication (adjusted odds ratio 7.8; 95% confidence interval [CI], 2.6-23.5) and a 4-fold greater likelihood of publication at each month (adjusted hazard ratio 4.5; 95% CI, 2.1-9.7) compared with rejected abstracts. Median journal impact factor was significantly higher for oral presentations than other presentation formats (P presentation; however, the low overall publication rate may indicate that presented results are preliminary or signify a need for increased mentorship and resources for research development in PHM.

  19. International Summit on Integrated Environmental Modeling

    Science.gov (United States)

    This report describes the International Summit on Integrated Environmental Modeling (IEM), held in Washington, DC 7th-9th December 2010. The meeting brought together 57 scientists and managers from leading US and European government and non-governmental organizations, universitie...

  20. Report from the 2012 European Gender Summit

    CERN Document Server

    European Gender Summit, 2012

    2012-01-01

    Report from the 2012 European Gender Summit to the European Parliament and the Council, the European Commission, the Council of Europe, EU Member and Associate States, Science Institutions. Developing Systematic Implementation Strategy to Advance EU Policy on Gender Equality in Science, as part of HORIZON 2020, European Research Area and Innovation Union.

  1. Geneva summit aims to bridge 'digital divide'

    CERN Multimedia

    Williams, F

    2003-01-01

    "With almost all the political hurdles swept aside in negotiations last weekend, the huge World Summit on the Information Society that opens in Geneva today will be clearly focused on its initial objective - boosting the use of information and communication technologies in the developing world" (1 page).

  2. The Challenge of "Fixing the Debt": Recommendations from the Summit.

    Science.gov (United States)

    Harris, Donna L; Chaddock, Harry M

    2018-01-01

    With education debt repayment taking up a significant amount of veterinarians' salaries, for a significant time into the working years, concern has been building that the current debt to starting salary ratio in the veterinary profession is not sustainable. The current ratio is 1.99:1, but it can be significantly higher for students who attend schools as an out-of-state resident. In April, 180 people concerned about this issue gathered at Michigan State University's College of Veterinary Medicine for a Fix the Debt Summit, which focused on actions that would reduce this ratio to a more sustainable level. Attendees were students; new graduates; those working in veterinary academia; employers of veterinarians; and those affiliated with the profession, such as professional associations. As solutions were proposed, participants also committed to taking action within their field of influence.

  3. Use of Herbal Medicine Among Pregnant Women on Antenatal Care at Nekemte Hospital, Western Ethiopia

    OpenAIRE

    Bayisa, Bodena; Tatiparthi, Ramanjireddy; Mulisa, Eshetu

    2014-01-01

    Background: Investigations across the world confirm dramatic increment in the use of complementary and alternative medicine in pregnant women. The most important aspect is lack of awareness of pregnant women about potential effects of using traditional medicine on fetus; some herbal products may be teratogenic in human and animal models. In this area, so far, no research has been conducted in Ethiopia to assess traditional medicine use in pregnant women. Objectives: Therefore, the main object...

  4. Barriers to Research Utilization among Registered Nurses in Traditional Chinese Medicine Hospitals: A Cross-Sectional Survey in China

    Directory of Open Access Journals (Sweden)

    Fen Zhou

    2015-01-01

    Full Text Available Background. As there might be relevant differences with regard to research utilization in the general hospitals, we aimed to study research utilization among registered nurses working in traditional Chinese medicine hospitals. Methods. A total of 648 registered nurses from 4 tertiary-level hospitals in China were recruited for participation. A modified BARRIERS Scale and self-designed questionnaires were used for data collection. Data were analyzed with descriptive statistics, t-tests, and one-way ANOVAs and Spearman correlation analysis. Results. Overall, items which belong to the subscale “Research” were identified as the most important barriers. Among the individual items, the lack of time on the job was ranked as the top barrier, followed by the lack of knowledgeable colleagues and by overwhelming research publications. Clinical experience, working pressure, job satisfaction, and research experience could be identified as associated factors for barriers to research utilization. Conclusions. Registered nurses in traditional Chinese medicine hospitals felt high barriers to research utilization. Reducing registered nurses’ working pressure, promoting their positive attitude to nursing, and improving research training might be helpful for increasing research utilization. Close cooperation between clinical and nursing schools or academic research centres might facilitate the necessary change in nursing education and routine.

  5. Accomplishments and future suggestions of 2012 seoul nuclear security summit

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jae San [Korea Institute of Nuclear Nonproliferation and Control, Daejeon (Korea, Republic of)

    2012-10-15

    The second Seoul Nuclear Security Summit was held in Seoul, March 26{approx}27, 2012. It was a very big political event for nuclear security. National and International organization leaders had a time to discuss in depth issues about nuclear security; nuclear terrorism, illicit trafficking of nuclear /radiological materials, sabotages for nuclear facilities, etc. Why did many national leaders still take part in the second nuclear security summit compared to Washington summit and what is the importance of nuclear security? This paper will be the answer from those questions and handle the background, outcomes and future tasks of nuclear security summit. And suggestions for the next summits were considered in the conclusion part.

  6. Accomplishments and future suggestions of 2012 seoul nuclear security summit

    International Nuclear Information System (INIS)

    Kim, Jae San

    2012-01-01

    The second Seoul Nuclear Security Summit was held in Seoul, March 26∼27, 2012. It was a very big political event for nuclear security. National and International organization leaders had a time to discuss in depth issues about nuclear security; nuclear terrorism, illicit trafficking of nuclear /radiological materials, sabotages for nuclear facilities, etc. Why did many national leaders still take part in the second nuclear security summit compared to Washington summit and what is the importance of nuclear security? This paper will be the answer from those questions and handle the background, outcomes and future tasks of nuclear security summit. And suggestions for the next summits were considered in the conclusion part

  7. Quality Control and Complication Screening Programme of Chinese Medicinal Drugs at the First German Hospital of Traditional Chinese Medicine - A Retrospective Analysis.

    Science.gov (United States)

    Melchart, Dieter; Hager, Stefan; Dai, Jingzhang; Weidenhammer, Wolfgang

    2016-01-01

    The use of drugs derived from plants is a cornerstone of Traditional Chinese Medicine (TCM). Yet, too little is known about risk and safety of Chinese medicinal drugs (CMD). Therefore, the TCM hospital Bad Kötzting has developed a quality control and complication screening programme in order to ensure a safe administration of TCM drugs to their patients. All Chinese medicinal drugs delivered to the hospital between September 1, 2012 and December 31, 2013 entered the quality control program and were screened for microbial contamination, aflatoxin, pesticides and heavy metals. A routinely applied complication screening programme monitored liver enzymes in all patients. Case causality assessment by CIOMS scale and identification of admitted herbs were conducted. Additionally, side effects of patients were identified by a routinely performed web-based documentation system. In 5 of 23 investigated samples (21.7%) the initial testing showed microbial contamination (2), pesticide (2) and heavy metals (1). The drugs were tested for authenticity and adulterations, respectively. All 994 patients (mean age 52.6 years; 72.6% female) admitted were available for analysis. 448 (45.1%) of all patients reported having perceived at least one side effect of treatment. They experienced mainly gastrointestinal symptoms (13.6%), neurovegetative symptoms (10.8 %), temporary deteriorations of pain (8.8%), diarrhoea (5.9%), nausea (1.6%) and vomiting (0.5%). Further, 6 patients with a more than 2-fold elevation (compared to maximum normal value or elevated admission values) of ALT were found in the systematic laboratory control with a non-conclusive causality assessment for TCM-drugs. Approximate incidence rates and analysed drugs associated with liver damage revealed a low rate of liver injury. Patients should be informed of the gastrointestinal symptoms caused by and potential hepatotoxicity of TCM herbs. © 2016 S. Karger GmbH, Freiburg.

  8. A novel organizational model to face the challenge of multimorbid elderly patients in an internal medicine setting: a case study from Parma Hospital, Italy.

    Science.gov (United States)

    Meschi, Tiziana; Ticinesi, Andrea; Prati, Beatrice; Montali, Arianna; Ventura, Antonio; Nouvenne, Antonio; Borghi, Loris

    2016-08-01

    Continuous increase of elderly patients with multimorbidity and Emergency Department (ED) overcrowding are great challenges for modern medicine. Traditional hospital organizations are often too rigid to solve them without consistently rising healthcare costs. In this paper we present a new organizational model achieved at Internal Medicine and Critical Subacute Care Unit of Parma University Hospital, Italy, a 106-bed internal medicine area organized by intensity of care and specifically dedicated to such patients. The unit is partitioned into smaller wards, each with a specific intensity level of care, including a rapid-turnover ward (mean length of stay model, compared with other peer units of the hospital and of other teaching hospitals of the region, showed a better performance, efficacy and effectiveness indexes calculated on Regional Hospital Discharge Records database system, allowing a capacity to face a massive (+22 %) rise in medical admissions from the ED. Further studies are needed to validate this model from a patient outcome point of view.

  9. Complementary Medicine and the Role of Oncology Nurses in an Acute Care Hospital: The Gap Between Attitudes and Practice.

    Science.gov (United States)

    Admi, Hanna; Eilon-Moshe, Yael; Ben-Arye, Eran

    2017-09-01

    To describe hospital nurses' knowledge, attitudes, and practices regarding complementary medicine (CM); to compare the knowledge and attitudes of nurse managers to staff nurses with diverse oncology experience; and to assess attitudes toward integrating CM into the role of the hospital oncology nurse. 
. Descriptive, cross-sectional study.
. Rambam Health Care Campus in northern Israel.
. A convenience sample of 434 hospital nurses with varied oncology experience.
. Nurses completed a knowledge and attitude questionnaire developed for the current study. Data were analyzed using parametric and nonparametric statistical tests. 
. Hospital nurses' knowledge of and attitudes toward CM, and attitudes toward integrating CM into the role of the hospital oncology nurse.
. Nurses lack knowledge and are unaware of the risks associated with CM. However, they believe this approach can improve the quality of life of patients with cancer; 51% expressed an interest in receiving training. Oncology nurses were ambivalent about the feasibility of applying an integrative approach, whereas nurse managers expressed significantly more positive attitudes toward integrating CM within the scope of nursing practices.
. A large discrepancy remains between nurses' strong interest in CM and awareness of associated benefits, and their ambivalence toward its integration in their nursing practice. 
. Although improving nurses' knowledge should be mandatory, it remains insufficient; a shift in the approach to integrating CM into conventional health care is needed, from practitioners' responsibility to healthcare policymakers' responsibility. Legislations and policies are necessary, along with providing respectable infrastructures.

  10. Epidemiology, species distribution, antifungal susceptibility and outcome of candidemia among Internal Medicine Wards of community hospitals of Udine province, Italy

    Directory of Open Access Journals (Sweden)

    Federico Silvestri

    2014-09-01

    Full Text Available Candidemia is an emerging problem among patients hospitalized in Internal Medicine Wards (IMW. We performed a retrospective study to assess the epidemiology, species distribution, antifungal susceptibility and outcome of candidaemia recorded over a 3-year period (2010-2012 among IMW of community hospitals of Udine province in Italy: forty-eight patients were identified, with an overall incidence of 1.44 cases/1000 hospital admissions/year. Candida albicans was the most frequent species, followed by Candida parapsilosis that accounted for 42.9% of Tolmezzo cases. All isolates were susceptible to amphotericin and caspofungin, while 11.4% of strains were not-susceptible to voriconazole and 14.3% to fluconazole. Crude mortality was 41.7%. In conclusion, in community hospitals overall incidence of candidemia is similar to tertiary care hospitals, but 80% of cases are detected in IMW. Candida species distribution is overlapping, but differences in local epidemiology were found and should be taken into consideration. No resistance to amphotericin and caspofungin was found while resistance to azoles was observed. Knowledge of this data might be useful when planning the best therapeutic strategy.

  11. Internal medicine network: a new way of thinking hospital-territory integration and public-private partnership

    Directory of Open Access Journals (Sweden)

    Filomena Pietrantonio

    2016-10-01

    Full Text Available This working proposal aims to establish an Internal Medicine Network (IMN model for the appropriate management of the poly-pathological complex patient in the different phases of his illness natural hystory. The IMN is based on an organization recalling the Hub and Spoke system already used for existing specialized networks. The Internal Medicine Unit (IMU is the natural destination of acutely ill patients suffering from systemic or multi-organ diseases. Three are the IMU specific tasks: i to stabilize acute, severe, poly-pathologic and complex patients; ii to develop difficult etiological diagnosis in these patients and in those who should necessarily be admitted to the hospital, not being possible, for different reasons, alternative routes; iii to select the acute poly-pathological complex patient’s priorities. The expected results of a new model of integration system inside the IMN are: i reduction and rationalization of expenditure in the medical area, increasing effectiveness, quality and safety guaranteeing patient centrality; ii patients stratification based on characteristics of gravity, acute illness, estimated duration of hospitalization; iii reduction of inappropriate hospital admissions ensuring connections between hospital and primary care units; iv definition of different care pathways for patients hospitalized due to non-communicable diseases; v implementation of new common medical records. The public-private partnership inside the IMN could be able to increase appropriateness reducing health costs. Patient-centered problems assessment, together with integration, cooperation, coordination and effective communication are some simple rules useful to achieve tangible results in a complex system and the IMN model represents its practical application.

  12. Nuclear terrorism: after the Washington summit

    International Nuclear Information System (INIS)

    Hautecouverture, Benjamin

    2016-01-01

    In this note, the author comments the issues addressed by the 2016 Nuclear Safety Summit (NSS) of Washington, and the content of its final statement. He notices that the scope of addressed topics has evolved since the first summits (issues related to highly enriched uranium and to plutonium), that not only technological but also political and diplomatic issues are taken into account, and that GNOs are always more involved. The author briefly comments some aspects of the content of the final statement: threat of nuclear terrorism, improvement of nuclear safety since 2010, recall of the three main pillars of the non proliferation Treaty (non proliferation, disarmament, specific uses of nuclear energy), implementation of nuclear safety under at the own responsibility and duty of countries possessing nuclear materials. Finally, the author discusses how the NSS process will go on, and evokes remaining questions regarding the existence of an actual international constraining regime, and financial and functional issues

  13. Association Between Treatment by Locum Tenens Internal Medicine Physicians and 30-Day Mortality Among Hospitalized Medicare Beneficiaries.

    Science.gov (United States)

    Blumenthal, Daniel M; Olenski, Andrew R; Tsugawa, Yusuke; Jena, Anupam B

    2017-12-05

    Use of locum tenens physicians has increased in the United States, but information about their quality and costs of care is lacking. To evaluate quality and costs of care among hospitalized Medicare beneficiaries treated by locum tenens vs non-locum tenens physicians. A random sample of Medicare fee-for-service beneficiaries hospitalized during 2009-2014 was used to compare quality and costs of hospital care delivered by locum tenens and non-locum tenens internal medicine physicians. Treatment by locum tenens general internal medicine physicians. The primary outcome was 30-day mortality. Secondary outcomes included inpatient Medicare Part B spending, length of stay, and 30-day readmissions. Differences between locum tenens and non-locum tenens physicians were estimated using multivariable logistic regression models adjusted for beneficiary clinical and demographic characteristics and hospital fixed effects, which enabled comparisons of clinical outcomes between physicians practicing within the same hospital. In prespecified subgroup analyses, outcomes were reevaluated among hospitals with different levels of intensity of locum tenens physician use. Of 1 818 873 Medicare admissions treated by general internists, 38 475 (2.1%) received care from a locum tenens physician; 9.3% (4123/44 520) of general internists were temporarily covered by a locum tenens physician at some point. Differences in patient characteristics, demographics, comorbidities, and reason for admission between locum tenens and non-locum tenens physicians were not clinically relevant. Treatment by locum tenens physicians, compared with treatment by non-locum tenens physicians (n = 44 520 physicians), was not associated with a significant difference in 30-day mortality (8.83% vs 8.70%; adjusted difference, 0.14%; 95% CI, -0.18% to 0.45%). Patients treated by locum tenens physicians had significantly higher Part B spending ($1836 vs $1712; adjusted difference, $124; 95% CI, $93 to $154

  14. Snow Drift Management: Summit Station Greenland

    Science.gov (United States)

    2016-05-01

    management Snow surveys Transport analysis Winds -- Speed 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 19a. NAME OF...that about 25% of the estimated snow that the wind transports to Summit each winter is deposited and forms drifts, mostly in close proxim- ity to...the structures. This analysis demonstrates that weather data ( wind speed and direction) and a transport analysis can aid in estimating the vol- ume of

  15. Mock climate summit: teaching and assessing learning

    Science.gov (United States)

    Schweizer, D.; Gautier, C.; Bazerman, C.

    2003-04-01

    This paper will demonstrate the effectiveness of a Mock Climate Summit as a pedagogical approach for teaching the science and policy aspects of global climate change. The Mock Climate Summit is a student-centered course simulating the Conference of the Parties (COP) where international environmental protocols are negotiated. Compared to traditional lecture-based methods common in the geoscience classroom, the Mock Climate Summit uses negotiations and arguments to teach the interactions between these two “spheres” and demonstrate the depth and breadth of these interactions. Through a detailed assessment of students’ dialogue transcribed from video and audio tapes, we found that the nature of the student dialogue matures rapidly as they are given multiple opportunities to present, negotiate and argue a specific topic. Students’ dialogue progress from hypothetical (what-if) scenarios to action-oriented scenarios and implementation plans. The progression of the students’ dialogue shows increased comfort with the communities’ discourse as they take ownership of the point-of-view associated with their assumed roles.

  16. CERN's Tree of Science at the Summit

    CERN Multimedia

    2004-01-01

    The World Summit on the Information Society held its closing session at Palexpo on 12 December. During the Summit, CERN organised the SIS Forum, the Tree of Science, at Palexpo. Kofi Annan and Tim Berners-Lee, sending a message to 800 schools around the world, from the first Web server will remain one of the abiding images of the Science Stand organised by CERN as part of the World Summit on the Information Society last December. According to its designer, François Fluckiger (IT Department) this stand was not intended purely as an exhibition or as a lecture point but as a forum. Thirty-two scientific institutions throughout the world made their own contributions to the information society over the five days of the exhibition. In all, 42 science projects were exhibited to several thousand visitors under four themes: education and culture; health; environment, development and risks; fundamental sciences and enabling technologies. CERN's stand represented a tree with a trunk in the centre with scre...

  17. [A paradigm change in German academic medicine. Merger and privatization as exemplified with the university hospitals in Marburg and Giessen].

    Science.gov (United States)

    Maisch, Bernhard

    2005-03-01

    1. The intended fusion of the university hospitals Marburg and Giessen in the state of Hessia is "a marriage under pressure with uncalculated risk" (Spiegel 2005). In the present political and financial situation it hardly appears to be avoidable. From the point of the view of the faculty of medicine in Marburg it is difficult to understand, that the profits of this well guided university hospital with a positive yearly budget should go to the neighboring university hospital which still had a fair amount of deficit spending in the last years.2. Both medical faculties suffer from a very low budget from the state of Hessia for research and teaching. Giessen much more than Marburg, have a substantial need for investments in buildings and infrastructure. Both institutions have a similar need for investments in costly medical apparatuses. This is a problem, which many university hospitals face nowadays.3. The intended privatisation of one or both university hospitals will need sound answers to several fundamental questions and problems:a) A privatisation potentially endangers the freedom of research and teaching garanteed by the German constitution. A private company will undoubtedly influence by active or missing additional support the direction of research in the respective academic institution. An example is the priorisation of clinical in contrast to basic research.b) With the privatisation practical absurdities in the separation of research and teaching on one side and hospital care on the other will become obvious with respect to the status of the academic employees, the obligatory taxation (16%) when a transfer of labor from one institution to the other is taken into account. The use of rooms for seminars, lectures and bedside with a double function for both teaching, research and hospital care has to be clarified with a convincing solution in everyday practice.c) The potential additional acquisition of patients, which has been advocated by the Hessian state

  18. Monitoring of Adverse Drug Reactions Associated with Antihypertensive Medicines at a University Teaching Hospital in New Delhi

    Directory of Open Access Journals (Sweden)

    Fowad Khurshid

    2012-09-01

    Full Text Available Aim To monitor the adverse drug reactions (ADRs caused by antihypertensive medicines prescribed in a university teaching hospital.Methods:he present work was an open, non-comparative, observational study conducted on hypertensive patients attending the Medicine OPD of Majeedia Hospital, Jamia Hamdard, New Delhi, India by conducting patient interviews and recording the data on ADR monitoring form as recommended by Central Drugs Standard Control Organization (CDSCO, Government of India.Results:A total of 21 adverse drug reactions were observed in 192 hypertensive patients. Incidence of adverse drug reactions was found to be higher in patients more than 40 years in age, and females experienced more ADRs (n = 14, 7.29 % than males, 7 (3.64 %. Combination therapy was associated with more number of adverse drug reactions (66.7 % as against monotherapy (33.3 %. Calcium channel blockers were found to be the most frequently associated drugs with adverse drug reactions (n = 7, followed by diuretics (n = 5, and beta- blockers (n = 4. Among individual drugs, amlodipine was found to be the commonest drug associated with adverse drug reactions (n = 7, followed by torasemide (n = 3. Adverse drug reactions associated with central nervous system were found to be the most frequent (42.8 % followed by musculo-skeletal complaints (23.8 % and gastro-intestinal disorders (14.3 %. Conclusions:The present pharmacovigilance study represents the adverse drug reaction profile of the antihypertensive medicines prescribed in our university teaching hospital. The above findings would be useful for physicians in rational prescribing. Calcium channel blockers were found to be the most frequently associated drugs with adverse drug reactions.

  19. Basic Geriatrics Knowledge Among Internal Medicine Trainees in a Teaching Hospital in Saudi Arabia.

    Science.gov (United States)

    Al-Aama, Tareef

    2016-06-01

    To assess the basic knowledge of medical trainees, in the absence of a structured geriatrics curriculum, around a variety of geriatric medicine components that are considered essential for the care of the rapidly increasing elderly population. Eighty-three trainees at different levels of training in internal medicine were asked about a variety of common geriatric conditions. Those included: delirium, falls, geriatric syndromes, pain, cognitive impairment, and medications. The trainees' knowledge about common geriatric condition was overall poor. The most pronounced deficits included: the lack of familiarity in diagnosing geriatric syndromes (63 %) or managing them (67 %), the underestimation of the prevalence of delirium (49 %), and the tendency to undertreat pain (64 %). Poor familiarity with polypharmacy and its impact, as well as inappropriate prescription practices in the elderly were also observed. In the absence of a structured geriatric medicine curriculum, internal medicine trainees' knowledge about important geriatric conditions is poor, even if their internal medicine knowledge is overall adequate. This would translate into suboptimal care for this vulnerable and rapidly expanding segment of the population.

  20. Automated system of control of radioactive liquid effluents of patients submitted to therapy in hospitals of nuclear medicine (SACEL)

    International Nuclear Information System (INIS)

    Ruiz C, M.A.; Rivero G, T.; Celis del Angel, L.; Sainz M, E.; Molina, G.

    2006-01-01

    Different hospitals of nuclear medicine require of the technical attendance for the design, construction and instrumentation of an effluents retention system coming from the room dedicated to the medical application of iodine 131, with the one object of giving execution to the normative requirements of radiological protection, settled down in the General Regulation of Radiological Safety (RGSR) emitted by the CNSNS in November, 1988 and in the corresponding official standards. An automatic system of flow measurement, the activity concentration of the effluents to the drainage, the discharges control and the automated report it will allow the execution of the national regulations, also the elimination of unhealthy activities as the taking of samples, analysis of those same and the corresponding paperwork, its will allow that the SACEL is capable of to carry out registrations that are to consult in an automated way. The changes in the demands of the National Commission of Nuclear Safety and Safeguards in relation to the liberation of radioactive material in hospitals by medical treatments, it has created the necessity to develop a system that quantifies and dose the liquid effluents of people under thyroid treatment with iodine-131 to the drainage. The Automated System of Control of radioactive liquids effluents generated in Hospitals of Nuclear Medicine (SACEL) developed in the National Institute of Nuclear Research, it fulfills this regulation, besides improving the work conditions for the medical and technical personnel of the hospital in that are installed, since this system has the advantage of to be totally automated and to require of a minimum of attendance. The SACEL is an electro-hydraulic system of effluents control, based in the alternate operation of two decay deposits of the activity of the material contaminated with iodine-131. The system allows to take a registration of those volumes and liberated dose, besides being able to be monitoring in remote

  1. Organizational barriers associated with the implementation of national essential medicines policy: A cross-sectional study of township hospitals in China.

    Science.gov (United States)

    Yang, Lianping; Liu, Chaojie; Ferrier, J Adamm; Zhang, Xinping

    2015-11-01

    This study identifies potential organizational barriers associated with the implementation of the Chinese National Essential Medicines Policy (NEMP) in rural primary health care institutions. We used a multistage sampling strategy to select 90 township hospitals from six provinces, two from each of eastern, middle, and western China. Data relating to eight core NEMP indicators and institutional characteristics were collected from January to September 2011, using a questionnaire. Prescription-associated indicators were calculated from 9000 outpatient prescriptions selected at random. We categorized the eight NEMP indicators using an exploratory factor analysis, and performed linear regressions to determine the association between the factor scores and institution-level characteristics. The results identified three main factors. Overall, low levels of expenditure of medicines (F1) and poor performance in rational use of medicines (F2) were evident. The availability of medicines (F3) varied significantly across both hospitals and regions. Factor scores had no significant relationship with hospital size (in terms of number of beds and health workers); however, they were associated with revenue and structure of the hospital, patient service load, and support for health workers. Regression analyses showed that public finance per health worker was negatively associated with the availability of medicines (p finance from local governments may reduce medicine stock lines of township hospitals and lead them to seek alternative sources of income, jeopardizing their capacity to meet the needs of local consumers. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Discharge Processes and 30-Day Readmission Rates of Patients Hospitalized for Heart Failure on General Medicine and Cardiology Services.

    Science.gov (United States)

    Salata, Brian M; Sterling, Madeline R; Beecy, Ashley N; Ullal, Ajayram V; Jones, Erica C; Horn, Evelyn M; Goyal, Parag

    2018-05-01

    Given high rates of heart failure (HF) hospitalizations and widespread adoption of the hospitalist model, patients with HF are often cared for on General Medicine (GM) services. Differences in discharge processes and 30-day readmission rates between patients on GM and those on Cardiology during the contemporary hospitalist era are unknown. The present study compared discharge processes and 30-day readmission rates of patients with HF admitted on GM services and those on Cardiology services. We retrospectively studied 926 patients discharged home after HF hospitalization. The primary outcome was 30-day all-cause readmission after discharge from index hospitalization. Although 60% of patients with HF were admitted to Cardiology services, 40% were admitted to GM services. Prevalence of cardiovascular and noncardiovascular co-morbidities were similar between patients admitted to GM services and Cardiology services. Discharge summaries for patients on GM services were less likely to have reassessments of ejection fraction, new study results, weights, discharge vital signs, discharge physical examinations, and scheduled follow-up cardiologist appointments. In a multivariable regression analysis, patients on GM services were more likely to experience 30-day readmissions compared with those on Cardiology services (odds ratio 1.43 95% confidence interval [1.05 to 1.96], p = 0.02). In conclusion, outcomes are better among those admitted to Cardiology services, signaling the need for studies and interventions focusing on noncardiology hospital providers that care for patients with HF. Copyright © 2018 Elsevier Inc. All rights reserved.

  3. [Clinical and economic analysis of an internal medicine-infectious disease department at a university general hospital (2005-2006)].

    Science.gov (United States)

    Gómez, Joaquín; García-Vázquez, Elisa; Antonio Puertas, José; Ródenas, Julio; Herrero, José Antonio; Albaladejo, Carmen; Baños, Víctor; Canteras, Manuel; Alcaraz, Manolo

    2009-02-01

    Comparative study in patients with infectious diseases admitted to a specialized Internal Medicine-Infectious Diseases Department (IMID) versus those admitted to other medical departments in a university general hospital, investigating quality and cost-effectiveness. Analysis of patients in 10 principle diagnosis-related groups (DRGs) of infectious diseases admitted to the IMID were compared to those admitted to other medical departments (2005-2006). The DRG were divided in 4 main groups: respiratory infections (DGR 88, 89, 90, 540), urinary infections (DRG 320, 321), sepsis (DRG 416, 584), and skin infections (DRG 277, 278). For each group, quality variables (mortality and readmission rate), efficacy variables (mean hospital stay and mean DRG-based cost per patient) and complexity variables (case mix, relative weight, and functional index) were analyzed. 542 patients included in the 10 main infectious disease DRGs were admitted to IMID and 2404 to other medical departments. After adjusting for DRG case mix (case mix 0.99 for IMID and 0.89 for others), mean hospital stay (5.11 days vs. 7.65 days), mortality (3.5% vs. 7.9%) and mean DRG-based economic cost per patient (1521euro/patient vs. 2952euro/patient) was significantly lower in the group of patients hospitalized in IMID than the group in other medical departments (peconomic cost per patient. Creation and development of IMID departments should be an essential objective to improve healthcare quality and respond to social demands.

  4. Vulnerabilities and rupture risk in the supply of materials and medicine on the supply chain in the Public Hospital

    Directory of Open Access Journals (Sweden)

    Lilian de Fátima Silva

    2018-06-01

    Full Text Available Constant disruptions in the hospital supply chain caused by various sources of risk and vulnerability have been identified. This article aims to identify and analyze the main vulnerabilities that cause rupture risk in the supply of materials and medicines, on the supply chain in a public hospital in the city of Belo Horizonte. From qualitative research, we interviewed ten employees of the hospital and five suppliers. The interview script used was adapted from the model proposed by Mason-Jones and Towill (1988 and adapted by Bastos Junior (2007. As part of the results, it is possible to mention the risks of supply and the processes risk as being among those which were of more concern to the employees and the supply risks and control risk of more concern in the suppliers vision. It is inferred that more investment is necessary in the hospital supply chain management, given that the processes are based on the reaction to the risks rather than their prevention.

  5. Hospitals

    Data.gov (United States)

    Department of Homeland Security — This database contains locations of Hospitals for 50 states and Washington D.C. , Puerto Rico and US territories. The dataset only includes hospital facilities and...

  6. Nigerian Quarterly Journal of Hospital Medicine - Vol 13, No 1 (2003)

    African Journals Online (AJOL)

    Appropriateness of removal of impacted lower third molars: a 2-year audit at the Lagos ... Optimizing directly observed treatment, short course strategy in Nigeria ... patients in Lagos University Teaching Hospital - a preliminary report · EMAIL ...

  7. Nigerian Quarterly Journal of Hospital Medicine - Vol 24, No 2 (2014)

    African Journals Online (AJOL)

    Pattern of tooth replacement and colour choice among patients in a Nigerian teaching hospital · EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. OA Oremosu, DC Umesi, OH Savage, 169-174 ...

  8. Assessment of radiation exposure at the nuclear medicine module from the Vladimir Ilich Lenin Hospital

    International Nuclear Information System (INIS)

    Velazquez Cruz, R.A.; Pupo Palma, C.

    1998-01-01

    The work evaluates the exposure to radiation during the last years in which radioactive substances had been employed. A statistical analysis was applied to evaluate radiological protection performance at the Hospital. Main elements from each study made are given

  9. An evaluation of paediatric medicines reconciliation at hospital discharge into the community

    OpenAIRE

    Huynh, Chi; Wong, Ian Chi Kei; Tomlin, Stephen; Halford, Ellisha; Jani, Yogini; Ghaleb, Maisoon

    2016-01-01

    OBJECTIVE: A UK national survey of primary care physicians has indicated that the medication information on hospital discharge summary was incomplete or inaccurate most of the time. Internationally, studies have shown that hospital pharmacist's interventions reduce these discrepancies in the adult population. There have been no published studies on the incidence and severity of the discrepancies of the medication prescribed for children specifically at discharge to date. The objectives of thi...

  10. Overnight Hospital Experiences for Medical Students: Results of the 2014 Clerkship Directors in Internal Medicine National Survey.

    Science.gov (United States)

    Goren, Eric N; Leizman, Debra S; La Rochelle, Jeffrey; Kogan, Jennifer R

    2015-09-01

    Since the 2011 Accreditation Council of Graduate Medical Education (ACGME) work hour rules for residents were implemented, 24-30 h call for interns has been replaced by shift work, including night-float. The impact of these changes on undergraduate medical education experiences in internal medicine has not been described. We aimed to determine the current status of medical students' overnight experiences in Internal Medicine clerkships and sub-internships, and to assess internal medicine educators' perceptions of the importance of overnight work during internal medicine rotations. In May 2014, the Clerkship Directors in Internal Medicine (CDIM) conducted its annual survey. Twenty-eight questions about student participation in overnight work and perceptions of the importance of overnight work (rated on 1-5 Likert scale, 1 = very unimportant and 5 =  ery important) were included. Descriptive statistics were used to summarize responses. Free text results were analyzed qualitatively. The response rate was 78 %. A minority of respondents reported students having any overnight experience during the clerkship (38.7 %) or the sub-internship (40.7 %). Only 5 % of respondents reported having students assigned to night-float rotations outside of clerkships or sub-internships. Respondents agreed that overnight experiences were more important during the sub-internship than the clerkship, 4.0 ± 1.1 vs. 3.2 ± 1.2, p intern in particular was an important chance to practice providing emergency cross coverage and other intern roles. In the era of ACGME duty hours, there is a need to further examine whether there is a role for increased overnight hospital experiences for medical students.

  11. Radiation exposure to the hospital staff from confined patients submitted to nuclear medicine examinations

    International Nuclear Information System (INIS)

    Guidarelli, G.; Rossi, F.; Rossi, A.; Adversi, I.; Abbati, A.; Gaiba, W.; Vianello Vos, C.

    1983-01-01

    Dosimetric measurements were made of the radioactive patients, and, all the data were analyzed, taking into account also the statistical data given by the administration, such as the total number of hospitalized patients in the different departments, the mean duration of hospitalization, the number of staff and the effective presence of them near the patient. Analyzing those data the mean dose absorbed individually by the staff of the hospital and the collective dose in terms of man-rem, were estimated. The annual exposure to the hospital assistants also with the conservative estimates, can reasonably be considered between 5 and 23 mR inclusive. In the actual situation owing to these low levels of exposure, which allow a maximum collective dose of 6.5 manrem (determined on a staff of 242 hospital attendants including the replacements), particular measures of radioprotection for hospital attendants, are not indispensable. However, detailed information about the precautions, which especially refer to correct behaviour in the nursing of the radioactive patients, is necessary

  12. [Cases and duration of mechanical ventilation in German hospitals : An analysis of DRG incentives and developments in respiratory medicine].

    Science.gov (United States)

    Biermann, A; Geissler, A

    2016-09-01

    Diagnosis-related groups (DRGs) have been used to reimburse hospitals services in Germany since 2003/04. Like any other reimbursement system, DRGs offer specific incentives for hospitals that may lead to unintended consequences for patients. In the German context, specific procedures and their documentation are suspected to be primarily performed to increase hospital revenues. Mechanical ventilation of patients and particularly the duration of ventilation, which is an important variable for the DRG-classification, are often discussed to be among these procedures. The aim of this study was to examine incentives created by the German DRG-based payment system with regard to mechanical ventilation and to identify factors that explain the considerable increase of mechanically ventilated patients in recent years. Moreover, the assumption that hospitals perform mechanical ventilation in order to gain economic benefits was examined. In order to gain insights on the development of the number of mechanically ventilated patients, patient-level data provided by the German Federal Statistical Office and the German Institute for the Hospital Remuneration System were analyzed. The type of performed ventilation, the total number of ventilation hours, the age distribution, mortality and the DRG distribution for mechanical ventilation were calculated, using methods of descriptive and inferential statistics. Furthermore, changes in DRG-definitions and changes in respiratory medicine were compared for the years 2005-2012. Since the introduction of the DRG-based payment system in Germany, the hours of ventilation and the number of mechanically ventilated patients have substantially increased, while mortality has decreased. During the same period there has been a switch to less invasive ventilation methods. The age distribution has shifted to higher age-groups. A ventilation duration determined by DRG definitions could not be found. Due to advances in respiratory medicine, new

  13. Paramedics' experiences of financial medicine practices in the pre-hospital environment. A pilot study

    Directory of Open Access Journals (Sweden)

    Craig Vincent-Lambert

    2016-12-01

    Conclusion: The results of this study are concerning as the actions of service providers described by the participants constitute gross violations of the ethical and professional guidelines for health care professionals. The authors recommend additional studies be conducted to further explore these findings and to establish the reasons for, and ways of, limiting financial medicine practices in the South African emergency care environment.

  14. Perception, attitude and usage of complementary and alternative medicine among doctors and patients in a tertiary care hospital in India.

    Science.gov (United States)

    Roy, Vandana; Gupta, Monica; Ghosh, Raktim Kumar

    2015-01-01

    Complementary and alternative medicine (CAM) has been practiced in India for thousands of years. The aim of this study was to determine the extent of use, perception and attitude of doctors and patients utilizing the same healthcare facility. This study was conducted among 200 doctors working at a tertiary care teaching Hospital, India and 403 patients attending the same, to determine the extent of usage, attitude and perception toward CAM. The use of CAM was more among doctors (58%) when compared with the patients (28%). Among doctors, those who had utilized CAM themselves, recommended CAM as a therapy to their patients (52%) and enquired about its use from patients (37%) to a greater extent. CAM was used concomitantly with allopathic medicine by 60% patients. Very few patients (7%) were asked by their doctors about CAM use, and only 19% patients voluntarily informed their doctors about the CAM they were using. Most patients who used CAM felt it to be more effective, safer, less costly and easily available in comparison to allopathic medicines. CAM is used commonly by both doctors and patients. There is a lack of communication between doctors and patients regarding CAM, which may be improved by sensitization of doctors and inclusion of CAM in the medical curriculum.

  15. Nigerian Quarterly Journal of Hospital Medicine - Vol 22, No 1 (2012)

    African Journals Online (AJOL)

    Pattern of Periodontal Treatments Performed at the Periodontology Clinic of the Lagos University Teaching Hospital: 22 Months Review. EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL ... Circulating Adipokine levels in Type 2 Diabetes Mellitus in Lagos, Nigeria. T Oshodi, OAT Ebuehi, O Ojewunmi, I Udenze, ...

  16. Nigerian Quarterly Journal of Hospital Medicine - Vol 17, No 1 (2007)

    African Journals Online (AJOL)

    Dimensional stability of alginate impressiion material over a four hours time frame · EMAIL FULL TEXT EMAIL FULL TEXT DOWNLOAD FULL ... Factors governing the choice of dentifrices by patients attending the dental centre, Lagos University Teaching Hospital · EMAIL FULL TEXT EMAIL FULL TEXT DOWNLOAD FULL ...

  17. Nigerian Quarterly Journal of Hospital Medicine - Vol 8, No 4 (1998)

    African Journals Online (AJOL)

    Clinical trial of Roxithromychin in the Lagos University Teaching Hospital and other health facilities in Lagos · EMAIL FULL TEXT EMAIL FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. A F Mabadeje, E O Bandele, T Odugbemi, M O Mabayoje, E L Bamgboye, R B Sanusi, A K Abiose, T A Odutola, 248-250.

  18. Hospital heavies. Venture capital bulks up companies that outsource medicine's newest specialty: inpatient-only care.

    Science.gov (United States)

    Huff, C

    They're the designated drivers of inpatient care, cutting hospital stays by 19 percent on average. Yet as venture capital firms infuse hospitalist startup companies, some primary care doctors complain that their sickest patients are being taken away from them.

  19. Radiation exposure to staff involved in diagnostic and therapeutic nuclear medicine procedures in some hospitals in Sudan

    International Nuclear Information System (INIS)

    Salih, Lamia Hamza Bashir

    2015-05-01

    Study was performed to evaluate radiation dose to staff involved in nuclear medicine procedures in some hospitals in Sudan. 15 radiation workers were studied in three hospitals. Radiation dose was measured using personal dose equivalent Hp (10), using calibrated electronic personal dosimeters (EPDs) worn on the chest and read at the end of the day. Staff doses were monitored in each hospital for a period of four weeks, The measured monthly Hp(10) values to staff ranged between 82.96-83.94μSv (to nurses), 38.81-53.97 μSv (to pharmacists), 16.87-70.21μSv (to technologists), 40.22-76.56μSv (to medical physicists). These mean monthly radiation doses were projected to the annual radiation doses received by the staff. The mean monthly radiation doses were projected to the annual radiation doses were found to be between ranges (185.57-923.34μSv/y). Results found showed that there was no dose that exceeded the limits of annual dose recommended for workers by International Commission on Radiology Protection (ICRP) (20 mSv/year). This study is expected to increase the awareness of staff about the radiation hazards and protection.(Author)

  20. The role and timing of palliative medicine consultation for women with gynecologic malignancies: association with end of life interventions and direct hospital costs.

    Science.gov (United States)

    Nevadunsky, Nicole S; Gordon, Sharon; Spoozak, Lori; Van Arsdale, Anne; Hou, Yijuan; Klobocista, Merieme; Eti, Serife; Rapkin, Bruce; Goldberg, Gary L

    2014-01-01

    Aggressive care interventions at the end of life (ACE) are reported metrics of sub-optimal quality of end of life care that are modifiable by palliative medicine consultation. Our objective was to evaluate the association of inpatient palliative medicine consultation with ACE scores and direct inpatient hospital costs of patients with gynecologic malignancies. A retrospective review of medical records of the past 100 consecutive patients who died from their primary gynecologic malignancies at a single institution was performed. Timely palliative medicine consultation was defined as exposure to inpatient consultation ≥ 30 days before death. Metrics utilized to tabulate ACE scores were ICU admission, hospital admission, emergency room visit, death in an acute care setting, chemotherapy at the end of life, and hospice admission Whitney U, Kaplan-Meier, and Student's T testing. 49% of patients had a palliative medicine consultation and 18% had timely consultation. Median ACE score for patients with timely palliative medicine consultation was 0 (range 0-3) versus 2 (range 0-6) p=0.025 for patients with untimely/no consultation. Median inpatient direct costs for the last 30 days of life were lower for patients with timely consultation, $0 (range 0-28,019) versus untimely, $7729 (0-52,720), p=0.01. Timely palliative medicine consultation was associated with lower ACE scores and direct hospital costs. Prospective evaluation is needed to validate the impact of palliative medicine consultation on quality of life and healthcare costs. © 2013. Published by Elsevier Inc. All rights reserved.

  1. Prevalence and correlates of herbal medicine use among type 2 diabetic patients in Teaching Hospital in Ethiopia: a cross-sectional study.

    Science.gov (United States)

    Mekuria, Abebe Basazn; Belachew, Sewunet Admasu; Tegegn, Henok Getachew; Ali, Dawit Simegnew; Netere, Adeladlew Kassie; Lemlemu, Eskedar; Erku, Daniel Asfaw

    2018-03-09

    Type 2 Diabetes Mellitus (T2DM) patients are increasingly using herbal remedies due to the fact that sticking to the therapeutic regimens is becoming awkward. However, studies towards herbal medicine use by diabetic patients is scarce in Ethiopia. Therefore, the aim of the current study was to explore the prevalence and correlates of herbal medicine use with different sociodemographic variables among type 2 diabetes patients visiting the diabetic follow-up clinic of University of Gondar comprehensive specialized hospital (UOGCSH), Ethiopia. A hospital-based cross sectional study was employed on 387 T2DM patients visiting the diabetes illness follow-up care clinic of UOGCSH from October 1 to November 30, 2016. An interviewer-administered questionnaire regarding the demographic and disease characteristics as well as herbal medicine use was completed by the study subjects. Descriptive, univariate and multivariate logistic regression statistics were performed to determine prevalence and come up with correlates of herbal medicine use. From 387 participants, 62% were reported to be herbal medicine users. The most prevalent herbal preparations used were Garlic (Allium sativum L.) (41.7%), Giesilla (Caylusea abyssinica (fresen.) (39.6%), Tinjute (Otostegia integrifolia Benth) (27.2%), and Kosso (Hagenia abyssinicaa) (26.9%). Most of herbal medicine users (87.1%) didn't consult their physicians about their herbal medicine use. Families and friends (51.9%) were the frontline sources of information about herbal medicine followed by other DM patients who used herbal medicines (28.9%). The present study revealed a high rate of herbal medicine use along with a very low rate use disclosure to the health care professionals. Higher educational status, a family history of DM, duration of T2DM and presence of DM complications were identified to be strong predictors of herbal medicine use. From the stand point of high prevalence and low disclosure rate, it is imperative for health

  2. The social summit: a gender perspective.

    Science.gov (United States)

    1995-01-01

    This editorial introduction to an issue of INSTRAW News notes that the UN has undertaken a year long series of important international conferences, starting with the September 1994 Conference on Population and Development. The second major conference is the World Summit for Social Development, and the third is the Fourth World Conference on Women. At these conferences, the international community is coming together to rescue the people whose lives have been threatened by the legacy of the Cold War: ethnic, religious, and cultural violence and exacerbation of the gap between rich and poor. Women are an integral part of the developing social agenda because women are a magnifying glass, rather than simply a mirror, of the problems of society. This issue of INSTRAW News provides a broad overview of how gender issues have evolved and the changes which occurred as a result. Specific gender issues are analyzed as they impact the three core items of the Social Summit agenda: attacking poverty, creating jobs, and building social solidarity.

  3. Sustainable development, a summit for the future

    International Nuclear Information System (INIS)

    Dessus, B.

    2002-01-01

    The Johannesburg summit, which took place at the end of the summer of 2002, was the opportunity to spread out to the large public worldwide the notion of sustainable development, a notion that remained confidential so far. It was also a good opportunity to show that the share of energy resources is a vital point for the future. The institute of energy and environment of the French-speaking world has published a huge dossier which takes stock of the overall questions raised by the summit and answered by French-speaking experts. This article reprints some large extracts of two contributions devoted to the energy and its key role in the sustainable development. The first contribution deals with the four energy stakes of the sustainable development: the energy and the fight against poverty, the mastery of energy demand, the development of renewable energy sources, and the nuclear question. The second contribution treats of the five points of the action plan of the world energy council (CME) for the implementation of a durable energy policy in developing countries. (J.S.)

  4. The global summit on nurse faculty migration.

    Science.gov (United States)

    Thompson, Patricia E; Benton, David C; Adams, Elizabeth; Morin, Karen H; Barry, Jean; Prevost, Suzanne S; Vlasich, Cynthia; Oywer, Elizabeth

    2014-01-01

    As global demand for health care workers burgeons, information is scant regarding the migration of faculty who will train new nurses. With dual roles as clinicians and educators, and corresponding dual sets of professional and legal obligations, nurse faculty may confront unique circumstances in migration that can impact nations' ability to secure an adequate, stable nursing workforce. In a seminal effort to address these concerns, the Honor Society of Nursing, Sigma Theta Tau International, and the International Council of Nurses invited a diverse group of international experts to a summit designed to elucidate forces that drive nurse faculty migration. The primary areas of consideration were the impact on nurse faculty migration of rapid health care workforce scale-up, international trade agreements, and workforce aging. Long-term summit goals included initiating action affecting national, regional, and global supplies of nurse educators and helping to avert catastrophic failure of health care delivery systems caused by an inadequate ability to educate next-generation nurses. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. Special radiation protection aspects of radiotherapy and nuclear medicine in a medium-sized Swiss hospital

    International Nuclear Information System (INIS)

    Benes, I.; Heinzel, F.; Mueller-Duysing, W.

    1985-01-01

    The evolution of radiation protection in Switzerland caused the Triemli City Hospital to implement building modifications throughout its 13 years of existence which have not been completed todate. However, modest methods allowed to find practicable solutions which largely comply with today's radiation protection regulation. Radiation protection provisions have been rendered more stringent thus resulting in more jobs. At least one additional staff member is required in order to discharge all supervisory functions required like incorporation controls, controls of cleaning and technical staff for their working correctly, contamination controls of floors and working areas, exit controls of special working clothes, etc. The best solution for the hospital would be to have one health physics man specifically commissioned with and employed for radiation protection. (orig./HSCH) [de

  6. Assessment of bacterial contamination in the sectors of Clinical Medicine and Surgery Small Animal Veterinary Hospital, UFCG, PB

    Directory of Open Access Journals (Sweden)

    Rafaela Alves Dias

    2015-06-01

    Full Text Available ABSTRACT. Dias R.A., Souza A.P. & Garino Júnior F. [Assessment of bacterial contamination in the sectors of Clinical Medicine and Surgery Small Animal Veterinary Hospital, UFCG, PB.] Avaliação da contaminação bacteriana nos setores de Clínica e Cirurgia de Pequenos Animais do Hospital Veterinário da UFCG, PB. Revista Brasileira de Medicina Veterinária, 37(2:173-177, 2015. Programa de Pós-Graduação em Medicina Veterinária, Universidade Federal de Campina Grande, Av. Universitária, s/n, Bairro Santa Cecília, Patos, PB 58708-110, Brasil. E-mail: rafa.ad@hotmail.com With this study aimed to evaluate bacterial contamination sectors Clinic and Surgery Small Animal Veterinary Hospital UFCG, in order to prevent infections in patients attending hospital. An assessment of the environmental contamination of sectors before and after disinfection, where was collected samples of air, surfaces and hands of people who deal directly with the animals. Then the test was made of the effectiveness of disinfectants used. Of the 40 samples collected, was identified in 5 of them (12.5% Enterobacteria such as Escherichia coli and Klebisiella pneumoniae and in 22 samples (55% was identified Staphylococcus coagulase negative and positive. Was seen in the quantitative analysis that the number of cfu in some sample was above the indicated. The test showed that the disinfectant solution was effective against all micro-organisms found in the environments. The results indicate that more attention to procedures performed in the disinfection of areas evaluated, and also include measures to prevent contamination at these sites.

  7. [Direct costs and clinical aspects of adverse drug reactions in patients admitted to a level 3 hospital internal medicine ward].

    Science.gov (United States)

    Tribiño, Gabriel; Maldonado, Carlos; Segura, Omar; Díaz, Jorge

    2006-03-01

    Adverse drug reactions (ADRs) occur frequently in hospitals and increase costs of health care; however, few studies have quantified the clinical and economic impact of ADRs in Colombia. These impacts were evaluated by calculating costs associated with ADRs in patients hospitalized in the internal medicine ward of a Level 3 hospital located in Bogotá, Colombia. In addition, salient clinical features of ADRs were identified and characterized. Intensive follow-ups for a cohort of patients were conducted for a five month period in order to detect ADRs; different ways to classify them, according to literature, were considered as well. Information was collected using the INVIMA reporting format, and causal probability was evaluated with the Naranjo algorithm. Direct costs were calculated from the perspective of payer, based on the following costs: additional hospital stay, medications, paraclinical tests, additional procedures, patient displacement to intermediate or intensive care units, and other costs. Of 836 patients admitted to the service, 268 adverse drug reactions were detected in 208 patients (incidence proportion 25.1%, occurence rate 0.32). About the ADRs found, 74.3% were classified as probable, 92.5% were type A, and 81.3% were moderate. The body system most often affected was the circulatory system (33.9%). Drugs acting on the blood were most frequently those ones associated with adverse reactions (37.6%). The costs resulting from medical care of adverse drug reactions varied from COL dollar 93,633,422 (USD dollar 35,014.92) to COL dollar 122,155,406 (USD dollar 45,680.94), according to insurance type, during the study period. Adverse drug reactions have a significant negative health and financial impact on patient welfare. Because of the substantial resources required for their medical care and the significant proportion of preventable adverse reactions, active programs of institutional pharmacovigilance are highly recommended.

  8. ACHP | Heritage Tourism and the Federal Government: Summit I Proceedings

    Science.gov (United States)

    Search skip specific nav links Home arrow Publications arrow Intro: Heritage Tourism and the Federal Government: Summit I—Report of Proceedings Heritage Tourism and the Federal Government: Summit I—Report of tourism promotes the preservation of communities' historic resources, educates tourists and local

  9. ACHP | Heritage Tourism and the Federal Government: Summit II Proceedings

    Science.gov (United States)

    Search skip specific nav links Home arrow Publications arrow Intro: Heritage Tourism and the Federal Government: Summit II—Report of Proceedings Heritage Tourism and the Federal Government: Summit II—Report Heritage tourism promotes the preservation of communities' historic resources, educates tourists and local

  10. Proceedings and Presentations from the 2015 Homeland Security Education Summit

    OpenAIRE

    2015-01-01

    Proceedings: 9th Annual Homeland Defense and Security Education Summit The 9th Annual Homeland Defense and Security Education Summit was held on September 25-26, 2015 at the Hyatt Regency Hotel in Orlando Florida. The theme of the event was Evolving Homeland Security…

  11. 2016 Personalized Learning & Student Success Summit: Summary from the NMC

    Science.gov (United States)

    New Media Consortium, 2016

    2016-01-01

    The New Media Consortium (NMC) hosted the Personalized Learning & Student Success Summit at SXSWedu on March 7-9 in Austin, Texas. The summit convened grantees and partners of the Postsecondary Strategy at the Bill & Melinda Gates Foundation and served as a call-to-action for education leaders to first imagine if and then commit to trying…

  12. Hospital-Acquired Urinary Tract Infections: Results of a Cohort Study Performed in an Internal Medicine Department.

    Science.gov (United States)

    Lobão, Maria João; Sousa, Paulo

    2017-09-29

    Urinary tract infections are the most frequent healthcare associated infections, being related to both high costs and morbidity. Our intention was to carry out an epidemiological characterization of hospital acquired urinary tract infections that occurred in an internal medicine department of a Portuguese hospital. Retrospective cohort study (historic cohort). Data were analysed from a systematic random sample of 388 patients, representative of the 3492 admissions occurred in 2014 in that department. One in four patients underwent the placement of a bladder catheter [24.7% (n = 96); 95% CI: 20% - 29%], 36.5% (95% CI: 33% - 48%) of which in the absence of clinical criteria for that procedure. The global cumulative incidence rate for nosocomial urinary tract infections was 4.6% (95% CI: 2.5% - 6.7%). Most hospital acquired urinary tract infections (61.1%) were related to bladder catheter use. We quantified 3.06 infections / 1000 patient-days and 14.5 infections / 1000 catheter-days. Catheter associated urinary tract infection occurred at an early stage of hospitalization. The vast majority of patients (66.7%) that developed a catheter associated urinary tract infection were subjected to bladder catheter placement at emergency department. Seventy one per cent of catheter associated urinary tract infection occurred in patients that were subjected to bladder catheter placement without criteria. These results point to an excessive and inadequate use of urinary catheters, highlighting the need for judicious use taking into account the formal clinical indications. The incidence of catheter associated urinary tract infection is similar to what we found in other studies. Nevertheless we found a very high incidence density per catheter-days that may foresee a problem probably related to the absence of early withdrawal of the device, and to both bladder catheter placement and maintenance practices. A significant part of catheter associated urinary tract infection

  13. The hospital educational environment and performance of residents in the General Medicine In-Training Examination: a multicenter study in Japan

    Directory of Open Access Journals (Sweden)

    Shimizu T

    2013-07-01

    Full Text Available Taro Shimizu,1 Yusuke Tsugawa,2,3 Yusuke Tanoue,4 Ryota Konishi,5 Yuji Nishizaki,6 Mitsumasa Kishimoto,7 Toshiaki Shiojiri,8 Yasuharu Tokuda9 1Hospitalist Division, Department of Medicine, Nerima Hikarigaoka Hospital, Tokyo, Japan; 2Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA; 3Center for Clinical Epidemiology, St Luke's Life Science Institute, 4Department of Vascular and Oncological Surgery, Hospital of Tokyo University, 5Department of General Internal Medicine, Kanto Rousai Hospital, 6Department of Cardiology, Juntendo University School of Medicine, 7Division of Rheumatology, St Luke's International Hospital, Tokyo, Japan; 8Asahi Chuo Hospital, Chiba, Japan; 9Department of Medicine, Tsukuba University Mito Kyodo General Hospital, Mito City, Ibaraki, Japan Background: It is believed that the type of educational environment in teaching hospitals may affect the performance of medical knowledge base among residents, but this has not yet been proven. Objective: We aimed to investigate the association between the hospital educational environment and the performance of the medical knowledge base among resident physicians in Japanese teaching hospitals. Methods: To assess the knowledge base of medicine, we conducted the General Medicine In-Training Examination (GM-ITE for second-year residents in the last month of their residency. The items of the exam were developed based on the outcomes designated by the Japanese Ministry of Health, Labor, and Welfare. The educational environment was evaluated using the Postgraduate Hospital Educational Environment Measure (PHEEM score, which was assessed by a mailed survey 2 years prior to the exam. A mixed-effects linear regression model was employed for the analysis of variables associated with a higher score. Results: Twenty-one teaching hospitals participated in the study and a total of 206 residents (67 women participated and

  14. Usage of Complementary and Alternative Medicine (CAM) among osteoarthritis patients attending an urban multi-specialist hospital in Lagos, Nigeria.

    Science.gov (United States)

    Obalum, D C; Ogo, C N

    2011-03-01

    Osteoarthritis (OA), a chronic degenerative disease of synovial joints is characterised by pain and stiffness. Aim of treatment is pain relief. Complementary and alternative medicine (CAM) refers to practices which are not an integral part of orthodox medicine. To determine the pattern of usage of CAM among OA patients in Nigeria. Consecutive patients with OA attending orthopaedic clinic of Havana Specialist Hospital, Lagos, Nigeria were interviewed over a 6- month period st st of 1 May to 31 October 2007 on usage of CAM. Structured and open-ended questions were used. Demographic data, duration of OA and treatment as well as compliance to orthodox medications were documented. One hundred and sixty four patients were studied.120 (73.25%) were females and 44(26.89%) were males. Respondents age range between 35-74 years. 66(40.2%) patients used CAM. 35(53.0%) had done so before presenting to the hospital. The most commonly used CAM were herbal products used by 50(75.8%) of CAM users. Among herbal product users, 74.0% used non- specific local products, 30.0% used ginger, 36.0% used garlic and 28.0% used Aloe Vera. Among CAM users, 35(53.0%) used local embrocation and massage, 10(15.2%) used spiritual methods. There was no significant difference in demographics, clinical characteristics and pain control among CAM users and non-users. Many OA patients receiving orthodox therapy also use CAM. Medical doctors need to keep a wary eye on CAM usage among patients and enquire about this health-seeking behaviour in order to educate them on possible drug interactions, adverse effects and long term complications.

  15. The Education Summit; A Different Signal

    Science.gov (United States)

    Lagowski, J. J.

    1996-05-01

    The last National Education Summit held by the Governors occurred in Charlottesville, Virginia in 1989. That Summit, chaired by then Governor Clinton, produced the national goals for education announced by President Bush. These top-down goals are unfulfilled and are, for all practical purposes, dead. The 1996 Education Summit seems different, although its recommendations may suffer the same fate of those of the 1989 Summit. The 1996 Education Summit was held at IBM's Executive Conference Center in Palisades, New York. The Governors invited 44 executives of major businesses from virtually every state. CEO's from IBM, AT&T, Bell South, Eastman Kodak, Procter & Gamble, and Boeing were a part of the planning committee. Absent, for the most part, were professional educators and their organizations. The constitution of the 1996 Education Summit sent a clear signal, viz., that the "professional educators," whatever their individual talents, as a group have failed the nation's public schools and now its time for someone else to try. The "someone else" is the group of individuals that are the ultimate consumers of the output of the American education system. The collective point of view of the attending CEO's is that companies have undergone radical changes to become globally competitive, now it's time to keep the work force equally competitive. And this can only come through radical changes in the educational system. The CEO's point out that the companies they represent live or die by the (international) standards they establish, some of which are expressed in the principles of Total Quality Management (TQM), which represents a systemic approach to the changes American industry had to undergo to stay competitive. The executives clearly have run out of patience with the current system of public education. Many feel that they are running out of talented people to fill the important jobs that this society will need to fill to keep it moving forward. That talent is not being

  16. Radiotherapy and Nuclear Medicine Project for an Integral Oncology Center at the Oaxaca High Specialization Regional Hospital

    International Nuclear Information System (INIS)

    De Jesus, M.; Trujillo-Zamudio, F. E.

    2010-01-01

    A building project of Radiotherapy and Nuclear Medicine services (diagnostic and therapy), within an Integral Oncology Center (IOC), requires interdisciplinary participation of architects, biomedical engineers, radiation oncologists and medical physicists. This report focus on the medical physicist role in designing, building and commissioning stages, for the final clinical use of an IOC at the Oaxaca High Specialization Regional Hospital (HRAEO). As a first step, during design stage, the medical physicist participates in discussions about radiation safety and regulatory requirements for the National Regulatory Agency (called CNSNS in Mexico). Medical physicists propose solutions to clinical needs and take decisions about installing medical equipment, in order to fulfill technical and medical requirements. As a second step, during the construction stage, medical physicists keep an eye on building materials and structural specifications. Meanwhile, regulatory documentation must be sent to CNSNS. This documentation compiles information about medical equipment, radioactivity facility, radiation workers and nuclear material data, in order to obtain the license for the linear accelerator, brachytherapy and nuclear medicine facilities. As a final step, after equipment installation, the commissioning stage takes place. As the conclusion, we show that medical physicists are essentials in order to fulfill with Mexican regulatory requirements in medical facilities.

  17. Does providing more services increase the primary hospitals' revenue? An assessment of national essential medicine policy based on 2,675 counties in China.

    Directory of Open Access Journals (Sweden)

    Fei Chen

    Full Text Available To understand whether the increased outpatient service provision (OSP brings in enough additional income (excluding income from essential medicine for primary hospitals (INCOME to compensate for reduced costs of medicine.The two outcomes, annual OSP and INCOME for the period of 2008-2012, were collected from 34,506 primary hospitals in 2,675 counties in 31 provinces in China by the national surveillance system. The data had a four-level hierarchical structure; time points were nested within primary hospital, hospitals within county, and counties within province. We fitted bivariate five-level random effects regression models to examine correlations between OSP and INCOME in terms of their mean values and dose-response effects of the essential medicine policy (EMP. We adjusted for the effects of time period and selected hospital resources.The estimated correlation coefficients between the two outcomes' mean values were strongly positive among provinces (r = 0.910, moderately positive among counties (r = 0.380, and none among hospitals (r = 0.002 and time (r = 0.007. The correlation between their policy effects was weakly positive among provinces (r = 0.234, but none at the county and hospital levels. However, there were markedly negative correlation coefficients between the mean and policy effects at -0.328 for OSP and -0.541 for INCOME at the hospital level.There was no evidence to suggest an association between the two outcomes in terms of their mean values and dose-response effects of EMP at the hospital level. This indicated that increased OSP did not bring enough additional INCOME. Sustainable mechanisms to compensate primary hospitals are needed.

  18. Experiences of the Nuclear Medicine Service at the University Hospital Surgical Clinic Dr. Salvador Allende 2013-2015

    International Nuclear Information System (INIS)

    Suárez Iznaga, Rodolfo; Pozo Almaguer, Armando del; Gil Valdés, Doris; Fleitas Anaya, Ricardo

    2016-01-01

    The Nuclear Medicine Service of the University Hospital Surgical Clinic D r. Salvador Allende , located in the municipality of Cerro, began the provision of scintigraphic services in May 2013. A retrospective descriptive and analytical study was carried out from May 2013 to December 2015 from the archived scintigraphic reports. The objective of the study was to present the results of the Nuclear Medicine Service during this period. The data were reflected in percentages, using tables and graphs. To determine the existence of a statistically significant relationship between the variables were used: Chi square test with a level of significance α = 0.05 being positive if p <0.05. Until December 2015, 798 cases had been reported, which included Bone scans (88.34%), renal (10.65%) and thyroid scans for follow-up of cancer patients (1%); (76.82%) and the female sex was the most attended with 446 (55.89%) patients, there were no statistically significant differences between the scintigraphic studies and the sex of the patients. There were statistically significant differences between the scintigraphic studies and the age of the patients. The most frequent diagnoses were: bone scintigraphy, metastasis in 86.52% of patients, renal cyst scintigraphy (48.78%) and dynamic scintigraphy of the kidneys with obstructive functional involvement (63.64%) It was recommended to create the necessary technical and human resources conditions to be able to introduce other scintigraphy studies in the Nuclear Medicine Service such as: breast scintigraphy and lymph node scans, high demand in the medical center. In addition, to use scientifically the criteria of approval of patients in the consultation of classification of the service, with the aim of achieving a better selection of the applicants for scintigraphic studies, which would favor a more rational and efficient use of these studies.

  19. The use of Skype in a community hospital inpatient palliative medicine consultation service.

    Science.gov (United States)

    Brecher, David B

    2013-01-01

    Skype™, an Internet-based communication tool, has enhanced communication under numerous circumstances. As telemedicine continues to be an increasing part of medical practice, there will be more opportunities to use Skype and similar tools. Numerous scenarios in the lay literature have helped to highlight the potential uses. Although most commonly used to enhance physician-to-patient communication, there has been limited reported use of Skype for patient-to-family communication, especially in end of life and palliative care. Our inpatient Palliative Medicine Consultation Service has offered and used this technology to enhance our patients' quality of life. The objective was to provide another tool for our patients to use to communicate with family and/or friends, especially under circumstances in which clinical symptoms, functional status, financial concerns, or geographic limitations preclude in-person face-to face communication.

  20. Oral mucosa lesion prevalence at Department of Oral Medicine, Halimah Daeng Sikati dental hospital in Makassar

    Directory of Open Access Journals (Sweden)

    Ayub Irmadani Anwar

    2016-06-01

    Full Text Available Oral soft tissue lesions based on clinical picture can be grouped in the form of discoloration, vesicles, tumor, erosion and ulceration. The purpose of this study is to provide apicture of people with oral mucosal lesions, including the factors thought to be the cause of the lesions listed in Department ofOral Medicine RSGMP Hj. Halimah Dg.Sikati, Makassar. This type of study is a descriptive observational study with cross-sectional research design study. This study showed that of 819 subjects, as many as 450 people were women with an average age of 15-49 years. Nutritional deficiency is one of the factors suspected to be causing the face of oral lesions in addition to other factors. These results are some what different from the results of several previous studies.

  1. Patient safety incident reports related to traditional Japanese Kampo medicines: medication errors and adverse drug events in a university hospital for a ten-year period.

    Science.gov (United States)

    Shimada, Yutaka; Fujimoto, Makoto; Nogami, Tatsuya; Watari, Hidetoshi; Kitahara, Hideyuki; Misawa, Hiroki; Kimbara, Yoshiyuki

    2017-12-21

    Kampo medicine is traditional Japanese medicine, which originated in ancient traditional Chinese medicine, but was introduced and developed uniquely in Japan. Today, Kampo medicines are integrated into the Japanese national health care system. Incident reporting systems are currently being widely used to collect information about patient safety incidents that occur in hospitals. However, no investigations have been conducted regarding patient safety incident reports related to Kampo medicines. The aim of this study was to survey and analyse incident reports related to Kampo medicines in a Japanese university hospital to improve future patient safety. We selected incident reports related to Kampo medicines filed in Toyama University Hospital from May 2007 to April 2017, and investigated them in terms of medication errors and adverse drug events. Out of 21,324 total incident reports filed in the 10-year survey period, we discovered 108 Kampo medicine-related incident reports. However, five cases were redundantly reported; thus, the number of actual incidents was 103. Of those, 99 incidents were classified as medication errors (77 administration errors, 15 dispensing errors, and 7 prescribing errors), and four were adverse drug events, namely Kampo medicine-induced interstitial pneumonia. The Kampo medicine (crude drug) that was thought to induce interstitial pneumonia in all four cases was Scutellariae Radix, which is consistent with past reports. According to the incident severity classification system recommended by the National University Hospital Council of Japan, of the 99 medication errors, 10 incidents were classified as level 0 (an error occurred, but the patient was not affected) and 89 incidents were level 1 (an error occurred that affected the patient, but did not cause harm). Of the four adverse drug events, two incidents were classified as level 2 (patient was transiently harmed, but required no treatment), and two incidents were level 3b (patient was

  2. The Impact of the Hospital Volume on the Performance of Residents on the General Medicine In-Training Examination: A Multicenter Study in Japan.

    Science.gov (United States)

    Mizuno, Atsushi; Tsugawa, Yusuke; Shimizu, Taro; Nishizaki, Yuji; Okubo, Tomoya; Tanoue, Yusuke; Konishi, Ryota; Shiojiri, Toshiaki; Tokuda, Yasuharu

    2016-01-01

    Objective Although several studies have been conducted worldwide on factors that might improve residents' knowledge, the relationship between the hospital volume and the internal medicine residents' knowledge has not been fully understood. We conducted a cross-sectional study to compare the relationships of the hospital volume and hospital resources with the residents' knowledge assessed by the In-training Examination. Methods We conducted a retrospective survey and a clinical knowledge evaluation of postgraduate year 1 and 2 (PGY-1 and -2) resident physicians in Japan by using the General Medicine In-training Examination (GM-ITE) in 2014. We compared the ITE score and the hospital volume. Results A total of 2,015 participants (70.6% men; age, 27.3±2.9 years old) from 208 hospitals were retrospectively analyzed. Generalized estimating equations were used, and the results revealed that an increasing number of hospitalizations, decreasing staff number, decreasing age and PGY-2 were significantly associated with higher GM-ITE scores. Conclusion The hospital volume, such as the number of hospitalizations, is thus considered to have a positive impact on the GM-ITE scores.

  3. Nuclear Power Plant Performance: Ascending The Summit

    International Nuclear Information System (INIS)

    Anderson, T. M.

    1986-01-01

    When we look back over the years and consider the progress we have made in improving nuclear plant performance, I'm sure that many of you must feel the same mixture of elation and apprehension the mountain climber feels when he finally confronts his summit. In the curse of the last 10 years, many of US have watched availability averages rise from 50% to 60%, to 65% -- and recently, to 70%, 80% and beyond. Yet, as impressive an accomplishment as that is, there comes, I think, a growing realization that the steady increases we have achieved up to now may, in fact, have been the easy part of the journey, the trek from base camp -- and that within a very small handful of years, we may find ourselves pushing plant performance right to the limit, only to discover that it is pushing back

  4. Emergency department performance measures updates: proceedings of the 2014 emergency department benchmarking alliance consensus summit.

    Science.gov (United States)

    Wiler, Jennifer L; Welch, Shari; Pines, Jesse; Schuur, Jeremiah; Jouriles, Nick; Stone-Griffith, Suzanne

    2015-05-01

    The objective was to review and update key definitions and metrics for emergency department (ED) performance and operations. Forty-five emergency medicine leaders convened for the Third Performance Measures and Benchmarking Summit held in Las Vegas, February 21-22, 2014. Prior to arrival, attendees were assigned to workgroups to review, revise, and update the definitions and vocabulary being used to communicate about ED performance and operations. They were provided with the prior definitions of those consensus summits that were published in 2006 and 2010. Other published definitions from key stakeholders in emergency medicine and health care were also reviewed and circulated. At the summit, key terminology and metrics were discussed and debated. Workgroups communicated online, via teleconference, and finally in a face-to-face meeting to reach consensus regarding their recommendations. Recommendations were then posted and open to a 30-day comment period. Participants then reanalyzed the recommendations, and modifications were made based on consensus. A comprehensive dictionary of ED terminology related to ED performance and operation was developed. This article includes definitions of operating characteristics and internal and external factors relevant to the stratification and categorization of EDs. Time stamps, time intervals, and measures of utilization were defined. Definitions of processes and staffing measures are also presented. Definitions were harmonized with performance measures put forth by the Centers for Medicare and Medicaid Services (CMS) for consistency. Standardized definitions are necessary to improve the comparability of EDs nationally for operations research and practice. More importantly, clear precise definitions describing ED operations are needed for incentive-based pay-for-performance models like those developed by CMS. This document provides a common language for front-line practitioners, managers, health policymakers, and researchers.

  5. Organized medicine and Scandinavian professional unionism: hospital policies and exit options in Denmark and Sweden.

    Science.gov (United States)

    Heidenheimer, A J; Johansen, L N

    1985-01-01

    Strikes by junior hospital doctors over the issue of on-call remuneration in Denmark and Sweden in 1981 are analyzed to clarify the impact of public-sector cost-control policies on intra- and interprofessional solidarity within the Scandinavian professional peak associations. The junior doctors' grievances could find expression either through increased "voice" within the medical negotiating machinery, or by pursuing the exit option in having the medical associations quit the peak associations. The article explains why the "exit" option was selected in Denmark, while in Sweden the granting of additional voice helped persuade the medical association to withdraw its exit threat and to remain within the peak association. The two cases are interpreted as presaging a divergence in the paths being taken by the various Scandinavian welfare states.

  6. [Supply medicinal products improvement in outpatient care in a hospital pharmacy service].

    Science.gov (United States)

    Santiago Pérez, A; Peña Pedrosa, J A; Alguacil Pau, A I; Pérez Morales, A; Molina Muñoz, P; Benítez Giménez, M T

    Pharmaceutical care to outpatients is currently one of the main occupations of hospital pharmacy services (PEX). There are several questionnaires to measure the satisfaction of the PEX of a pharmacy service, and the results of these questionnaires can generate improvement actions that result in satisfaction. To verify if a satisfaction questionnaire for outpatients is valid for the generation of improvements in the care provided, and if after its implementation, the same questionnaire is able to detect changes in satisfaction. Prospective study of a single center carried out in a tertiary hospital in 2015 and 2016. A questionnaire previously validated with 16 Likert-type items was used. Demographic and classification data were collected. A descriptive analysis was performed and the internal consistency was calculated using the Cronbach's α value. A total of 258 questionnaires were collected in 2015 and 493 in 2016. There were no differences in the baseline characteristics of the patients and users of the service. The items with the lowest satisfaction scores in 2015 (comfort of the waiting room, dispensing privacy, drug pick-up time and medication pick-up time) guided the improvement actions to be implemented. In 2016 there was an improvement in the waiting time until collection in 12.3% (p = 0.002); in the comfort of the waiting room 4.9% (p = 0.304); business hours for medication collection, 10.7% (p = 0.013); and in the confidentiality of the dispensation 4% (p = 0.292). The remaining scores fluctuated minimally, with no statistical significance at all. A 5.1% improvement in overall satisfaction was found (p improve the care received in an outpatient unit of a pharmacy service. This same questionnaire is a tool to monitor the changes implemented to improve the care received. Copyright © 2018 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  7. Clinically Prepared Veterinary Students: Enhancing Veterinary Student Hands-on Experiences and Supporting Hospital Caseload Using Shelter Medicine Program

    Directory of Open Access Journals (Sweden)

    Jacob M. Shivley

    2018-05-01

    Full Text Available Referral-level medicine is important in the veterinary curriculum, however veterinary students also need a solid base knowledge of clinically relevant, routine surgical and diagnostic skills to be clinically prepared after graduation. Exposure to a referral-only, or primarily referral caseload, does not always provide veterinary students with the routine hands-on experiences and competencies expected by the American Veterinary Medical Association Council on Education, the Royal College of Veterinary Surgeons, the Australian Veterinary Boards Council, or prospective employers. The aim of this descriptive study was to assess how a shelter medicine program can fill the companion animal caseload gap and create the necessary hands-on experiences considered essential in the veterinary curriculum. Pedagogical frameworks, course curriculum and design, student experiences, and student assessments were described for three core curricular areas (surgery, medical days, population medicine of the Shelter Medicine Program at Mississippi State University. The shelter surgery experience provided a high-quality, high-volume spay/neuter environment where fourth-year students averaged 65 sterilization surgeries in two weeks and demonstrated a quantifiable decrease in surgical time. The shelter surgery experience added on average 9,000 small animal cases per year to the overall hospital caseload. Shelter medical days, where students provide veterinary care during on-site shelter visits, created opportunities for third-year students to directly interact with shelter animals by performing physical examinations and diagnostic testing, and to gain experience in developing treatment protocols and recommendations for commonly encountered problems. The shelter medical days experience averaged over 700 small animal cases per year and over 1,500 diagnostic procedures. Finally, students participated in 15 onsite shelter consultations where they obtained a working knowledge

  8. Clinically Prepared Veterinary Students: Enhancing Veterinary Student Hands-on Experiences and Supporting Hospital Caseload Using Shelter Medicine Program.

    Science.gov (United States)

    Shivley, Jacob M; Brookshire, Wilson C; Bushby, Philip A; Woodruff, Kimberly A

    2018-01-01

    Referral-level medicine is important in the veterinary curriculum, however veterinary students also need a solid base knowledge of clinically relevant, routine surgical and diagnostic skills to be clinically prepared after graduation. Exposure to a referral-only, or primarily referral caseload, does not always provide veterinary students with the routine hands-on experiences and competencies expected by the American Veterinary Medical Association Council on Education, the Royal College of Veterinary Surgeons, the Australian Veterinary Boards Council, or prospective employers. The aim of this descriptive study was to assess how a shelter medicine program can fill the companion animal caseload gap and create the necessary hands-on experiences considered essential in the veterinary curriculum. Pedagogical frameworks, course curriculum and design, student experiences, and student assessments were described for three core curricular areas (surgery, medical days, population medicine) of the Shelter Medicine Program at Mississippi State University. The shelter surgery experience provided a high-quality, high-volume spay/neuter environment where fourth-year students averaged 65 sterilization surgeries in two weeks and demonstrated a quantifiable decrease in surgical time. The shelter surgery experience added on average 9,000 small animal cases per year to the overall hospital caseload. Shelter medical days, where students provide veterinary care during on-site shelter visits, created opportunities for third-year students to directly interact with shelter animals by performing physical examinations and diagnostic testing, and to gain experience in developing treatment protocols and recommendations for commonly encountered problems. The shelter medical days experience averaged over 700 small animal cases per year and over 1,500 diagnostic procedures. Finally, students participated in 15 onsite shelter consultations where they obtained a working knowledge of biosecurity at a

  9. Overdependence on For-Profit Pharmacies: A Descriptive Survey of User Evaluation of Medicines Availability in Public Hospitals in Selected Nigerian States.

    Science.gov (United States)

    Ushie, Boniface Ayanbekongshie; Ugal, David Betelwhobel; Ingwu, Justin Agorye

    2016-01-01

    Lower availability of medicines in Nigerian public health facilities-the most affordable option for the masses-undermines global health reforms to improve access to health for all, especially the chronically ill and poor. Thus, a sizeable proportion of healthcare users, irrespective of purchasing power, buy medicines at higher costs from for-profit pharmacies. We examined user evaluation of medicine availability in public facilities and how this influences their choice of where to buy medicines in selected states-Cross River, Enugu and Oyo-in Nigeria. We approached and interviewed 1711 healthcare users using a semi-structured, interviewer-administered questionnaire as they exited for-profit pharmacies after purchasing medicines. This ensured that both clients who had presented at health facilities (private/public) and those who did not were included. Information was collected on why respondents could not buy medicines at the hospitals they attended, their views of medicine availability and whether their choice of where to buy medicines is influenced by non-availability. Respondents' mean age was 37.7±14.4 years; 52% were males, 59% were married, 82% earned ≥NGN18, 000 (US$57.19) per month, and 72% were not insured. Majority (66%) had prescriptions; of this, 70% were from public facilities. Eighteen percent of all respondents indicated that all their medicines were usually available at the public facilities, most (29%), some (44%) and not always available (10%). Reasons for using for-profit pharmacies included: health workers attitudes (43%), referral by providers (43%); inadequate money to purchase all prescribed drugs (42%) and cumbersome processes for obtaining medicines. Lower availability of medicines has serious implications for healthcare behavior, especially because of poverty. It is crucial for government to fulfill its mandate of equitable access to care for all by making medicines available and cheap through reviving and sustaining the drug revolving

  10. Activity based costing of diagnostic procedures at a nuclear medicine center of a tertiary care hospital.

    Science.gov (United States)

    Hada, Mahesh Singh; Chakravarty, Abhijit; Mukherjee, Partha

    2014-10-01

    Escalating health care expenses pose a new challenge to the health care environment of becoming more cost-effective. There is an urgent need for more accurate data on the costs of health care procedures. Demographic changes, changing morbidity profile, and the rising impact of noncommunicable diseases are emphasizing the role of nuclear medicine (NM) in the future health care environment. However, the impact of emerging disease load and stagnant resource availability needs to be balanced by a strategic drive towards optimal utilization of available healthcare resources. The aim was to ascertain the cost of diagnostic procedures conducted at the NM Department of a tertiary health care facility by employing activity based costing (ABC) method. A descriptive cross-sectional study was carried out over a period of 1 year. ABC methodology was utilized for ascertaining unit cost of different diagnostic procedures and such costs were compared with prevalent market rates for estimating cost effectiveness of the department being studied. The cost per unit procedure for various procedures varied from Rs. 869 (USD 14.48) for a thyroid scan to Rs. 11230 (USD 187.16) for a meta-iodo-benzyl-guanidine (MIBG) scan, the most cost-effective investigations being the stress thallium, technetium-99 m myocardial perfusion imaging (MPI) and MIBG scan. The costs obtained from this study were observed to be competitive when compared to prevalent market rates. ABC methodology provides precise costing inputs and should be used for all future costing studies in NM Departments.

  11. Activity based costing of diagnostic procedures at a nuclear medicine center of a tertiary care hospital

    International Nuclear Information System (INIS)

    Hada, Mahesh Singh; Chakravarty, Abhijit; Mukherjee, Partha

    2014-01-01

    Escalating health care expenses pose a new challenge to the health care environment of becoming more cost-effective. There is an urgent need for more accurate data on the costs of health care procedures. Demographic changes, changing morbidity profile, and the rising impact of noncommunicable diseases are emphasizing the role of nuclear medicine (NM) in the future health care environment. However, the impact of emerging disease load and stagnant resource availability needs to be balanced by a strategic drive towards optimal utilization of available healthcare resources. The aim was to ascertain the cost of diagnostic procedures conducted at the NM Department of a tertiary health care facility by employing activity based costing (ABC) method. A descriptive cross-sectional study was carried out over a period of 1 year. ABC methodology was utilized for ascertaining unit cost of different diagnostic procedures and such costs were compared with prevalent market rates for estimating cost effectiveness of the department being studied. The cost per unit procedure for various procedures varied from Rs. 869 (USD 14.48) for a thyroid scan to Rs. 11230 (USD 187.16) for a meta-iodo-benzyl-guanidine (MIBG) scan, the most cost-effective investigations being the stress thallium, technetium-99 m myocardial perfusion imaging (MPI) and MIBG scan. The costs obtained from this study were observed to be competitive when compared to prevalent market rates. ABC methodology provides precise costing inputs and should be used for all future costing studies in NM Departments

  12. Hospitals

    DEFF Research Database (Denmark)

    Mullins, Michael

    2013-01-01

    The challenge could be briefly seen in these terms: hospitals as places for treatment where there’s a technology focus and hospitals for healing where there’s a human focus. In the 60s - 70s wave of new hospital building, an emphasis on technology can be seen. It’s time to move from the technology...... focus. It is not enough to consider only the factors of function within architecture, hygiene, economy and logistics. We also need to look at aspects of aesthetics, bringing nature into the building, art, color, acoustics, volume and space as we perceive them. Contemporary methods and advances...... placed, accessible, provided with plenty of greenery, and maximize sensory impressions, providing sounds, smells, sight and the possibility to be touched. This is a very well documented area I can say. Hygiene, in terms of architecture can give attention to hand wash facilities and their positioning...

  13. Medicine, madness and murderers: the context of English forensic psychiatric hospitals.

    Science.gov (United States)

    McDonald, Ruth; Furtado, Vivek; Völlm, Birgit

    2017-08-21

    Purpose The purpose of this paper is to add to the understanding of context by shedding light on the relationship between context and organisational actors' abilities to resolve ongoing challenges. Design/methodology/approach The authors used qualitative data collection (interviews and focus groups with staff and site visits to English forensic psychiatry hospitals) and the analysis was informed by Lefebvre's writings on space. Findings Responses to ongoing challenges were both constrained and facilitated by the context, which was negotiated and co-produced by the actors involved. Various (i.e. societal and professional) dimensions of context interacted to create tensions, which resulted in changes in service configuration. These changes were reconciled, to some extent, via discourse. Despite some resolution, the co-production of context preserved contradictions which mean that ongoing challenges were modified, but not resolved entirely. Originality/value The paper highlights the importance of viewing context as co-produced in a continuous manner. This helps us to delineate and understand its dynamic nature and its relationship with the everyday actions and beliefs of the organisational actors concerned.

  14. Present status of radioactive wastes from nuclear medicine in the hospitals of Guangdong province and the preliminary exploration to some relevant problems

    International Nuclear Information System (INIS)

    Kong Lingfeng

    1999-01-01

    In Guangdong province of China nuclear medicine is quite developed. There are about 50 hospitals (not including the hospitals only with radioimmunoassay) in the medical units of Guangdong province which have their own nuclear medical departments. More than 40 ECTs are owned by the hospitals and more than 10 radioisotopes, such as 131 I, 125 I, 99 Mo- 99m Tc, 90 Sr, 32 P, 153 Sm etc., are mainly used. The thesis, based on the author's work in checking the use of radiopharmaceuticals in the hospitals of Guangdong province, investigates and summarizes the actual situations of the use of radiopharmaceuticals and the discharge and treatment of radioactive wastes in nuclear medical departments of the hospitals in Guangdong province. According to the actual problems in administration and disposal of the radioactive wastes in the hospitals, it makes a preliminary exploration and puts forward some countermeasures and suggestions on how to supervise and administer the discharge of radioactive wastes in the hospitals, and how to further solve them, in order to prevent and reduce the radioactive contamination and damage to the environment and the public caused by the development of nuclear medicine

  15. Winter Camp: A Blog from the Greenland Summit, Part II

    Science.gov (United States)

    Koenig, Lora

    2009-01-01

    An earlier issue presents the first half of the author's experience living and working at the National Science Foundation's (NSF) Greenland Summit Camp. The author is a remote-sensing glaciologist at NASA s Goddard Space Flight Center. She took measurements that will be used to validate data collected by NASA s Aqua, Terra, and Ice, Clouds, and land Elevation Satellite (ICESat) satellites with ground-truth measurements of the Greenland Ice Sheet she made at Summit Camp from November 2008-February 2009. This article presents excerpts from the second half of her stay and work at the Greenland Summit.

  16. Proceedings Report from the Sustainability Education Summit, September 20-21, 2010

    Science.gov (United States)

    US Department of Education, 2011

    2011-01-01

    The first-ever U. S. Department of Education summit on sustainability, "Sustainability Education Summit: Citizenship and Pathways for a Green Economy," was held on Sept. 20-21, 2010, in Washington, D.C. The Sustainability Education Summit (the Summit) brought together leaders from higher education, business and industry, labor,…

  17. Complementary and alternative medicine use among elderly patients living with chronic diseases in a teaching hospital in Ethiopia.

    Science.gov (United States)

    Ayele, Asnakew Achaw; Tegegn, Henok Getachew; Haile, Kaleab Taye; Belachew, Sewunet Admasu; Mersha, Amanual Getnet; Erku, Daniel Asfaw

    2017-12-01

    The use of complementary and alternative medicine (CAM) among patients with chronic diseases has grown rapidly worldwide. Yet, little has been known about CAM use by elderly patients with chronic diseases in Ethiopia. This study aimed at assessing the prevalence and reasons for CAM utilization among elderly patients living with chronic diseases in Ethiopia. An institution-based quantitative cross-sectional survey was conducted among elderly patients with chronic disease attending outpatient ambulatory clinics of University of Gondar referral and teaching hospital (UoGRTH). An interviewer-administered and semi-structured questionnaire were utilized to collect the data. Of the total respondents, 240 (74%) reported the use of CAM, with herbal medicine and spiritual healing being the most commonly utilized CAM modalities (50.4% and 40.8% respectively). Dissatisfaction with conventional therapy (40.8%) and belief in the effectiveness of CAM (30.8%) are the most commonly cited reasons for the use of CAM therapies. Rural residency, higher educational status, higher average monthly income and presence of co-morbidity were positively associated with the use of CAM. This survey revealed a higher rate of CAM use among elderly patients with chronic diseases, along with a very low rate of disclosing their use to their health care providers. Special attention should be given for these patient population due to the potentially harmful interaction of different herbal remedies with the prescribed medications, thereby predisposing the patient to untoward adverse effects and compromised overall health outcome. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Electronic health record in the internal medicine clinic of a Brazilian university hospital: Expectations and satisfaction of physicians and patients.

    Science.gov (United States)

    Duarte, Jurandir Godoy; Azevedo, Raymundo Soares

    2017-06-01

    To evaluate the satisfaction and expectations of patients and physicians before and after the implementation of an electronic health record (EHR) in the outpatient clinic of a university hospital. We conducted 389 interviews with patients and 151 with physicians before and after the implementation of a commercial EHR at the internal medicine clinic of Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo (HC-FMUSP), Brazil. The physicians were identified by their connection to the outpatient clinic and categorized by their years since graduation: residents and preceptors (with 10 years or less of graduation) or assistants (with more than 10 years of graduation). The answers to the questionnaire given by the physicians were classified as favorable or against the use of EHR, before and after the implementation of this system in this clinic, receiving 1 or 0 points, respectively. The sum of these points generated a multiple regression score to determine which factors contribute to the acceptance of EHR by physicians. We also did a third survey, after the EHR was routinely established in the outpatient clinic. The degree of patient satisfaction was the same before and after implementation, with more than 90% positive evaluations. They noted the use of the computer during the consultation and valued such use. Resident (younger) physicians had more positive expectations than assistants (older physicians) before EHR implementation. This optimism was reduced after implementation. In the third evaluation the use of EHR was higher among resident physicians. Resident physicians perceived and valued the EHR more and used it more. In 28 of the 57 questions on performance of clinical tasks, resident physicians found it easier to use EHR than assistant physicians with significant differences (pclinical setting should be preceded by careful planning to improve physician's adherence to the use of EHR. Patients do not seem to notice much difference to the

  19. Complementary alternative medicine use among patients with dengue fever in the hospital setting: a cross-sectional study in Malaysia.

    Science.gov (United States)

    Ching, SiewMooi; Ramachandran, Vasudevan; Gew, Lai Teck; Lim, Sazlyna Mohd Sazlly; Sulaiman, Wan Aliaa Wan; Foo, Yoke Loong; Zakaria, Zainul Amiruddin; Samsudin, Nurul Huda; Lau, Paul Chih Ming Chih; Veettil, Sajesh K; Hoo, Fankee

    2016-01-29

    In Malaysia, the number of reported cases of dengue fever demonstrates an increasing trend. Since dengue fever has no vaccine or antiviral treatment available, it has become a burden. Complementary and alternative medicine (CAM) has become one of the good alternatives to treat the patients with dengue fever. There is limited study on the use of CAM among patients with dengue fever, particularly in hospital settings. This study aims to determine the prevalence, types, reasons, expenditure, and resource of information on CAM use among patients with dengue fever. This is a descriptive, cross-sectional study of 306 patients with dengue fever, which was carried out at the dengue clinic of three hospitals. Data were analysed using IBM SPSS Statistics version 21.0 and logistic regression analysis was used to determine the factors associated with CAM use. The prevalence of CAM use was 85.3% among patients with dengue fever. The most popular CAMs were isotonic drinks (85.8%), crab soup (46.7%) and papaya leaf extract (22.2%). The most common reason for CAM use was a good impression of CAM from other CAM users (33.3%). The main resource of information on CAM use among patients with dengue fever was family (54.8%). In multiple logistic regression analysis, dengue fever patients with a tertiary level are more likely to use CAM 5.8 (95% confidence interval (CI 1.62-20.45) and 3.8 (95% CI 1.12-12.93) times than secondary level and primary and below respectively. CAM was commonly used by patients with dengue fever. The predictor of CAM use was a higher level of education.

  20. Use of complementary and alternative medicine by cancer patients at the University of Nigeria Teaching Hospital, Enugu, Nigeria

    Directory of Open Access Journals (Sweden)

    Anarado Agnes N

    2007-09-01

    Full Text Available Abstract Background The use of Complementary and Alternative Medicine (CAM by cancer patients is very common and varies between populations. The referenced English literature has no local study from Africa on this subject. This study was conducted to define the prevalence, pattern of use, and factors influencing the use of CAM by cancer patients at the University of Nigeria Teaching Hospital Enugu (UNTH-E, Nigeria Method Face-to-face interviews using semi-structured questionnaire were used to determine the use of CAM by cancer patients. All consenting cancer patients were interviewed as they presented at the core surgical units of the UNTH- E, from June 2003 to September 2005. Results 160 patients were interviewed; 68 (42.5% were males and 94 (57.5% were females. Ages ranged from 13–86 years. Breast, urogenital system, gastrointestinal system, and soft tissue cancers predominated. One hundred and four patients (65.0% have used CAM at some time during their current cancer illness; 56 (35.0% patients have not used any form of CAM. There were more females than males among the non-CAM users. The use of CAM was not affected by age, marital status, level of education, religious affiliation, or socioeconomic status. The most frequently used CAMs were herbs (51.9%, faith/prayer healing (49.4%, aloe vera (23.1%, Forever Living Products (16.3%, medicinal tea (14.4%, and Blackstone (12.5%. Over 23% of those who used CAM were satisfied, but 68.3% were disappointed. Most users (67.3% did not see any benefit from the CAM, but 25% could describe some specific benefits. More than 21% of users reported various unwanted effects. While 86.5% of CAM users will use orthodox medicine instead of CAM in the future, 9.6% will use the two together to help each other. Most users (79.8% will not repeat CAM or recommend its use for cancer. The majority of patients (55.8% did not mention their use of CAM to their doctors – mostly because the doctor did not ask

  1. Port Stakeholder Summit: Advancing More Sustainable Ports (April 2014)

    Science.gov (United States)

    EPA's National Port Stakeholders Summit, Advancing More Sustainable Ports, focused on actions to protect air quality while reducing climate risk and supporting economic growth, making ports more environmentally sustainable.

  2. Report of the DHS National Small Vessel Security Summit

    National Research Council Canada - National Science Library

    Brownstein, Charles; Baker, John; Hull, Peter; Minogue, Nicholas; Murphy, George; Winston, Phyllis

    2007-01-01

    The purpose of the National Small Vessel Security Summit (NSVSS) was to engage private, commercial and government stakeholders in discussions on a range of issues involving the security risks posed by small vessels in the U.S...

  3. European Summit on the Prevention and Self-Management of Chronic Respiratory Diseases: report of the European Union Parliament Summit (29 March 2017).

    Science.gov (United States)

    Hellings, Peter W; Borrelli, David; Pietikainen, Sirpa; Agache, Ioana; Akdis, Cezmi; Bachert, Claus; Bewick, Michael; Botjes, Erna; Constantinidis, Jannis; Fokkens, Wytske; Haahtela, Tari; Hopkins, Claire; Illario, Maddalena; Joos, Guy; Lund, Valerie; Muraro, Antonella; Pugin, Benoit; Seys, Sven; Somekh, David; Stjärne, Pär; Valiulis, Arunas; Valovirta, Erkka; Bousquet, Jean

    2017-01-01

    On March 29, 2017, a European Summit on the Prevention and Self-Management of Chronic Respiratory Diseases (CRD) was organized by the European Forum for Research and Education in Allergy and Airway Diseases. The event took place in the European Parliament of Brussels and was hosted by MEP David Borrelli and MEP Sirpa Pietikainen. The aim of the Summit was to correspond to the needs of the European Commission and of patients suffering from CRD to join forces in Europe for the prevention and self-management. Delegates of the European Rhinologic Society, European Respiratory Society, European Academy of Allergy and Clinical Immunology, European Academy of Paediatrics, and European Patients Organization EFA all lectured on their vision and action plan to join forces in achieving adequate prevention and self-management of CRD in the context of Precision Medicine. Recent data highlight the preventive capacity of education on optimal care pathways for CRD. Self-management and patient empowerment can be achieved by novel educational on-line materials and by novel mobile health tools enabling patients and doctors to monitor and optimally treat CRDs based on the level of control. This report summarizes the contributions of the representatives of different European academic stakeholders in the field of CRD.

  4. At crossroads between laboratory disciplines and medical advancements-The Center for Molecular Medicine at the Karolinska University Hospital.

    Science.gov (United States)

    Terenius, Lars

    2009-04-01

    The Center for Molecular Medicine (CMM) was conceived and built to respond to the challenges presented by the still common chronic diseases such as atherosclerosis, rheumatoid arthritis, diabetes, allergy, and alcoholism. The Karolinska University Hospital has a proud history of research with developments such as the pacemaker and the gamma-knife. The nearby Karolinska Institutet has a strong presence internationally on the basic sciences. However, the challenges of the "new biology" and the access to the complete human genome, transcriptome, and proteome raised the need for a new research institute that could meet the experimental requirements for translational research. A Foundation was established in 1994 with the goal to build and govern the new enterprise. After an intense fundraising campaign, building could start and CMM (Fig. 1) was inaugurated in 1997. Through more than 10 years of existence, it has evolved into a multidisciplinary research institute with research in four programs, Cardiovascular and Metabolic Diseases, Infection and Immunity, Neuropsychiatric Diseases, and Medical Genetics. Performance parameters have been introduced and scientific impact and relevance are followed annually. Transparency and collaboration between groups (now 28 groups with an approximate total of 400 people engaged in research) and leadership training for junior faculty are means to stimulate "centerness".

  5. Negotiating competency, professionalism and risk: the integration of complementary and alternative medicine by nurses and midwives in NHS hospitals.

    Science.gov (United States)

    Cant, Sarah; Watts, Peter; Ruston, Annmarie

    2011-02-01

    This qualitative interview study examined the use of complementary and alternative medicine (CAM) by nurses and midwives in NHS hospital settings in 2008 in the UK. It showed that the groundswell of interest in CAM in the 1990s had diminished by this time due to changes to policy and funding, and increasingly stringent clinical governance. Nevertheless, CAM provided an opportunity for committed and self-motivated practitioners to extend their therapeutic repertoire and develop affective dimensions of practice. However, the integration of CAM did not afford the autonomy, status and material gains traditionally associated with a collective professional project. In practice, occupational strategies were individualistic, and grounded in the assertion of competency through expressions of professionalism rather than the credentialism which underpins classic professionalisation. Central to these strategies was CAM related risk, which became a means by which to claim occupational space. However, the extent to which the adoption of CAM enhanced the nurses' and midwives' roles was limited by traditional medical authority; the uncertain status of CAM knowledge; and the absence of collective strategies - which together often left practitioners in a position of vulnerability. Copyright © 2011 Elsevier Ltd. All rights reserved.

  6. Analysis of Herbal Medicine Prescriptions for Patients in An Academic Korean Medical Hospital: A Cross Sectional Study of Electronic Medical Records (2010-2013).

    Science.gov (United States)

    Lee, Byung-Wook; Lee, Hyeon-Yeop; Heo, Kwang-Ho; Cho, Hyun-Woo; Hwang, Man-Suk; Heo, In; Shin, Byung-Cheul; Hwang, Eui-Hyoung

    2018-06-01

    To obtain fundamental information for the standardization of herbal medicine in Korea. We analyzed the herbal medicine prescription data of patients at the Pusan National University Korean Medicine Hospital from March 2010 to February 2013. We used the Dongui-Bogam (Dong Yi Bao Jian) to classify prescribed herbal medicines. The study revealed that the most frequently prescribed herbal medicine was 'Liuwei Dihuang Pill (LWDHP, )' which was used for invigorating 'Shen (Kidndy)-yin'. 'LWDHP' was most frequently prescribed to male patients aged 50-59, 60-69, 70-79 and 80-89 years, and 'Xionggui Tiaoxue Decoction (XGTXD, )' was most frequently prescribed to female patients aged 30-39 and 40-49 years. According to the International Classification of Diseases (ICD) codes, 'Diseases of the musculoskeletal system and connective tissue' showed the highest prevalence. 'LWDHP' and 'XGTXD' was the most frequently prescribed in categories 5 and 3, respectively. Based on the percentage of prescriptions for each sex, 'Ziyin Jianghuo Decoction ()' was prescribed to mainly male patients, and 'XGTXD' with 'Guima Geban Decoction ()' were prescribed to mainly female patients. This study analysis successfully determined the frequency of a variety of herbal medicines, and many restorative herbal medicines were identified and frequently administered.

  7. The Dubai 2015 Global Islamic Economy Summit - and what it will take to become a heavyweight champion

    OpenAIRE

    Wilson, Jonathan

    2015-01-01

    I just attended the 2015 Global Islamic Economy Summit, in Dubai and it was a fantastic experience. The hospitality was first class and only surpassed by the energy, passion, sincerity and friendship selflessly handed out to everyone attending.\\ud \\ud However, two things that I think need addressing are the understanding, articulation, and execution of two key areas, which were weak in terms of intelligence and insight: Consumer Behaviour and Branding.

  8. G8 SUMMIT MEETING AT EVIAN

    CERN Multimedia

    2003-01-01

    The Swiss and French authorities have informed CERN that plans are in hand for the safety and traffic arrangements associated with the G8 Summit Meeting, which will be held in Evian between 1 and 3 June 2003. Detailed information will be communicated in the coming weeks. However, changes to traffic arrangements on certain sections of the road network in the Canton of Geneva (particularly the left bank) and the neighbouring parts of France (specially Haute-Savoie) from 22 May 2003 can already be predicted. All pertinent information and any recommendations by the authorities concerned will be brought to the attention of the personnel as soon as possible. In the mean time, those concerned can consult the various Web sites devoted to this event, especially: - http://www.g8.fr/evian/english/home.html (French site); - http://www.g8info.ch/accueil.htm (Swiss site). Relations with the Host States Service http://www.cern.ch/relations/ Tel. 72848

  9. Canada's green plan and the earth summit

    International Nuclear Information System (INIS)

    1992-01-01

    In June 1992 one of the largest international conferences ever held took place in Rio de Janeiro, Brazil. It was attended by the heads of state of more than 100 countries. The ambitious aim of the United Nations Conference on Environment and Development (UNCED) -- the Earth Summit -- was to try to reconcile the need for global environmental protection with the need for continuing economic development. The purpose of this document is to provide a brief account of the results of Rio and the way Canadians participated. In addition, this document outlines the immediate priorities of the Government of Canada and the actions under way. It is not meant to be a comprehensive response to the entire Rio agenda. Rather, it is intended to report to Canadians on the steps the government has taken so far and, where possible, the direction in which it is headed. On the number of important issues, the government's plans are well advanced. For example, action is well under way on the Convention on Climate Change, as high-lighted in the Green Plan's National Action Strategy on Global Warming. On a number of other issues, it is clear that there is work to be done. The government is committed to completing the task through continuing action and leadership

  10. An eighteen year experience of differentiated thyroid carcinoma treatment with 131 radioiodine at the Military Hospital Nuclear Medicine Department

    Energy Technology Data Exchange (ETDEWEB)

    Jofre, M J; Sierralta, M P [Military Hospital Nuclear Medicine Department, Santiago (Chile); Del Campo, G; Ide, A; Wiener, R [Department of Endocrinology of the Military Hospital, Santiago (Chile)

    2002-09-01

    An eighteen year experience of differentiated thyroid carcinoma treatment with 131 radioiodine at the Military Hospital Nuclear Medicine Department. Since the beginning of Nuclear Medicine, the thyroid gland has been an important subject for study. In the fifties, the complimentary use of 131 radioiodine after differentiated thyroid carcinoma (DTC) surgery was postulated. The aim of the study was to analyze our experience of the management of patients with DTC. Material and methods: An 18-year retrospective analysis was made including 109 patients with previous diagnosis of DTC, 90 % females, mean age 47 +/- 17 y.o. (range: 19-85 y.o). Tumoral histology was 67 % papillary, 28 % follicular and 5% non-determined in the medical record. First doses of 131 radioiodine were between 50 and 200 mCi. In all, 156 radioiodine doses were given and 6 patients received 4 doses or more, with total doses between 300 and 570 mCi. Results: The distribution of first and total radioiodine doses is presented in the table below. Of the group of patients who received a first radioiodine dose of less than 100 mCi post surgery, 79% were treated before 1990. Those who received 150mCi or more had cervical ganglionar compromise, trachea invasion or subtotal thyroidectomy. In 50% of the patients who received 4 or more doses, the first two doses were 50 mCi. It is important to mention that there was one patient who received 8 radioiodine doses in 4 years , seven of them were 50 mCi ( total dose 438 mCi). This patient presented trachea and larynx invasion in the early stages, with a persistent focus in the left supraclavicular region. She later developed pulmonary fibrosis, for which she was treated with complimentary radiotherapy (30 Gy), before dying. Distribution of radioiodine doses is presented. Conclusion: It is important to emphasize the validity of a first 131 radioiodine dose after surgery of DTC patients of 100 mCi or more, to obtain the ablation of the remaining thyroid tissue. This

  11. An eighteen year experience of differentiated thyroid carcinoma treatment with 131 radioiodine at the Military Hospital Nuclear Medicine Department

    International Nuclear Information System (INIS)

    Jofre, M.J.; Sierralta, M.P.; Del Campo, G.; Ide, A.; Wiener, R.

    2002-01-01

    An eighteen year experience of differentiated thyroid carcinoma treatment with 131 radioiodine at the Military Hospital Nuclear Medicine Department. Since the beginning of Nuclear Medicine, the thyroid gland has been an important subject for study. In the fifties, the complimentary use of 131 radioiodine after differentiated thyroid carcinoma (DTC) surgery was postulated. The aim of the study was to analyze our experience of the management of patients with DTC. Material and methods: An 18-year retrospective analysis was made including 109 patients with previous diagnosis of DTC, 90 % females, mean age 47 +/- 17 y.o. (range: 19-85 y.o). Tumoral histology was 67 % papillary, 28 % follicular and 5% non-determined in the medical record. First doses of 131 radioiodine were between 50 and 200 mCi. In all, 156 radioiodine doses were given and 6 patients received 4 doses or more, with total doses between 300 and 570 mCi. Results: The distribution of first and total radioiodine doses is presented in the table below. Of the group of patients who received a first radioiodine dose of less than 100 mCi post surgery, 79% were treated before 1990. Those who received 150mCi or more had cervical ganglionar compromise, trachea invasion or subtotal thyroidectomy. In 50% of the patients who received 4 or more doses, the first two doses were 50 mCi. It is important to mention that there was one patient who received 8 radioiodine doses in 4 years , seven of them were 50 mCi ( total dose 438 mCi). This patient presented trachea and larynx invasion in the early stages, with a persistent focus in the left supraclavicular region. She later developed pulmonary fibrosis, for which she was treated with complimentary radiotherapy (30 Gy), before dying. Distribution of radioiodine doses is presented. Conclusion: It is important to emphasize the validity of a first 131 radioiodine dose after surgery of DTC patients of 100 mCi or more, to obtain the ablation of the remaining thyroid tissue. This

  12. Transfusion practice in anemic, non-bleeding patients: Cross-sectional survey of physicians working in general internal medicine teaching hospitals in Switzerland.

    Science.gov (United States)

    von Babo, Michelle; Chmiel, Corinne; Müggler, Simon Andreas; Rakusa, Julia; Schuppli, Caroline; Meier, Philipp; Fischler, Manuel; Urner, Martin

    2018-01-01

    Transfusion practice might significantly influence patient morbidity and mortality. Between European countries, transfusion practice of red blood cells (RBC) greatly differs. Only sparse data are available on transfusion practice of general internal medicine physicians in Switzerland. In this cross-sectional survey, physicians working in general medicine teaching hospitals in Switzerland were investigated regarding their self-reported transfusion practice in anemic patients without acute bleeding. The definition of anemia, transfusion triggers, knowledge on RBC transfusion, and implementation of guidelines were assessed. 560 physicians of 71 hospitals (64%) responded to the survey. Anemia was defined at very diverging hemoglobin values (by 38% at a hemoglobin Switzerland. Identifying and subsequently correcting this deficit in knowledge translation may have a significant impact on patient care.

  13. Pattern of complementary and alternative medicine use among Malaysian stroke survivors: A hospital-based prospective study

    Directory of Open Access Journals (Sweden)

    Azidah Abdul Kadir

    2015-07-01

    Full Text Available Complementary and alternative medicine (CAM; 補充與替代醫學 bǔ chōng yǔ tì dài yī xué is widely practiced among stroke patients globally. We conducted a study to determine the pattern of CAM use and its associated factors in stroke survivors attending a tertiary hospital in Malaysia within 6 months after the stroke. This was a prospective cohort study that included all stroke patients who were admitted to a tertiary center in Malaysia from December 2009 to December 2010. Patients were interviewed and examined within 72 hours of admission. The sociodemographic data and medical history were collected. Clinical examinations were done to assess the stroke severity using the Scandinavian Stroke Scale and functional status based on modified Barthel index (MBI. Patients were reassessed at 6 months after the stroke on the CAM use and functional status (MBI. The response rate was 92%. The study population consisted of 52 men and 41 women with a mean age of 63.7 ± 10.3 years. Sixty-seven percent practiced CAM. Massage was the most frequently used method (63.4%, followed by vitamins (7.5%. In multiple logistic regression analysis, functional status (MBI score on discharge (p = 0.004, odds ratio 1.034, 95% confidence interval 1.01–1.06 and Scandinavian Stroke Scale score (p = 0.045, odds ratio 1.87, 95% confidence interval 1.01–3.43 were significant predictors for use of CAM. In conclusion, the use of CAM among stroke survivors is high. Patients who have better functional status on discharge and less severe stroke are more likely to use CAM.

  14. Establishing data-intensive healthcare: the case of Hospital Electronic Prescribing and Medicines Administration systems in Scotland

    Directory of Open Access Journals (Sweden)

    Kathrin Cresswell

    2016-10-01

    Full Text Available Background Creating learning health systems, characterised by the use and repeated reuse of demographic, process and clinical data to improve the safety, quality and efficiency of care, is a key aim in realising the potential benefits and efficiency savings associated with the implementation of health information technology. Objectives We sought to investigate stakeholder perspectives on and experiences of the implementation of hospital electronic prescribing and medicines administration (HEPMA systems in Scotland and use these to inform political decisions on approaches to promoting the use and reuse of digitised prescribing and medication administration data in order to improve care processes and outcomes. Methods We identified and recruited key national stakeholders involved in implementing and/or using HEPMA data from generic and specialty systems. These included representatives from healthcare settings (i.e. doctors, pharmacists and nurses, managers of existing national databases, policy makers, healthcare analytics companies, system suppliers and patient representatives. We conducted multi-disciplinary focus group discussions, audio-recorded these, transcribed data verbatim and thematically analysed the transcripts with the help of NVivo10. In analysing the data, we drew on theoretical and previous empirical work on information infrastructures. Results We identified the following key themes: 1 micro-factors – usability of systems and motivating users to input data; 2 meso-factors – developing technical and organisational infrastructures to facilitate the aggregation of data; and 3 macro-factors – facilitating interoperability and data reuse at larger scales to ensure that data are effectively generated and used. Conclusions This work is relevant not only to countries in the early stages of data strategy development but also to countries aiming to aggregate data at national levels. An overall shared vision of a learning health system

  15. Air quality and acute myocardial infarction in adults during the 2016 Hangzhou G20 summit.

    Science.gov (United States)

    Wang, Ming-Wei; Chen, Juan; Cai, Ran

    2018-04-01

    To fulfill its commitment to a successful Hangzhou G20 summit (4 to 5 September 2016), the Chinese government implemented a series of measures to improve the air quality in Hangzhou. We report findings on air quality and acute myocardial infarction (AMI) hospital admissions in adults during the Hangzhou G20 summit. Three study periods were defined. The first period was pre-G20 (28 July to 27 August: limited restrictions on industrial emissions). The second period was G20 (28 August to 6 September) when there were further restrictions on industrial emissions and increased transportation restrictions. The third period was post-G20 (7 September to 6 October) when restrictions were relaxed again. The mean number of AMI admissions per day was, respectively, 8.2 during G20, 13.3 during pre-G20, and 15.1 during post-G20. We used time-series Poisson regression models to estimate the relative risk (RR) for AMI associated with pollution levels. Our results suggest that the air quality improvement can reduce the number of hospital admissions for AMI.

  16. Check-up and follow-up of papillary and follicular thyroid carcinoma in the department of nuclear medicine at Ibn Sina hospital Rabat

    International Nuclear Information System (INIS)

    Ben Rais Aouad, N.; Ghfir, I.; Guerrouj, H.; Fellah, S.; Rahali, J.; Ksyar, R.; Missoum, F.; Bssis, A.; Azrak, S.

    2009-01-01

    In the department of nuclear medicine at Ibn Sina university hospital. Thyroid carcinoma follow-up strategy has been modified and includes cervical ultrasonography and thyroglobulin measurement. The role of radio-iodine scanning in the management of differentiated thyroid carcinoma is decreasing. Papillary and follicular carcinoma have good prognosis but late metastases exist and can lead to death. A lifelong follow-up is therefore mandatory. The main goal of follow-up is to detect earlier persistent or recurrent disease. (authors)

  17. On a Work Expected to the Department of Emergency and Critical Care Medicine and the Emergency Unit of the Niigata University Hospital

    OpenAIRE

    小山, 真; Koyama, Shin

    2001-01-01

    The author would like to celebrate the start of the Department of emergency and critical care medicine and the Emergency unit of the Niigata University Hospital. The author also wishes to express his opinion, which is mentioned below, on preparing the Department and the Emergency unit for their future activity. 1 . The stuff members of the Department are expected to instruct undergraduate students in the knowledge and technique of Triage and the first aid in emergency exactly. 2 . The Emergen...

  18. The derivation and validation of a simple model for predicting in-hospital mortality of acutely admitted patients to internal medicine wards.

    Science.gov (United States)

    Sakhnini, Ali; Saliba, Walid; Schwartz, Naama; Bisharat, Naiel

    2017-06-01

    Limited information is available about clinical predictors of in-hospital mortality in acute unselected medical admissions. Such information could assist medical decision-making.To develop a clinical model for predicting in-hospital mortality in unselected acute medical admissions and to test the impact of secondary conditions on hospital mortality.This is an analysis of the medical records of patients admitted to internal medicine wards at one university-affiliated hospital. Data obtained from the years 2013 to 2014 were used as a derivation dataset for creating a prediction model, while data from 2015 was used as a validation dataset to test the performance of the model. For each admission, a set of clinical and epidemiological variables was obtained. The main diagnosis at hospitalization was recorded, and all additional or secondary conditions that coexisted at hospital admission or that developed during hospital stay were considered secondary conditions.The derivation and validation datasets included 7268 and 7843 patients, respectively. The in-hospital mortality rate averaged 7.2%. The following variables entered the final model; age, body mass index, mean arterial pressure on admission, prior admission within 3 months, background morbidity of heart failure and active malignancy, and chronic use of statins and antiplatelet agents. The c-statistic (ROC-AUC) of the prediction model was 80.5% without adjustment for main or secondary conditions, 84.5%, with adjustment for the main diagnosis, and 89.5% with adjustment for the main diagnosis and secondary conditions. The accuracy of the predictive model reached 81% on the validation dataset.A prediction model based on clinical data with adjustment for secondary conditions exhibited a high degree of prediction accuracy. We provide a proof of concept that there is an added value for incorporating secondary conditions while predicting probabilities of in-hospital mortality. Further improvement of the model performance

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

    Science.gov (United States)

    Itoh, Tsunetoshi

    2009-01-01

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

  20. Integrating the Principles of Evidence Based Medicine and Evidence Based Public Health: Impact on the Quality of Patient Care and Hospital Readmission Rates in Jordan

    Directory of Open Access Journals (Sweden)

    Mohammad S. Alyahya

    2016-08-01

    Full Text Available Introduction: Hospital readmissions impose not only an extra burden on health care systems but impact patient health outcomes. Identifying modifiable behavioural risk factors that are possible causes of potentially avoidable readmissions can lower readmission rates and healthcare costs. Methods: Using the core principles of evidence based medicine and public health, the purpose of this study was to develop a heuristic guide that could identify what behavioural risk factors influence hospital readmissions through adopting various methods of analysis including regression models, t-tests, data mining, and logistic regression. This study was a retrospective cohort review of internal medicine patients admitted between December 1, 2012 and December 31, 2013 at King Abdullah University Hospital, in Jordan. Results: 29% of all hospitalized patients were readmitted during the study period. Among all readmissions, 44% were identified as potentially avoidable. Behavioural factors including smoking, unclear follow-up and discharge planning, and being non-compliant with treatment regimen as well as discharge against medical advice were all associated with increased risk of avoidable readmissions. Conclusion: Implementing evidence based health programs that focus on modifiable behavioural risk factors for both patients and clinicians would yield a higher response in terms of reducing potentially avoidable readmissions, and could reduce direct medical costs.

  1. Integrating the Principles of Evidence Based Medicine and Evidence Based Public Health: Impact on the Quality of Patient Care and Hospital Readmission Rates in Jordan

    Science.gov (United States)

    Hijazi, Heba H.; Alshraideh, Hussam A.; Alsharman, Mohammad Aser; Al Abdi, Rabah; Harvey, Heather Lea

    2016-01-01

    Introduction: Hospital readmissions impose not only an extra burden on health care systems but impact patient health outcomes. Identifying modifiable behavioural risk factors that are possible causes of potentially avoidable readmissions can lower readmission rates and healthcare costs. Methods: Using the core principles of evidence based medicine and public health, the purpose of this study was to develop a heuristic guide that could identify what behavioural risk factors influence hospital readmissions through adopting various methods of analysis including regression models, t-tests, data mining, and logistic regression. This study was a retrospective cohort review of internal medicine patients admitted between December 1, 2012 and December 31, 2013 at King Abdullah University Hospital, in Jordan. Results: 29% of all hospitalized patients were readmitted during the study period. Among all readmissions, 44% were identified as potentially avoidable. Behavioural factors including smoking, unclear follow-up and discharge planning, and being non-compliant with treatment regimen as well as discharge against medical advice were all associated with increased risk of avoidable readmissions. Conclusion: Implementing evidence based health programs that focus on modifiable behavioural risk factors for both patients and clinicians would yield a higher response in terms of reducing potentially avoidable readmissions, and could reduce direct medical costs. PMID:28413365

  2. People, poverty and the Earth Summit.

    Science.gov (United States)

    Wheeler, J

    1992-01-01

    UNCED is about human beings managing their affairs so that all can achieve a reasonably good life without destroying the life-supporting environment. Currently human activities are approaching an upset of environmental balance through production of greenhouse gases, depletion of the ozone layer, and reduction of natural resources. Equity is the right to a decent life for the current human population of 5.5 billion and the future 10 billion expected within the next 50 years. A minimum use of environmental space/person is required. The Earth Summit will be a broad statement of environmental policy. Agenda 21 includes 115 action programs within 40 chapters. Separate conventions will be held on climate and biodiversity. The secretariat of UNCED has been working primarily with Agenda 21. Population issues are emphasized in Chapter 5 ("Demographic Dynamics and Sustainability") of the first section in Agenda 21 on Social and Economic Dimensions. The program areas include 1) research on the links between population, the environment, and development; 2) formulation by governments of integrated national policies on environment and development, which account for demographic trends, and promotion of population literacy; and 3) implementation of local level programs to ensure access to education and information and services in order to plan families freely and responsibly. Increases in funding for the population program are anticipated to be US $9 billion by the year 2000 and about US $7 billion/year until then. The year 2000 will bring with it a doubling of urban population in developing countries. There are challenges and opportunities to expand private sector job creation, education, clean water, and family health services. In addition to managing human settlements, there is also management of fragile ecosystems, which means relieving the pressure on these lands through urban migration or relocation to richer agricultural areas. The goal for agriculture is to triple food

  3. The subjectively perceived quality of postgraduate medical training in integrative medicine within the public healthcare systems of Germany and Switzerland: the example of anthroposophic hospitals.

    Science.gov (United States)

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

    2014-06-16

    Integrative medicine (IM) integrates evidence-based Complementary and Alternative Medicine (CAM) with conventional medicine (CON). Medical schools offer basic CAM electives but in postgraduate medical training (PGMT) little has been done for the integration of CAM. An exception to this is anthroposophic medicine (AM), a western form of CAM based on CON, offering an individualized holistic IM approach. AM hospitals are part of the public healthcare systems in Germany and Switzerland and train AM in PGMT. We performed the first quality evaluation of the subjectively perceived quality of this PGMT. An anonymous full survey of all 214 trainers (TR) and 240 trainees (TE) in all 15 AM hospitals in Germany and Switzerland, using the ETHZ questionnaire for annual national PGMT assessments in Switzerland (CH) and Germany (D), complemented by a module for AM. Data analysis included Cronbach's alpha to assess internal consistency questionnaire scales, 2-tailed Pearson correlation of specific quality dimensions of PGMT and department size, 2-tailed Wilcoxon Matched-Pair test for dependent variables and 2-tailed Mann-Whitney U-test for independent variables to calculate group differences. The level of significance was set at p 0.8 or >0.9, and >0.7 to >0.5 for TR scales. Swiss hospitals surpassed German ones significantly in Global Satisfaction with AM (TR and TE); Clinical Competency training in CON (TE) and AM (TE, TR), Error Management, Culture of Decision Making, Evidence-based Medicine, and Clinical Competency in internal medicine CON and AM (TE). When the comparison was restricted to departments of comparable size, differences remained significant for Clinical Competencies in AM (TE, TR), and Culture of Decision Making (TE). CON received better grades than AM in Global Satisfaction and Clinical Competency. Quality of PGMT depended on department size, working conditions and structural training features. The lower quality of PGMT in German hospitals can be attributed to

  4. The subjectively perceived quality of postgraduate medical training in integrative medicine within the public healthcare systems of Germany and Switzerland: the example of anthroposophic hospitals

    Science.gov (United States)

    2014-01-01

    Background Integrative medicine (IM) integrates evidence-based Complementary and Alternative Medicine (CAM) with conventional medicine (CON). Medical schools offer basic CAM electives but in postgraduate medical training (PGMT) little has been done for the integration of CAM. An exception to this is anthroposophic medicine (AM), a western form of CAM based on CON, offering an individualized holistic IM approach. AM hospitals are part of the public healthcare systems in Germany and Switzerland and train AM in PGMT. We performed the first quality evaluation of the subjectively perceived quality of this PGMT. Methods An anonymous full survey of all 214 trainers (TR) and 240 trainees (TE) in all 15 AM hospitals in Germany and Switzerland, using the ETHZ questionnaire for annual national PGMT assessments in Switzerland (CH) and Germany (D), complemented by a module for AM. Data analysis included Cronbach’s alpha to assess internal consistency questionnaire scales, 2-tailed Pearson correlation of specific quality dimensions of PGMT and department size, 2-tailed Wilcoxon Matched-Pair test for dependent variables and 2-tailed Mann–Whitney U-test for independent variables to calculate group differences. The level of significance was set at p 0.8 or >0.9, and >0.7 to >0.5 for TR scales. Swiss hospitals surpassed German ones significantly in Global Satisfaction with AM (TR and TE); Clinical Competency training in CON (TE) and AM (TE, TR), Error Management, Culture of Decision Making, Evidence-based Medicine, and Clinical Competency in internal medicine CON and AM (TE). When the comparison was restricted to departments of comparable size, differences remained significant for Clinical Competencies in AM (TE, TR), and Culture of Decision Making (TE). CON received better grades than AM in Global Satisfaction and Clinical Competency. Quality of PGMT depended on department size, working conditions and structural training features. Conclusion The lower quality of PGMT in

  5. sCO2 Power Cycles Summit Summary November 2017.

    Energy Technology Data Exchange (ETDEWEB)

    Mendez Cruz, Carmen Margarita; Rochau, Gary E.; Lance, Blake

    2018-04-01

    Over the past ten years, the Department of Energy (DOE) has helped to develop components and technologies for the Supercritical Carbon Dioxide (sCO2) power cycle capable of efficient operation at high temperatures and high efficiency. The DOE Offices of Fossil Energy, Nuclear Energy, and Energy Efficiency and Renewable Energy collaborated in the planning and execution of the sCO2 Power Cycle Summit conducted in Albuquerque, NM in November 2017. The summit brought together participants from government, national laboratories, research, and industry to engage in discussions regarding the future of sCO 2 Power Cycles Technology. This report summarizes the work involved in summit planning and execution, before, during, and after the event, including the coordination between three DOE offices and technical content presented at the event.

  6. Geologic Map of the Summit Region of Kilauea Volcano, Hawaii

    Science.gov (United States)

    Neal, Christina A.; Lockwood, John P.

    2003-01-01

    This report consists of a large map sheet and a pamphlet. The map shows the geology, some photographs, description of map units, and correlation of map units. The pamphlet gives the full text about the geologic map. The area covered by this map includes parts of four U.S. Geological Survey 7.5' topographic quadrangles (Kilauea Crater, Volcano, Ka`u Desert, and Makaopuhi). It encompasses the summit, upper rift zones, and Koa`e Fault System of Kilauea Volcano and a part of the adjacent, southeast flank of Mauna Loa Volcano. The map is dominated by products of eruptions from Kilauea Volcano, the southernmost of the five volcanoes on the Island of Hawai`i and one of the world's most active volcanoes. At its summit (1,243 m) is Kilauea Crater, a 3 km-by-5 km collapse caldera that formed, possibly over several centuries, between about 200 and 500 years ago. Radiating away from the summit caldera are two linear zones of intrusion and eruption, the east and the southwest rift zones. Repeated subaerial eruptions from the summit and rift zones have built a gently sloping, elongate shield volcano covering approximately 1,500 km2. Much of the volcano lies under water; the east rift zone extends 110 km from the summit to a depth of more than 5,000 m below sea level; whereas the southwest rift zone has a more limited submarine continuation. South of the summit caldera, mostly north-facing normal faults and open fractures of the Koa`e Fault System extend between the two rift zones. The Koa`e Fault System is interpreted as a tear-away structure that accommodates southward movement of Kilauea's flank in response to distension of the volcano perpendicular to the rift zones.

  7. The Grand Challenges of Organ Banking: Proceedings from the first global summit on complex tissue cryopreservation.

    Science.gov (United States)

    Lewis, Jedediah K; Bischof, John C; Braslavsky, Ido; Brockbank, Kelvin G M; Fahy, Gregory M; Fuller, Barry J; Rabin, Yoed; Tocchio, Alessandro; Woods, Erik J; Wowk, Brian G; Acker, Jason P; Giwa, Sebastian

    2016-04-01

    The first Organ Banking Summit was convened from Feb. 27 - March 1, 2015 in Palo Alto, CA, with events at Stanford University, NASA Research Park, and Lawrence Berkeley National Labs. Experts at the summit outlined the potential public health impact of organ banking, discussed the major remaining scientific challenges that need to be overcome in order to bank organs, and identified key opportunities to accelerate progress toward this goal. Many areas of public health could be revolutionized by the banking of organs and other complex tissues, including transplantation, oncofertility, tissue engineering, trauma medicine and emergency preparedness, basic biomedical research and drug discovery - and even space travel. Key remaining scientific sub-challenges were discussed including ice nucleation and growth, cryoprotectant and osmotic toxicities, chilling injury, thermo-mechanical stress, the need for rapid and uniform rewarming, and ischemia/reperfusion injury. A variety of opportunities to overcome these challenge areas were discussed, i.e. preconditioning for enhanced stress tolerance, nanoparticle rewarming, cyroprotectant screening strategies, and the use of cryoprotectant cocktails including ice binding agents. Copyright © 2015.

  8. Epidemiology and outcome of Clostridium difficile infections in patients hospitalized in Internal Medicine: findings from the nationwide FADOI-PRACTICE study

    Directory of Open Access Journals (Sweden)

    Giorgio Cioni

    2016-11-01

    Full Text Available Abstract Background Clostridium difficile (CD is a leading cause of diarrhoea among hospitalized patients. The objective of this study was to evaluate the rate, the optimal diagnostic work-up, and outcome of CD infections (CDI in Internal Medicine (IM wards in Italy. Methods PRACTICE is an observational prospective study, involving 40 IM Units and evaluating all consecutive patients hospitalized during a 4-month period. CDI were defined in case of diarrhoea when both enzyme immunoassay for GDH, and test for A/B toxin were positive. Patients with CDI were followed-up for recurrences for 4 weeks after the end of therapy. Results Among the 10,780 patients observed, 103 (0.96 % showed CDI, at admission or during hospitalization. A positive history for CD, antibiotics in the previous 4 weeks, recent hospitalization, female gender and age were significantly associated with CDI (multivariable analysis. In-hospital mortality was 16.5 % in CD group vs 6.7 % in No-CD group (p < 0.001, whereas median length of hospital stay was 16 (IQR = 13 vs 8 (IQR = 8 days (p < 0.001 among patients with or without CDI, respectively. Rate of CD recurrences was 14.6 %. As a post-hoc evaluation, 23 out of 34 GDH+/Tox- samples were toxin positive, when analysed by molecular method (a real-time PCR assay. The overall CD incidence rate was 5.3/10,000 patient-days. Conclusions Our results confirm the severity of CDI in medical wards, showing high in-hospital mortality, prolonged hospitalization and frequent short-term recurrences. Further, our survey supports a 2–3 step algorithm for CD diagnosis: EIA for detecting GDH, A and B toxin, followed by a molecular method in case of toxin-negative samples.

  9. Reducing Medical Admissions into Hospital through Optimising Medicines (REMAIN HOME) Study: protocol for a stepped-wedge, cluster-randomised trial

    Science.gov (United States)

    Foot, Holly; Freeman, Christopher; Hemming, Karla; Scott, Ian; Coombes, Ian D; Williams, Ian D; Connelly, Luke; Whitty, Jennifer A; Sturman, Nancy; Kirsa, Sue; Nicholson, Caroline; Russell, Grant; Kirkpatrick, Carl; Cottrell, Neil

    2017-01-01

    Introduction A model of general practitioner (GP) and pharmacist collaboration in primary care may be an effective strategy to reduce medication-related problems and provide better support to patients after discharge. The aim of this study is to investigate whether a model of structured pharmacist and GP care reduces hospital readmissions in high-risk patients. Methods and analysis This protocol details a stepped-wedge, cluster-randomised trial that will recruit participants over 9 months with a 12-month follow-up. There will be 14 clusters each representing a different general practice medical centre. A total of 2240 participants will be recruited from hospital who attend an enrolled medical centre, take five or more long-term medicines or whose reason for admission was related to heart failure or chronic obstructive pulmonary disease. The intervention is a multifaceted service, involving a pharmacist integrated into a medical centre to assist patients after hospitalisation. Participants will meet with the practice pharmacist and their GP after discharge to review and reconcile their medicines and discuss changes made in hospital. The pharmacist will follow-up with the participant and liaise with other health professionals involved in the participant’s care. The control will be usual care, which usually involves a patient self-organising a visit to their GP after hospital discharge. The primary outcome is the rate of unplanned, all-cause hospital readmissions over 12 months, which will be analysed using a mixed effects Poisson regression model with a random effect for cluster and a fixed effect to account for any temporal trend. A cost analysis will be undertaken to compare the healthcare costs associated with the intervention to those of usual care. Ethics and dissemination The study has received ethical approval (HREC/16/QRBW/410). The study findings will be disseminated through peer-reviewed publications, conferences and reports to key stakeholders. Trial

  10. 77 FR 68117 - Blue Summit Wind, LLC; Notice of Petition for Declaratory Order

    Science.gov (United States)

    2012-11-15

    ... from the Blue Summit's wind energy generator (Blue Summit Facility) located within the Southwest Power... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. EL13-17-000] Blue Summit Wind, LLC; Notice of Petition for Declaratory Order Take notice that on November 6, 2012, pursuant to...

  11. Medically unexplained illness and the diagnosis of hysterical conversion reaction (HCR in women’s medicine wards of Bangladeshi hospitals: a record review and qualitative study

    Directory of Open Access Journals (Sweden)

    Kendall Emily A

    2012-10-01

    Full Text Available Abstract Background Frequent reporting of cases of hysterical conversion reaction (HCR among hospitalized female medical patients in Bangladesh’s public hospital system led us to explore the prevalence of “HCR” diagnoses within hospitals and the manner in which physicians identify, manage, and perceive patients whom they diagnose with HCR. Methods We reviewed admission records from women’s general medicine wards in two public hospitals to determine how often and at what point during hospitalization patients received diagnoses of HCR. We also interviewed 13 physicians about their practices and perceptions related to HCR. Results Of 2520 women admitted to the selected wards in 2008, 6% received diagnoses of HCR. HCR patients had wide-ranging symptoms including respiratory distress, headaches, chest pain, convulsions, and abdominal complaints. Most doctors diagnosed HCR in patients who had any medically-unexplained physical symptom. According to physician reports, women admitted to medical wards for HCR received brief diagnostic evaluations and initial treatment with short-acting tranquilizers or placebo agents. Some were referred to outpatient psychiatric treatment. Physicians reported that repeated admissions for HCR were common. Physicians noted various social factors associated with HCR, and they described failures of the current system to meet psychosocial needs of HCR patients. Conclusions In these hospital settings, physicians assign HCR diagnoses frequently and based on vague criteria. We recommend providing education to increase general physicians’ awareness, skill, and comfort level when encountering somatization and other common psychiatric issues. Given limited diagnostic capacity for all patients, we raise concern that when HCR is used as a "wastebasket" diagnosis for unexplained symptoms, patients with treatable medical conditions may go unrecognized. We also advocate introducing non-physician hospital personnel to address

  12. 77 FR 51731 - All-Terrain Vehicle Safety Summit

    Science.gov (United States)

    2012-08-27

    ...; Physical sizing of ATVs 2. Consumer Awareness Suggested topics: Point-of-purchase information; on-product... safety require additional research that is beyond the Commission's current budget and resources. CPSC.... The Summit will take place over 2 days and will feature a mix of rulemaking and nonrulemaking topic...

  13. Dynamics of ozone and nitrogen oxides at Summit, Greenland

    NARCIS (Netherlands)

    Dam, Van Brie; Helmig, Detlev; Toro, Claudia; Doskey, Paul; Kramer, Louisa; Murray, Keenan; Ganzeveld, Laurens; Seok, Brian

    2015-01-01

    A multi-year investigation of ozone (O3) and nitrogen oxides (NOx) in snowpack interstitial air down to a depth of 2.8 m was conducted at Summit, Greenland, to elucidate mechanisms controlling the production and destruction of these important trace gases within the snow.

  14. Modernizing the G8 Summit Process | CRDI - Centre de recherches ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Modernizing the G8 Summit Process. This project is based on the premise that emerging countries must be full participants in key agenda-setting bodies if international governance mechanisms are to be realistic and relevant. The project brings together leaders, senior advisors, experts, researchers and opinion leaders to ...

  15. Gender Summit 2011: Equality Research and Innovation Through Equality

    Czech Academy of Sciences Publication Activity Database

    Tenglerová, Hana

    2011-01-01

    Roč. 19, č. 2 (2011), s. 72-74 ISSN 1210-6658. [European Gender Summit 2011: Equality Research and Innovation Through Equality . Brusel, 07.11.2011-08.11.2011] R&D Projects: GA MŠk OK08007 Institutional research plan: CEZ:AV0Z70280505 Keywords : gender equality * science * policy Subject RIV: AO - Sociology, Demography

  16. Summary points and consensus recommendations from the international protein summit

    NARCIS (Netherlands)

    Hurt, Ryan T; McClave, Stephen A; Martindale, Robert G; Ochoa Gautier, Juan B; Coss-Bu, Jorge A; Dickerson, Roland N; Heyland, Daren K; Hoffer, L John; Moore, Frederick A; Morris, Claudia R; Paddon-Jones, Douglas; Patel, Jayshil J; Phillips, Stuart M; Rugeles, Saúl J; Sarav Md, Menaka; Weijs, Peter J M; Wernerman, Jan; Hamilton-Reeves, Jill; McClain, Craig J; Taylor, Beth

    2017-01-01

    The International Protein Summit in 2016 brought experts in clinical nutrition and protein metabolism together from around the globe to determine the impact of high-dose protein administration on clinical outcomes and address barriers to its delivery in the critically ill patient. It has been

  17. Reaching the Summit: Deaf Adults as Essential Partners in Education

    Science.gov (United States)

    Bourne-Firl, Bridgetta

    2016-01-01

    How do we reach the summit in terms of supporting the best transition possible for each young deaf or hard of hearing individual in the United States? Should professionals who are hearing work alone to succeed with deaf and hard of hearing students? No matter how good the intention, if we want deaf and hard of hearing students to transition from…

  18. Global Summit on Student Affairs and Services: Prof. Adam Habib's ...

    African Journals Online (AJOL)

    2016-11-01

    Nov 1, 2016 ... He was a keynote speaker at the 2016 Global Summit on Student Affairs and Services held from 27–28 October ... and Services, with 50 student affairs leaders in attendance. To survive the 21st century, .... While Habib knew there was tax avoidance, if increased taxes resulted in a 20% contraction in gross ...

  19. Global Summit on Student Affairs and Services | Moscaritolo ...

    African Journals Online (AJOL)

    Global Summit on Student Affairs and Services. Lisa Bardill Moscaritolo, Karen Davis. Abstract. No Abstract. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors ...

  20. Globalization and Summit Reform: An Experiment in International ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2 juin 2008 ... Featuring a Foreword by Dr Gordon Smith, an Afterword by the Right Honourable Paul Martin, former Prime Minister of Canada, and a glossary of terms, Globalization and Summit Reform provides a unique, insiders' perspective on the process of international governance and its future prospects. A course ...

  1. Retrospective analysis of the role and performance of family medicine versus emergency medical services in the pre-hospital management of patients with AMI in Banja Luka.

    Science.gov (United States)

    Lakić, Biljana; Račić, Maja; Vulić, Duško

    2016-05-01

    The aim of this study was to investigate the differences in pre-hospital care of patients with acute myocardial infarction between emergency medical services and family medicine. This retrospective descriptive study included patients treated for acute myocardial infarction at the University Clinical Centre of Banja Luka, in the period from 1st January to 31st December 2011. The patients were divided into two groups: patients who received a hospital referral from the family medicine service and those who received one from the emergency medical service. The majority of patients (54.8%) received pre-hospital care from emergency medical services, while in 24.8% of cases the care was provided by family medicine physicians. The analysis showed that the time that passed from the onset of symptoms to the visit to the health institution of first medical contact was shorter in the emergency medical service (pfamily practice was 24 hours, and to the emergency service 2 hours. The patients who established their first medical contact with the emergency service reported more severe symptoms than the ones who visited a family practice over the same period of time. The severity of symptoms affected the patients' decisions to seek help in a timely manner and to choose the facility of first medical contact. Interventions to decrease delay must focus on improving public awareness of acute myocardial infarction symptoms and increasing their knowledge of the benefits of early medical contact and treatment. Continuing education of family practitioners in this field is required. Copyright © 2016 by Academy of Sciences and Arts of Bosnia and Herzegovina.

  2. Spatial map dose of nuclear medicine service of the Clinical Hospital of Botucatu, SP, Brazil; Mapa espacial de dose do servico de medicina nuclear do Hospital das Clinicas de Botucatu

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, Caio V.; Mendonca, Caroline; Silva, Eduardo T.; Moriguchi, Sonia M.; Koga, Katia H., E-mail: caiov_oliveira@yahoo.com.br [Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Botucatu, SP (Brazil). Faculdade de Medicina

    2013-12-15

    This study was conducted to describe levels of occupational and environmental exposure of the Nuclear Medicine Service of the Clinical Hospital of Botucatu. To this end, measurements were made of the radiometric levels of points strategically defined, in all the environments, for a period of six months, sampling different days and times, during operation normal routine of the sector. The results allow to estimate the expected dose for each environment, comparing them to the dose limitation established by the National Commission of Nuclear Energy (CNEN), allowing better targeting of occupationally exposed individuals, indicating the points where the occupation should be the minimum required, enabling the reduction of risks to potential exposures. (author)

  3. Emergency medicine physicians' and pediatricians' use of computed tomography in the evaluation of pediatric patients with abdominal pain without trauma in a community hospital.

    Science.gov (United States)

    Grim, Paul Francis

    2014-05-01

    There is a paucity of data regarding emergency department (ED) provider type and computed tomography (CT) scan use in the evaluation of pediatric patients with abdominal pain without trauma. The purpose of this retrospective single community hospital study was to determine if there was a difference in CT use between emergency medicine physicians (EMPs) and pediatricians (PEDs) in all patients younger than 18 years with abdominal pain without trauma who presented to the ED during the study period. The study included 165 patients. EMPs saw 83 patients and used CT in 31 compared with PEDs who saw 82 patients and used CT in 12 (P = .002). EMPs used CT significantly more frequently than PEDs in the designated sample. Economic pressures may cause changes in ED provider type in community and rural hospitals and this study shows that ED provider type may affect medical decision making, including CT use.

  4. Initial Results of the Master's Degree Programme in "Leadership in Medicine" – Impact on hospital-based follow-on training of doctors

    Directory of Open Access Journals (Sweden)

    Wulfert, Chris-Henrik

    2017-11-01

    Full Text Available Objective: This pilot project, which was jointly conducted by a hospital and a university, describes the development of the Master's Degree Programme in Leadership in Medicine, a course designed to supplement medical specialty training. The aim of the pilot project is to demonstrate how hospital-based projects on personnel and organisational development undertaken under academic supervision can be used to increase leadership responsibility among doctors whose duties include providing initial and follow-on training and to professionalise medical specialty training as a leadership task. This need arose from the nationwide requirements and an internal audit regarding follow-on training. The version of the degree programme described below aims to further the personnel development of the participants in the field of didactics. Method: Each of the nine modules is made up of two classroom-based phases and one distance learning phase. The distance learning phase involves undertaking hospital-based projects on personnel and organisational development under academic supervision. The pilot phase participants were hospital doctors who, as part of their duties, hold leadership responsibility or are involved in the follow-on training of doctors.Results: The 17 participants successfully implemented more than 30 hospital-based projects during the distance learning phases of the nine modules. These projects included the development of medical specialty curricula, relevant didactic methods and evaluation design and were subsequently presented and subjected to reflection in interdisciplinary groups. The project presentation together with the project report were regarded as proof of competency. Conclusion: In addition to enhancing participant competency, the degree model described, which interlinks theory and practice, promotes organisational development through the implementation of projects undertaken under academic supervision. This has a double impact on the

  5. Identifying Knowledge Sharing Barriers in the Collaboration of Traditional and Western Medicine Professionals in Chinese Hospitals: A Case Study

    Science.gov (United States)

    Zhou, Lihong; Nunes, Miguel Baptista

    2012-01-01

    This paper reports on a research project that aims at identifying knowledge sharing (KS) barriers between traditional and western medicine practitioners co-existing and complementing each other in Chinese healthcare organisations. The study focuses on the tacit aspects of patient knowledge, rather than the traditional technical information shared…

  6. Nuclear medicine

    International Nuclear Information System (INIS)

    Chamberlain, M.J.

    1986-01-01

    Despite an aggressive, competitive diagnostic radiology department, the University Hospital, London, Ontario has seen a decline of 11% total (in vivo and in the laboratory) in the nuclear medicine workload between 1982 and 1985. The decline of in vivo work alone was 24%. This trend has already been noted in the U.S.. Nuclear medicine is no longer 'a large volume prosperous specialty of wide diagnostic application'

  7. High prevalence of complementary and alternative medicine use among patients with sickle cell disease in a tertiary hospital in Lagos, South West, Nigeria.

    Science.gov (United States)

    Busari, A A; Mufutau, M A

    2017-06-07

    Attention and interest in the use of complementary and alternative medicine (CAM) has been reignited globally, most especially in patients with chronic diseases. Sickle cell disease (SCD) is one of such chronic diseases associated with devastating clinical and psychosocial consequences, thus leading those affected to seek alternative treatment apart from orthodox medicine. Hence, this study aimed to determine the prevalence, pattern and tolerability of the use of CAM in patients with SCD in the Lagos University Teaching Hospital (LUTH). This was a cross-sectional survey of 200 respondents with SCD attending the hematology clinics of the Lagos University Teaching Hospital over a period of 3 months. Data on socio-demographic characteristic, clinical profile, the types and sources of CAM used were collected using a well structured pretested questionnaire. The data obtained were analyzed using Statistical Package for Social Sciences (SPSS®) version 17. Of the 200 patients who participated in the study, 113; 56.5% were males and 87; 43.5% were females. Majority of the SCD patients were 1-10 years old and their mean age was 18.8 ± 14.39 years. CAM was reportedly used by 88.5% of the respondents. Biological (herbal) products 156; 62.9% were the most commonly used CAM, followed by alternative medical systems 52; 20.9% and mind-body interventions 30; 12.1%. Relations, friends and neighbors influenced 85.2% of CAM users by recommending CAM to them. Tolerability of CAM was perceived to be excellent as only 33 (18.6%) of the respondents abandoned the use of CAM. Comparing CAM users and CAM non-users, there was no statistical significant difference in the proportion of those >18 years (45.76% vs 52.17%; p = 0.658), those who experienced two or more crises (51.41% vs 34.78%; p = 0.183), and those with stable haemoglobin concentration of >7 g/dL (15.81% vs 8.69%; p = 0.539) More patients among CAM non-users (91.30%) significantly spend over 3000 Naira (USD 15) per

  8. Empleo de plantas medicinales en usuarios de dos hospitales referenciales del Cusco, Perú Use of medicinal plants among people attending two reference hospitals in Cusco, Peru

    Directory of Open Access Journals (Sweden)

    Gladys Oblitas

    2013-03-01

    Full Text Available Con el fin de determinar la frecuencia de empleo de plantas medicinales y describir las características de su uso en pacientes de dos hospitales referenciales de la ciudad de Cusco, se realizó un estudio transversal entre agosto y septiembre de 2011. Para el recojo de datos se construyó un instrumento, validado por juicio de expertos. El tamaño de la muestra fue de 250 personas seleccionadas no probabilísticamente. El 83,2 y 75,3% informaron haber empleado plantas medicinales alguna vez en su vida y en el último mes, respectivamente; además, el 85,7 señaló que desearía que su médico le recete plantas medicinales. Sus usos más frecuentes son para problemas digestivos (62,4%; urinarios (42,4%, y respiratorios (40,4%. Se concluye que el empleo de plantas medicinales se encuentra bastante difundido entre los usuarios de dos hospitales referenciales de la ciudad de Cusco. Los patrones de empleo revelan que los pacientes desean que los médicos del sistema de salud prescriban plantas medicinales en su acto médicoIn order to determine the frequency and characteristics of the use of medicinal plants in patients from two third-level hospitals in the city of Cusco, a cross-sectional study was conducted between August and September 2011. For data collection, an instrument was built and validated through experts’ judgment. The sample included 250 people selected in a non-probabilistic way. 83.2 and 75.3% informed having had used medicinal plants sometime during their lives and in the last month, respectively; additionally, 85.7 indicated that they wished their doctor would have prescribed them medicinal plants. Their most frequent uses include digestive problems (62.4% as well as urinary (42.4% and respiratory problems (40.4%. We conclude that the use of medicinal plants is widely spread among users of two hospitals in the city of Cusco. Utilization patterns show that patients wished the physicians of the health system prescribed medicinal

  9. Security in transport, storage and disposal of radioactive materials, providing to the department of nuclear medicine in hospitals Rafael Angel Calderon Guardia, San Juan de Dios and Mexico

    International Nuclear Information System (INIS)

    Elizondo Valle, Alejandro; Jimenez Mendez, Christian; Leiton Araya, Christopher; Villalobos Rodriguez, Geovanny; Leal Vega, Olga Maritza; Lopez Gatjens, Santiago

    2010-01-01

    The security is analysed for the transport and storage of radioactive sources and the management of radioactive waste product of practices and interventions in nuclear medicine services in hospitals Calderon Guardia, San Juan de Dios and Mexico. The objective is to assess the compliance with current regulations, the effectiveness and efficiency of the same. The security and compliance with current regulations were considered related to the transport of radioactive sources by the two private companies that provide this service, from the Juan Santamaria airport customs to three hospitals evaluated. Compliance with national and international rules on storage of radioactive sources and waste materials were analyzed. For this has been studied Costa Rican law and the recommendations of international organizations related to the subject matter, in the three nuclear medicine services valued. The national and international background related to radiological accidents occurred with radioactive sources during transport, storage and waste were revised, where highlights that in most cases, these accidents occurred for breach of the regulations established. Studies in Costa Rica on radioactive waste management were analysed, and the current status of nuclear medicine services in terms of radiation safety, which helped with the investigation. The compliance and regulations were analyzed by the result of observation and interviews during development, to finally make a series of findings and provide recommendations that are considered relevant. Various variants and indicators that are defined in the theoretical framework were used; also, the strategy of methodology is described. The purpose of the work has been to provide a scientific nature, and that methodology met the objectives, offering an approach from different angles and the actors involved, and a critical and objective analysis strictly in order to contribute to public health. The research is a valuable tool that provides

  10. Rise to SUMMIT: the Sydney University Multiple-Mirror Telescope

    Science.gov (United States)

    Moore, Anna M.; Davis, John

    2000-07-01

    The Sydney University Multiple Mirror Telescope (SUMMIT) is a medium-sized telescope designed specifically for high resolution stellar spectroscopy. Throughout the design emphasis has been placed on high efficiency at low cost. The telescope consists of four 0.46 m diameter mirrors mounted on a single welded steel frame. Specially designed mirror cells support and point each mirror, allowing accurate positioning of the images on optical fibers located at the foci of the mirrors. Four fibers convey the light to the future location of a high resolution spectrograph away from the telescope in a stable environment. An overview of the commissioning of the telescope is presented, including the guidance and automatic mirror alignment and focussing systems. SUMMIT is located alongside the Sydney University Stellar Interferometer at the Paul Wild Observatory, near Narrabri, Northern New South Wales.

  11. Diagnostic performance of a multiple real-time PCR assay in patients with suspected sepsis hospitalized in an internal medicine ward.

    Science.gov (United States)

    Pasqualini, Leonella; Mencacci, Antonella; Leli, Christian; Montagna, Paolo; Cardaccia, Angela; Cenci, Elio; Montecarlo, Ines; Pirro, Matteo; di Filippo, Francesco; Cistaro, Emma; Schillaci, Giuseppe; Bistoni, Francesco; Mannarino, Elmo

    2012-04-01

    Early identification of causative pathogen in sepsis patients is pivotal to improve clinical outcome. SeptiFast (SF), a commercially available system for molecular diagnosis of sepsis based on PCR, has been mostly used in patients hospitalized in hematology and intensive care units. We evaluated the diagnostic accuracy and clinical usefulness of SF, compared to blood culture (BC), in 391 patients with suspected sepsis, hospitalized in a department of internal medicine. A causative pathogen was identified in 85 patients (22%). Sixty pathogens were detected by SF and 57 by BC. No significant differences were found between the two methods in the rates of pathogen detection (P = 0.74), even after excluding 9 pathogens which were isolated by BC and were not included in the SF master list (P = 0.096). The combination of SF and BC significantly improved the diagnostic yield in comparison to BC alone (P < 0.001). Compared to BC, SF showed a significantly lower contamination rate (0 versus 19 cases; P < 0.001) with a higher specificity for pathogen identification (1.00, 95% confidence interval [CI] of 0.99 to 1.00, versus 0.94, 95% CI of 0.90 to 0.96; P = 0.005) and a higher positive predictive value (1.00, 95% CI of 1.00 to 0.92%, versus 0.75, 95% CI of 0.63 to 0.83; P = 0.005). In the subgroup of patients (n = 191) who had been receiving antibiotic treatment for ≥24 h, SF identified more pathogens (16 versus 6; P = 0.049) compared to BC. These results suggest that, in patients with suspected sepsis, hospitalized in an internal medicine ward, SF could be a highly valuable adjunct to conventional BC, particularly in patients under antibiotic treatment.

  12. SUMMIT (Serially Unified Multicenter Multiple Sclerosis Investigation): creating a repository of deeply phenotyped contemporary multiple sclerosis cohorts.

    Science.gov (United States)

    Bove, Riley; Chitnis, Tanuja; Cree, Bruce Ac; Tintoré, Mar; Naegelin, Yvonne; Uitdehaag, Bernard Mj; Kappos, Ludwig; Khoury, Samia J; Montalban, Xavier; Hauser, Stephen L; Weiner, Howard L

    2017-08-01

    There is a pressing need for robust longitudinal cohort studies in the modern treatment era of multiple sclerosis. Build a multiple sclerosis (MS) cohort repository to capture the variability of disability accumulation, as well as provide the depth of characterization (clinical, radiologic, genetic, biospecimens) required to adequately model and ultimately predict a patient's course. Serially Unified Multicenter Multiple Sclerosis Investigation (SUMMIT) is an international multi-center, prospectively enrolled cohort with over a decade of comprehensive follow-up on more than 1000 patients from two large North American academic MS Centers (Brigham and Women's Hospital (Comprehensive Longitudinal Investigation of Multiple Sclerosis at the Brigham and Women's Hospital (CLIMB; BWH)) and University of California, San Francisco (Expression/genomics, Proteomics, Imaging, and Clinical (EPIC))). It is bringing online more than 2500 patients from additional international MS Centers (Basel (Universitätsspital Basel (UHB)), VU University Medical Center MS Center Amsterdam (MSCA), Multiple Sclerosis Center of Catalonia-Vall d'Hebron Hospital (Barcelona clinically isolated syndrome (CIS) cohort), and American University of Beirut Medical Center (AUBMC-Multiple Sclerosis Interdisciplinary Research (AMIR)). We provide evidence for harmonization of two of the initial cohorts in terms of the characterization of demographics, disease, and treatment-related variables; demonstrate several proof-of-principle analyses examining genetic and radiologic predictors of disease progression; and discuss the steps involved in expanding SUMMIT into a repository accessible to the broader scientific community.

  13. Text of the joint U.S.-Soviet summit statement

    International Nuclear Information System (INIS)

    1987-12-01

    The document reproduces the text of the joint U.S.-Soviet summit statement issued on 10 December 1987 at the conclusion of the meeting between the President of the United States and the General Secretary of the Central Committee of the Communist Party of the Soviet Union (Washington, December 7-10, 1987). It refers to the arms control (including nuclear weapons), human rights and humanitarian concerns, regional issues, bilateral affairs and further meetings

  14. Energy and the World Summit on Sustainable Development: what next?

    International Nuclear Information System (INIS)

    Spalding-Fecher, Randall; Winkler, Harald; Mwakasonda, Stanford

    2005-01-01

    Given the importance of energy issues to sustainable development, energy was a priority issue at the World Summit on Sustainable Development in August 2002. The objective of this paper is to examine the outcomes of the Summit on energy, and to assess them against proposals to address the lack of access to modern energy and the need to move toward a cleaner energy system. We find that lack of political leadership from key countries prevented agreement not only on targets for renewable energy, but also on a programme to promote access. The achievements of the Summit were limited to enabling activities such as capacity building and technology transfer, rather than substantive agreements. While WSSD put energy higher on the agenda than before, no institutional home or programme to take the issues forward has emerged. This therefore remains a critical challenge to be addressed. Achieving this broad goal will require building a coalition to promote cleaner energy, and committing resources to programme for energy access. Based on analysis of proposals and the negotiations, we propose several key areas where progress is still possible and necessary, including: shifting more international public and private energy financing toward access investments and cleaner energy investments, advancing regional approaches to access and renewable energy targets, and a range of mechanisms to strengthen institutional capacity for integrating energy and sustainable development

  15. Summit on Improving the Economics of America's Nuclear Power Plants

    International Nuclear Information System (INIS)

    Collins, John; Mason, Charles

    2016-01-01

    The Summit on Improving the Economics of America's Nuclear Power Plants was convened May 19, 2016, by Secretary of Energy Ernest Moniz and co-sponsored by Idaho Senator Mike Crapo to stress the importance of existing nuclear reactors in meeting our nation's energy goals. The summit was also designed to identify and discuss policy options that can be pursued at federal and state levels to address economic challenges, as well as technical options that utilities can use to improve the economic competitiveness of operating nuclear power plants (NPPs) and avoid early plant retirements that are driven by temporary market conditions. The owners of NPPs face difficult economic decisions and are working to improve the performance of existing NPPs. However, it soon became clear that some of the actions taken by states and regional markets have had an impact on the economic viability of existing power plants, including carbon free NPPs. Summit speakers identified concepts and actions that could be taken at state and federal levels to improve the economics of the existing fleet within these regulated and restructured electricity markets. This report summarizes the speeches, concepts, and actions taken.

  16. Energy summit discussions with Federal Chancellor Merkel - potential legislative consequences

    International Nuclear Information System (INIS)

    Heller, W.

    2006-01-01

    The energy summit discussions held by Federal Chancellor Merkel are to converge in a consistent energy policy concept by late 2007. The second summit held on October 9, 2006 was prepared by three working groups. Working Group 1 was to handle 'International Aspects', Working Group 2, the 'National Aspects of Energy Supply', and Working Group 3, finally, 'Research and Energy Efficiency'. The reports dealing with international aspects and with research and energy efficiency were in the focus of discussions at the summit. The report about national aspects had not yet reached the level of maturity required for discussion. None of the reports contained anything under the headings of 'Setting aside the Gorleben Moratorium' and 'Continued Exploration of the Salt Dome for a Repository' and 'Extension of the Plant Life of Our Nuclear Power Plants'. This sounds very easy and is urgently required, but it is neither announced nor seriously debated in politics. If these legislative measures were taken and the rhetoric about the broad energy mix turned into energy policy reality, many problems in climate protection, in energy supply continuity, and in competitive electricity supply could be solved more easily. (orig.)

  17. Extreme event medicine: considerations for the organisation of out-of-hospital care during obstacle, adventure and endurance competitions.

    Science.gov (United States)

    Laskowski-Jones, Linda; Caudell, Michael J; Hawkins, Seth C; Jones, Lawrence J; Dymond, Chelsea A; Cushing, Tracy; Gupta, Sanjey; Young, David S; Starling, Jennifer M; Bounds, Richard

    2017-10-01

    Obstacle, adventure and endurance competitions in challenging or remote settings are increasing in popularity. A literature search indicates a dearth of evidence-based research on the organisation of medical care for wilderness competitions. The organisation of medical care for each event is best tailored to specific race components, participant characteristics, geography, risk assessments, legal requirements, and the availability of both local and outside resources. Considering the health risks and logistical complexities inherent in these events, there is a compelling need for guiding principles that bridge the fields of wilderness medicine and sports medicine in providing a framework for the organisation of medical care delivery during wilderness and remote obstacle, adventure and endurance competitions. This narrative review, authored by experts in wilderness and operational medicine, provides such a framework. The primary goal is to assist organisers and medical providers in planning for sporting events in which participants are in situations or locations that exceed the capacity of local emergency medical services resources. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  18. Following the American Example? American Models for Hospital Medicine and Research: The Case of the Kerckhoff Institute in Bad Nauheim

    OpenAIRE

    Timmermann, C

    2010-01-01

    This essay examines how and why American models were applied in the reorganization of West German hospitals and medical research centers in the post-war period. After discussing why American clinical medical centers turned into model institutions over the last century or so, a case study is discussed in some detail: the Kerckhoff Institute for cardiovascular research in Bad Nauheim, since 1951 an institute within the Max Planck Society with its own research clinic (which was unusual for Max P...

  19. Development of electronic medical record charting for hospital-based transfusion and apheresis medicine services: Early adoption perspectives

    Directory of Open Access Journals (Sweden)

    Rebecca Levy

    2010-01-01

    Full Text Available Background: Electronic medical records (EMRs provide universal access to health care information across multidisciplinary lines. In pathology departments, transfusion and apheresis medicine services (TAMS involved in direct patient care activities produce data and documentation that typically do not enter the EMR. Taking advantage of our institution′s initiative for implementation of a paperless medical record, our TAMS division set out to develop an electronic charting (e-charting strategy within the EMR. Methods: A focus group of our hospital′s transfusion committee consisting of transfusion medicine specialists, pathologists, residents, nurses, hemapheresis specialists, and information technologists was constituted and charged with the project. The group met periodically to implement e-charting TAMS workflow and produced electronic documents within the EMR (Cerner Millenium for various service line functions. Results: The interdisciplinary working group developed and implemented electronic versions of various paper-based clinical documentation used by these services. All electronic notes collectively gather and reside within a unique Transfusion Medicine Folder tab in the EMR, available to staff with access to patient charts. E-charting eliminated illegible handwritten notes, resulted in more consistent clinical documentation among staff, and provided greater real-time review/access of hemotherapy practices. No major impediments to workflow or inefficiencies have been encountered. However, minor updates and corrections to documents as well as select work re-designs were required for optimal use of e-charting by these services. Conclusion: Documentation of pathology subspecialty activities such as TAMS can be successfully incorporated into the EMR. E-charting by staff enhances communication and helps promote standardized documentation of patient care within and across service lines. Well-constructed electronic documents in the EMR may also

  20. Heart Surgery Experience in Hitit University Faculty of Medicine Corum Research and Training Hospital: First Year Results

    Directory of Open Access Journals (Sweden)

    Adem Diken

    2014-03-01

    Full Text Available Aim: We aimed to assess the clinical outcomes of our department of cardiac surgery which was newly introduced in Hitit University Corum Education and Research Hospital. Material and Method: Between November 2012 and November 2013, a total of 110 open-heart surgeries were performed. Ten out of these (9.1% were emergency operations for acute ST elevation myocardial infarction Off-pump technique was used in 31 (29.2% patients and cardiopulmonary bypass was used in 75 (70.8%. A total of 106 patients received coronary artery bypass grafting, 1 received mitral reconstruction, 1 received Bentall procedure, 1 received tricuspid valve repair, 1 received mitral valve replacement, 1 received aortic valve replacement with aortic root enlargement and 1 received aortic supracoronary graft replacement. Results: Hospital mortality occurred in 1 (0.9% patient. Four patients (3.6% who were on dual antiaggregants underwent a revision for bleeding on the day of the operation. Morbidities occurred in 3 (2.7% patients. Atrial fibrillation occurred in 11 (10% patients and the normal sinus rhythm was achieved by amiodarone. Intraaortic balloon counterpulsation was used in 5 (4.5% patients. Discussion: The newly introduced cardiac surgery department of the Hitit University Corum Education and Research Hospital, which provides tertiary care to a wide rural community, serves with low morbidity and mortality.

  1. Employee use and perceived benefit of a complementary and alternative medicine wellness clinic at a major military hospital: evaluation of a pilot program.

    Science.gov (United States)

    Duncan, Alaine D; Liechty, Janet M; Miller, Cathy; Chinoy, Gail; Ricciardi, Richard

    2011-09-01

    The objectives of this study were to examine the feasibility of a weekly on-site complementary and alternative medicine (CAM) wellness clinic for staff at a military hospital, and to describe employees' perceptions of program effectiveness. The study setting was the Restore & Renew(®) Wellness Clinic at a United States Department of Defense hospital. The subjects were hospital nurses, physicians, clinicians, support staff, and administrators. The walk-in wellness clinic was open 8:00 am-2:00 pm 1 day a week. Participants selected one or more modalities each visit: ear acupuncture, clinical acupressure, and Zero Balancing.(®) A self-report survey was done after each clinic visit to evaluate clinic features and perceived impact on stress-related symptoms, compassion for patients, sleep, and workplace or personal relationships. Surveys completed after first-time and repeat visits (n=2,756 surveys) indicated that most participants agreed or strongly agreed they felt more relaxed after sessions (97.9%), less stress (94.5%), more energy (84.3%), and less pain (78.8%). Ninety-seven percent (97%) would recommend it to a co-worker. Among surveys completed after five or more visits, more than half (59%-85%) strongly agreed experiencing increased compassion with patients, better sleep, improved mood, and more ease in relations with co-workers. Perceived benefits were sustained and enhanced by number of visits. The most frequently reported health habit changes were related to exercise, stress reduction, diet/nutrition, and weight loss. This evaluation suggests that a hospital-based wellness clinic based on CAM principles and modalities is feasible, well-utilized, and perceived by most participants to have positive health benefits related to stress reduction at work, improved mood and sleep, and lifestyle.

  2. [Physical medicine in hospital. Minimum standards in a physical medical department in acute inpatient areas in rheumatology].

    Science.gov (United States)

    Reißhauer, A; Liebl, M E

    2012-07-01

    Standards for what should be available in terms of equipment and services in a department of physical medicine caring for acute inpatients do not exist in Germany. The profile of a department determines the therapeutic services it focuses on and hence the technical facilities required. The German catalogue of operations and procedures defines minimum thresholds for treatment. In the opinion of the authors a department caring for inpatients with acute rheumatic diseases must, as a minimum, have the facilities and equipment necessary for offering thermotherapeutic treatment. Staff trained in physical therapeutic procedures and occupational therapy is also crucial. Moreover, it is desirable that the staff should be trained in manual therapy.

  3. Distribution and characterization of methicillin-resistant Staphylococcus aureus (MRSA) at the small animal hospital, faculty of veterinary medicine, Chiang Mai University, Thailand.

    Science.gov (United States)

    Patchanee, Prapas; Tadee, Pakpoom; Ingkaninan, Pimlada; Tankaew, Pallop; Hoet, Armando E; Chupia, Vena

    2014-03-01

    Of 416 samples taken from veterinary staff (n = 30), dogs (n = 356) and various environmental sites (n = 30) at the Small Animal Hospital, Faculty of Veterinary Medicine, Chiang Mai University, Thailand, 13 samples contained methicillin-resistant Staphylococcus aureus (MRSA), of which 1 (SCCmec type II) came from veterinarian, 9 (SCCmec types I, III, IVa, V and untypeable) from dogs, and 3 (SCCmec types I, III, and IVb) from environmental samples. The MRSA isolates were 100% susceptible to vancomycin (100%), 69% to cephazolin and 62% to gentamicin, but were up to 92% resistant to tetracycline group, 69% to trimethoprim-sulfamethoxazoles and 62% to ceftriaxone. In addition, all MRSA isolates showed multidrug resistance. As the MRSA isolates from the veterinary staff and dogs were of different SCCmec types, this suggests there were no cross-infections. However, environmental contamination appears to have come from dogs, and appropriate hygienic practices should be introduced to solve this problem.

  4. [Appropriateness admissions to the Department of Internal Medicine of the Hospital de Santa Luzia (Elvas) evaluated by the AEP (Appropriateness Evaluation Protocol)].

    Science.gov (United States)

    Cordero, A; Aguila, J; Massalana, A; Escoto, V; Lopes, L; Susano, R

    2004-01-01

    The authors analyse the appropriateness admissions to the Internal Medicine ward of the Hospital de Santa Luzia (Elvas). A retrospective study was performed during 6 months of 2001, using the Appropriateness Evaluation Protocol (AEP). Non-appropriateness admissions were found in 19% (CI95%: 16-22), and this group of patients had less mean age (63 + 16 vs 69 + 16; p <0.01), and less mean days of admission (7.1 + 6 vs 9.3 + 7; p <0.01) than group with appropriateness admissions. Appropriateness admissions were mainly found in patients admitted from the emergency room (86% vs 49%; p <0.001). Most of patients with non-appropriate admissions were admitted to undergo diagnostic tests (44%; CI95%: 35-53), or to be referred to other medical centres for specialized study and/or treatment (12%; CI95%: 6-18).

  5. Partnerships in global health and collaborative governance: lessons learnt from the Division of Tropical and Humanitarian Medicine at the Geneva University Hospitals.

    Science.gov (United States)

    Beran, David; Aebischer Perone, Sigiriya; Alcoba, Gabriel; Bischoff, Alexandre; Bussien, Claire-Lise; Eperon, Gilles; Hagon, Olivier; Heller, Olivia; Jacquerioz Bausch, Frédérique; Perone, Nicolas; Vogel, Thomas; Chappuis, François

    2016-04-29

    In 2007 the "Crisp Report" on international partnerships increased interest in Northern countries on the way their links with Southern partners operated. Since its establishment in 2007 the Division of Tropical and Humanitarian Medicine at the Geneva University Hospitals has developed a variety of partnerships. Frameworks to assess these partnerships are needed and recent attention in the field of public management on collaborative governance may provide a useful approach for analyzing international collaborations. Projects of the Division of Tropical and Humanitarian Medicine were analyzed by collaborators within the Division using the model proposed by Emerson and colleagues for collaborative governance, which comprises different components that assess the collaborative process. International projects within the Division of Tropical and Humanitarian Medicine can be divided into four categories: Human resource development; Humanitarian response; Neglected Tropical Diseases and Noncommunicable diseases. For each of these projects there was a clear leader from the Division of Tropical and Humanitarian Medicine as well as a local counterpart. These individuals were seen as leaders both due to their role in establishing the collaboration as well as their technical expertise. Across these projects the actual partners vary greatly. This diversity means a wide range of contributions to the collaboration, but also complexity in managing different interests. A common definition of the collaborative aims in each of the projects is both a formal and informal process. Legal, financial and administrative aspects of the collaboration are the formal elements. These can be a challenge based on different administrative requirements. Friendship is part of the informal aspects and helps contribute to a relationship that is not exclusively professional. Using collaborative governance allows the complexity of managing partnerships to be presented. The framework used highlights the

  6. Use and toxicity of traditional and complementary medicine among patients seeking care at an emergency department of a teaching hospital in Malaysia.

    Science.gov (United States)

    Jatau, Abubakar Ibrahim; Aung, Myat Moe Thwe; Kamauzaman, Tuan Hairulnizam Tuan; Ab Rahman, Ab Fatah

    2018-05-01

    Traditional and Complementary Medicines (TCM) are widely used worldwide, and many of them have the potential to cause toxicity, interaction with conventional medications and non-adherence to prescribed medications due to patients' preference for the TCM use. However, information regarding their use among patients seeking care at emergency departments (ED) of a healthcare facility is limited. The study aimed to evaluate the TCM use among patients attending the ED of a teaching hospital in Malaysia. A sub-analysis of data from a prevalence study of medication-related visits among patients at the ED of Hospital Universiti Sains Malaysia was conducted. The study took place over a period of six weeks from December 2014 to January 2015 involving 434 eligible patients. Data on demography, conventional medication, and TCM uses were collected from patient interview and the medical folders. Among this cohort, 66 patients (15.2%, 95%CI 12.0, 19.0) reported concurrent TCM use. Sixteen (24.2%) of the TCM users were using more than one (1) type of TCM, and 17 (25.8%) came to the ED for medication-related reasons. Traditional Malay Medicine (TMM) was the most frequently used TCM by the patients. Five patients (7.6%) sought treatment at the ED for medical problems related to use of TCM. Patients seeking medical care at the ED may be currently using TCM. ED-physicians should be aware of these therapies and should always ask patients about the TCM use. Copyright © 2018 Elsevier Ltd. All rights reserved.

  7. Transfusion practice in anemic, non-bleeding patients: Cross-sectional survey of physicians working in general internal medicine teaching hospitals in Switzerland.

    Directory of Open Access Journals (Sweden)

    Michelle von Babo

    Full Text Available Transfusion practice might significantly influence patient morbidity and mortality. Between European countries, transfusion practice of red blood cells (RBC greatly differs. Only sparse data are available on transfusion practice of general internal medicine physicians in Switzerland.In this cross-sectional survey, physicians working in general medicine teaching hospitals in Switzerland were investigated regarding their self-reported transfusion practice in anemic patients without acute bleeding. The definition of anemia, transfusion triggers, knowledge on RBC transfusion, and implementation of guidelines were assessed.560 physicians of 71 hospitals (64% responded to the survey. Anemia was defined at very diverging hemoglobin values (by 38% at a hemoglobin <130 g/L for men and by 57% at <120 g/L in non-pregnant women. 62% and 43% respectively, did not define anemia in men and in women according to the World Health Organization. Fifty percent reported not to transfuse RBC according to international guidelines. Following factors were indicated to influence the decision to transfuse: educational background of the physicians, geographical region of employment, severity of anemia, and presence of known coronary artery disease. 60% indicated that their knowledge on Transfusion-related Acute Lung Injury (TRALI did not influence transfusion practice. 50% of physicians stated that no local transfusion guidelines exist and 84% supported the development of national recommendations on transfusion in non-acutely bleeding, anemic patients.This study highlights the lack of adherence to current transfusion guidelines in Switzerland. Identifying and subsequently correcting this deficit in knowledge translation may have a significant impact on patient care.

  8. A smartphone-enabled communication system to improve hospital communication: usage and perceptions of medical trainees and nurses on general internal medicine wards.

    Science.gov (United States)

    Wu, Robert; Lo, Vivian; Morra, Dante; Appel, Eva; Arany, Teri; Curiale, Beth; Ryan, Joanne; Quan, Sherman

    2015-02-01

    There is increasing interest in the use of information and communication technologies to improve how clinicians communicate in hospital settings. We implemented a communication system with support for physician handover and secure messaging on 2 general internal medicine wards. We measured usage and surveyed physicians and nurses on perceptions of the system's effects on communication. Between May 2011 and August 2012, a clinical teaching team received, on average, 14.8 messages per day through the system. Messages were typically sent as urgent (69.1%) and requested a text reply (76.5%). For messages requesting a text reply, 8.6% did not receive a reply. For those messages that did receive a reply, the median response time was 2.3 minutes, and 84.5% of messages received a reply within 15 minutes. Of those who completed the survey, 95.3% were medical residents (82 of 86) and 81.7% were nurses (83 of 116). Medical trainees (82.8%) and nursing staff (78.3%) agreed or strongly agreed that the system helped to speed up their daily work tasks. Overall, 67.1% of the trainees and 73.2% of nurses agreed or strongly agreed that the system made them more accountable in their clinical roles. Only 35.8% of physicians and 26.3% of nurses agreed or strongly agreed that the system was useful for communicating complex issues. In summary, with a system designed to improve communication, we found that there was high uptake and that users perceived that the system improved efficiency and accountability but was not appropriate for communicating complex issues. © 2014 Society of Hospital Medicine.

  9. The Effect of a Statewide Mandatory Prescription Drug Monitoring Program on Opioid Prescribing by Emergency Medicine Providers Across 15 Hospitals in a Single Health System.

    Science.gov (United States)

    Suffoletto, Brian; Lynch, Michael; Pacella, Charissa B; Yealy, Donald M; Callaway, Clifton W

    2018-04-01

    Prescription drug monitoring programs (PDMPs) enable registered prescribers to obtain real-time information on patients' prescription history of controlled medications. We sought to describe the effect of a state-mandated PDMP on opioid prescribing by emergency medicine providers. We retrospectively analyzed electronic medical records of 122,732 adult patients discharged with an opioid prescription from 15 emergency departments in a single health system in Pennsylvania from July 2015 to March, 2017. We used an interrupted time series design to evaluate the percentage of patients discharged each month with an opioid prescription before and after state law-mandated PDMP use on August 25, 2016. From August (pre-PDMP) to September, 2016 (post-PDMP), the opioid prescribing rate decreased from 12.4% (95% confidence interval [CI], 10.8%-14.1%) to 10.2% (95% CI, 8.8%-11.8%). For each month between September 2016 to March 2017, there was a mean decline of .46% (95% CI, -.38% to -.53%) in the percentage of patients discharged with an opioid prescription. There was heterogeneity in opioid prescribing across hospitals as well as according to patient diagnosis. This study examined the effect of a state-mandated PDMP on opioid prescribing among emergency medicine providers from 15 different hospitals in a single health system. Findings support current PDMP mandates in reducing opioid prescriptions, which could curb the prescription opioid epidemic and may ultimately reduce abuse, misuse, and overdose death. Copyright © 2017 The American Pain Society. Published by Elsevier Inc. All rights reserved.

  10. Between history, art and medicine: the Dresden-Friedrichstadt hospital, its Neptune fountain and connections to Vienna.

    Science.gov (United States)

    Wollina, Uwe; Hunger, Sabine; Koch, André; França, Katlein; Lotti, Torello; Fioranelli, Massimo; Roccia, Maria Grazia

    2017-10-01

    The Dresden-Friedrichstadt hospital originated from Marcolini's summer palace. It was founded in 1845 and opened in 1849. It is a place where history and art of European importance mixes with technical and medical innovations. We reflect on the meetings of Napoleon Bonaparte and Metternich in 1812, the creation of the famous Neptune fountain by Longuelune and Matielli and two outstanding physicians of the 19 th  century, the surgeon Eduard Zeis, who coined the medical term "plastic surgery", and Maximilian Nitze, inventor of the first "modern" cystoscope and the father of urology.

  11. Reducing the risk of healthcare‐associated infections through Lean Six Sigma: The case of the medicine areas at the Federico II University Hospital in Naples (Italy)

    Science.gov (United States)

    Cesarelli, Mario; Montuori, Paolo; Santillo, Liberatina Carmela; Triassi, Maria

    2017-01-01

    Abstract Rationale, aims, and objectives Lean Six Sigma (LSS) has been recognized as an effective management tool for improving healthcare performance. Here, LSS was adopted to reduce the risk of healthcare‐associated infections (HAIs), a critical quality parameter in the healthcare sector. Methods Lean Six Sigma was applied to the areas of clinical medicine (including general medicine, pulmonology, oncology, nephrology, cardiology, neurology, gastroenterology, rheumatology, and diabetology), and data regarding HAIs were collected for 28,000 patients hospitalized between January 2011 and December 2016. Following the LSS define, measure, analyse, improve, and control cycle, the factors influencing the risk of HAI were identified by using typical LSS tools (statistical analyses, brainstorming sessions, and cause‐effect diagrams). Finally, corrective measures to prevent HAIs were implemented and monitored for 1 year after implementation. Results Lean Six Sigma proved to be a useful tool for identifying variables affecting the risk of HAIs and implementing corrective actions to improve the performance of the care process. A reduction in the number of patients colonized by sentinel bacteria was achieved after the improvement phase. Conclusions The implementation of an LSS approach could significantly decrease the percentage of patients with HAIs. PMID:29098756

  12. Reducing the risk of healthcare-associated infections through Lean Six Sigma: The case of the medicine areas at the Federico II University Hospital in Naples (Italy).

    Science.gov (United States)

    Improta, Giovanni; Cesarelli, Mario; Montuori, Paolo; Santillo, Liberatina Carmela; Triassi, Maria

    2018-04-01

    Lean Six Sigma (LSS) has been recognized as an effective management tool for improving healthcare performance. Here, LSS was adopted to reduce the risk of healthcare-associated infections (HAIs), a critical quality parameter in the healthcare sector. Lean Six Sigma was applied to the areas of clinical medicine (including general medicine, pulmonology, oncology, nephrology, cardiology, neurology, gastroenterology, rheumatology, and diabetology), and data regarding HAIs were collected for 28,000 patients hospitalized between January 2011 and December 2016. Following the LSS define, measure, analyse, improve, and control cycle, the factors influencing the risk of HAI were identified by using typical LSS tools (statistical analyses, brainstorming sessions, and cause-effect diagrams). Finally, corrective measures to prevent HAIs were implemented and monitored for 1 year after implementation. Lean Six Sigma proved to be a useful tool for identifying variables affecting the risk of HAIs and implementing corrective actions to improve the performance of the care process. A reduction in the number of patients colonized by sentinel bacteria was achieved after the improvement phase. The implementation of an LSS approach could significantly decrease the percentage of patients with HAIs. © 2017 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons Ltd.

  13. Plant-based Complementary and alternative medicine used by breast cancer patients at the Hospital Universitario San Ignacio in Bogotá, Colombia.

    Directory of Open Access Journals (Sweden)

    Marcela Mercado

    2012-12-01

    Full Text Available The present study estimates the frequency of the use of plant-based Complementary and Alternative Medicine (CAM by breast cancer patients. From June to December of 2011, a self-administered questionnaire was given to 404 breast cancer patients receiving outpatient therapy at the Javeriana Oncology Center of the Hospital Universitario San Ignacio in Bogotá. The prevalence of patient CAM use was 57%, out of which 76% was based on plants like anamú, aloe, red fruits and soursop. Sixty-five percent of the patients had a positive perception of using medicinal plants and 57% used them simultaneously with the oncologist recommended allopathic treatment. We concluded that the frequency of CAM use in breast cancer patients at the Javeriana Oncology Center is within the prevalence range reported worldwide, despite differences in CAM types and frequencies. The high rates of plant-based CAM use without physician consent, brings about the lack of assessment of the synergic or antagonistic effects of CAM therapies on the allopathic treatment of breast cancer and evaluation of the antitumor and immunomodulatory potential of the traditionally used plants.

  14. Advancing the Agenda. IAEA Technical Co-operation in support of the Earth Summit's Agenda 21

    International Nuclear Information System (INIS)

    Garner, Andy W.; Wedekind, Lothar

    2001-09-01

    The Earth Summit took place in September 2002 in Johannesburg, South Africa to discuss the far-reaching goals of Agenda 21 - an ambitious and comprehensive plan of action covering all spheres of social, economic, and human development affecting our environment. The Summit - officially named the World Summit on Sustainable Development - was expected to attract more than 60,000 national and international delegates, including heads of State and leaders of major organizations and institutes. Agenda 21 was among the documents that governments adopted at the first Earth Summit in 1992, officially known as the UN Conference on Environment and Development, held in Rio de Janeiro, Brazil

  15. Oiling the gate: a mobile application to improve the admissions process from the emergency department to an academic community hospital inpatient medicine service.

    Science.gov (United States)

    Fung, Russell; Hyde, Jensen Hart; Davis, Mike

    2018-01-01

    The process of admitting patients from the emergency department (ED) to an academic internal medicine (AIM) service in a community teaching hospital is one fraught with variability and disorder. This results in an inconsistent volume of patients admitted to academic versus private hospitalist services and results in frustration of both ED and AIM clinicians. We postulated that implementation of a mobile application (app) would improve provider satisfaction and increase admissions to the academic service. The app was designed and implemented to be easily accessible to ED physicians, regularly updated by academic residents on call, and a real-time source of the number of open AIM admission spots. We found a significant improvement in ED and AIM provider satisfaction with the admission process. There was also a significant increase in admissions to the AIM service after implementation of the app. We submit that the implementation of a mobile app is a viable, cost-efficient, and effective method to streamline the admission process from the ED to AIM services at community-based hospitals.

  16. The Attitudes of Physicians, Nurses, Physical Therapists, and Midwives Toward Complementary Medicine for Chronic Pain: A Survey at an Academic Hospital.

    Science.gov (United States)

    Aveni, Eléonore; Bauer, Brent; Ramelet, Anne-Sylvie; Kottelat, Yolande; Decosterd, Isabelle; Finti, Guillaume; Ballabeni, Pierluigi; Bonvin, Eric; Rodondi, Pierre-Yves

    2016-01-01

    To assess the attitudes of physicians, nurses, physical therapists, and midwives toward complementary medicine (CM) at a Swiss academic hospital and toward its use for treating chronic pain. The cross-sectional survey took place from October to December 2013. An e-mail sent to 4925 healthcare professionals (1969 physicians, 2372 nurses, 145 physical therapists, and 111 midwives) working at Lausanne University Hospital, Switzerland, invited them to answer a web-based questionnaire. The questionnaire was answered by 1247 healthcare professionals (response rate: 25.3%). Of these, 96.1% strongly agreed or agreed that CM could be useful for the treatment of chronic pain, with more nurses (96.7%) and midwives (100%) than physicians (93.8%) agreeing that CM could be useful (P chronic pain. Respondents listed migraine (74.7%), tension headaches (70.6%), and low back pain (70.1%) as three main conditions for which they would refer patients for acupuncture. The three therapies with which respondents were the most unfamiliar were neuraltherapy (57.2%), mindfulness-based stress reduction (MBSR) (54.1%), and biofeedback (51.9%). Over half of respondents, 58.3%, had never referred a patient to a CM practitioner. A total of 84.3% of the respondents felt that they lacked the knowledge to inform their patients about CM. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Voluntary self-poisoning as a cause of admission to a tertiary hospital internal medicine clinic in Piraeus, Greece within a year

    Directory of Open Access Journals (Sweden)

    Peppas Theodoros A

    2001-10-01

    Full Text Available Abstract Background Out of 1705 patients hospitalised for various reasons in the 3rd Internal Medicine Department of the Regional General Hospital of Nikaea, in Piraeus, 146(8,5% persons were admitted for drug intoxication between November 1999 and November 2000. Methods On average, these persons [male 50(34,2% – female 96(65,8%] were admitted to the hospital within 3.7 hours after taking the drug. Results The drugs that were more frequently taken, alone or in combination with other drugs, were sedatives (67.1%, aspirins and analgesics (mainly paracetamol (43.5%. 38.3% of patients had a mental illness history, 31.5% were in need of psychiatric help and 45.2% had made a previous suicide attempt. No death occurred during the above period and the outcome of the patients' health was normal. After mental state examination, the mental illnesses diagnosed were depression (20.96%, psychosis (15.32%, dysthymic disorder (16,2%, anxiety disorder (22.58% and personality disorder (8.87%. Conclusions Self-poisoning remains a crucial problem. The use of paracetamol and sedatives are particularly important in the population studied. Interpersonal psychiatric therapy may be a valuable treatment after people tried to poison themselves.

  18. Skin cancer patients profile at faculty of medicine university of North Sumatera pathology anatomy laboratory and Haji Adam Malik general hospital in the year of 2012-2015

    Science.gov (United States)

    Sembiring, E. K.; Delyuzar; Soekimin

    2018-03-01

    The most common types of skin cancer found worldwide are basal cell carcinoma, squamous cell carcinoma, and malignant melanoma. In America, about 800,000 people suffer from skin cancer every year and 75% are basal cell carcinoma. According to WHO, around 160,000 people suffer from malignant melanoma every year and 48,000 deaths were reported every year. In Jakarta, in 2000-2009, dr. CiptoMangunkusumo Hospital (RSCM) reported 261 cases of basal cell carcinoma, followed by 69 cases of squamous cell carcinoma and 22 cases of malignant melanoma.This study was descriptive study with retrospective design and consecutive sampling method. Data consisted of age, gender, tumor location, occupation and histopathology subtype which were taken from skin cancer patients’ medical record at Faculty of Medicine University of North Sumatera Pathology Anatomy Laboratory and Haji Adam Malik General Hospital Medan in 2012-2015. Data were analyzed using SPSS program and classified based on WHO. From 92 study subjects, squamous cell carcinoma is the most common form of skin cancer which is 59 cases (64.13%), found in 48 women (52.2%), and often found between 45-47 years old (30.4%).

  19. The intended and unintended consequences of communication systems on general internal medicine inpatient care delivery: a prospective observational case study of five teaching hospitals.

    Science.gov (United States)

    Wu, Robert C; Lo, Vivian; Morra, Dante; Wong, Brian M; Sargeant, Robert; Locke, Ken; Cavalcanti, Rodrigo; Quan, Sherman D; Rossos, Peter; Tran, Kim; Cheung, Mark

    2013-01-01

    Effective clinical communication is critical to providing high-quality patient care. Hospitals have used different types of interventions to improve communication between care teams, but there have been few studies of their effectiveness. To describe the effects of different communication interventions and their problems. Prospective observational case study using a mixed methods approach of quantitative and qualitative methods. General internal medicine (GIM) inpatient wards at five tertiary care academic teaching hospitals. Clinicians consisting of residents, attending physicians, nurses, and allied health (AH) staff working on the GIM wards. Ethnographic methods and interviews with clinical staff (doctors, nurses, medical students, and AH professionals) were conducted over a 16-month period from 2009 to 2010. We identified four categories that described the intended and unintended consequences of communication interventions: impacts on senders, receivers, interprofessional collaboration, and the use of informal communication processes. The use of alphanumeric pagers, smartphones, and web-based communication systems had positive effects for senders and receivers, but unintended consequences were seen with all interventions in all four categories. Interventions that aimed to improve clinical communications solved some but not all problems, and unintended effects were seen with all systems.

  20. Nonpharmacological Interventions Targeted at Delirium Risk Factors, Delivered by Trained Volunteers (Medical and Psychology Students, Reduced Need for Antipsychotic Medications and the Length of Hospital Stay in Aged Patients Admitted to an Acute Internal Medicine Ward: Pilot Study

    Directory of Open Access Journals (Sweden)

    Stanislaw Gorski

    2017-01-01

    Full Text Available Purpose. Effectiveness of nonpharmacological multicomponent prevention delivered by trained volunteers (medical and psychology students, targeted at delirium risk factors in geriatric inpatients, was assessed at an internal medicine ward in Poland. Patients and Methods. Participants were recruited to intervention and control groups at the internal medicine ward (inclusion criteria: age ≥ 75, acute medical condition, basic orientation, and logical contact on admission; exclusion criteria: life expectancy < 24 hours, surgical hospitalization, isolation due to infectious disease, and discharge to other medical wards. Every day trained volunteers delivered a multicomponent standardized intervention targeted at risk factors of in-hospital complications to the intervention group. The control group, selected using a retrospective individual matching strategy (1 : 1 ratio, regarding age, gender, and time of hospitalization, received standard care. Outcome Measures. Hospitalization time, deaths, falls, delirium episodes, and antipsychotic prescriptions were assessed retrospectively from medical documentation. Results. 130 patients (38.4% males participated in the study, with 65 in the intervention group. Antipsychotic medications were initiated less frequently in the intervention group compared to the control group. There was a trend towards a shorter hospitalization time and a not statistically significant decrease in deaths in the intervention group. Conclusion. Nonpharmacological multicomponent intervention targeted at delirium risk factors effectively reduced length of hospitalization and need for initiating antipsychotic treatment in elderly patients at the internal medicine ward.

  1. Climate Change Student Summits: A Model that Works (Invited)

    Science.gov (United States)

    Huffman, L. T.

    2013-12-01

    The C2S2: Climate Change Student Summit project has completed four years of activities plus a year-long longitudinal evaluation with demonstrated positive impacts beyond the life of the project on both students and teachers. This presentation will share the lessons learned about implementing this climate change science education program and suggest that it is a successful model that can be used to scale up from its Midwestern roots to achieve measurable national impact. A NOAA Environmental Literacy grant allowed ANDRILL (ANtarctic geological DRILLing) to grow a 2008 pilot program involving 2 Midwestern sites, to a program 4 years later involving 10 sites. The excellent geographical coverage included 9 of the U.S. National Climate Assessment regions defined by the U.S. Global Change Research Program. Through the delivery of two professional development (PD) workshops, a unique opportunity was provided for both formal and informal educators to engage their classrooms/audiences in understanding the complexities of climate change. For maximum contact hours, the PD experience was extended throughout the school year through the use of an online grouphub. Student teams were involved in a creative investigative science research and presentation experience culminating in a Climate Change Student Summit, an on-site capstone event including a videoconference connecting all sites. The success of this program was based on combining multiple aspects, such as encouraging the active involvement of scientists and early career researchers both in the professional development workshops and in the Student Summit. Another key factor was the close working relationships between informal and formal science entities, including involvement of informal science learning facilities and informal science education leaders. The program also created cutting-edge curriculum materials titled the ELF, (Environmental Literacy Framework with a focus on climate change), providing an earth systems

  2. NATO Summit – 2016: results and prospects for Ukraine

    Directory of Open Access Journals (Sweden)

    O. S. Vonsovych

    2016-06-01

    Full Text Available The article investigates the results and prospects of the NATO Summit in Warsaw in 2016 for Ukraine. It was determined that one of the Summit’s outcomes for Ukraine can be considered categorical NATO’s condemnation of aggression acts of the Russian Federation against our country, and also that will never be legitimized its actions on the change of borders, in particular the annexation of Crimea and support of separatism in Ukraine. It is proved that the approval of the Comprehensive Assistance Package for Ukraine will contribute to the reforming of the defense and security structures based on NATO’s standards and principles, including the establishment of civilian democratic control over the armed forces and to ensure their interoperability with NATO. Reasoned argument that the presentation of the Strategic Defense Bulletin of Ukraine at the Summit is a demonstration of execution of the programming steps of Ukraine’s cooperation with NATO, but at the same time, its practical component of the full implementation raises a number of doubts. It is founded that the content of the joint statement of the Commission Ukraine – NATO at the highest level is, to a greater extent, declarative than practical. It made a conclusion that the outcomes of the NATO Summit on Ukraine could be more if the Ukrainian delegation had previously worked in more detail the practical component of their positions. It was determined that an important issue for Ukraine in the future will clearly define NATO’s position with regard to the Russian Federation. On how quickly this happens will depends the further determining (or, perhaps, transformation of the course of cooperation with NATO.

  3. Coordination and Convening of the 2016 Arctic Science Summit Week

    Energy Technology Data Exchange (ETDEWEB)

    Hinzman, Larry D. [Univ. of Alaska, Fairbanks, AK (United States)

    2016-11-13

    The Arctic Science Summit Week, Arctic Observing Summit, Arctic Council Senior Arctic Officials, Model Arctic Council, and International Arctic Assembly were convened on the campus of the University of Alaska Fairbanks with great productivity and satisfaction of the participants. We were pleased to welcome over 1000 participants from 30 different nations and over 130 different institutions. The organization and execution of these meetings was extensive and complex involving more than 250 coordinators, volunteers and contributors from across Alaska. The participants were enthusiastic in their praise of the content and accomplishments of the meeting, but they were equally happy about the genuine welcome offered to our guests by the people of Alaska. Hosting a complex event such as this summit required an army of supporting services and we were blessed to have volunteers from Fairbanks, North Pole, Anchorage and other communities throughout Alaska helping us meet these needs. This truly was an event hosted by the people of Alaska. The significance of these events cannot be overstated. The US and global communities are finally coming to the realization of the important role that the Arctic plays in international politics, economics, and science. The Arctic has experienced tremendous changes in recent years, offering new opportunities that may be addressed through international collaborations, and serious challenges that must be addressed through active investment, adaptation and national and international coordination. Over 10% of the meeting participants were indigenous peoples, from indigenous organizations or hailed from small remote communities. This is still lower than we had hoped, but it is greater participation than similar meetings have experienced in the past. It is through such engagement that we can attack problems related to the changing environment, stagnant economies, and social ills.

  4. Prevalence and associated factors of herbal medicine use among pregnant women on antenatal care follow-up at University of Gondar referral and teaching hospital, Ethiopia: a cross-sectional study.

    Science.gov (United States)

    Mekuria, Abebe Basazn; Erku, Daniel Asfaw; Gebresillassie, Begashaw Melaku; Birru, Eshetie Melese; Tizazu, Balem; Ahmedin, Alima

    2017-02-01

    Improving maternal and child health is one of the public health priorities in several African countries including Ethiopia. However, research on herbal medicine use during pregnancy is scarce in Ethiopia. The present study aimed at assessing the prevalence and correlates of herbal medicine use among pregnant women on antenatal care (ANC) follow-up at Gondar university referral hospital, Ethiopia METHODS: An institutional-based cross sectional study was conducted on 364 pregnant women attending ANC clinic from March to May 2016 at University of Gondar referral and teaching hospital, northwest Ethiopia. Data on socio-demography, pregnancy related information as well as herbal medicine use was collected through an interviewer-administered questionnaire. Descriptive statistics, univariate and multivariate logistic regression analysis were performed to determine prevalence and associated factors of herbal medicine use. From 364 respondents, 48.6% used herbal medicine during current pregnancy. ginger (40.7%) and garlic (19%) were the two most commonly used herbs in pregnancy. Common cold (66%) and inflammation (31.6%) were the most common reasons for herbal use. Majority of herbal medicine users (89.8%) had not consulted their doctors about their herbal medicine use. Rural residency (Adjusted odds ratio (AOR): 3.15, Confidence interval (CI): 1.17-6.14), illiteracy (AOR: 4.05, CI: 2.47-6.62) and average monthly income less than 100 USD (AOR: 3.08CI: 1.221-7.77) were found to be strong predictors of herbal medicine use. The use of herbal medicine during pregnancy is a common practice and associated with residency, level of education and average monthly income. From the stand point of high prevalence and low disclosure rate, the health care providers should often consult pregnant women regarding herbal medicine use.

  5. The ability of clinical and laboratory findings to predict in-hospital death in patients with thrombotic thrombocytopenic purpura in an internal and emergency medicine department

    Directory of Open Access Journals (Sweden)

    Filippo Pieralli

    2012-01-01

    Full Text Available Introduction: Thrombotic thrombocytopenic purpura (TTP is a rare, life-threatening syndrome characterized by microangiopathic anemia, thrombocytopenia, diffuse microvascular thrombosis, and ischemia. It is associated with very low levels of ADAMTS-13. Measurement of ADAMTS-13 levels is used for diagnostic and prognostic purposes, but in every-day clinical practice, this type of analysis is not always readily available. In this retrospective study, we evaluated prognostic value of clinical and laboratory findings in patients with TTP. Materials and methods: We retrospectively investigated patients with clinically diagnosed TTP treated in a unit of Internal and Emergency Medicine (1996-2007. Clinical and laboratory findings were collected and analyzed in order to assess their ability to predict in-hospital death. Results: Twelve patients were identified (mean age 59 + 22 years; 58% were women. Five (42% died during the hospitalization, and the variables significantly associated with this outcome were: a delay between diagnosis and symptom onset (HR 1.36; 95% CI 1.04-1.78; p < 0.05; a higher severity score (HR 1.48; 95%CI 1,23-3.86; p < 0.05; hemodynamic instability with hypotension and/or shock (HR 3.35; 95%CI 3.02-9.26; p < 0.01; a higher schistocyte count on blood smear (HR 1.84; 95%CI 1.04-3.27; p < 0.05; and higher lactate values (HR 1.85; 95%CI 1.08- 3.16; p < 0.05. Conclusions: TTP is a rare and potentially fatal disease with protean manifestations. Delayed diagnosis after symptom onset is a major determinant of poor outcome. Hypotension and shock are also prognostically unfavourable. Laboratory evidence of cardiocirculatory compromise (i.e., elevated lactate levels and extension of the disease process (i.e., schistocyte count > 3 are predictive of in-hospital death, independently of the hemodynamic profile on admission.

  6. [Management of diabetic children at the University Hospital Center of Rabat: an example of partnership or personal initiative on the periphery of the school of medicine?].

    Science.gov (United States)

    Balafrej, A

    2003-04-01

    In Morocco there are at least 10,000 children under the age of 15 who suffer from type 1 diabetes who, due to the lack of appropriate management and care, are extremely susceptible to repeated hospital re-admission and long-term disabling degenerative complications. With the aim to reduce the frequency of complications, a specialised outpatient clinic was created at the children's hospital in Rabat in 1986. A multi-disciplinary team provides medical care as well as initial training and continuing education to the patients and their families according to a standardised protocol. The 700 young diabetics who are monitored in the clinic are at present autonomous in the delivery of their own daily treatment and continue to increasingly improve. After 10 years, this group of patients has experienced a diabetic retinopathy rate which is six times lower than since the onset of their illness. The programme is administered in partnership and with the financial support of a private sponsor and assistance of a parents' association. The programme is designed in compliance with the WHO Towards Unity for Health strategy and its core principles, namely: relevance, equity, quality, and effectiveness. In order to achieve sustainability, the programme needs an adopted geographic management structure and more formalised relationships linking the partners. Nevertheless, the programme could be considered as a laboratory experiment for the School of Medicine, in its search to create a wider social movement. This level of commitment implies recasting the foci of the medical training curriculum, promoting therapeutic patient education, giving more attention to the hospital's operations and building sustainable partnerships.

  7. [Following the American example? American models for hospital medicine and research: the case of the Kerckhoff Institute in Bad Nauheim].

    Science.gov (United States)

    Timmermann, Carsten

    2010-01-01

    This essay examines how and why American models were applied in the reorganization of West German hospitals and medical research centers in the post-war period. After discussing why American clinical medical centers turned into model institutions over the last century or so, a case study is discussed in some detail: the Kerckhoff Institute for cardiovascular research in Bad Nauheim, since 1951 an institute within the Max Planck Society with its own research clinic (which was unusual for Max Planck Institutes). The history of this institution illustrates which local and specific considerations drove historical actors to embrace American models. German academic and administrative realities, however, imposed tight constraints on the implementation of US institutional models.

  8. Discrepant Views of Oncologists and Cancer Patients on Complementary and Alternative Medicine in a Chinese General Hospital.

    Science.gov (United States)

    Yang, Geliang; Zhang, Huiqing; Gan, Zheng; Fan, Yifu; Gu, Wei; Ling, Changquan

    2018-06-01

    Complementary and alternative medicine (CAM) has been widely used by cancer patients but rarely discussed by oncologists. This study was designed to evaluate the communication gap between China's oncologists and cancer patients on CAM. Two parallel cross-sectional studies assessed 83 oncologists and 402 cancer patients on CAM communication between patients and oncologists, and attitudes toward CAM use and clinical decisions about CAM. A majority (75.1%) of the cancer patients (302/402) were identified as CAM users within the most recent three months while 77.6% of the cancer patients (312/402) were identified as CAM users since diagnosis of cancer. Oncologists and patients responded differently ( P effectiveness of CAM, cancer patients were more likely to believe that CAM was effective while oncologists had more concerns about adverse effects of CAM use. CAM use by patients was predicted by disease duration (≥9 months) in the multivariable logistic regression model. China's oncologists and cancer patients may hold discrepant views on CAM. China's oncologists are encouraged to improve their knowledge on CAM and to initiate more discussions with their patients regarding effective and the safe use of CAM.

  9. Performance of Physical Examination Skills in Medical Students during Diagnostic Medicine Course in a University Hospital of Northwest China

    Science.gov (United States)

    Li, Yan; Li, Na; Han, Qunying; He, Shuixiang; Bae, Ricard S.; Liu, Zhengwen; Lv, Yi; Shi, Bingyin

    2014-01-01

    This study was conducted to evaluate the performance of physical examination (PE) skills during our diagnostic medicine course and analyze the characteristics of the data collected to provide information for practical guidance to improve the quality of teaching. Seventy-two fourth-year medical students were enrolled in the study. All received an assessment of PE skills after receiving a 17-week formal training course and systematic teaching. Their performance was evaluated and recorded in detail using a checklist, which included 5 aspects of PE skills: examination techniques, communication and care skills, content items, appropriateness of examination sequence, and time taken. Error frequency and type were designated as the assessment parameters in the survey. The results showed that the distribution and the percentage in examination errors between male and female students and among the different body parts examined were significantly different (pexaminations was higher than in abdominal (0.867) and head, neck and nervous system examinations (0.917). Female students had a lower average error frequency than males in cardiac examinations (p = 0.041). Additionally, error in examination techniques was the highest type of error among the 5 aspects of PE skills irrespective of participant gender and assessment content (pexaminations and examination techniques may be included in the main focus of improving the teaching of diagnostics in these medical students. PMID:25329685

  10. Radiological safety analysis of the nuclear medicine service at the 'Hospital Nacional Dos de Mayo'/Peru

    International Nuclear Information System (INIS)

    Acosta R, N.; Ramirez Q, R.

    1996-01-01

    For the purpose of applying for installation licenses for nuclear medicine, as it is required by the peruvian Law, it is necessary to make an analysis of safety and protection of the installation and its procedures, so that the technical criteria can be satisfied. Previous information includes a description of activities that employs I 131 and Tc 99m in the diagnosis and treatment. A description of the installations, surrounding areas and construction details is performed, especially in hot zones. The safety analysis takes into account the normal operation risk in terms of doses for each process or operation that is executed (for example: division, fraction, extraction, dilution, etc),the operation time and the frequency. The annual doses are not more than 5,88 mSv for diagnostics and 5 mSv in therapy. In accidental situations, events of individual contamination, spills, fire and explosion, which are the most likely to happen, have been taken into account. Due to these events, the doses are between 5.5 mSv and 0.53 mSv under reasonable assumptions. In view of the possibility of these normal and potential doses, it is necessary the implementation of procedures and specifications to complete the protection in the practice. The documents were evaluated and the installation license was granted. (authors). 7 refs., 1 fig

  11. Annals of African Medicine

    African Journals Online (AJOL)

    The Annals of African Medicine is published by the Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria and the Annals of African Medicine Society. The Journal is intended to serve as a medium for the publication of research findings in the broad field of Medicine in Africa and other developing countries, and ...

  12. Radiation exposure to nuclear medicine staffs during 18F-FDG PET/CT procedures at Ramathibodi Hospital

    International Nuclear Information System (INIS)

    Donmoon, T; Chamroonrat, W; Tuntawiroon, M

    2016-01-01

    The aim of this study is to estimate the whole body and finger radiation doses per study received by nuclear medicine staff involved in dispensing, administration of 18 F-FDG and interacting with radioactive patients during PET/CT imaging procedures in a PET/CT facility. The whole-body doses received by radiopharmacists, technologists and nurses were measured by electronic dosimeter and the finger doses by ring dosimeter during a period of 4 months. In 70 PET/CT studies, the mean whole-body dose per study to radiopharmacist, technologist, and nurse were 1.07±0.09, 1.77±0.46, μSv, and not detectable respectively. The mean finger doses per study received by radiopharmacist, technologist, and nurse were 265.65±107.55, 4.84±1.08 and 19.22±2.59 μSv, respectively. The average time in contact with 18 F-FDG was 5.88±0.03, 39.06±1.89 and 1.21±0.02 minutes per study for radiopharmacist, technologist and nurse respectively. Technologists received highest mean effective whole- body dose per study and radiopharmacist received the highest finger dose per study. When compared with the ICRP dose limit, each individual worker can work with many more 18 F- FDG PET/CT studies for a whole year without exceeding the occupational dose limits. This study confirmed that low levels of radiation does are received by our medical personnel involved in 18 F-FDG PET/CT procedures. (paper)

  13. Hydrothermal activity on the summit of Loihi Seamount, Hawaii

    Energy Technology Data Exchange (ETDEWEB)

    Sakai, H; Tsubota, H; Nakai, T; Ishibashi, J; Akagi, T; Gamo, T; Tilbrook, B; Igarashi, G; Kodera, M; Shitashima, K

    1987-01-01

    Loihi Seamount is located about 30km southeast of the Island of Hawaii; it rises from the sea floor at a depth of 4000m and reaches a maximum elevation of 1000m blow sea level. Oceanographic studies including CTD survey of warm sites and bottom photography confirmed several hydrothermal fields on the summit of the seamount. The summit is covered with hydrothermal plumes which are extremely rich in methane, helium, carbon dioxide, iron and manganese; the maximum concentration of helium is 91.8 n1/1, the highest so far reported for open-ocean water. The /sup 3/He//sup 4/He ratio of helium injected into seawater is 14 times the atmospheric level. The 3He/heat and CO/sub 2//heat ratios in the plumes are one to two orders of magnitude greater than those at oceanic spreading centers, implying a more primitive source region for hotspot volcanism. The plumes also show negative pH anomalies up to half a pH unit from ambient owing to the high injection rate of CO/sub 2/. (4 figs, 3 photos, 1 tab, 31 refs)

  14. Outcomes and Suggestions of the Nuclear Security Summit

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jae San; Jung, Myung Tak [Korea Institute of Nuclear Nonproliferation and Control Daejeon (Korea, Republic of)

    2014-10-15

    Through The third Nuclear Security Summit (NSS), the measurement for the nuclear security has become more strengthening and participating countries could recognize the importance of nuclear security than before. From the NSS sessions, the leaders of participating countries and international organizations (IAEA, UN, EU and INTERPOL) had an in-depth discussion about the seriousness of the nuclear terrorism, the urgency issues for strengthening the nuclear security, etc. What issues was discussed in NSS processes since 2010 and which facts become more important than ever for nuclear security? The purpose of this paper is to provide the substantive outcomes from the 1st to 3rd NSS and suggestions for consolidating the next NSS. The summit process has helped strengthen the nuclear security measures. In the following two years before 4th NSS, there will be various follow-up activities for making an effort to implementing national commitments, joint statement, continuous outreach with IAEA/UN and agreed measures in Hague. It should produce the substantial measures for enhancing the nuclear security that are aimed to the each country. And preemptively, it is necessary to understand the each nuclear security level by using the concrete questionnaire sheets substitute for the national progress report.

  15. Outcomes and Suggestions of the Nuclear Security Summit

    International Nuclear Information System (INIS)

    Kim, Jae San; Jung, Myung Tak

    2014-01-01

    Through The third Nuclear Security Summit (NSS), the measurement for the nuclear security has become more strengthening and participating countries could recognize the importance of nuclear security than before. From the NSS sessions, the leaders of participating countries and international organizations (IAEA, UN, EU and INTERPOL) had an in-depth discussion about the seriousness of the nuclear terrorism, the urgency issues for strengthening the nuclear security, etc. What issues was discussed in NSS processes since 2010 and which facts become more important than ever for nuclear security? The purpose of this paper is to provide the substantive outcomes from the 1st to 3rd NSS and suggestions for consolidating the next NSS. The summit process has helped strengthen the nuclear security measures. In the following two years before 4th NSS, there will be various follow-up activities for making an effort to implementing national commitments, joint statement, continuous outreach with IAEA/UN and agreed measures in Hague. It should produce the substantial measures for enhancing the nuclear security that are aimed to the each country. And preemptively, it is necessary to understand the each nuclear security level by using the concrete questionnaire sheets substitute for the national progress report

  16. Report of the 2014 Programming Models and Environments Summit

    Energy Technology Data Exchange (ETDEWEB)

    Heroux, Michael [US Dept. of Energy, Washington, DC (United States); Lethin, Richard [US Dept. of Energy, Washington, DC (United States)

    2016-09-19

    Programming models and environments play the essential roles in high performance computing of enabling the conception, design, implementation and execution of science and engineering application codes. Programmer productivity is strongly influenced by the effectiveness of our programming models and environments, as is software sustainability since our codes have lifespans measured in decades, so the advent of new computing architectures, increased concurrency, concerns for resilience, and the increasing demands for high-fidelity, multi-physics, multi-scale and data-intensive computations mean that we have new challenges to address as part of our fundamental R&D requirements. Fortunately, we also have new tools and environments that make design, prototyping and delivery of new programming models easier than ever. The combination of new and challenging requirements and new, powerful toolsets enables significant synergies for the next generation of programming models and environments R&D. This report presents the topics discussed and results from the 2014 DOE Office of Science Advanced Scientific Computing Research (ASCR) Programming Models & Environments Summit, and subsequent discussions among the summit participants and contributors to topics in this report.

  17. Proceedings of the clean air and climate change summit

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2010-07-01

    The Clean Air Partnership was established in the Greater Toronto Area (GTA) over 10 years ago to work on issues related to air pollution and climate change. This summit presented details of the partnership's municipal activities and provided an outline of various projects conducted to reduce air pollution, increase the use of green energy, and encourage residents to reduce their ecological footprint. Climate change was discussed in relation to the recent economic crisis and recently discovered problems related to ocean acidification. The International Energy Agency (IEA) annual report was discussed in relation to peak oil and future economic crises. Advancements in green energy policy in Ontario were outlined. Sustainable housing and renewable energy projects in Germany were presented along with successful urban designs in Melbourne, New York City, and Denver. The GTA-CAC inter-governmental declaration on clean air was discussed, and an interim progress report was presented. The summit concluded with a video presentation of a collaborative artistic piece about climate change and the Arctic. 11 figs.

  18. Proceedings of the clean air and climate change summit

    International Nuclear Information System (INIS)

    2010-01-01

    The Clean Air Partnership was established in the Greater Toronto Area (GTA) over 10 years ago to work on issues related to air pollution and climate change. This summit presented details of the partnership's municipal activities and provided an outline of various projects conducted to reduce air pollution, increase the use of green energy, and encourage residents to reduce their ecological footprint. Climate change was discussed in relation to the recent economic crisis and recently discovered problems related to ocean acidification. The International Energy Agency (IEA) annual report was discussed in relation to peak oil and future economic crises. Advancements in green energy policy in Ontario were outlined. Sustainable housing and renewable energy projects in Germany were presented along with successful urban designs in Melbourne, New York City, and Denver. The GTA-CAC inter-governmental declaration on clean air was discussed, and an interim progress report was presented. The summit concluded with a video presentation of a collaborative artistic piece about climate change and the Arctic. 11 figs.

  19. Primative components, crustal assimilation, and magmatic degassing of the 2008 Kilauea summit eruption

    Science.gov (United States)

    Rowe, Michael C.; Thornber, Carl R.; Orr, Tim R.

    2015-01-01

    Simultaneous summit and rift zone eruptions at Kīlauea starting in 2008 reflect a shallow eruptive plumbing system inundated by a bourgeoning supply of new magma from depth. Olivine-hosted melt inclusions, host glass, and bulk lava compositions of magma erupted at both the summit and east rift zone demonstrate chemical continuity at both ends of a well-worn summit-to-rift pipeline. Analysis of glass within dense-cored lapilli erupted from the summit in March – August 2008 show these are not samplings of compositionally distinct magmas stored in the shallow summit magma reservoir, but instead result from remelting and assimilation of fragments from conduit wall and vent blocks. Summit pyroclasts show the predominant and most primitive component erupted to be a homogenous, relatively trace-element-depleted melt that is a compositionally indistinguishable from east rift lava. Based on a “top-down” model for the geochemical variation in east rift zone lava over the past 30 years, we suggest that the apparent absence of a 1982 enriched component in melt inclusions, as well as the proposed summit-rift zone connectivity based on sulfur and mineral chemistry, indicate that the last of the pre-1983 magma has been flushed out of the summit reservoir during the surge of mantle-derived magma from 2003-2007.

  20. Changing Public Discourse on the Environment: Danish Media Coverage of the Rio and Johannesburg UN Summits

    DEFF Research Database (Denmark)

    Petersen, Lars Kjerulf

    2008-01-01

    Environmental degradation and unsustainable development were addressed on a global scale at the UN Summits in Rio de Janeiro in 1992 and Johannesburg in 2002. This article presents analyses of Danish television coverage of these two summits and related topics viewing the media stories as exemplary...

  1. Demographic Characteristics and Medical Service Use of Failed Back Surgery Syndrome Patients at an Integrated Treatment Hospital Focusing on Complementary and Alternative Medicine: A Retrospective Review of Electronic Medical Records

    Directory of Open Access Journals (Sweden)

    Hee Seung Choi

    2014-01-01

    Full Text Available Objective. To report the patient demographics and nonsurgical complementary and alternative medicine treatment used at a Korean medicine hospital for low back pain (LBP and/or sciatica after surgery. Methods. Medical records of patients who visited a spine-specialized Korean medicine hospital at 2 separate sites for continuous or recurrent LBP or sciatica following back surgery were reviewed. The demographics, MRI and/or CT scans, and treatments were assessed. Results. Of the total 707 patients, 62% were male and the average age was 50.20 years. Ninety percent of patients presented with LBP and 67% with sciatica. Eighty-four percent were diagnosed with herniated nucleus pulposus at time of surgery. Of these patients, 70% had pain recurrence 6 months or later, but 19% experienced no relief or immediate aggravation of pain after surgery. Many patients selected traditional Korean medicine treatment as primary means of postsurgery care (47%. When time to pain recurrence was short or pain persisted after surgery, return of symptoms at the same disc level and side was frequent. Conclusion. An integrative treatment model focusing on Korean medicine and used in conjunction with radiological diagnostics and conventional medicine is currently used as a treatment option for patients with pain after lumbar spine surgery.

  2. Physician perspectives on collaborative working relationships with team-based hospital pharmacists in the inpatient medicine setting.

    Science.gov (United States)

    Makowsky, Mark J; Madill, Helen M; Schindel, Theresa J; Tsuyuki, Ross T

    2013-04-01

    Collaborative care between physicians and pharmacists has the potential to improve the process of care and patient outcomes. Our objective was to determine whether team-based pharmacist care was associated with higher physician-rated collaborative working relationship scores than usual ward-based pharmacist care at the end of the COLLABORATE study, a 1 year, multicentre, controlled clinical trial, which associated pharmacist intervention with improved medication use and reduced hospital readmission rates. We conducted a cross-sectional survey of all team-based and usual care physicians (attending physicians and medical residents) who worked on the participating clinical teaching unit or primary healthcare teams during the study period. They were invited to complete an online version of the validated Physician-Pharmacist Collaboration Index (PPCI) survey at the end of the study. The main endpoint of interest was the mean total PPCI score. Only three (response rate 2%) of the usual care physicians responded and this prevented us from conducting pre-specified comparisons. A total of 23 team-based physicians completed the survey (36%) and reported a mean total PPCI score of 81.6 ± 8.6 out of a total of 92. Mean domain scores were highest for relationship initiation (14.0 ± 1.4 out of 15), and trustworthiness (38.9 ± 3.7 out of 42), followed by role specification (28.7 ± 4.3 out of 35). Pharmacists who are pursuing collaborative practice in inpatient settings may find the PPCI to be a meaningful tool to gauge the extent of collaborative working relationships with physician team members. © 2012 The Authors. IJPP © 2012 Royal Pharmaceutical Society.

  3. [Assessment of compliance for oral medicines with MMSE, Mini-Mental State Examination, in hospitalized elderly patients].

    Science.gov (United States)

    Miura, Masatomo; Kakei, Masafumi; Iwasawa, Saaya; Morii, Tsukasa; Miura, Takeshi; Sasaki, Hiroshi; Satoh, Takehiro; Fujita, Hiroki; Narita, Takuma; Shirakawa, Hideko; Yamada, Yuichiro; Suzuki, Toshio

    2007-10-01

    The minimental state examination (MMSE) is a widely used, standardized method to assess cognitive function including movement-related disorders with high reliability. We studied the relationship between MMSE scores and the ability to take oral medications correctly (ingestion compliance) in 70 elderly inpatients (mean age 71.3+/-7.0 years). Patients with abnormal glucose tolerance as determined by an HbA(1c) level of 5.8% or greater including diabetes showed a trend of lower MMSE scores compared with patients with normal glucose tolerance, and the scores were negatively correlated with HbA1c, age, and systolic blood pressure (P<0.05). Self-management in taking oral medications was very difficult in 4 patients whose MMSE scores were 21 points or less. Thus ingestion supervisions by nurses were required in these patients. Furthermore, 9 of 12 noncompliant patients had MMSE scores ranging from 22 to 26 points. We instructed these patients to take medications in a one-dose package as a useful tool to improve compliance. The MMSE score was 27 or higher in 44 of 54 compliant patients, and 10 patients had scores ranging from 21 to 26. The sensitivity and specificity for noncompliance at an MMSE score cut-off point of 26 were 75.0% and 81.5%, respectively. In conclusion, it is necessary to coordinate ingestion methods matched to each patient according to their abilities to comply with medication schedules. They should be preevaluated with the MMSE to improve ingestion compliance. The MMSE is a recommended test in hospitalized elderly patients for the assessment of the ability to take medications safely.

  4. Catheter associated urinary tract infection (CA-UTI) incidence in an Internal Medicine Ward of a Northern Italian Hospital.

    Science.gov (United States)

    Izzo, Ilaria; Lania, Donatella; Bella, Daniele; Formaini Marioni, Cesare; Coccaglio, Romana; Colombini, Paolo

    2015-09-01

    Catheter-associated urinary tract infections (CA-UTI) are estimated to be the most frequent nosocomial infections (40%). A catheter is introduced to 10-25% of inpatients, and is often left on site for a long period of time. We carried out a prospective study on inpatients of our Internal Medicine ward to assess the incidence of CA-UTI under the implementation of corrective action. All inpatients who underwent introduction of a urinary catheter upon or after admission to our ward were included in the study. Patients with bacteriuria or positive urine culture before catheterization, others with less than 24 hours catheterism, or bearing a catheter on admission were all excluded from the study. CA-UTI diagnosis was assessed on the basis of CDC 2009 guidelines. The investigation was held between June 2010 and March 2013 in five steps or phases. In the first phase open circuit drainage catheterism was used, in the second phase close circuit drainage catheterism was introduced, while in the third phase disposable lubrification was added to closed circuit drainage catheterism. In the next step (phase 4) we introduced number of days of catheterism control and nurse training; in the last phase (5) emptying urine collection bags on a container was added. In phase 1 we estimated six UTIs out of 18 patients (incidence 33%), in phase 2 we had four infections out of 10 patients (40%). Given the results, we had to reflect on the quality of the procedures of catheter positioning and management . Where feasible, we improved technical practices and during follow-up there was evidence of CA-UTI in 10 patients over 25 (phase 3, 40%), and eight infections over 25 (phase 4, 32%). Once all these steps had been implemented, in phase 5 we determined a sharp reduction in CA-UTI (2 patients over 27, or 7.5%, p=0.025). This improvement was particularly evident in the rate of infection per days of catheter, which was reduced from 43.4/1000 to 13.6/1000. Although the statistical power of the

  5. Multiple barriers against successful care provision for depressed patients in general internal medicine in a Japanese rural hospital: a cross-sectional study

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    Saitoh Akiyoshi

    2010-04-01

    Full Text Available Abstract Background A general internist has an important role in primary care, especially for the elderly in rural areas of Japan. Although effective intervention models for depressed patients in general practice and primary care settings have been developed in the US and UK medical systems, there is little information regarding even the recognition rate and prescription rate of psychotropic medication by general internists in Japan. The present study surveyed these data cross-sectionally in a general internal medicine outpatient clinic of a Japanese rural hospital. Methods Patients were consecutively recruited and evaluated for major depressive disorder or any mood disorder using the Patient Health Questionnaire (PHQ. Physicians who were blinded to the results of the PHQ were asked to diagnose whether the patients had any mental disorders, and if so, whether they had mood disorders or not. Data regarding prescription of psychotropic medicines were collected from medical records. Results Among 312 patients, 27 (8.7% and 52 (16.7% were identified with major depressive disorder and any mood disorder using the PHQ, respectively. Among those with major depressive disorder, 21 (77.8% were recognized by physicians as having a mental disorder, but only three (11.1% were diagnosed as having a mood disorder. Only two patients with major depressive disorder (7.4% had been prescribed antidepressants. Even among those (n = 15 whom physicians diagnosed with a mood disorder irrespective of the PHQ results, only four (26.7% were prescribed an antidepressant. Conclusions Despite a high prevalence of depression, physicians did not often recognize depression in patients. In addition, most patients who were diagnosed by physicians as having a mood disorder were not prescribed antidepressants. Multiple barriers to providing appropriate care for depressed patients exist, such as recognizing depression, prescribing appropriate medications, and appropriately referring

  6. A cohort study to analyze the risk of venous thromboembolism mortality in patients admitted to the general medicine department, tan tock seng hospital, singapore.

    Science.gov (United States)

    Sule, Ashish Anil; Chin, Tay Jam; Sinnathamby, Letchumi; Lee, Hwei Khien; Earnest, Arul

    2011-06-01

    The purpose of this study was to assess the risk of venous thromboembolism (VTE) in patients admitted to the Tan Tock Seng Hospital (TTSH), Singapore during October and November 2009. The primary outcome assessed was mortality due to VTE, or development of deep vein thrombosis or pulmonary embolism (PE) within 3 months from the day of admission. Both univariate and multivariate analyses were performed for all-cause mortality and deaths associated with PE. Seven hundred twenty-one patients admitted to the 5th floor of the General Medicine Department, TTSH, during the 2 months were analyzed. There were 368 (51.04%) female patients and 353 (48.96%) male patients. As per race distribution, 566 (78.50%) patients were Chinese, 100 (13.86%) patients were Malaysians, 46 (6.38%) patients were Indians, and 9 (1.26%) were other races. Four hundred ninety-two (68.24%) were independent for activities of daily living (ADL) and 229 (31.76%) were dependent for all ADL. There were in all 42 deaths. There were definite PE deaths in 2 (4.76%) patients, probable PE deaths in 3 (7.14%) patients, and suspected PE deaths in 8 (19.05%) patients. Twenty (47.62%) deaths were due to pneumonia, 3 (7.14%) deaths were due to urinary tract infections, and 4 (9.52%) deaths were due to other infections. Two (4.76%) deaths were due to myocardial infarction. The risk of VTE was high in acutely ill patients admitted to the General Medicine Department, TTSH, Singapore. The factors that predispose patients to a very high risk are ADL dependence, acute heart failure, past history of VTE, or if they are clinically dehydrated and have acute renal failure. This warrants increased awareness and need for VTE prophylaxis.

  7. Uso de hierbas medicinales en mujeres gestantes y en lactancia en un hospital universitario de Bogotá (Colombia The use of herbal medicine among pregnant and lactating women attending a university hospital in Bogota, Colombia

    Directory of Open Access Journals (Sweden)

    Gloria Paulina Pulido Acuña

    2012-12-01

    Full Text Available Las mujeres durante la gestación y lactancia utilizan diferentes hierbas y es escasa la información en el ámbito clínico en Colombia. Objetivo: Describir las prácticas relacionadas con el uso de hierbas en mujeres gestantes y en lactancia del Hospital de San José, Bogotá (Colombia. Metodología: Estudio de corte transversal. Con un cuestionario estructurado se indagó el uso, la frecuencia, el modo y razones de uso, de las hierbas medicinales y de quién se aprendió la práctica. Resultados: El uso de hierbas en mujeres gestantes y en lactancia fue de 33.6% (IC95%: 29.2% - 38% y 36.6% (IC95%: 30.8% - 42.3%, respectivamente. En el grupo de gestantes la hierba más usada fue la manzanilla (36.7% y en las mujeres en lactancia fue el hinojo (65%. Conclusión: Las mujeres gestantes y en lactancia, utilizan hierbas para las molestias del embarazo, acelerar el parto, disminuir el frío y promover la producción de leche.The use of herbal supplements is a common practice about pregnant and lactating women, however in Colombia there is limited data regarding the extent of women's use of herbal medicines during pregnancy and breastfeeding. The aim of this study was to describe the patterns of herbal medication use among pregnant and lactating women at the Hospital San Jose in Bogota, Colombia. Methods: Cross-sectional study. A questionnaire was designed to measure the frequency of herbal supplementation, why women took the herbal medicine, form of supplements, and who recommended the supplements or how did they learn about the herbal supplements. Results: The use of herbal supplements among pregnant and lactating women is 33.6% (CI 95%: 29.2%-38% and 36.6 (CI 95%: 30.8%-42.3%, respectively. The most common supplement used by pregnant women is Chamomile (36,7%, and among lactating women is Fennel (Foeniculum vulgare (65%. Conclusion: Pregnant and breastfeeding women use herbal supplements for specific pregnancy-related problems, to induce labor, to

  8. BioChroma - A New and Patented Technology for Processing Radioactive Wastewater from Nuclear Medicine Therapy Facilities in Hospitals and Clinics.

    Science.gov (United States)

    Rodríguez, José Canga

    2012-01-01

    After undergoing radionuclide therapy, patients generate wastewater with a considerable amount of radioactivity, which can reach levels of as much as 90% of the administered dose. Due to the risk of accumulation after discharge into the sewer, it is advisable to collect this effluent for its treatment prior to final discharge. Delay and decay (natural decomposition of the isotope) is the most commonly used technical method of abating radioactive iodine, but it is frequently criticized as being complex and very expensive. BioChroma is a technology that has been developed as an alternative to these complicated and expensive systems. This paper describes this new technology and presents, as an example, a system that was installed and successfully commissioned in the middle of 2008 in a nuclear medicine ward with 12 beds in Stuttgart (Germany). Based on existing legislation, the responsible authorities and the company that operated the hospital agreed on a maximum activity level of 5 Bq/l. If a typical delay and decay system would have been installed, the 180 m(3) treatment plant that was already available in the hospital cellar would have to be extended by additional 150 m(3). By implementing the patented BioChroma process, the space requirements were reduced by 75%. For instance, since the new system was integrated into the existing installation, tanks accounting for 120 m³ could be used as buffering volume in the new wastewater treatment plant. The operation of the referred plant is currently producing very good results with values below the specified limit of 5 Bq/l for the isotope (131)I. In addition, (90)Y has been reported to be eliminated at the same time. Over the past 2 years of operation, the wastewater treatment plant has been able to achieve a maximum processing capacity of more than 2,000 l/day, which equates to a nuclear medicine ward with approx. 20 beds. The highest level recorded during the test period (of 180 days after start-up) was a peak of

  9. BioChroma – A New and Patented Technology for Processing Radioactive Wastewater from Nuclear Medicine Therapy Facilities in Hospitals and Clinics

    International Nuclear Information System (INIS)

    Rodríguez, José Canga

    2012-01-01

    After undergoing radionuclide therapy, patients generate wastewater with a considerable amount of radioactivity, which can reach levels of as much as 90% of the administered dose. Due to the risk of accumulation after discharge into the sewer, it is advisable to collect this effluent for its treatment prior to final discharge. Delay and decay (natural decomposition of the isotope) is the most commonly used technical method of abating radioactive iodine, but it is frequently criticized as being complex and very expensive. BioChroma is a technology that has been developed as an alternative to these complicated and expensive systems. This paper describes this new technology and presents, as an example, a system that was installed and successfully commissioned in the middle of 2008 in a nuclear medicine ward with 12 beds in Stuttgart (Germany). Based on existing legislation, the responsible authorities and the company that operated the hospital agreed on a maximum activity level of 5 Bq/l. If a typical delay and decay system would have been installed, the 180 m 3 treatment plant that was already available in the hospital cellar would have to be extended by additional 150 m 3 . By implementing the patented BioChroma process, the space requirements were reduced by 75%. For instance, since the new system was integrated into the existing installation, tanks accounting for 120 m³ could be used as buffering volume in the new wastewater treatment plant. The operation of the referred plant is currently producing very good results with values below the specified limit of 5 Bq/l for the isotope 131 I. In addition, 90 Y has been reported to be eliminated at the same time. Over the past 2 years of operation, the wastewater treatment plant has been able to achieve a maximum processing capacity of more than 2,000 l/day, which equates to a nuclear medicine ward with approx. 20 beds. The highest level recorded during the test period (of 180 days after start-up) was a peak of nearly 2

  10. [Cross-sectional analysis of heart failure among patients in the Internal Medicine Service at a third-level hospital. Part I: epidemiologic analysis].

    Science.gov (United States)

    Cinza Sanjurjo, S; Cabarcos Ortiz de Barrón, A; Enrique Nieto Pol, E; Torre Carballada, J A

    2007-06-01

    To observe the epidemiologic characteristics of the patients intake during five years in a internal medicine department, with heart failure. A cross-sectional study of the intake patients in the Internal Medicine Service in the Hospital Clínico Universitario de Santiago de Compostela between 1999 to 2003. The variables analized were: sex, age, days of hospital stay, number of intake by failure cardiac, reason for admission (guide symptom), hypertension, diabetes mellitus, cardiac disease, fibrillation atrium, previous treatment with beta-blockers, blood pressure in the admission moment, to make echocardiography, disfunction systolic, etiology, deceased, treatment at the end. The statistical analysis was performed with qualitative and quantitative measures, chi-cuadrado and t-student, and multivariant analyses. 248 patients were accepted for the study. We observed more women than men (55.2%) and bigger median age (79 years old vs. 73 years old in men, p < 0.001). The mean income was 13.61 days and a median of 11 days. The 41,8% of the patients had hypertension, 30.9% diabetes mellitus and 81,9% had someone heart disease. The aetiologies of heart failure most frequent were ischemic cardiopathy (27.2%) and hypertension (24.2%). The most frequent symptom was the dyspnea (68.9%). It made echocardiography in 20.9% of patients and 45.1% showed systolic disfunction. The only factor related with this small percentage of echocardiographies was the incoming time. The most frequent etiology was respiratory infections (39.5%). The 8.6% of patients was deceased. The pharmacologic treatment more prescribed were the diuretics (86.9%) and transcutaneous nitrates (49.5%). It was indicated ECAI or AAR-II in the 86.9% of patients and beta-blockers in 0.9%. The number of echocardiograms practiced to the patients is smaller that the number advised by international associations and smaller to the cardiologist registers. The beta-blockers and ECAI use is smaller too.

  11. Knowledge about complementary, alternative and integrative medicine (CAM) among registered health care providers in Swedish surgical care: a national survey among university hospitals.

    Science.gov (United States)

    Bjerså, Kristofer; Stener Victorin, Elisabet; Fagevik Olsén, Monika

    2012-04-12

    Previous studies show an increased interest and usage of complementary and alternative medicine (CAM) in the general population and among health care workers both internationally and nationally. CAM usage is also reported to be common among surgical patients. Earlier international studies have reported that a large amount of surgical patients use it prior to and after surgery. Recent publications indicate a weak knowledge about CAM among health care workers. However the current situation in Sweden is unknown. The aim of this study was therefore to explore perceived knowledge about CAM among registered healthcare professions in surgical departments at Swedish university hospitals. A questionnaire was distributed to 1757 registered physicians, nurses and physiotherapists in surgical wards at the seven university hospitals in Sweden from spring 2010 to spring 2011. The questionnaire included classification of 21 therapies into conventional, complementary, alternative and integrative, and whether patients were recommended these therapies. Questions concerning knowledge, research, and patient communication about CAM were also included. A total of 737 (42.0%) questionnaires were returned. Therapies classified as complementary; were massage, manual therapies, yoga and acupuncture. Alternative therapies; were herbal medicine, dietary supplements, homeopathy and healing. Classification to integrative therapy was low, and unfamiliar therapies were Bowen therapy, iridology and Rosen method. Therapies recommended by > 40% off the participants were massage and acupuncture. Knowledge and research about CAM was valued as minor or none at all by 95.7% respectively 99.2%. Importance of possessing knowledge about it was valued as important by 80.9%. It was believed by 61.2% that more research funding should be addressed to CAM research, 72.8% were interested in reading CAM-research results, and 27.8% would consider taking part in such research. Half of the participants (55.8%) were

  12. Knowledge about complementary, alternative and integrative medicine (CAM among registered health care providers in Swedish surgical care: a national survey among university hospitals

    Directory of Open Access Journals (Sweden)

    Bjerså Kristofer

    2012-04-01

    Full Text Available Abstract Background Previous studies show an increased interest and usage of complementary and alternative medicine (CAM in the general population and among health care workers both internationally and nationally. CAM usage is also reported to be common among surgical patients. Earlier international studies have reported that a large amount of surgical patients use it prior to and after surgery. Recent publications indicate a weak knowledge about CAM among health care workers. However the current situation in Sweden is unknown. The aim of this study was therefore to explore perceived knowledge about CAM among registered healthcare professions in surgical departments at Swedish university hospitals. Method A questionnaire was distributed to 1757 registered physicians, nurses and physiotherapists in surgical wards at the seven university hospitals in Sweden from spring 2010 to spring 2011. The questionnaire included classification of 21 therapies into conventional, complementary, alternative and integrative, and whether patients were recommended these therapies. Questions concerning knowledge, research, and patient communication about CAM were also included. Result A total of 737 (42.0% questionnaires were returned. Therapies classified as complementary; were massage, manual therapies, yoga and acupuncture. Alternative therapies; were herbal medicine, dietary supplements, homeopathy and healing. Classification to integrative therapy was low, and unfamiliar therapies were Bowen therapy, iridology and Rosen method. Therapies recommended by > 40% off the participants were massage and acupuncture. Knowledge and research about CAM was valued as minor or none at all by 95.7% respectively 99.2%. Importance of possessing knowledge about it was valued as important by 80.9%. It was believed by 61.2% that more research funding should be addressed to CAM research, 72.8% were interested in reading CAM-research results, and 27.8% would consider taking part in

  13. [Cross-sectional study of heart failure of patients intaked in an Internal Medicine Service in the third level hospital in mixed area. Part III: mortality analysis].

    Science.gov (United States)

    Cinza Sanjurjo, S; Cabarcos Ortiz de Barrón, A; Nieto Pol, E; Torre Carballada, J A

    2007-08-01

    To establish the characteristics of the deceased in intaked patients by heart failure. A cross-sectional study of the intaked patients in the Internal Medicine Service in the Hospital Clínico Universitario de Santiago de Compostela between 1999 to 2003. The variables analized were: sex, age, days of hospital stay, number of intaked by failure cardiac, reason for admission (guide symptom), hypertension, diabetes mellitus, cardiac disease, fibrillation atrium, previous treatment with beta-blockers, blood pressure in the admission moment, to make echocardiography, disfunction systolic, etiology, deceased, treatment at the end. The statistical analysis was performed with cualitative and cuantitative measures, chi-cuadrado and t-student. 248 patients were accepted for the study, with the mortality rate rising 8.6% (21 patients). We did not observed differences between sexes, but the median age in death patients was greater than other patients. The median income was 5 days, letter than study population. The hypertension prevalence (30 vs. 42.6%, p = 0.27) and ischemic cardiopathy (30 vs. 27.7%, p = 0.82) did not showed differences with the population. The hypertension prevalence in women (16.7 vs. 35.7%, p = 0.21) and the ischemic cardiopathy prevalence in men (50 vs. 21.4%, p = 0.20) did not showed differences. It made echocardiography in 21.0% of death patients, p = 0.76. The systolic disfunction prevalence was bigger in death patients (80 vs. 41.3%), this difference was not significant statistically. The older patients showed letter survival. We did not observe any influence of sex or left ventricular systolic function on mortality in patients with heart failure.

  14. [A retrospective study on the incidence of chronic renal failure in the Department of Internal Medicine and Nephrology at University Hospital of Antananarivo (the capital city of Madagascar)].

    Science.gov (United States)

    Ramilitiana, Benja; Ranivoharisoa, Eliane Mikkelsen; Dodo, Mihary; Razafimandimby, Evanirina; Randriamarotia, Willy Franck

    2016-01-01

    Chronic renal failure is a global public health problem. In developed countries, this disease occurs mainly in the elderly, but in Africa it rather affects active young subjects. This disease need for expensive treatments in a low income country, because of its costs. Our aim is to describe the epidemiology of new cases of chronic renal failure in Madagascar. This is a retrospective, descriptive study of 239 patients with chronic renal failure over a 3 year period, starting from 1 January 2007 to 31 December 2009, in the Department of Internal Medicine and Nephrology at University Hospital of Antananarivo. The incidence was 8.51% among patients hospitalized in the Department. The average age of patients was 45.4 years with extremes of 16 and 82 years and a sex ratio 1,46. The main antecedent was arterial hypertension (59.8%). Chronic renal failure was terminal in 75.31% of the cases (n=180). The causes of chronic renal failure were dominated by chronic glomerulonephritis (40.1%), nephroangiosclerosis (35.5%). Hemodialysis was performed in 3 patients (1.26%), no patient was scheduled for a renal transplantation. Mortality rate in the Department was 28.87%. Chronic renal failure is a debilitating disease with a dreadful prognosis which affects young patients in Madagascar. Its treatment remains inaccessible to the majority of patients. The focus must be mainly on prevention, especially on early effective management of infections, arterial hypertension and diabetes to reduce its negative impacts on the community and public health. The project on renal transplantation: living donor, effective and less expensive treatment compared to hemodialysis could also be a good solution for these Malagasy young subjects.

  15. Clinical characteristics of very old patients hospitalized in internal medicine wards for heart failure: a sub-analysis of the FADOI-CONFINE Study Group

    Directory of Open Access Journals (Sweden)

    Paolo Biagi

    2014-03-01

    Full Text Available The incidence and prevalence of chronic heart failure are increasing worldwide, as is the number of very old patients (>85 years affected by this disease. The aim of this sub-analysis of the multicenter, observational CONFINE study was to detect clinical and therapeutic peculiarities in patients with chronic heart failure aged >85 years. We recruited patients admitted with a diagnosis of chronic heart failure and present in the hospital in five index days, in 91 Units of Internal Medicine. The patients’ clinical characteristics, functional and cognitive status, and the management of the heart failure were analyzed. A total of 1444 subjects were evaluated, of whom 329 (23.1% were over 85 years old. Signs and symptoms of chronic heart failure were more common in very old patients, as were severe renal insufficiency, anemia, disability and cognitive impairment. The present survey found important age-related differences (concomitant diseases, cognitive status among patients with chronic heart failure, as well as different therapeutic strategies and clinical outcome for patients over 85 years old. Since these patients are usually excluded from clinical trials and their management remains empirical, specific studies focused on the treatment of very old patients with chronic heart failure are needed.

  16. Third Space Weather Summit Held for Industry and Government Agencies

    Science.gov (United States)

    Intriligator, Devrie S.

    2009-12-01

    The potential for space weather effects has been increasing significantly in recent years. For instance, in 2008 airlines flew about 8000 transpolar flights, which experience greater exposure to space weather than nontranspolar flights. This is up from 368 transpolar flights in 2000, and the number of such flights is expected to continue to grow. Transpolar flights are just one example of the diverse technologies susceptible to space weather effects identified by the National Research Council's Severe Space Weather Events—Understanding Societal and Economic Impacts: A Workshop Report (2008). To discuss issues related to the increasing need for reliable space weather information, experts from industry and government agencies met at the third summit of the Commercial Space Weather Interest Group (CSWIG) and the National Oceanic and Atmospheric Administration's (NOAA) Space Weather Prediction Center (SWPC), held 30 April 2009 during Space Weather Week (SWW), in Boulder, Colo.

  17. Economic impact of the world summit on sustainable development

    Directory of Open Access Journals (Sweden)

    JH Martins

    2004-04-01

    Full Text Available South Africa hosted the World Summit on Sustainable Development (WSSD in 2002.  This event is regarded as the single biggest conference to be held anywhere in the world. The aim of this paper is to set out the estimated economic impact of the WSSD and its parallel events on South Africa.  This impact can be expressed in monetary terms as well as employment figures.  The impact is calculated by using an input-output model and employment spin-offs determined from the IO table by using partial multipliers.  The input data were derived from a survey amongst WSSD delegates as well as information on government and private investments made.

  18. Assessing Summit Engagement with Other International Organizations in Global Governance

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    Marina Larionova

    2016-03-01

    Full Text Available Recent decades have witnessed dramatic changes all over the world. One major trend is the proliferation and diversification of actors, forums and their arrangements to address global governance challenges, which has led to fragmentation in global governance. However, such contested multilateralism has a positive dimension, as the emergence of informal multilateral institutions claiming a major role in defining the global governance agenda creates alternatives for providing common goods. New arrangements acquire their own actorness and place in the system of global governance. In certain policy areas, there is a clear trend for the new summit institutions’ leadership. The most visible recent cases include the Group of 20 (G20, the BRICS group of Brazil, Russia, India, China and South Africa, and the Asia-Pacific Economic Cooperation (APEC forum, with APEC gaining importance regionally and globally. These new informal groupings work on their own agenda. They also engage with established international organizations to steer global governance processes. Taken together, the transformative trends in international relations, the emergence of new actors, tensions between exclusive and inclusive clubs, and demands for the legitimacy and effectiveness of the international institutions define the relevance of the study, systematization and comparative analysis of the effectiveness of this model of cooperation among international institutions. This article builds an analytical framework by undertaking three tasks. It first reviews the key concepts. Second, it argues for a rational choice institutionalist approach. Third, it puts forward a hypothesis for research: to compensate for their inefficiencies, summit institutions engage with other international organizations in a mode they regard most efficient for attainment of their goals. The modes of those institutions’ engagement with other international organizations as reflected in the leaders

  19. The VCU Pressure Ulcer Summit-Developing Centers of Pressure Ulcer Prevention Excellence: A Framework for Sustainability.

    Science.gov (United States)

    Creehan, Sue; Cuddigan, Janet; Gonzales, Dana; Nix, Denise; Padula, William; Pittman, Joyce; Pontieri-Lewis, Vicky; Walden, Christine; Wells, Belinda; Wheeler, Robinetta

    2016-01-01

    Hospital-acquired pressure ulcer occurrences have declined over the past decade as reimbursement policies have changed, evidence-based practice guidelines have been implemented, and quality improvement initiatives have been launched. However, the 2006-2008 Institute for Healthcare Improvement goal of zero pressure ulcers remains difficult to achieve and even more challenging to sustain. Magnet hospitals tend to have lower hospital-acquired pressure ulcer rates than non-Magnet hospitals, yet many non-Magnet hospitals also have robust pressure ulcer prevention programs. Successful programs share commonalities in structure, processes, and outcomes. A national summit of 55 pressure ulcer experts was convened at the Virginia Commonwealth University Medical Center in March 2014. The group was divided into 3 focus groups; each was assigned a task to develop a framework describing components of a proposed Magnet-designated Center of Pressure Ulcer Prevention Excellence. Systematic literature reviews, analysis of exemplars, and nominal group process techniques were used to create the framework. This article presents a framework describing the proposed Magnet-designated Centers of Pressure Ulcer Prevention Excellence. Critical attributes of Centers of Excellence are identified and organized according to the 4 domains of the ANCC model for the Magnet Recognition Program: transformational leadership; structural empowerment; exemplary professional practice; and new knowledge innovation and improvements. The structures, processes, and outcome measures necessary to become a proposed Center of Pressure Ulcer Prevention Excellence are discussed.

  20. Obstetric medicine: Interlinking obstetrics and internal medicine

    African Journals Online (AJOL)

    1 Mayo Clinic Hospitals, Division of Hospital Internal Medicine, Rochester, Minn, USA ... Obstetric physicians have a specific role in managing pregnant and postpartum women with ... problems may also affect pregnancy outcomes, with increased risk of ... greatly benefited from good control of her diabetes and hypertension.

  1. Traditional eye medicine use by newly presenting ophthalmic patients to a teaching hospital in south-eastern Nigeria: socio-demographic and clinical correlates

    Directory of Open Access Journals (Sweden)

    Uche Judith

    2009-10-01

    Full Text Available Abstract Background This study set out to determine the incidence, socio-demographic, and clinical correlates of Traditional Eye Medicine (TEM use in a population of newly presenting ophthalmic outpatients attending a tertiary eye care centre in south-eastern Nigeria. Methods In a comparative cross-sectional survey at the eye clinic of the University of Nigeria Teaching Hospital (UNTH, Enugu, between August 2004 - July 2006, all newly presenting ophthalmic outpatients were recruited. Participants' socio-demographic and clinical data and profile of TEM use were obtained from history and examination of each participant and entered into a pretested questionnaire and proforma. Participants were subsequently categorized into TEM- users and non-users; intra-group analysis yielded proportions, frequencies, and percentages while chi-square test was used for inter-group comparisons at P = 0.01, df = 1. Results Of the 2,542 (males, 48.1%; females, 51.9% participants, 149 (5.9% (males, 45%; females, 55% used TEM for their current eye disease. The TEMs used were chemical substances (57.7%, plant products (37.7%, and animal products (4.7%. They were more often prescribed by non-traditional (66.4% than traditional (36.9% medicine practitioners. TEMs were used on account of vision loss (58.5%, ocular itching (25.4% and eye discharge (3.8%. Reported efficacy from previous users (67.1% and belief in potency (28.2% were the main reasons for using TEM. Civil servants (20.1%, farmers (17.7%, and traders (14.1% were the leading users of TEM. TEM use was significantly associated with younger age (p Conclusion The incidence of TEM use among new ophthalmic outpatients at UNTH is low. The reasons for TEM use are amenable to positive change through enhanced delivery of promotive, preventive, and curative public eye care services. This has implications for eye care planners and implementers. To reverse the trend, we suggest strengthening of eye care programmes, even

  2. Implementation of WHO multimodal strategy for improvement of hand hygiene: a quasi-experimental study in a Traditional Chinese Medicine hospital in Xi'an, China.

    Science.gov (United States)

    Shen, Li; Wang, Xiaoqing; An, Junming; An, Jialu; Zhou, Ning; Sun, Lu; Chen, Hong; Feng, Lin; Han, Jing; Liu, Xiaorong

    2017-01-01

    Hand hygiene (HH) is an essential component for preventing and controlling of healthcare-associated infection (HAI), whereas compliance with HH among health care workers (HCWs) is frequently poor. This study aimed to assess compliance and correctness with HH before and after the implementation of a multimodal HH improvement strategy launched by the World Health Organization (WHO). A quasi-experimental study design including questionnaire survey generalizing possible factors affecting HH behaviors of HCWs and direct observation method was used to evaluate the effectiveness of WHO multimodal HH strategy in a hospital of Traditional Chinese Medicine. Multimodal HH improvement strategy was drawn up according to the results of questionnaire survey. Compliance and correctness with HH among HCWs were compared before and after intervention. Also HH practices for different indications based on WHO "My Five Moments for Hand Hygiene" were recorded. In total, 553 HCWs participated in the questionnaire survey and multimodal HH improvement strategy was developed based on individual, environment and management levels. A total of 5044 observations in 23 wards were recorded in this investigation. The rate of compliance and correctness with HH improved from 66.27% and 47.75% at baseline to 80.53% and 88.35% after intervention. Doctors seemed to have better compliance with HH after intervention (84.04%) than nurses and other HCWs (81.07% and 69.42%, respectively). When stratified by indication, compliance with HH improved for all indications after intervention ( P  Implementing the WHO multimodal HH strategy can significantly improve HH compliance and correctness among HCWs.

  3. Contribution of radio-iodine 131 in the treatment of Grave's Basedow disease in the department of nuclear medicine of Ibn Sina Hospital in Rabat

    International Nuclear Information System (INIS)

    Mbodj, M.; Amjad, I.; Guerrouj, H.; Ben Rais, N.A.

    2009-01-01

    One hundred and twenty-nine Grave's Basedow diseases in any gender and variable age patients, coming from several cities of Morocco, were randomized in a study of radio-iodine treatment who took place at the nuclear medicine department of Ibn Sina Hospital (Rabat, Morocco) during the period (from January 2001 to December 2008). The radio-iodine treatment was a first, second or third option and radio-iodine activities delivered varied (from 222 to 555 MBq 6 to 15 mCi) according to the age, the thyroid volume, the degree of hyperthyroidism and socio-economical situation. The high amounts of 131 I were reserved especially to the patients who live far and whose socio-economic level is low with an aim of quickly obtaining an easily controllable state of hypothyroidism by a substitute treatment. The results showed that: (1) 57.36% of patients reverted to euthyroidism (n = 74) with a patient having received two 131 I cures. The second cure was justified by recurrence of hyperthyroidism after the first cure; (2) 34.88% passed in hypothyroidism (n = 45) with three patients having received two cures of 131 I, the second cure was justified by recurrence of hyperthyroidism after the first cure in two patients and by the persistence of the hyperthyroidism after the first cure for the third patient. The average time of passage in hypothyroidism was 4.5 months; (3) 7.76% had remained in hyperthyroidism after the radioactive iodine treatment. Finally, 92.24% of our patients treated by radioactive iodine had passed in euthyroidism or hypothyroidism against 7.76% whose hyperthyroidism had persisted or occurred. (authors)

  4. Evaluation The Result Of Treating 1200 Patients Brain Tumor And Some Intracranial Diseases By Rotating GAMMA Knife (RGK) At The Nuclear Medicine And Oncology Center, Bach Mai Hospital

    International Nuclear Information System (INIS)

    Mai Trong Khoa; Nguyen Quang Hung; Tran Dinh Ha

    2011-01-01

    The paper is evaluating results of treating brain tumor and some intracranial diseases by rotating gamma knife (RGK) at The Nuclear Medicine and Oncology Center, Bach Mai Hospital, from July 2007 to August 2010, for 1200 patients treated with RGK. In 1200 patients - average age: 42.6 years old, Male/Female ratio:1/1.08 - pituitary tumors accounted for 19.8%, meningioma 18.3%, arteriovenous malformations (AVM) (16.7%), acoustic neuroma (8.7%), brain metastases (7.5%), craniopharyngeal tumor (5.0%), pineal tumor (3.5%), cavernoma (6%), astrocytoma (5.2%), meduloblastoma (2.9%), ependymoma (2.6%), others (3.8%). Average target volume: minimum 0.6cm 3 , maximum 27.6cm 3 , median 6.2 ± 4.6 cm 3 . Average radiosurgery dose changed depend on nature of the tumor: pituitary tumor (12.4 Gy), meningioma (18.8 Gy), AVM (18 Gy), acoustic neuroma (14.6 Gy), brain metastases (18.2 Gy), craniopharyngeal tumor (12.8 Gy), pineal tumor (16.3 Gy), cavernoma (17.5 Gy), astrocytoma (14.6 Gy), medulloblastoma (16.1 Gy), ependymoma (16.3 Gy), others (15 Gy). Conclusions: Almost case have improved clinical symptoms significantly: 80.2% after 1 month (complete response 20.2%), 100% at 36th month (complete response: 94%). Size of the tumor were reduced remarkably. Treatment were safe, no death or severe complications were observed within and after radiosurgery. (author)

  5. Images in medicine

    African Journals Online (AJOL)

    abp

    2016-04-15

    Apr 15, 2016 ... 1Department of Oral Medicine and Radiology MNR Dental College and Hospital, ... A 38 year old male patient presented to a radiology center for cone beam computed tomography (CBCT) and the working maxillofacial.

  6. Mass balance and surface movement of the Greenland Ice Sheet at Summit, Central Greenland

    DEFF Research Database (Denmark)

    Hvidberg, C.S.; Keller, K.; Gundestrup, N.S.

    1997-01-01

    During the GRIP deep drilling in Central Greenland, the ice sheet topography and surface movement at Summit has been mapped with GPS. Measurements of the surface velocity are presented for a strain net consisting of 13 poles at distances of 25-60 km from the GRIP site. Some results are: The GRIP...... site is located approximately 2 km NW of the topographic summit; the surface velocity at the GISP 2 site is 1.7 m/yr in the W direction. The present mass balance at Summit is calculated to be -0.03+/-0.04 m/yr, i.e. close to steady state. This result is the best now available for Summit. A small...... thinning rate might be a transient response of the Greenland Ice Sheet due to the temperature increase at the Wisconsin-Holocene transition....

  7. Senior executive transportation & public safety summit : national traffic incident management leadership & innovation roadmap for success

    Science.gov (United States)

    2012-09-05

    This report summarizes the proceedings, findings, and recommendations from a two-day Senior Executive Summit on Transportation and Public Safety, held June 26 and 27, 2012 at the United States Department of Transportation (USDOT) in Washington, D.C. ...

  8. Kayenta Township Building & Safety Department, Tribal Green Building Code Summit Presentation

    Science.gov (United States)

    Tribal Green Building Code Summit Presentation by Kayenta Township Building & Safety Department showing how they established the building department, developed a code adoption and enforcement process, and hired staff to carry out the work.

  9. World Summit on the Information Society finding the best use of a global asset

    CERN Multimedia

    2003-01-01

    "The first global summit on bridging the digital divide between rich and poor countries - the first meeting of its kind - convened in Geneva last week as governments struggled to agree on what they wanted to achieve" (2 pages)

  10. 78 FR 21906 - Six Rivers National Forest, California, Trinity Summit Range Assessment Environmental Impact...

    Science.gov (United States)

    2013-04-12

    ..., wilderness characteristics, water quality, soil productivity, and quality fish and wildlife habitat... DEPARTMENT OF AGRICULTURE Forest Service Six Rivers National Forest, California, Trinity Summit Range Assessment Environmental Impact Statement AGENCY: Forest Service, USDA. ACTION: Notice of Intent...

  11. Optimization Review: French Gulch/Wellington-Oro Mine Site Water Treatment Plant, Breckenridge, Summit County, Colorado

    Science.gov (United States)

    The French Gulch/Wellington-Oro Mine Site is located near the town of Breckenridge in Summit County, Colorado. Environmental contamination of surface water, groundwater, soil and sediment at the site resulted from mining activities dating to the 1880s.

  12. Impacts and societal benefits of research activities at Summit Station, Greenland

    Science.gov (United States)

    Hawley, R. L.; Burkhart, J. F.; Courville, Z.; Dibb, J. E.; Koenig, L.; Vaughn, B. H.

    2017-12-01

    Summit Station began as the site for the Greenland Ice Sheet Project 2 ice core in 1989. Since then, it has hosted both summer campaign science, and since 1997, year-round observations of atmospheric and cryospheric processes. The station has been continuously occupied since 2003. While most of the science activities at the station are supported by the US NSF Office of Polar Programs, the station also hosts many interagency and international investigations in physical glaciology, atmospheric chemistry, satellite validation, astrophysics and other disciplines. Summit is the only high elevation observatory north of the Arctic circle that can provide clean air or snow sites. The station is part of the INTER-ACT consortium of Arctic research stations with the main objective to identify, understand, predict and respond to diverse environmental changes, and part of the International Arctic Systems for Observing the Atmosphere (IASOA) that coordinates Arctic research activities and provides a networked, observations-based view of the Arctic. The Summit Station Science Summit, sponsored by NSF, assembled a multidisciplinary group of scientists to review Summit Station science, define the leading research questions for Summit, and make community-based recommendations for future science goals and governance for Summit. The impact of several on-going observation records was summarized in the report "Sustaining the Science Impact of Summit Station, Greenland," including the use of station data in weather forecasts and climate models. Observations made at the station as part of long-term, year-round research or during shorter summer-only campaign seasons contribute to several of the identified Social Benefit Areas (SBAs) outlined in the International Arctic Observations Assessment Framework published by the IDA Science and Technology Policy Institute and Sustaining Arctic Observing Networks as an outcome of the 2016 Arctic Science Ministerial. The SBAs supported by research

  13. Increasing human resource capacity in African countries: A nursing and midwifery Research Summit

    Directory of Open Access Journals (Sweden)

    Carolyn Sun

    2017-01-01

    Conclusions: Evaluations provided favorable feedback regarding the process leading up to as well as the content of the Research Summit. While further long-term evaluations will be needed to determine the sustainability of this initiative, the Summit format afforded the opportunity for regional experts to meet, examine research priorities, and develop strategic action and mentorship plans. This paper describes a replicable method that could be utilized in other regions using available resources to minimize costs and modest grant funding.

  14. 6th Annual Homeland Security and Defense Education Summit, Developing an Adaptive Homeland Security Environment

    OpenAIRE

    2013-01-01

    6th Annual Homeland Security and Defense Education Summit Developing an Adaptive Homeland Security Environment, Burlington, MA, September 26-28, 2013 2013 Summit Agenda Naval Postgraduate School Center for Homeland Defense and Security In Partnership With Northeastern University, Department of Homeland Security, Federal Emergency Management Agency, National Guard Homeland Security Institute, National Homeland Defense Foundation Naval Postgraduate School Center for Homeland Defense and S...

  15. World Materials Summit (3rd). Held in Washington, DC on 9-12 October, 2011

    Science.gov (United States)

    2012-05-23

    creates bumps on the backplane of a thin monocrystalline silicon solar cell. This increases the efficiency through a light trapping mechanism. They are...atoms in motion," Brinkman said. The third and fourth days of the Summit were occupied with panel sessions, each discussing one aspect of materials...lighting; energy fuels; water; renewables; and policy and education. Some highlights of the panel reports to the Summit as a whole: • The smart

  16. Youth Climate Summits: Empowering & Engaging Youth to Lead on Climate Change

    Science.gov (United States)

    Kretser, J.

    2017-12-01

    The Wild Center's Youth Climate Summits is a program that engages youth in climate literacy from knowledge and understanding to developing action in their schools and communities. Each Youth Climate Summit is a one to three day event that brings students and teachers together to learn about climate change science, impacts and solutions at a global and local level. Through speakers, workshops and activities, the Summit culminates in a student-driven Climate Action Plan that can be brought back to schools and communities. The summits have been found to be powerful vehicles for inspiration, learning, community engagement and youth leadership development. Climate literacy with a focus on local climate impacts and solutions is a key component of the Youth Climate Summit. The project-based learning surrounding the creation of a unique, student driven, sustainability and Climate Action Plan promotes leadership skills applicable and the tools necessary for a 21st Century workforce. Student driven projects range from school gardens and school energy audits to working with NYS officials to commit to going 100% renewable electricty at the three state-owned downhill ski facilities. The summit model has been scaled and replicated in other communities in New York State, Vermont, Ohio, Michigan and Washington states as well as internationally in Finland, Germany and Sri Lanka.

  17. Immoral behaviour in medicine.

    Science.gov (United States)

    Carmon, P; Tabak, N

    1997-03-01

    The purpose of this paper is to emphasize a social phenomenon that exists in Israel: immoral medicine. In recent years, nurses have been exposed to many instances of immoral medicine in hospitals. We want to protest about the demands for money from patients who are waiting for surgical intervention, arouse the medical community's conscience concerning these immoral activities, and improve professional and moral behaviour.

  18. Canada`s green plan and the earth summit

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1993-12-31

    In June 1992 one of the largest international conferences ever held took place in Rio de Janeiro, Brazil. It was attended by the heads of state of more than 100 countries. The ambitious aim of the United Nations Conference on Environment and Development (UNCED) -- the Earth Summit -- was to try to reconcile the need for global environmental protection with the need for continuing economic development. The purpose of this document is to provide a brief account of the results of Rio and the way Canadians participated. In addition, this document outlines the immediate priorities of the Government of Canada and the actions under way. It is not meant to be a comprehensive response to the entire Rio agenda. Rather, it is intended to report to Canadians on the steps the government has taken so far and, where possible, the direction in which it is headed. On the number of important issues, the government`s plans are well advanced. For example, action is well under way on the Convention on Climate Change, as high-lighted in the Green Plan`s National Action Strategy on Global Warming. On a number of other issues, it is clear that there is work to be done. The government is committed to completing the task through continuing action and leadership.

  19. Action and pursuit of the summit of the earth

    International Nuclear Information System (INIS)

    Saavedra, Sandra; Guerrero, Juan Carlos

    1996-01-01

    The effect to guarantee the execution and of the commitments and activities to materialize the agreements and the program 21 emanated of the summit of the earth, the international community gathered in Rio called in that program to conform a Commission of Sustainable Development (CSD) through the United Nations (UN) In its session number forty seven of 1992, the general assembly of the UN defined, by means of the resolution 471 191, the composition of the CSD, the bases for the participation of the non government organizations (ONG) in her and its relationship with other organisms of the UN. Today the commission has an own secretary and it is attributed to the Economic and Social Council (ECOSOC) The CSD should carry out an effective pursuit on the world execution of all the commitments acquired in the conference of Rio, evaluating, mainly, the progressive application of the program 21 to national, regional and international scale. It also promotes the development of the international cooperation and it contributes to rationalize the process of taking of intergovernmental decisions as regards sustainable development

  20. «Eastern Partnership» after the Vilnius Summit

    Directory of Open Access Journals (Sweden)

    Anna Chernova

    2014-01-01

    Full Text Available The third summit of EU's Eastern Partnership held in Vilnius in November 2013 became a real turning point in the development of this organization. And it didn't happen due to signing of the first EU Association Agreement of its kind with the partner states but due to a sudden turn of the largest and most important of them - Ukraine - to the Russia's rival integration project. By doing so Ukraine at least temporarily joined two of the other participating countries: Armenia and Belarus, the latter of which is already in the Custom Union. At the other pole of the Eastern Partnership there are Georgia and Moldavia which initialed the Association and Free Trade agreements with the EU in Vilnius. This widening gap within the Eastern Partnership attracted everybody's attention to the EU - Russia rivalry in the post-Soviet countries which is increasingly interpreted in terms of the clash of civilizations. In this article we'd rather touch upon some of the peculiarities of the Eastern Partnership itself and its participating countries which to a large extent predetermined such an outcome. Among them is the ambiguous legacy of the European Neighbourhood Policy, lack of membership perspective in the EU as well as the nature of societies and elites in these post-Soviet states.

  1. The Future of Sleep Technology: Report from an American Association of Sleep Technologists Summit Meeting

    Science.gov (United States)

    Brooks, Rita; Trimble, Melinda

    2014-01-01

    The American Association of Sleep Technologists (AAST) Board of Directors hosted a Sleep Technology Summit on September 21, 2013 with the goals of identifying changes in the delivery of diagnostic and treatment services to sleep disorders patients, predicting the impact on sleep technologists, identifying new roles for sleep technologists, and determining appropriate education to prepare technologists for the future. A carefully chosen panel of speakers focused on the business skills necessary to provide care cost effectively and the clinical skills that will be essential for the technologist of the future to help care for patients with sleep disorders. A group of selected leaders, educators, and industry professionals reviewed the current state of affairs and examined opportunities to sustain the profession and define the role of the sleep technologist of the future. Facilitated group discussions of these critical topics followed each session. There was a clear consensus that regulatory and economic pressures are changing the way sleep disorders patients are diagnosed and treated. Private insurers are requiring pre-authorization for laboratory sleep studies and are incentivizing home sleep testing for most patients suspected of obstructive sleep apnea. Reimbursement for home testing will be lower than for laboratory testing, and further reductions in overall reimbursement are anticipated. These factors will almost certainly reduce the need for technologists to perform laboratory diagnostic studies and pressure sleep centers to reduce payrolls. Remaining laboratory patients will have more complicated sleep disorders, have more comorbidity, and require a higher level of care than most of the patients currently tested in sleep centers. Testing these patients will require technologists with a higher level of training, experience, and sophistication. A second area of consensus was that the focus in medicine is changing from diagnosis to outcomes. New models of

  2. Knowledge, attitude, and practices toward ayurvedic medicine use among allopathic resident doctors: A cross-sectional study at a tertiary care hospital in India.

    Science.gov (United States)

    Gawde, Suchita R; Shetty, Yashashri C; Pawar, Dattatray B

    2013-07-01

    Ayurveda is most commonly practiced form of complementary and alternative medicine (CAM) in India. There are very few studies showing the knowledge, attitude, and practices (KAP) of allopathic doctors about Ayurvedic drugs and its use. The study was initiated to assess KAP toward Ayurvedic medicine use among allopathic resident doctors. Cross-sectional and prospective study. After obtaining permission from the Institutional Ethics Committee, allopathic resident doctors from clinical departments were approached personally. They were given pre-formed validated questionnaire to assess KAP toward Ayurvedic medicine use. Descriptive statistics. Allopathic residents had little knowledge about basic concepts of Ayurveda, that is, 'panchakarma' and 'tridosha'. Majority residents (99%) had no opportunity to learn basics of Ayurveda, but 67% residents prescribed Ayurvedic medicines to patients. However, many residents (76%) mentioned that cross practice should not be allowed due to lack of knowledge. One resident knew that cross-practice was not allowed by law. The commonly prescribed proprietary Ayurvedic medicines were Liv-52 (39%), Shatavari (13%), Cystone (12%) and common ailments for which these medicines prescribed were liver disorders (34%), arthritis (18%), cough and cold (13%), kidney stones (11%), and piles (10%). Nearly 76% residents felt incorporation of Ayurveda with modern medicine would attract more patients and at the same time most residents (92%) agreed that Ayurvedic medicines need scientific testing before use. Though 50% of the residents agreed for voluntary training in Ayurveda, 80% denied compulsory training. Nearly 63% residents recommended Ayurveda among all CAMs. Most of residents heard of Ayurveda from their colleagues. This study reveals that allopathic resident doctors had little knowledge about Ayurveda and Ayurvedic medicine use but engaged in prescription of Ayurvedic medicines. So some interventions should be taken to increase the knowledge

  3. Nuclear Medicine

    Science.gov (United States)

    ... Parents/Teachers Resource Links for Students Glossary Nuclear Medicine What is nuclear medicine? What are radioactive tracers? ... funded researchers advancing nuclear medicine? What is nuclear medicine? Nuclear medicine is a medical specialty that uses ...

  4. An Evidence-based, Longitudinal Curriculum for Resident Physician Wellness: The 2017 Resident Wellness Consensus Summit.

    Science.gov (United States)

    Arnold, Jacob; Tango, Jennifer; Walker, Ian; Waranch, Chris; McKamie, Joshua; Poonja, Zafrina; Messman, Anne

    2018-03-01

    Physicians are at much higher risk for burnout, depression, and suicide than their non-medical peers. One of the working groups from the May 2017 Resident Wellness Consensus Summit (RWCS) addressed this issue through the development of a longitudinal residency curriculum to address resident wellness and burnout. A 30-person (27 residents, three attending physicians) Wellness Curriculum Development workgroup developed the curriculum in two phases. In the first phase, the workgroup worked asynchronously in the Wellness Think Tank - an online resident community - conducting a literature review to identify 10 core topics. In the second phase, the workgroup expanded to include residents outside the Wellness Think Tank at the live RWCS event to identify gaps in the curriculum. This resulted in an additional seven core topics. Seventeen foundational topics served as the framework for the longitudinal resident wellness curriculum. The curriculum includes a two-module introduction to wellness; a seven-module "Self-Care Series" focusing on the appropriate structure of wellness activities and everyday necessities that promote physician wellness; a two-module section on physician suicide and self-help; a four-module "Clinical Care Series" focusing on delivering bad news, navigating difficult patient encounters, dealing with difficult consultants and staff members, and debriefing traumatic events in the emergency department; wellness in the workplace; and dealing with medical errors and shame. The resident wellness curriculum, derived from an evidence-based approach and input of residents from the Wellness Think Tank and the RWCS event, provides a guiding framework for residency programs in emergency medicine and potentially other specialties to improve physician wellness and promote a culture of wellness.

  5. An Evidence-based, Longitudinal Curriculum for Resident Physician Wellness: The 2017 Resident Wellness Consensus Summit

    Directory of Open Access Journals (Sweden)

    Jacob Arnold

    2018-02-01

    Full Text Available Introduction: Physicians are at much higher risk for burnout, depression, and suicide than their non-medical peers. One of the working groups from the May 2017 Resident Wellness Consensus Summit (RWCS addressed this issue through the development of a longitudinal residency curriculum to address resident wellness and burnout. Methods: A 30-person (27 residents, three attending physicians Wellness Curriculum Development workgroup developed the curriculum in two phases. In the first phase, the workgroup worked asynchronously in the Wellness Think Tank – an online resident community – conducting a literature review to identify 10 core topics. In the second phase, the workgroup expanded to include residents outside the Wellness Think Tank at the live RWCS event to identify gaps in the curriculum. This resulted in an additional seven core topics. Results: Seventeen foundational topics served as the framework for the longitudinal resident wellness curriculum. The curriculum includes a two-module introduction to wellness; a seven-module “Self-Care Series” focusing on the appropriate structure of wellness activities and everyday necessities that promote physician wellness; a two-module section on physician suicide and self-help; a four-module “Clinical Care Series” focusing on delivering bad news, navigating difficult patient encounters, dealing with difficult consultants and staff members, and debriefing traumatic events in the emergency department; wellness in the workplace; and dealing with medical errors and shame. Conclusion: The resident wellness curriculum, derived from an evidence-based approach and input of residents from the Wellness Think Tank and the RWCS event, provides a guiding framework for residency programs in emergency medicine and potentially other specialties to improve physician wellness and promote a culture of wellness.

  6. Identifying Gaps and Launching Resident Wellness Initiatives: The 2017 Resident Wellness Consensus Summit.

    Science.gov (United States)

    Zaver, Fareen; Battaglioli, Nicole; Denq, William; Messman, Anne; Chung, Arlene; Lin, Michelle; Liu, Emberlynn L

    2018-03-01

    Burnout, depression, and suicidality among residents of all specialties have become a critical focus for the medical education community, especially among learners in graduate medical education. In 2017 the Accreditation Council for Graduate Medical Education (ACGME) updated the Common Program Requirements to focus more on resident wellbeing. To address this issue, one working group from the 2017 Resident Wellness Consensus Summit (RWCS) focused on wellness program innovations and initiatives in emergency medicine (EM) residency programs. Over a seven-month period leading up to the RWCS event, the Programmatic Initiatives workgroup convened virtually in the Wellness Think Tank, an online, resident community consisting of 142 residents from 100 EM residencies in North America. A 15-person subgroup (13 residents, two faculty facilitators) met at the RWCS to develop a public, central repository of initiatives for programs, as well as tools to assist programs in identifying gaps in their overarching wellness programs. An online submission form and central database of wellness initiatives were created and accessible to the public. Wellness Think Tank members collected an initial 36 submissions for the database by the time of the RWCS event. Based on general workplace, needs-assessment tools on employee wellbeing and Kern's model for curriculum development, a resident-based needs-assessment survey and an implementation worksheet were created to assist residency programs in wellness program development. The Programmatic Initiatives workgroup from the resident-driven RWCS event created tools to assist EM residency programs in identifying existing initiatives and gaps in their wellness programs to meet the ACGME's expanded focus on resident wellbeing.

  7. Identifying Gaps and Launching Resident Wellness Initiatives: The 2017 Resident Wellness Consensus Summit

    Directory of Open Access Journals (Sweden)

    Nicole Battaglioli

    2018-02-01

    Full Text Available Introduction: Burnout, depression, and suicidality among residents of all specialties have become a critical focus for the medical education community, especially among learners in graduate medical education. In 2017 the Accreditation Council for Graduate Medical Education (ACGME updated the Common Program Requirements to focus more on resident wellbeing. To address this issue, one working group from the 2017 Resident Wellness Consensus Summit (RWCS focused on wellness program innovations and initiatives in emergency medicine (EM residency programs. Methods: Over a seven-month period leading up to the RWCS event, the Programmatic Initiatives workgroup convened virtually in the Wellness Think Tank, an online, resident community consisting of 142 residents from 100 EM residencies in North America. A 15-person subgroup (13 residents, two faculty facilitators met at the RWCS to develop a public, central repository of initiatives for programs, as well as tools to assist programs in identifying gaps in their overarching wellness programs. Results: An online submission form and central database of wellness initiatives were created and accessible to the public. Wellness Think Tank members collected an initial 36 submissions for the database by the time of the RWCS event. Based on general workplace, needs-assessment tools on employee wellbeing and Kern’s model for curriculum development, a resident-based needs-assessment survey and an implementation worksheet were created to assist residency programs in wellness program development. Conclusion: The Programmatic Initiatives workgroup from the resident-driven RWCS event created tools to assist EM residency programs in identifying existing initiatives and gaps in their wellness programs to meet the ACGME’s expanded focus on resident wellbeing.

  8. Kīlauea summit eruption—Lava returns to Halemaʻumaʻu

    Science.gov (United States)

    Babb, Janet L.; Wessells, Stephen M.; Neal, Christina A.

    2017-10-06

    In March 2008, a new volcanic vent opened within Halemaʻumaʻu, a crater at the summit of Kīlauea Volcano in Hawaiʻi Volcanoes National Park on the Island of Hawaiʻi. This new vent is one of two ongoing eruptions on the volcano. The other is on Kīlauea’s East Rift Zone, where vents have been erupting nearly nonstop since 1983. The duration of these simultaneous summit and rift zone eruptions on Kīlauea is unmatched in at least 200 years.Since 2008, Kīlauea’s summit eruption has consisted of continuous degassing, occasional explosive events, and an active, circulating lava lake. Because of ongoing volcanic hazards associated with the summit vent, including the emission of high levels of sulfur dioxide gas and fragments of hot lava and rock explosively hurled onto the crater rim, the area around Halemaʻumaʻu remains closed to the public as of 2017.Through historical photos of past Halemaʻumaʻu eruptions and stunning 4K imagery of the current eruption, this 24-minute program tells the story of Kīlauea Volcano’s summit lava lake—now one of the two largest lava lakes in the world. It begins with a Hawaiian chant that expresses traditional observations of a bubbling lava lake and reflects the connections between science and culture that continue on Kīlauea today.The video briefly recounts the eruptive history of Halemaʻumaʻu and describes the formation and continued growth of the current summit vent and lava lake. It features USGS Hawaiian Volcano Observatory scientists sharing their insights on the summit eruption—how they monitor the lava lake, how and why the lake level rises and falls, why explosive events occur, the connection between Kīlauea’s ongoing summit and East Rift Zone eruptions, and the impacts of the summit eruption on the Island of Hawaiʻi and beyond. The video is also available at the following U.S. Geological Survey Multimedia Gallery link (video hosted on YouTube): Kīlauea summit eruption—Lava returns to Halemaʻumaʻu

  9. Prevalence of common canine digestive problems compared with other health problems in teaching veterinary hospital, Faculty of Veterinary Medicine, Cairo University, Egypt

    Directory of Open Access Journals (Sweden)

    Gamal M. H. Rakha

    2015-03-01

    Full Text Available Aim: The present study was conducted to ascertain the prevalence of common digestive problems compared to other health problems among dogs that were admitted to the teaching veterinary hospital, faculty of veterinary medicine, Cairo University, Egypt during 1 year period from January to December 2013. Also, study the effect of age, sex, breeds, and season on the distribution of digestive problems in dogs. Materials and Methods: A total of 3864 dogs included 1488 apparently healthy (included 816 males and 672 females and 2376 diseased dogs (included 1542 males and 834 females were registered for age, sex, breed, and the main complaint from their owners. A complete history and detailed clinical examination of each case were applied to the aids of radiographic, ultrasonographic, and endoscopic examination tools. Fecal examination was applied for each admitted case. Rapid tests for parvovirus and canine distemper virus detection were also performed. Results: A five digestive problems were commonly recorded including vomiting, diarrhea, concurrent vomiting with diarrhea, anorexia, and constipation with a prevalence (% of 13.6, 19.1, 10.1, 13.1, and 0.5 respectively while that of dermatological, respiratory, urinary, neurological, cardiovascular, auditory, and ocular problems was 27.9, 10.5, 3.3, 0.84, 0.4, 0.25, and 0.17 (% respectively. This prevalence was obtained on the basis of the diseased cases. Age and breed had a significant effect on the distribution of digestive problems in dogs (p0.05 on the distribution of such problems. Conclusion: Digestive problems were the highest recorded problems among dogs, and this was the first records for such problems among dogs in Egypt. Age, gender, and breeds had a significant effect on the distribution of the digestive problems in dogs while season had a non-significant effect on the distribution of such problems. The present data enable veterinarians in Egypt to ascertain their needs for diagnostic tools

  10. Evaluation of radiation dose to patients from Tc-99m during bone scan in nuclear medicine at Korle-Bu Teaching Hospital

    International Nuclear Information System (INIS)

    Bambara, T. L.

    2014-07-01

    Internal dosimetry deals with the measurement of the radiation dose absorbed internally by an organ after the administration of isotopes for diagnosis and treatment. In the present study radiation absorbed dose has been calculated for technetium-99m methylene diphosphonate (Tc-99m MDP) which is used frequently for bone scan in Korle-Bu teaching hospital nuclear medicine department. In these cases a small amount of isotopes are accumulated in kidney, urinary bladder etc. Study on sixty-five patients undergoing bone scans has been performed quantitatively using e.soft software. The Tc-99m MDP doses were administered to the patients with activity ranging from 377.4 to 932.4 MBq depending on their weights, and were then scanned with an installed e.Cam SPECT system. A 256 × 1024 matrix size was used in acquiring the bone scans. Also the scans of five volunteer patients at three different times (1 hour, 2 hour and 3 hour after injection) were used to determine the residence time in the bladder and kidney. To determine the amount of activity in patient kidney and urinary bladder, conjugate view method was applied on images information. MIRD equation and OLINDA/EXM software were then used to estimate absorbed dose in different organs of patients. The absorbed value obtained from the two methods were compared. The activity in patient’s left kidney, right kidney and urinary bladder undergoing bone scan three hours after injection of Tc-99m were 1.52±0.48 MBq, 1.52±0.44 MBq 4.88±3.11MBq respectively. The residence time for the kidney and urinary bladder were 0.128±0.043 hour and 1.099±0.330 hour respectively. The absorbed dose per unit of injected activity (mGy/MBq) for bladder, kidneys, liver, lungs, red marrow, ovaries, pancreas, skin and spleen were calculated for the male and the female patients using the two methods. The absorbed dose values obtained from the two methods were compared. In the study for absorbed dose calculation, MIRD equation is in agreement with

  11. [Information and Communication Technology in medicine in Italy: problems and perspectives. A document by the "e-cardio" area of the Italian Association of Hospital Cardiologists (ANMCO)].

    Science.gov (United States)

    Mantero, Antonio; Posteraro, Alfredo; Giordano, Guido; Tonti, Gianni; Pinciroli, Francesco

    2013-12-01

    In Italy, health protection is an individual right protected by the article 32 of the Constitution, granted to everyone since 1978 by the foundation of the National Health Service. However, regionalization of the healthcare system has caused noticeable discrepancies among the different areas of the country. The use of the Information and Communication Technology (ICT) may be useful to solve them. The purpose of this document is to analyze the implementation of ICT in Italy, on the basis of the suggestions given by the Italian Association of Hospital Cardiologists (ANMCO). In 2010, the Italian government introduced the electronic health record (EHR), which includes a minimum core of essential documents that should be created and updated by general practitioners. The obvious limitations of this methodology become clear in the urgency-emergency clinical setting, where the availability of particular clinical data may influence both patient prognosis and cost reduction. Also the privacy rules, currently very restrictive, cause a drawback in reliability of the data reported in the EHR, thus arising the need for a balance shift from privacy to health rights at the level of both the individual and the community. A minimum core of mandatory clinical data to be included in the EHR should be defined. No formal indications for filling out the medical records are available and most few experiences concern "bureaucratic documents" on the diagnostic and therapeutic process. Conversely, we believe that medical records should become a diagnostic and therapeutic tool that makes health rights uniform across the country. Each medical record form should include the following features: a simple interface, a mandatory association of clinical findings and reports, data portability and accessibility, and adherence of the information to a minimal dataset. Additionally, medical records data should merge into a modified EHR available at any time and place through network access points with

  12. Assessment and monitoring of recreation impacts and resource conditions on mountain summits: examples from the Northern Forest, USA

    Science.gov (United States)

    Monz, Christopher A.; Marion, Jeffrey L.; Goonan, Kelly A.; Manning, Robert E.; Wimpey, Jeremy; Carr, Christopher

    2010-01-01

    Mountain summits present a unique challenge to manage sustainably: they are ecologically important and, in many circumstances, under high demand for recreation and tourism activities. This article presents recent advances in the assessment of resource conditions and visitor disturbance in mountain summit environments, by drawing on examples from a multiyear, interdisciplinary study of summits in the northeastern United States. Primary impact issues as a consequence of visitor use, such as informal trail formation, vegetation disturbance, and soil loss, were addressed via the adaption of protocols from recreation ecology studies to summit environments. In addition, new methodologies were developed that provide measurement sensitivity to change previously unavailable through standard recreation monitoring protocols. Although currently limited in application to the northeastern US summit environments, the methods presented show promise for widespread application wherever summits are in demand for visitor activities.

  13. The Social Development Summit and the developing countries.

    Science.gov (United States)

    Barnabas, A P; Kulkarni, P D; Nanavatty, M C; Singh, R R

    1996-01-01

    This article discusses some concerns of the 1996 UN Summit on Social Development. Conference organizers identified the three key conference issues as poverty alleviation, social integration of the marginalized and disadvantaged, and expansion of productive employment. The goal of a "society for all" means dealing with the increasing differences between rich and poor countries, the survival of weaker economies in a competitive market system, wide variations in consumption patterns between countries, attainment of political stability while respecting ethnic identity, the rise in social problems among countries with a high human development index, and increasing joblessness. The Human Development Report for 1994 emphasizes human security. Social development is not the equivalent of human resource development nor a side issue of economic growth. The integration of ethnic groups poses social and political problems. There remains a question about what political system and culture would be best for social integration. Developed countries define poverty as the inability of people and government to provide resources and necessary services for people's productive activity. Poverty in developing countries is blamed on colonialism. Globally, developed countries control 71% of world trade. Sharing resources to meet basic needs throughout the world is not an operational ideal. The highest 20% of income earners receive 83% of the world income. The culture of poverty is the strategy used by the poor to survive. Welfare is not an end in itself but does enable the poor to improve their conditions. Development that focuses on productive employment is uncertain. Developed and developing countries do not share similar perceptions of human rights. There is a question as to who should set the priorities for social development. Sustainable social development is related to preservation of natural resources, control of population growth, and promotion of social security.

  14. Marketing herbal medicines.

    Science.gov (United States)

    Lazarus, M

    1999-01-01

    HIV-positive support groups, together with hospital pharmacists in Thailand are fighting the high cost and lack of access to pharmaceuticals by producing and distributing herbal medicines. In Theung district, Chiang Rai province, members of the local support group for people with HIV produce their own, low-cost, herbal medicines. Although the herbal medicines they produce do not provide a cure for HIV/AIDS, they do offer relief for some of the symptoms of opportunistic infections. The herbs are prepared by the group members under the supervision of the pharmacy department at the district hospital. Local people judge their effectiveness by hearing testimonials from people who have witnessed improvement in symptoms. In response to the popularity and effectiveness of herbal medicines, the Ministry of Public Health has approved plans to sell products derived from local herbs in the pharmacies of government hospitals.

  15. Proceedings of the November 2011 Traceability Research Summit: this report is the third in a series on Traceability Summits sponsored by IFT beginning in July 2011.

    Science.gov (United States)

    Hickey, Caitlin; Bhatt, Tejas

    2013-12-01

    Fifty thought leaders in the area of food traceability met for a 3rd time to discuss methodologies and finalize the principles that define their vision for traceability. Participants in the summit included representatives from industry, trade associations, government, academia, consumer groups, and more. One main focus of this summit included a discussion on the current regulations and voluntary initiatives in place regarding traceability. Overall, it was recognized that the recommendations from this summit group would be more specific and stringent in comparison to these current regulations and initiatives. The participants sought to be leaders in the traceability arena, with their recommendations leading the industry to optimal traceability systems and methods. Participants agreed on many principles for their vision of traceability, emphasizing the importance of access to traceability data. They discussed having industry be asked for "basic" tracing data prior to the need for a large-scale investigation, having standards for sharing data, and having the data in electronic form. Participants foresaw the importance of capturing data electronically in the future, although they recognized that many firms do not currently do this. The group also saw a need for a transition period to implement changes, and to provide implementation training and resource aid to small businesses. Summit participants discussed specific definitions and examples for key data elements and critical tracking events that could be used by industry to capture tracing data at specific points within the supply chain. Overall, participants refined the goals of the summit group and started to identify specific ways to achieve those goals. © 2013 Institute of Food Technologists®

  16. The meta-leadership summit for preparedness initiative: an innovative model to advance public health preparedness and response.

    Science.gov (United States)

    Sobelson, Robyn K; Young, Andrea C; Marcus, Leonard J; Dorn, Barry C; Neslund, Verla S; McNulty, Eric J

    2013-12-01

    This article reports on the design, evaluation framework, and results from the Meta-Leadership Summit for Preparedness Initiative. The Meta-Leadership Summit for Preparedness was a 5-year initiative based on the premise that national preparedness and emergency response is not solely the responsibility of government. From 2006 to 2011, 36 Meta-Leadership Summits were delivered in communities across the country. Summits were customized, 10-hour leadership development, networking, and community action planning events. They included participation from targeted federal, state, local, nonprofit/philanthropic, and private sector leaders who are directly involved in decision making during a major community or state-wide emergency. A total of 4,971 government, nonprofit, and business leaders attended Meta-Leadership Summits; distribution of attendees by sector was balanced. Ninety-three percent of respondents reported the summit was a valuable use of time, 91% reported the overall quality as "good" or "outstanding," and 91% would recommend the summit to their colleagues. In addition, approximately 6 months after attending a summit, 80% of respondents reported that they had used meta-leadership concepts or principles. Of these, 93% reported that using meta-leadership concepts or principles had made a positive difference for them and their organizations. The Meta-Leadership Summit for Preparedness Initiative was a value-added opportunity for communities, providing the venue for learning the concepts and practice of meta-leadership, multisector collaboration, and resource sharing with the intent of substantively improving preparedness, response, and recovery efforts.

  17. PACS in nuclear medicine

    International Nuclear Information System (INIS)

    Kang, Keon Wook

    2000-01-01

    PACS (Picture Archiving and Communication System) is being rapidly spread and installed in many hospitals, but most of the system do not include nuclear medicine field. Although additional costs of hardware for nuclear medicine PACS is low, the complexity in developing viewing software and little market have made the nuclear medicine PACS not popular. Most PACS utilize DICOM 3.0 as standard format, but standard format in nuclear medicine has been Interfile. Interfile should be converted into DICOM format if nuclear images are to be stored and visualized in most PACS. Nowadays, many vendors supply the DICOM option in gamma camera and PET. Several hospitals in Korea have already installed nucler PACS with DICOM, but only the screen captured images are supplied. Software for visualizing pseudo-color with color lookup tables and expressing with volume view should be developed to fulfill the demand of referring physicians and nuclear medicine physicians. PACS is going to integrate not only radiologic images but also endoscopic and pathologic images. Web and PC based PACS is now a trend and is much compatible with nuclear medicine PACS. Most important barrier for nuclear medicine PACS that we encounter is not a technical problem, but indifference of investor such as administrator of hospital or PACS. Now it is time to support and invest for the development of nuclear medicine PACS

  18. Standardization of tests of quality control with the aid of quality tools used in management systems of processes at the Sector of Nuclear Medicine of the University Hospital of Santa Maria, Rio Grande do Sul

    International Nuclear Information System (INIS)

    Da Cas, E.V.; Weis, G.L.; Bahunhardt, T.; Shuch, L.A.; Lopes, L.F.D.

    2009-01-01

    This work tries to standardize the tests of quality control at the Sector of Nuclear Medicine at the University Hospital of Santa Maria, using tools of the quality used in systems of management of processes such as, PDCA, brainstorming, diagram of cause and effect (Ishikawa), 5W2H, verifying list and fluxogram. The tests of quality control refer to the scintillation camera (center of rotation, intrinsic uniformity, intrinsic spatial resolution and linearity, energy resolution for each radionuclide), to the dose calibrator (accuracy, reproducibility and linearity), to the Geiger-Mueller detector (reproducibility of the detector). (author)

  19. Annual report of the Summit Members' Working Group on Controlled Thermonuclear Fusion (Fusin Working Group (FWG))

    International Nuclear Information System (INIS)

    1987-04-01

    The Summit Members' Working Group on Controlled Thermonuclear Fusion [Fusion Working Group (FWG)] was established in 1983 in response to the Declaration of the Heads of State and Government at the Versailles Economic Summit meeting of 1982, and in response to the subsequent report of the Working Group in Technology, Growth and Employment (TGE) as endorsed at the Williamsburg Summit meeting, 1983. This document contains the complete written record of each of the three FWG meetings which include the minutes, lists of attendees, agendas, statements, and summary conclusions as well as the full reports of the Technical Working Party. In addition, there is a pertinent exchange of correspondence between FWG members on the role of the Technical Working Party and a requested background paper on the modalities associated with a possible future ETR project

  20. Automated system of control of radioactive liquid effluents of patients submitted to therapy in hospitals of nuclear medicine (SACEL); Sistema automatizado de control de efluentes liquidos radiactivos de pacientes sometidos a terapia en hospitales de medicina nuclear (SACEL)

    Energy Technology Data Exchange (ETDEWEB)

    Ruiz C, M A; Rivero G, T; Celis del Angel, L; Sainz M, E; Molina, G [ININ, 52045 Ocoyoacac, Estado de Mexico (Mexico)

    2006-07-01

    Different hospitals of nuclear medicine require of the technical attendance for the design, construction and instrumentation of an effluents retention system coming from the room dedicated to the medical application of iodine 131, with the one object of giving execution to the normative requirements of radiological protection, settled down in the General Regulation of Radiological Safety (RGSR) emitted by the CNSNS in November, 1988 and in the corresponding official standards. An automatic system of flow measurement, the activity concentration of the effluents to the drainage, the discharges control and the automated report it will allow the execution of the national regulations, also the elimination of unhealthy activities as the taking of samples, analysis of those same and the corresponding paperwork, its will allow that the SACEL is capable of to carry out registrations that are to consult in an automated way. The changes in the demands of the National Commission of Nuclear Safety and Safeguards in relation to the liberation of radioactive material in hospitals by medical treatments, it has created the necessity to develop a system that quantifies and dose the liquid effluents of people under thyroid treatment with iodine-131 to the drainage. The Automated System of Control of radioactive liquids effluents generated in Hospitals of Nuclear Medicine (SACEL) developed in the National Institute of Nuclear Research, it fulfills this regulation, besides improving the work conditions for the medical and technical personnel of the hospital in that are installed, since this system has the advantage of to be totally automated and to require of a minimum of attendance. The SACEL is an electro-hydraulic system of effluents control, based in the alternate operation of two decay deposits of the activity of the material contaminated with iodine-131. The system allows to take a registration of those volumes and liberated dose, besides being able to be monitoring in remote

  1. Database for the Geologic Map of the Summit Region of Kilauea Volcano, Hawaii

    Science.gov (United States)

    Dutton, Dillon R.; Ramsey, David W.; Bruggman, Peggy E.; Felger, Tracey J.; Lougee, Ellen; Margriter, Sandy; Showalter, Patrick; Neal, Christina A.; Lockwood, John P.

    2007-01-01

    INTRODUCTION The area covered by this map includes parts of four U.S. Geological Survey (USGS) 7.5' topographic quadrangles (Kilauea Crater, Volcano, Ka`u Desert, and Makaopuhi). It encompasses the summit, upper rift zones, and Koa`e Fault System of Kilauea Volcano and a part of the adjacent, southeast flank of Mauna Loa Volcano. The map is dominated by products of eruptions from Kilauea Volcano, the southernmost of the five volcanoes on the Island of Hawai`i and one of the world's most active volcanoes. At its summit (1,243 m) is Kilauea Crater, a 3 km-by-5 km collapse caldera that formed, possibly over several centuries, between about 200 and 500 years ago. Radiating away from the summit caldera are two linear zones of intrusion and eruption, the east and the southwest rift zones. Repeated subaerial eruptions from the summit and rift zones have built a gently sloping, elongate shield volcano covering approximately 1,500 km2. Much of the volcano lies under water: the east rift zone extends 110 km from the summit to a depth of more than 5,000 m below sea level; whereas, the southwest rift zone has a more limited submarine continuation. South of the summit caldera, mostly north-facing normal faults and open fractures of the Koa`e Fault System extend between the two rift zones. The Koa`e Fault System is interpreted as a tear-away structure that accommodates southward movement of Kilauea's flank in response to distension of the volcano perpendicular to the rift zones. This digital release contains all the information used to produce the geologic map published as USGS Geologic Investigations Series I-2759 (Neal and Lockwood, 2003). The main component of this digital release is a geologic map database prepared using ArcInfo GIS. This release also contains printable files for the geologic map and accompanying descriptive pamphlet from I-2759.

  2. Massage Therapy and Canadians’ Health Care Needs 2020: Proceedings of a National Research Priority Setting Summit

    Science.gov (United States)

    Dryden, Trish; Sumpton, Bryn; Shipwright, Stacey; Kahn, Janet; Reece, Barbara (Findlay)

    2014-01-01

    Background The health care landscape in Canada is changing rapidly as forces, such as an aging population, increasingly complex health issues and treatments, and economic pressure to reduce health care costs, bear down on the system. A cohesive national research agenda for massage therapy (MT) is needed in order to ensure maximum benefit is derived from research on treatment, health care policy, and cost effectiveness. Setting A one-day invitational summit was held in Toronto, Ontario to build strategic alliances among Canadian and international researchers, policy makers, and other stakeholders to help shape a national research agenda for MT. Method Using a modified Delphi method, the summit organizers conducted two pre-summit surveys to ensure that time spent during the summit was relevant and productive. The summit was facilitated using the principles of Appreciative Inquiry which included a “4D” strategic planning approach (defining, discovery, dreaming, designing) and application of a SOAR framework (strengths, opportunities, aspirations, and results). Participants Twenty-six researchers, policymakers, and other stakeholders actively participated in the events. Results Priority topics that massage therapists believe are important to the Canadian public, other health care providers, and policy makers and massage therapists themselves were identified. A framework for a national massage therapy (MT) research agenda, a grand vision of the future for MT research, and a 12-month action plan were developed. Conclusion The summit provided an excellent opportunity for key stakeholders to come together and use their experience and knowledge of MT to develop a much-needed plan for moving the MT research and professionalization agenda forward. PMID:24592299

  3. Massage therapy and canadians' health care needs 2020: proceedings of a national research priority setting summit.

    Science.gov (United States)

    Dryden, Trish; Sumpton, Bryn; Shipwright, Stacey; Kahn, Janet; Reece, Barbara Findlay

    2014-03-01

    The health care landscape in Canada is changing rapidly as forces, such as an aging population, increasingly complex health issues and treatments, and economic pressure to reduce health care costs, bear down on the system. A cohesive national research agenda for massage therapy (MT) is needed in order to ensure maximum benefit is derived from research on treatment, health care policy, and cost effectiveness. A one-day invitational summit was held in Toronto, Ontario to build strategic alliances among Canadian and international researchers, policy makers, and other stakeholders to help shape a national research agenda for MT. Using a modified Delphi method, the summit organizers conducted two pre-summit surveys to ensure that time spent during the summit was relevant and productive. The summit was facilitated using the principles of Appreciative Inquiry which included a "4D" strategic planning approach (defining, discovery, dreaming, designing) and application of a SOAR framework (strengths, opportunities, aspirations, and results). Twenty-six researchers, policymakers, and other stakeholders actively participated in the events. Priority topics that massage therapists believe are important to the Canadian public, other health care providers, and policy makers and massage therapists themselves were identified. A framework for a national massage therapy (MT) research agenda, a grand vision of the future for MT research, and a 12-month action plan were developed. The summit provided an excellent opportunity for key stakeholders to come together and use their experience and knowledge of MT to develop a much-needed plan for moving the MT research and professionalization agenda forward.

  4. Abasto, surtimiento y gasto de bolsillo en medicamentos en hospitales públicos de México en 2009 Supply prescription filling and out-of-pocket expenditures on medicines in public hospitals in Mexico in 2009

    Directory of Open Access Journals (Sweden)

    Sergio Sesma-Vázquez

    2011-01-01

    Full Text Available OBJETIVO. Analizar la disponibilidad de medicamentos en las farmacias hospitalarias, el surtimiento de prescripciones a pacientes egresados y el gasto de bolsillo en medicamentos de pacientes hospitalizados. MATERIAL Y MÉTODOS. Análisis descriptivo de la Encuesta Nacional de Satisfacción y Trato Adecuado (ENSATA de 2009 con una muestra representativa de hospitales públicos sobre disponibilidad de una lista de 83 medicamentos en el momento de la visita a la farmacia, la proporción del surtimiento de recetas a pacientes en el momento de su alta y su gasto de bolsillo durante su estancia hospitalaria. RESULTADOS. En total se entrevistó a 26 271 pacientes egresados de los 160 hospitales públicos visitados. La disponibilidad de medicamentos en el ámbito nacional fue de 82%. Los hospitales de los Servicios Estatales de Salud (SESA mostraron una disponibilidad de 77% (variación de 30 a 96%. El surtimiento completo de recetas fue de 97% en las instituciones de seguridad social, cifra que contrasta con 56.2% de los hospitales de los SESA, que además presentaron una gran varianza entre estados (13 a 94% La mediana del gasto de pacientes hospitalizados fue de 150 pesos moneda nacional (1% gastó más de 10 000 pesos. CONCLUSIONES. La falta de los medicamentos en los hospitales tiene un impacto económico en el gasto de los hogares, particularmente en aquellos que cuentan con pocos recursos, y puede aumentar la morbilidad o mortalidad de los pacientes hospitalizados en las instituciones públicas.OBJECTIVE. To analyze the availability of drugs in public hospitals, the prescription-filling patterns for in-patients when they are discharged and their out-of-pocket expenditure during their hospitalization. MATERIAL AND METHODS. Using the National Satisfaction and Responsiveness Survey (ENSATA 2009, which includes a representative sample of public hospitals in Mexico in 2009, the availability of 83 essential medicines in the hospital pharmacies at the

  5. 77 FR 36549 - Nursing Workforce Diversity Invitational Summit-“Nursing in 3D: Workforce Diversity, Health...

    Science.gov (United States)

    2012-06-19

    ... Workforce Diversity Invitational Summit--``Nursing in 3D: Workforce Diversity, Health Disparities, and..., Division of Nursing, will host an invitational summit that focuses on Nursing Workforce Diversity (NWD..., thought leaders, and key workforce diversity stakeholders to identify the full range of academic and...

  6. 76 FR 47596 - Notice of Scientific Summit; The Science of Compassion-Future Directions in End-of-Life and...

    Science.gov (United States)

    2011-08-05

    ...; The Science of Compassion--Future Directions in End-of-Life and Palliative Care SUMMARY: Notice is... science at the end-of-life. On August 11-12, the summit will feature keynote presentations, three plenary...), Department of Health and Human Services, will convene a scientific summit titled ``The Science of Compassion...

  7. Talent Development Research, Policy, and Practice in Europe and the United States: Outcomes from a Summit of International Researchers

    Science.gov (United States)

    Subotnik, Rena F.; Stoeger, Heidrun; Olszewski-Kubilius, Paula

    2017-01-01

    The goal of this article is to convey a summary of research and conversation on talent development on the part of a small group of European and American researchers who participated in the Inaugural American European Research Summit in Washington. In the final hours of the summit, participants discussed the state of research on talent development…

  8. The Use of Herbal Medicine in Children

    OpenAIRE

    Suryawati, Suryawati; Suardi, Hijra Novia

    2015-01-01

    The herbal medicine has been widely used in children for the treatment of several symptoms and the prevention of diseases before accessing the hospital for professionals help. There are 3 kinds of marketed herbal medicine including empirical based herbal medicine (jamu), standardized herbal medicine (obat herbal terstandar) and clininically tested herbal medicine (fitofarmaka). This study aimed to investigate the utilization of the marketed herbal medicine along with non marketed ones which w...

  9. Navy Medicine - World Class Care... Anytime, Anywhere

    Science.gov (United States)

    Search Saturday, May 26th, 2018 Home About Disclaimer Search Navy Medicine Navy Medicine World Class Care... Anytime, Anywhere Home Disclaimer Navy Medicine WebSite About Leadership Readiness Health Partnerships Inside Navy Medicine Dental Corps Hospital Corps Medical Corps Medical Service Corps Nurse Corps

  10. GENERAL PRACTITIONERS AND HOSPITALS

    African Journals Online (AJOL)

    In recent years in South Africa the position of the general practi- tioner in hospitals has ... ments, and it is in these hospitals that difficulties have arisen. On the other hand, ... great extent deprived of contact with his colleagues. He comes to ... eventually lose interest in the results of treatment and advances in medicine. In fact ...

  11. Quality of medical service, patient satisfaction and loyalty with a focus on interpersonal-based medical service encounters and treatment effectiveness: a cross-sectional multicenter study of complementary and alternative medicine (CAM) hospitals.

    Science.gov (United States)

    Kim, Chang Eun; Shin, Joon-Shik; Lee, Jinho; Lee, Yoon Jae; Kim, Me-Riong; Choi, Areum; Park, Ki Byung; Lee, Ho-Joo; Ha, In-Hyuk

    2017-03-28

    Treatment effectiveness holds considerable importance in the association between service quality and satisfaction in medical service studies. While complementary and alternative medicine (CAM) use grows more prominent, comprehensive evaluations of the quality of medical service at CAM-oriented hospitals are scarce. This study assesses the quality of medical services provided at a CAM-oriented hospital of Korean medicine using the service encounter system approach and analyzes the influence of treatment effectiveness on patient loyalty. A survey study using one-on-one interviews was conducted using a cross-sectional design in outpatients visiting one of fifteen Korean medicine facilities located throughout Korea. A total of 880 surveys were completed from June to July, 2014, and 728 surveys were included in the final analysis after excluding incomplete or incorrect questionnaires. The reliability and validity of the surveys was confirmed using Cronbach's alpha coefficient and confirmatory factor analysis, and a structural equation modeling analysis was performed to verify causality and association between factors (quality of medical service, treatment effectiveness, patient satisfaction, and intent to revisit). The measured factors of physician performance and quality of service procedures had a positive effect on treatment effectiveness. The impression of the facilities and environment directly impacted satisfaction rates for interpersonal-based medical service encounters, while treatment effectiveness positively affected satisfaction regarding quality of medical service. However, treatment effectiveness had a more significant effect on satisfaction compared to facilities and environment, and it indirectly affected satisfaction and directly influenced intent to revisit. Treatment effectiveness and satisfaction both positively influenced intent to revisit. The importance of treatment effectiveness should be recognized when examining quality of medical services, and

  12. State of emergency medicine in Azerbaijan

    OpenAIRE

    Sule, Harsh; Kazimov, Shirin; Shahmaliyev, Oktay; Sirois, Adam

    2008-01-01

    Background There has been no previous study into the state of emergency medicine in Azerbaijan. As a legacy of the Soviet Semashko system, the ?specialty? model of emergency medicine and integrated emergency departments do not exist here. Instead, pre-hospital emergency care is delivered by ambulance physicians and in-hospital care by individual departments, often in specialty hospitals. Emergency care is therefore fragmented, highly specialized and inefficient. Aims The Emergency Medicine De...

  13. Biomedical imaging graduate curricula and courses: report from the 2005 Whitaker Biomedical Engineering Educational Summit.

    Science.gov (United States)

    Louie, Angelique; Izatt, Joseph; Ferrara, Katherine

    2006-02-01

    We present an overview of graduate programs in biomedical imaging that are currently available in the US. Special attention is given to the emerging technologies of molecular imaging and biophotonics. Discussions from the workshop on Graduate Imaging at the 2005 Whitaker Educational Summit meeting are summarized.

  14. Curtain Down and Nothing Settled. Global Sustainability Governance after the 'Rio 20+20' Earth Summit

    NARCIS (Netherlands)

    Biermann, F.

    2012-01-01

    The United Nations Conference on Sustainable Development, held in June 2012 in Rio de Janeiro, was probably the largest event in a long series of mega-summits on environmental protection and sustainable development. Roughly 44000 participants descended on Rio de Janeiro to take part in ten days of

  15. 77 FR 13232 - Security Zones; G8/North Atlantic Treaty Organization (NATO) Summit, Chicago, IL

    Science.gov (United States)

    2012-03-06

    ... political figures, the G8/NATO Summit is expected to draw significant domestic and international media... mitigate the threat of violence and ensure the safety and security of those who attend, participate, and... NATO; the high concentration of dignitaries and political figures; the expected interest of domestic...

  16. Participants to the 3rd HEP Information Resources Summit, 6-7 May 2009

    CERN Multimedia

    Fermilab, Photo Service

    2009-01-01

    The broad theme of the 3rd HEP Information Resources Summit was "Collaboration between Information Services." As HEP increasingly borders fields such as instrumentation and astrophysics, it was discussed what potential interrelationships and communication this group have to serve this broader research community seamlessly.

  17. Text of the Moscow nuclear safety and security summit declaration Moscow, 19-20 April 1996

    International Nuclear Information System (INIS)

    1996-01-01

    As requested by the Resident Representatives to the International Atomic Energy Agency of France and the Russian Federation, the two States -Co-Chairmen of the summit meeting held in Moscow from 19-20 April 1996, the text of the Moscow Nuclear Safety and Security Declaration is being circulated

  18. Using Film Clips to Teach Teen Pregnancy Prevention: "The Gloucester 18" at a Teen Summit

    Science.gov (United States)

    Herrman, Judith W.; Moore, Christopher C.; Anthony, Becky

    2012-01-01

    Teaching pregnancy prevention to large groups offers many challenges. This article describes the use of film clips, with guided discussion, to teach pregnancy prevention. In order to analyze the costs associated with teen pregnancy, a film clip discussion session based with the film "The Gloucester 18" was the keynote of a youth summit. The lesson…

  19. Text of the Moscow nuclear safety and security summit declaration Moscow, 19-20 April 1996

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-06-04

    As requested by the Resident Representatives to the International Atomic Energy Agency of France and the Russian Federation, the two States -Co-Chairmen of the summit meeting held in Moscow from 19-20 April 1996, the text of the Moscow Nuclear Safety and Security Declaration is being circulated.

  20. The World Solar Summit Process. The solar electricity highway for peace and environment

    International Nuclear Information System (INIS)

    Berkovski, B.

    1996-01-01

    Due to the growth of the world, energy demand will continue to increase. The question of providing additional energy is discussed by the World Solar Summit Process (WSSP). The actions, plans, recommendations and possible prospects of WSSP are discussed. (R.P.)

  1. The aspen mortality summit; December 18 and 19, 2006; Salt Lake City, UT

    Science.gov (United States)

    Dale L. Bartos; Wayne D. Shepperd

    2010-01-01

    The USDA Forest Service Rocky Mountain Research Station sponsored an aspen summit meeting in Salt Lake City, Utah, on December 18 and19, 2006, to discuss the rapidly increasing mortality of aspen (Populus tremuloides) throughout the western United States. Selected scientists, university faculty, and managers from Federal, State, and non-profit agencies with experience...

  2. Proceedings of resources for optimal care of acute care and emergency surgery consensus summit Donegal Ireland

    NARCIS (Netherlands)

    Sugrue, M.; Maier, R.; Moore, E. E.; Boermeester, M.; Catena, F.; Coccolini, F.; Leppaniemi, A.; Peitzman, A.; Velmahos, G.; Ansaloni, L.; Abu-Zidan, F.; Balfe, P.; Bendinelli, C.; Biffl, W.; Bowyer, M.; DeMoya, M.; de Waele, J.; di Saverio, S.; Drake, A.; Fraga, G. P.; Hallal, A.; Henry, C.; Hodgetts, T.; Hsee, L.; Huddart, S.; Kirkpatrick, A. W.; Kluger, Y.; Lawler, L.; Malangoni, M. A.; Malbrain, M.; MacMahon, P.; Mealy, K.; O'Kane, M.; Loughlin, P.; Paduraru, M.; Pearce, L.; Pereira, B. M.; Priyantha, A.; Sartelli, M.; Soreide, K.; Steele, C.; Thomas, S.; Vincent, J. L.; Woods, L.

    2017-01-01

    Background: Opportunities to improve emergency surgery outcomes exist through guided better practice and reduced variability. Few attempts have been made to define optimal care in emergency surgery, and few clinically derived key performance indicators (KPIs) have been published. A summit was

  3. Emergency medicine program targets "brain drain" in Ethiopia ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2016-04-29

    Apr 29, 2016 ... ... (TAAAC-EM) project, access to emergency medicine is increasing for Ethiopians. With IDRC support, the TAAAC-EM postgraduate emergency medicine training program ... From hospitals to herbalists: Rx herbal medicines.

  4. Emergency preparedness of Research Center for Radiation medicine and its hospital to admit and treat the patients with signs of acute radiation sickness

    International Nuclear Information System (INIS)

    Belyi, D. A.; Khomenko, V. I.; Bebeshko, V. G.

    2009-01-01

    After the Chernobyl accident, the Research Center for Radiation Medicine (RCRM) was established in Kiev (Ukraine). Its main task was to maintain a high level of emergency preparedness and be ready to examine and treat patients who suffer as a result of hypothetical radiation accident. Based on the previous experience, this institution's specialists worked out new diagnostic criteria and drug treatment schemata for acute radiation sickness, created a database on 75 patients with this diagnosis and improved educational programmes for medical students and physicians working in the field of radiation medicine. RCRM collaborates fruitfully with western partners through the joint research projects and connects with the World Health Organisation's Radiation Emergency Medical Preparedness and Assistance Network centre. Collaboration with Kiev Center for Bone Marrow Transplantation allows RCRM to use aseptic wards having highly filtered air for the treatment of most severely irradiated patients. (authors)

  5. Program for carrying out studies for the diagnoses in the nuclear medicine department at the Dr Gustavo Aldereguia Hospital in Cienfuegos province

    International Nuclear Information System (INIS)

    Romero Cabrera, J.L.

    1996-01-01

    Considering the relation conditions existing in the Dr Gustavo Aldereguia Lima Hospital this work tries to analyze the critical ways that lead to the dossefication of radiopharmaceutical drugs that do not fit the ALARA criterion and to propose a program that in a general consensus with all medical specialists would determine the precise medical test needed to be done

  6. Integration of Homeopathy and Complementary Medicine in the Tuscan Public Health System and the Experience of the Homeopathic Clinic of the Lucca Hospital.

    Science.gov (United States)

    Rossi, E; Di Stefano, M; Picchi, M; Panozzo, M A; Noberasco, C; Nurra, L; Baccetti, S

    2018-03-17

     The healthcare programs of the Region of Tuscany (Italy) have started the process of integration of some types of complementary medicine (CM), including homeopathy, which began in 1996. The Homeopathic Clinic of Lucca was opened in 1998, followed by the Homeopathic Clinic for Women in 2003, and the Clinic for CM and Diet in Oncology in 2013.  Observational longitudinal studies conducted on 5,877 patients (3,937 in the general clinic, 1,606 in the women's clinic and 334 in oncology) were consecutively examined from 2003 to 2016. The Outcome in Relation to Impact on Daily Living (ORIDL) was generally used to assess outcomes.  Comparing the clinical conditions before and after homeopathic treatment, improvement was observed in 88.8% of general medicine patients with follow-up (45.1%); in particular, 68.1% of the patients had a major improvement in or resolution (ORIDL +2, +3, +4) of their condition. In women, an improvement was obtained in 74.1% cases and a major improvement in 61.2%. In cancer patients with homeopathic and integrative treatment, a significant improvement was observed for all the symptoms during anti-cancer therapy, particularly for hot flashes, nausea, depression, asthenia, and anxiety.  These results suggest that homeopathy can effectively be integrated with allopathic medicine and that the Tuscan experience could provide a useful reference for developing national and European regulations on the use of CM and homeopathy in public healthcare. The Faculty of Homeopathy.

  7. The pre-hospital administration of tranexamic acid to patients with multiple injuries and its effects on rotational thrombelastometry: a prospective observational study in pre-hospital emergency medicine.

    Science.gov (United States)

    Kunze-Szikszay, Nils; Krack, Lennart A; Wildenauer, Pauline; Wand, Saskia; Heyne, Tim; Walliser, Karoline; Spering, Christopher; Bauer, Martin; Quintel, Michael; Roessler, Markus

    2016-10-10

    Hyperfibrinolysis (HF) is a major contributor to coagulopathy and mortality in trauma patients. This study investigated (i) the rate of HF during the pre-hospital management of patients with multiple injuries and (ii) the effects of pre-hospital tranexamic acid (TxA) administration on the coagulation system. From 27 trauma patients with pre-hospital an estimated injury severity score (ISS) ≥16 points blood was obtained at the scene and on admission to the emergency department (ED). All patients received 1 g of TxA after the first blood sample was taken. Rotational thrombelastometry (ROTEM) was performed for both blood samples, and the results were compared. HF was defined as a maximum lysis (ML) >15 % in EXTEM. The median (min-max) ISS was 17 points (4-50 points). Four patients (15 %) had HF diagnosed via ROTEM at the scene, and 2 patients (7.5 %) had HF diagnosed via ROTEM on admission to the ED. The median ML before TxA administration was 11 % (3-99 %) vs. 10 % after TxA administration (4-18 %; p > 0.05). TxA was administered 37 min (10-85 min) before ED arrival. The ROTEM results before and after TxA administration did not significantly differ. No adverse drug reactions were observed after TxA administration. HF can be present in severely injured patients during pre-hospital care. Antifibrinolytic therapy administered at the scene is a significant time saver. Even in milder trauma fibrinogen can be decreased to critically low levels. Early administration of TxA cannot reverse or entirely stop this decrease. The pre-hospital use of TxA should be considered for severely injured patients to prevent the worsening of trauma-induced coagulopathy and unnecessarily high fibrinogen consumption. ClinicalTrials.gov ID NCT01938768 (Registered 5 September 2013).

  8. Aerospace Medicine

    Science.gov (United States)

    Michaud, Vince

    2015-01-01

    NASA Aerospace Medicine overview - Aerospace Medicine is that specialty area of medicine concerned with the determination and maintenance of the health, safety, and performance of those who fly in the air or in space.

  9. Performance evaluation of the activity meters of nuclear medicine services of the hospitals Rafael Angel Calderon, San Juan de Dios and Mexico during the period from July 1, 2008 to December 31, 2008

    International Nuclear Information System (INIS)

    Barahona Navarro, Alvaro; Binns Quiros, Natalia

    2009-01-01

    Nuclear medicine has used radioisotopes associated to drugs in order to get them to an organ of interest. The radioisotope has the quality to emit radiation, which passes through the body, after being admitted to it, and this is perceived by equipment such as a gamma camera to study the behavior of the organ under study. The radiation is a energy emission able to boot electrons from atoms and produce ions, thus the chemical composition may be altered, resulting in alterations in the cells. Conditions such as: a onreproductive of the cells, causing a tumor; or alterations in geminal cells, causing genetic alterations, which may occur in the offspring of an individual. For the above reason is that the use of radiopharmaceuticals should be as careful as possible, doing as little radiation exposure, without compromising the quality of the study, these should be applied with more important in more radiosensitive population such as children and older adults. The doses used in nuclear medicine are quantified using a device called activity meters and the proper functioning of the overexposures shall impose or low-quality studies doses outside the range of usefulness. The operation of these machines based on the quality control logs have been studied to discover if there are alterations in dosages of nuclear medicine departments of hospitals Calderon Guardia, San Juan de Dios and Mexico. Tests of zero settings, display, physical monitoring, high voltage, linearity test, stability, background radiation, precision, accuracy and consistency have been performed as quality control. This research is classified as non-experimental longitudinal quantitative. The study population was the record set and the realization of quality control tests made to the hospital activity meters above. The collection of data was performed by two steps, the first taking records concerning quality control of the different hospitals, completed tabulation, gratification and analysis of the same. The

  10. Implementation of radioactive wastes management system in nuclear medicine service of Hospital das Clinicas of Universidade de Campinas - UNICAMP, in Sao Paulo State, Brazil

    International Nuclear Information System (INIS)

    Rinaldi Neto, A.; Coelho, R.F.; Brunetto, S.Q.

    2001-01-01

    This work reports the experience acquired at the Servico de Medicina Nuclear of the Hospital de Clinicas/UNICAMP (SMN/HC) in planning and implementing the management system of radioactive waste. This system respects the Comissao Nacional de Energia Nuclear' (CNEN) standards and has been of relatively easy and simple performance, without disturbing the SMN/HC's routine. It has also proof to keep its quality along the time. (author)

  11. A Cohort Study to Analyze the Risk of Venous Thromboembolism Mortality in Patients Admitted to the General Medicine Department, Tan Tock Seng Hospital, Singapore

    OpenAIRE

    Sule, Ashish Anil; Chin, Tay Jam; Sinnathamby, Letchumi; Lee, Hwei Khien; Earnest, Arul

    2011-01-01

    The purpose of this study was to assess the risk of venous thromboembolism (VTE) in patients admitted to the Tan Tock Seng Hospital (TTSH), Singapore during October and November 2009. The primary outcome assessed was mortality due to VTE, or development of deep vein thrombosis or pulmonary embolism (PE) within 3 months from the day of admission. Both univariate and multivariate analyses were performed for all-cause mortality and deaths associated with PE. Seven hundred twenty-one patients adm...

  12. The Meta-Leadership Summit for Preparedness Initiative: An Innovative Model to Advance Public Health Preparedness and Response

    Science.gov (United States)

    Sobelson, Robyn K.; Young, Andrea C.; Marcus, Leonard J.; Dorn, Barry C.; Neslund, Verla S.; McNulty, Eric J.

    2017-01-01

    This article reports on the design, evaluation framework, and results from the Meta-Leadership Summit for Preparedness Initiative. The Meta-Leadership Summit for Preparedness was a 5-year initiative based on the premise that national preparedness and emergency response is not solely the responsibility of government. From 2006 to 2011, 36 Meta-Leadership Summits were delivered in communities across the country. Summits were customized, 10-hour leadership development, networking, and community action planning events. They included participation from targeted federal, state, local, nonprofit/philanthropic, and private sector leaders who are directly involved in decision making during a major community or state-wide emergency. A total of 4,971 government, nonprofit, and business leaders attended Meta-Leadership Summits; distribution of attendees by sector was balanced. Ninety-three percent of respondents reported the summit was a valuable use of time, 91% reported the overall quality as “good” or “outstanding,” and 91% would recommend the summit to their colleagues. In addition, approximately 6 months after attending a summit, 80% of respondents reported that they had used meta-leadership concepts or principles. Of these, 93% reported that using meta-leadership concepts or principles had made a positive difference for them and their organizations. The Meta-Leadership Summit for Preparedness Initiative was a value-added opportunity for communities, providing the venue for learning the concepts and practice of meta-leadership, multisector collaboration, and resource sharing with the intent of substantively improving preparedness, response, and recovery efforts. PMID:24251597

  13. The teaching of nuclear medicine

    International Nuclear Information System (INIS)

    Bok, B.; Ducassou, D.

    1984-01-01

    Having first recalled the need of a specialized teaching in the field of nuclear medicine, the authors describe the training programmes now available in this sector for doctors, chemists and hospital-attendants [fr

  14. Analysis of pattern of mortality in Medicine and Allied Departments at a tertiary care hospital in Islamabad: A losing battle against sepsis.

    Science.gov (United States)

    Azim, Saad; Zahoor, Sidra; Janjua, Jamal; Majeed, Azer; Hussain, Syed Waqar

    2017-01-01

    To identify the pattern of mortality in medical wards of a tertiary care hospital. This retrospective study was conducted at the Khan Research Laboratories Hospital, Islamabad, Pakistan, and comprised medical records of people who died during hospital stay between December 2013 and November 2014.SPSS 11 was used for data analysis. Of the 3,228 admissions, 105(3.25%) patients expired. Of them, 41(39.04%) were men with a mean age of 55±13.48 years (range: 17-88 years) and 64±11.76 (60.9%) were women with a mean age of 61±15.5 years (range: 23-91 years). The mean length of time between admission and death was 6.58±3.7 days (range: 1-33 days). The causes of death were categorised as infectious in 37(35.23%) patients, cancer-related in 20(19.045%), pulmonary in 19(18.09%), cardiovascular in 18(17.14%), gastrointestinal and neurological in 13(12.38%) each, nephrology in 10(9.52%), autoimmune disorders in 6(5.71%) and miscellaneous in 9(8.57%). Complications of sepsis were the most common cause of death in 38(36.19%) cases. Sepsis, primarily from pneumonia, was the major cause of mortality.

  15. Evaluation of the Effectiveness of Postgraduate General Medicine Training by Objective Structured Clinical Examination—Pilot Study and Reflection on the Experiences of Kaohsiung Medical University Hospital

    Directory of Open Access Journals (Sweden)

    Jer-Chia Tsai

    2008-12-01

    Full Text Available Objective structured clinical examination (OSCE is an effective assessment method to evaluate medical students' clinical competencies performance. Postgraduate year 1 (PGY1 residents have been initiated in a general medicine training program in Taiwan since 2003. However, little is known about the learning effectiveness of trainees from this program. This pilot study aimed to evaluate the clinical core competencies of PGY1 residents using OSCE, and to reflect on the strengths and weaknesses of this pilot assessment project. OSCE was conducted for five PGY1 examinees (4 men, 1 woman with five stations covering core themes, including history taking, physical examination, clinical procedure of airway intubation, clinical reasoning, and communication skills for informing bad news. Itemized checklists and five-point Likert scale global ratings were used for evaluating performance. The results showed that the performance of our PGY1 residents on history taking was significantly better after about 2 months of postgraduate training on general internal medicine. Self-evaluation on performance by examinees revealed significantly lower global ratings on post-course OSCE (4.14 ± 0.80 vs. 3.68 ± 0.66; p < 0.02. Surveys from tutors and standardized patients (SPs completed at pre- and post-course OSCEs showed consistently favorable responses on the purposes, content, process, and environment of this assessment (4.0 ± 0.17 vs. 4.0 ± 0.12, nonsignificant. However, a survey of the examinees completed at preand post-course OSCEs showed relatively unfavorable responses to the same aspects, and to tutors and SPs (4.1 ± 0.09 vs. 3.7 ± 0.18; p < 0.05. Qualitative information revealed that tutors and SPs remarked that PGY1 residents' medical knowledge performance was satisfactory but their clinical reasoning performance, communication skills (giving bad news and self-confidence were unsatisfactory. In conclusion, this pilot study has demonstrated that OSCE is a

  16. From the High Energy Physics Laboratory to the hospital -some experiences of the application of MWPC [multiwire proportional counter] technology to medicine

    International Nuclear Information System (INIS)

    Bateman, J.E.

    1989-01-01

    In this talk I wish to briefly review the experience we have obtained at the Rutherford Appleton Laboratory over the past decade in the adaptation of MWPC (multiwire proportional counter) technology to diagnostic imaging applications in medicine. A cursory glance at the history of science and technology quickly shows the often intimate and mutually beneficial relationship between ''pure'' science (and scientists) and practical applications. The following talk traces some of the principal features of the situation which have been brought to my attention in the course of the last decade. (author)

  17. Glacial erosion of high-elevation low-relief summits on passive continental margins constrained by cosmogenic nuclides

    DEFF Research Database (Denmark)

    Andersen, Jane Lund; Egholm, David Lundbek; Knudsen, Mads Faurschou

    We present a new, extensive in-situ cosmogenic 10Be and 26Al dataset from high-elevation low-relief summits along Sognefjorden in Norway. Contrary to previous studies of high-elevation low-relief summits in cold regions, we find only limited cosmogenic nuclide inheritance in bedrock surfaces......, indicating that warm-based ice eroded the summits during the last glacial period. From the isotope concentrations we model denudation histories using a recently developed Monte Carlo Markov Chain inversion model (Knudsen et al, 2015). The model relies on the benthic d18O curve (Lisiecki and Raymo, 2005...

  18. Family Medicine Maternity Care Call to Action: Moving Toward National Standards for Training and Competency Assessment.

    Science.gov (United States)

    Magee, Susanna R; Eidson-Ton, W Suzanne; Leeman, Larry; Tuggy, Michael; Kim, Thomas O; Nothnagle, Melissa; Breuner, Joseph; Loafman, Mark

    2017-03-01

    Maternity care is an integral part of family medicine, and the quality and cost-effectiveness of maternity care provided by family physicians is well documented. Considering the population health perspective, increasing the number of family physicians competent to provide maternity care is imperative, as is working to overcome the barriers discouraging maternity care practice. A standard that clearly defines maternity care competency and a systematic set of tools to assess competency levels could help overcome these barriers. National discussions between 2012 and 2014 revealed that tools for competency assessment varied widely. These discussions resulted in the formation of a workgroup, culminating in a Family Medicine Maternity Care Summit in October 2014. This summit allowed for expert consensus to describe three scopes of maternity practice, draft procedural and competency assessment tools for each scope, and then revise the tools, guided by the Family Medicine and OB/GYN Milestones documents from the respective residency review committees. The summit group proposed that achievement of a specified number of procedures completed should not determine competency; instead, a standardized competency assessment should take place after a minimum number is performed. The traditionally held required numbers for core procedures were reassessed at the summit, and the resulting consensus opinion is proposed here. Several ways in which these evaluation tools can be disseminated and refined through the creation of a learning collaborative across residency programs is described. The summit group believed that standardization in training will more clearly define the competencies of family medicine maternity care providers and begin to reduce one of the barriers that may discourage family physicians from providing maternity care.

  19. Annals of Nigerian Medicine

    African Journals Online (AJOL)

    The Annals of Nigerian Medicine is an editorially independent publication by the Association of Resident Doctors of the Ahmadu Bello University Teaching hospital Zaria, Nigeria. the journal is multidisciplinary and provides a forum for the dissemination of research finding, reviews, theories and information on all aspects of ...

  20. Jos Journal of Medicine

    African Journals Online (AJOL)

    Jos Journal of Medicine is a peer-reviewed journal and editorially independent publication of the Association of Resident Doctors of Jos University Teaching Hospital. It seeks to provide a forum for the dissemination of research, review articles and information in all aspects of medical sciences among medical professionals ...

  1. Images in medicine

    African Journals Online (AJOL)

    abp

    Pearled papules over tattoo: Molluscum cotagiosum. Ricardo Ruiz-Villaverde1,&, Daniel Sánchez-Cano2. 1Dermatology Unit. Complejo Hospitalario de Jaen, Jaen, Spain, 2Internal Medicine. Hospital Santa Ana, Motril, Granada, Spain. &Corresponding author: Ricardo Ruiz-Villaverde, Dermatology Unit. Complejo ...

  2. Global medicinal chemistry and GPCR conference: interview with Stevan Djuric.

    Science.gov (United States)

    Djuric, Stevan

    2018-04-01

    Stevan Djuric speaks to Benjamin Walden, Commissioning Editor. Stevan Djuric is head of the global Medicinal Chemistry Leadership Team at AbbVie and is also Vice President of the Discovery Chemistry and Technology organization within their Discovery organization and chemistry outsourcing activities. He spoke at the Global-Medicinal-Chemistry and GPCR summit on the imperative to develop chemistry related technology that can reduce cycle time, cost of goods and improve probability of success. To this end, he discussed his efforts in the chemistry technology area with a focus on integrated synthesis-purification bioassay, and flow photochemistry and high temperature chemistry platforms.

  3. IMPLEMENTASI PROGRAM CORPORATE SOCIAL RESPONSIBILITY (CSR USED MOTORCYCLE DEPARTMENT DALAM MENINGKATKAN CITRA PT. SUMMIT OTO FINANCE

    Directory of Open Access Journals (Sweden)

    FERRIANSYAH FIRDAUS

    2016-11-01

    Full Text Available Corporate Social Responsibility (CSR is a program that held by the company as a form of social or environmental responsibility. UMC Dept of PT Summit Oto Finance do the CSR programs to establish good relations with the public and dealers. CSR program is handled by some sections, namely UMC Dept. Head, UMC Staff, Branch Manager and Marketing Head.The purpose of this report is to investigate the preparation, implementation and evaluation of Corporate Social Responsibility (CSR UMC Department to improve the image of PT Summit Oto Finance. The concept of this research is public relations, corporate social responsibility and corporate image. This study used a qualitative approach with case study method. The data obtained by using observation, library research and in-depth interviews of key informants. The results of this study discusses the UMC Dept. CSR program in improving the image of PT Summit Oto Finance are divided into three stages, namely the preparation and planning stages, stages of implementation and evaluation stages. These three stages are carried out by the HO (head office that UMC Dept. Head and Staff and from the branch are Branch Manager and Marketing Head. The conclusion of this report is the CSR program UMC held on July 22, 2014. The three stages are performed optimally for results that have been planned, namely to establish good relations with the community and dealers as well as increasing the image that has been built.   Tanggung Jawab Sosial Perusahaan (CSR adalah program yang diselenggarakan oleh perusahaan sebagai bentuk tanggung jawab sosial atau lingkungan. UMC Dept dari PT Summit Oto Finance melakukan program CSR untuk menjalin hubungan baik dengan masyarakat dan dealer. Program CSR ditangani oleh beberapa bagian, yaitu Kepala Dept UMC, Staf UMC, Branch Manager dan Marketing Head. Tujuan dari laporan ini adalah untuk mengetahui persiapan, pelaksanaan dan evaluasi Tanggung Jawab Sosial Perusahaan UMC untuk memperbaiki

  4. The 'weekend effect' in acute medicine: a protocol for a team-based ethnography of weekend care for medical patients in acute hospital settings.

    Science.gov (United States)

    Tarrant, Carolyn; Sutton, Elizabeth; Angell, Emma; Aldridge, Cassie P; Boyal, Amunpreet; Bion, Julian

    2017-04-05

    It is now well-recognised that patients admitted to hospital on weekends are at higher risk of death than those admitted during weekdays. However, the causes of this 'weekend effect' are poorly understood. Some contend that there is a deficit of medical staff on weekends resulting in poorer quality care, whereas others find that patients admitted to hospital on weekends are sicker and therefore at higher risk of adverse outcomes. Clarifying the causal pathway is clearly important in order to identify effective solutions. In this article we describe an ethnographic approach to evaluating the organisation and delivery of medical care on weekends compared with weekdays, with a specific focus on the role of medical staff as part of National Health Service England's plan to implement 7-day services. We will conduct an ethnographic study of 20 acute hospitals in England between April 2016 and March 2018 as part of the High-intensity Specialist-Led Acute Care project (www.hislac.org). Data will be collected through observations and shadowing, and interviews with staff, in 10 hospitals with higher intensity specialist (consultant) staffing on weekends and 10 with lower intensity specialist staffing. Interviews will be conducted with up to 20 patients sampled from two high-intensity and two low-intensity sites. We will coordinate, compare and contrast observations across our team of ethnographers. Analysis will be both in-depth and cross-cutting, exploring specific features within individual sites and making comparisons between them. We outline how data collection and analysis will be facilitated and organised. The project has received ethics approval from the South West Wales Research Ethics Committee: Reference 13/WA/0372. Informed consent will be obtained for all interview participants. The findings will be disseminated through peer-reviewed publications in high-quality journals and at national and international conferences. © Article author(s) (or their employer

  5. WEST AFRICAN JOURNAL OF MEDICINE

    African Journals Online (AJOL)

    user1

    Departments of *Medicine, University of Benin Teaching Hospital, Benin City, Edo State, †Medicine, College of Health Sciences,. Benue State University, Makurdi, Benue State, Nigeria. *Correspondence: Dr Andrew Edo, PO BOX 10458, Ugbowo, Benin City, Edo State. E-mail: osayumen@yahoo.com. Tel No.

  6. Direct hospital marketing: an idea whose time has come.

    Science.gov (United States)

    Dodson, D C; Dotson, M J; Cussimanio, L

    1990-01-01

    Health care marketing has arrived swiftly and with significant impact upon the hospital scene. From the early days of rejection and suspicion of only a few years ago, it has now taken its place with other hospital management functions. Still, however, hospitals have not yet reached the degree of expertise that exists in other sectors. One of the reasons why hospitals have not fully emerged to the level of marketing expertise as many of their traditional business counterparts is that many of the areas of both the science and art of marketing have not been fully developed. One such area is direct mail marketing. Presented here is an overview of the advantages and functions of hospital direct mail marketing. A variety of examples are given with a more thorough case example being provided by Lee's Summit Community Hospital in Lee's Summit, Missouri. The successful direct mail marketing campaign there should be both an inspiration and a model for success for other hospitals. Space limitations prevent the authors from some of the more exacting details of mail marketing and, of course, successful campaigns do not happen by magic. They take careful planning, strategy, and execution. They also require a coordinated organizational and human effort to be successful. But direct mail marketing does offer a potentially new arena of marketing for most hospitals. The expertise, skill, knowledge, and technology are in place. All that is really needed is the commitment on the part of the hospital leadership.

  7. Nuclear medicine

    International Nuclear Information System (INIS)

    Lentle, B.C.

    1986-01-01

    Several growth areas for nuclear medicine were defined. Among them were: cardiac nuclear medicine, neuro-psychiatric nuclear medicine, and cancer diagnosis through direct tumor imaging. A powerful new tool, Positron Emission Tomography (PET) was lauded as the impetus for new developments in nuclear medicine. The political environment (funding, degree of autonomy) was discussed, as were the economic and scientific environments

  8. The Effect of Medicinal Education on Adherence Taking Warfarin in Acute Coronary Syndrome (ACS and Atrial Fibrilation (AF Patients at PKU Muhammadiyah Yogyakarta Hospital

    Directory of Open Access Journals (Sweden)

    Jastria Pusmarani

    2015-12-01

    Full Text Available In order to improve warfarin medication adherence in patient with Acute Coronary Syndrome (ACS and Atrial Fibrillation (AF, giving education with leaflet administration is one of the solutions. This study was aim to know the impact of pharmacist education with using prepared leaflet on the adherence to warfarin in ACS and AF patients. This study used pre test and post test with control group design. Data were collected prospectively during 8 weeks in June–July 2014 at the ambulatory ACS and AF patients at PKU Muhammadiyah Yogyakarta hospital, Indonesia. Data were collected by medical record and the questionnaire using Morisky Medication Adherence Scale (MMAS. Wilcoxon test was used for statistical analysis. The results shows pre test and post test value in the control group was p=0.194 and pre and post test value in the test group was p=0.058. There was no significant difference (p>0.05 after giving education with leaflet. The education with leaflet had no effect to adherence in warfarin in ACS and AF patients at PKU Muhammadiyah Yogyakarta hospital.

  9. Heart failure - medicines

    Science.gov (United States)

    CHF - medicines; Congestive heart failure - medicines; Cardiomyopathy - medicines; HF - medicines ... You will need to take most of your heart failure medicines every day. Some medicines are taken ...

  10. Landscape preservation under ice? In-situ 10Be and 26Al from summit surfaces along Sognefjord, Norway

    DEFF Research Database (Denmark)

    Andersen, Jane Lund; Egholm, David Lundbek; Knudsen, Mads Faurschou

    then be used to determine the total Quaternary bedrock erosion between the summits. However, the amount of Quaternary erosion of these summit flats remains debated (e.g. Steer, 2012) Here, we present an extensive new dataset of in-situ produced cosmogenic 10Be and 26Al in bedrock and boulders from high...... and flat summits along a 200 km long transect from the coast to the inner parts of Sognefjorden. Our results indicate substantial glacial modification of the summits within the last 50 ka. Close to the coast, at an elevation of around 700 meters, the cosmogenic nuclide signal was reset around the Younger...... et al. Landscape preservation under Fennoscandian ice sheets determined from in situ produced 10 Be and 26 Al. Earth and Planetary Science Letters 201(2), 397-406, 2002. Gjermundsen et al. Minimal erosion of Arctic alpine topography during late Quaternary glaciation. Nature Geoscience 8(10), 789...

  11. The first conference of Signatory States to the UN Global Climate Convention: Results of the Berlin summit conference

    International Nuclear Information System (INIS)

    Ehrmann, M.

    1996-01-01

    The article briefly explains the background of the Berlin summit conference as well as some results, as for instance the ''Berlin mandate'', or agreements concerning organisational structures or procedures like those termed ''joint implementation''. (Orig./CB) [de

  12. Joy Development Properties, LLC, Pleasant Valley, Iowa and Summit Concrete, Inc., LeClaire, Iowa - Clean Water Act Public Notice

    Science.gov (United States)

    The EPA is providing notice of a proposed Administrative Penalty Assessment against Joy Development Properties, LLC and Summit Concrete, Inc., for alleged violations at the companies’ residential construction site known as the Schutter Farms Addition loca

  13. The clinical and integrated management of COPD. An official document of AIMAR (Interdisciplinary Association for Research in Lung Disease), AIPO (Italian Association of Hospital Pulmonologists), SIMER (Italian Society of Respiratory Medicine), SIMG (Italian Society of General Medicine).

    Science.gov (United States)

    Bettoncelli, Germano; Blasi, Francesco; Brusasco, Vito; Centanni, Stefano; Corrado, Antonio; De Benedetto, Fernando; De Michele, Fausto; Di Maria, Giuseppe U; Donner, Claudio F; Falcone, Franco; Mereu, Carlo; Nardini, Stefano; Pasqua, Franco; Polverino, Mario; Rossi, Andrea; Sanguinetti, Claudio M

    2014-01-01

    respond promptly to treatment at home hospital admission should be considered. Patients with "severe" or "very severe" COPD who experience exacerbations should be carried out in respiratory unit, based on the severity of acute respiratory failure. An integrated system is required in the community in order to ensure adequate treatments also outside acute care hospital settings and rehabilitation centers. This article is being simultaneously published in Sarcoidosis Vasc Diffuse Lung Dis 2014, 31(Suppl. 1);3-21.

  14. From the Earth Summit to Rio+20: integration of health and sustainable development.

    Science.gov (United States)

    Haines, Andy; Alleyne, George; Kickbusch, Ilona; Dora, Carlos

    2012-06-09

    In 2012, world leaders will meet at the Rio+20 conference to advance sustainable development--20 years after the Earth Summit that resulted in agreement on important principles but insufficient action. Many of the development goals have not been achieved partly because social (including health), economic, and environmental priorities have not been addressed in an integrated manner. Adverse trends have been reported in many key environmental indicators that have worsened since the Earth Summit. Substantial economic growth has occurred in many regions but nevertheless has not benefited many populations of low income and those that have been marginalised, and has resulted in growing inequities. Variable progress in health has been made, and inequities are persistent. Improved health contributes to development and is underpinned by ecosystem stability and equitable economic progress. Implementation of policies that both improve health and promote sustainable development is urgently needed. Copyright © 2012 Elsevier Ltd. All rights reserved.

  15. Raising the profile of worker safety: highlights of the 2013 North American Agricultural Safety Summit.

    Science.gov (United States)

    Nelson, William J; Heiberger, Scott; Lee, Barbara C

    2014-01-01

    The 2013 North American Agricultural Safety Summit, an unprecedented gathering of industry leaders and safety experts, was held September 25-27 in Minneapolis, MN. Hosted by the industry-led Agricultural Safety and Health Council of America (ASHCA), there were 250 attendees, 82 speakers, 76 abstracts with poster presentations, along with "best practices" videos, genius bars sessions, learning stations, exhibits, breakfast roundtable topics, and receptions. The event was a mix of knowledge, inspiration and networking to enable participants to influence the adoption of safety practices in their home/work settings. Given the agriculture industry's commitment to feed nine billion people, the projected world population by 2050, it is imperative that producers and agribusiness strive to do it safely, humanely and sustainably. Evaluation feedback was very positive, indicating ASHCA's original objectives for the Summit were achieved.

  16. Peran Penting Asia Africa Smart City Summit (AASCS 2015 terhadap Perkembangan Paradiplomasi Kota Bandung

    Directory of Open Access Journals (Sweden)

    Irsyaad Suharyadi

    2016-05-01

    Full Text Available Bandung merupakan salah satu kota yang telah menerapkan  konsep smart city untuk menghadapi berbagai permasalahan kota. Sayangnya, konsep ini masih terkendala pada ketersediaan dana dan teknologi. Oleh karena itu, Ridwan Kamil sebagai kepala pemerintahan kota Bandung melakukan kegiatan paradiplomasi untuk mempromosikan Smart Kota Bandung. Salah satunya, melalui program 'Mercusuar' Asia Afrika Cerdas Kota Summit (AASCS. Kegitan Asia Afrika Cerdas Kota Summit (AASCS ini dihadiri oleh 26 walikota di seluruh Asia dan Afrika, dan delegasi dari 39 negara dan mengeluarkan kesepakatan Bandung Declaration on Smart Cities. Dalam penelitian ini, penulis akan menilai manfaat dan AASCS peran dalam kegiatan paradiplomasi Bandung menggunakan teori paradiplomasi yang dipopulerkan oleh Ivo Duchacek (1990, dan membandingkannya dengan prestasi kota lain, seperti Amsterdam dan Bogota. Hasil penelitian ini menunjukkan bahwa konferensi internasional seperti AASCS mampu meningkatkan secara signifikan popularitas kota, serta kesempatan untuk mengadakan kerjasama lebih lanjut.

  17. Technology for Children With Brain Injury and Motor Disability: Executive Summary From Research Summit IV.

    Science.gov (United States)

    Christy, Jennifer B; Lobo, Michele A; Bjornson, Kristie; Dusing, Stacey C; Field-Fote, Edelle; Gannotti, Mary; Heathcock, Jill C; OʼNeil, Margaret E; Rimmer, James H

    Advances in technology show promise as tools to optimize functional mobility, independence, and participation in infants and children with motor disability due to brain injury. Although technologies are often used in adult rehabilitation, these have not been widely applied to rehabilitation of infants and children. In October 2015, the Academy of Pediatric Physical Therapy sponsored Research Summit IV, "Innovations in Technology for Children With Brain Insults: Maximizing Outcomes." The summit included pediatric physical therapist researchers, experts from other scientific fields, funding agencies, and consumers. Participants identified challenges in implementing technology in pediatric rehabilitation including accessibility, affordability, managing large data sets, and identifying relevant data elements. Participants identified 4 key areas for technology development: to determine (1) thresholds for learning, (2) appropriate transfer to independence, (3) optimal measurement of subtle changes, and (4) how to adapt to growth and changing abilities.

  18. Current research in aging: a report from the 2015 Ageing Summit.

    Science.gov (United States)

    Moyse, Emmanuel; Lahousse, Lies; Krantic, Slavica

    2015-01-01

    Ageing Summit, London, UK, 10-12 February 2015 The Ageing Summit 2015 held on 10-12 February 2015 in London (UK) provided an extensive update to our knowledge of the 'Biology of Ageing' and a forum to discuss the participants' latest research progress. The meeting was subdivided into four thematic sessions: cellular level research including the aging brain; slowing down progression, rejuvenation and self-repair; genetic and epigenetic regulation; and expression and pathology of age-related diseases. Each session included multiple key presentations, three to five short research communications and ongoing poster presentations. The meeting provided an exciting multidisciplinary overview of the aging process from cellular and molecular mechanisms to medico-social aspects of human aging.

  19. Efficient Mobility Summit: Transportation and the Future of Dynamic Mobility Systems

    Energy Technology Data Exchange (ETDEWEB)

    2015-12-01

    On October 27, 2015, The U.S. Department of Energy's National Renewable Energy Laboratory (NREL) brought together local and national thought leaders to discuss the convergence of connectivity, vehicle automation, and transportation infrastructure investments at the Future Energy Efficient Mobility Workshop. The half-day workshop was held in conjunction with the Colorado Department of Transportation's (CDOT) Transportation Matters Summit and featured four panel sessions that showcased perspectives on efficient mobility from federal and state agencies, automakers and their suppliers, transportation data providers, and freight companies. This summary provides highlights from the meeting's exchanges of ideas and existing applications. Transportation's (CDOT) Transportation Matters Summit and featured four panel sessions that showcased perspectives on efficient mobility from federal and state agencies, automakers and their suppliers, transportation data providers, and freight companies. This summary provides highlights from the meeting's exchanges of ideas and existing applications.

  20. On sustainable development problems, also according to the world summit in Johannesburg

    Directory of Open Access Journals (Sweden)

    Gino Moncada lo Giudice

    2002-02-01

    Full Text Available In the intervention at the Environment Commission of the Senate on the problems of the sustainable development, following the recent World Summit in Johannesburg, some fundamental points are underpinned: the question is summed up and an exam is made about the results of the Summit and on the meaning of the commitments taken for the future. Indeed, it is universally accepted that, to be considered sustainable, the development must reach a compromise between economical, social and environmental goals, to maximize the present well-being, without challenging the right of future generations to satisfy their own needs. It is also accepted that this cannot be realised without defence for our eco-system and without a simultaneous and well coordinated intervention of all Countries and the participation of all productive and social categories; probably, this should be the true finality of the so much acclaimed “globalisation”.

  1. El único hotel asociado con summit hotels & resorts en Colombia - Hotel Bogotá Plaza

    Directory of Open Access Journals (Sweden)

    Diana Carolina Rojas

    2008-11-01

    Full Text Available Es importante conocer acerca de la historia del Hotel Bogotá Plaza. Este es el primer hotel del norte de Bogotá. La misión del hotel es permanecer en el corazón de los huéspedes y visitantes, al satisfacer sus deseos con amor, calidez, amabilidad, seguridad y servicio de excelente calidad. Desde 1996 el Bogotá Plaza Hotel ha pertenecido a Summit Hotels & Resorts. Esta es una firma que proporciona al hotel un sistema de reservas por Internet, esta alianza ha generado que el hotel sea reconocido en muchos países del mundo. Summit además se ha establecido como una organización líder en ventas, mercadeo y reservas hoteleras del mundo. Es importante asociarse con compañías destacadas así como lo hizo el Hotel Bogotá Plaza.

  2. Educator Toolkits on Second Victim Syndrome, Mindfulness and Meditation, and Positive Psychology: The 2017 Resident Wellness Consensus Summit

    OpenAIRE

    Jon Smart; Michael Zdradzinski; Sarah Roth; Alecia Gende; Kylie Conroy; Nicole Battaglioli

    2018-01-01

    Introduction: Burnout, depression, and suicidality among residents of all specialties have become a critical focus of attention for the medical education community. Methods: As part of the 2017 Resident Wellness Consensus Summit in Las Vegas, Nevada, resident participants from 31 programs collaborated in the Educator Toolkit workgroup. Over a seven-month period leading up to the summit, this workgroup convened virtually in the Wellness Think Tank, an online resident community, to perform a li...

  3. A Comparative Analysis on the Strategy of Impression Management and Public Diplomacy of Two Indonesian Presidents at APEC CEO Summit

    OpenAIRE

    INDRAYANI, INRI INGGRIT

    2016-01-01

    This research aims to analyze speeches of the former Indonesian President SusiloBambang Yudhoyono (SBY) and the current Indonesia President Joko Widodo(Jokowi) at the APEC CEO Summit. Jokowi gave his speech in Beijing, China in2014, while SBY delivered his speech in Bali in 2013. Both speeches have constructively examined as image management strategies to build an impressionmanagement at the APEC CEO Summit. APEC is one of crucial forum to buildinternational relationships, draw the investment...

  4. NEUMOCISTOSIS EN EL SERVICIO DE MEDICINA INTERNA, COMPLEJO HOSPITALARIO UNIVERSITARIO “DR. LUIS RAZETTI”, BARCELONA, VENEZUELA, 2011-2012 I PNEUMOCYSTOSIS IN THE INTERNAL MEDICINE SERVICE, UNIVERSITY HOSPITAL COMPLEX “DR. LUIS RAZETTI”, BARCELONA, VENEZUELA, 2011-2012

    Directory of Open Access Journals (Sweden)

    Fadi Wahab-El-Fatairi

    2015-07-01

    Full Text Available In Venezuela and in the state Anzoátegui, the pneumocystosis, is little studied. To weigh that it is an infection opportunist caused by Pneumocystis jirovecii, it causes pneumonia of high morbility and mortality. The inmunocompromised patient is those that present bigger risks of acquiring this infection. The objectives of this investigation were to determine the infection frequency for P. jirovecii in patient with breathing symptoms and immunocompromised hospitalized in the Service of Internal Medicine of the Complex Hospital University “Dr. Luis Razetti", and to describe the clinical parameters, of laboratory, radiological and epidemic. To increase the sensibility of the diagnosis etiologic of the pneumocystosis you employment the combination of microscopic methods (Giemsa and direct immunofluorescence technique. 52 samples of spontaneous sputum were studied, which were processed by fluidification -concentration. Results: 8 patients (15.38% they were positive. The most frequent clinical manifestations among the patients with pneumocystosis were the dyspnea (75%, cough (62% and bullous (50% they were the most common signs among those infected, the one infiltrated alveolar (62.5% and the spill pleural (37.5% they prevailed as radiological signs. Was the LDH presented in values 300 UI/L in 5 of the positive patients. Other common discoveries were: moderate anemia and breathing alkalosis. The evaluated epidemic aspects were the gender, occupation, smoking, accumulation and comorbidities, in this last aspect, the diabetes, hypertension and infection for the VIH was opposing comorbidities among these patients. The confirmation of the infection in the state Anzoátegui, demonstrates that in this hospital the agent exists and probably you this underdiagnosticated the pneumocystosis.

  5. Romania's Iliescu to attend World Summit on Information Society organized by UN

    CERN Multimedia

    2003-01-01

    "Romanian President Ion Iliescu will be in Geneva, December 9-11, to attend a world summit on information society, organized by the United Nations Department of Public Information. On this occasion, Iliescu will visit on Tuesday the Geneva-based European Center for Nuclear Research (CERN), where he will meet CERN General Director Luciano Maiani, as well as young Romanian researchers working there and will participate in a scientific session called The Role of Science in the Information Society" (1 page).

  6. Some comments about the situation of the Steel Industry in the Arab Countries (Arab Steel Summit)

    International Nuclear Information System (INIS)

    Haidar, Y.; Astier, J.

    2009-01-01

    The Arab Steel Summit, that convened in Abu Dhabi in April, gave us another opportunity to review the situation of the Arab Iron and Steel Industry, with regard to the present World economic context. We will address: - the World situation of steel production, focusing on the Arab Countries; - the related situation of steel consumption; - the steel trade, including imports, exports and prices; - the consequences for technology and economy. (authors)

  7. Properties of horizontally oriented ice crystals observed by polarization lidar over summit, Greenland

    Directory of Open Access Journals (Sweden)

    Neely Ryan R.

    2018-01-01

    Full Text Available A source of error in microphysical retrievals and model simulations is the assumption that clouds are composed of only randomly oriented ice crystals. This assumption is frequently not true, as evidenced by optical phenomena such as parhelia. Here, observations from the Cloud, Aerosol and Polarization Backscatter Lidar at Summit, Greenland are utilized along with other sensors and beam imaging to examine the properties of horizontally oriented ice crystals and the environment conditions in which they occur.

  8. Travel Daily China Travel Innovation Summit to Be Held in Beijing

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    Guangzhou,China,April 7th- TravelDaily (www.traveldaily.cn), China’s leading online publisher and event organizer with emphasis on trends in the distribution,marketing and technology of the travel and tourism industries,today announced it will partner with PhoCusWright to host the 2009 China Travel Innovation Summit in Beijing from May 12 to 13,2009.

  9. Energy summit Hessen. Implementation concept of the state government Hessen; Hessischer Energiegipfel. Umsetzungskonzept der Hessischen Landesregierung

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-02-15

    By means of the concept under consideration, the state government of Hessen (Federal Republic of Germany) has pursued the possible and realistic course for the implementation of the targets of the energy summit. The main aspects of this contribution are the implementation of the energy policy of Hessen into the European and national framework; Status quo of the energy consumption in Hessen; Areas of action and measures of the state government of Hessen; Actors of the energy policy turnaround; Monitoring.

  10. Emerging hemodynamic signatures of the right heart (Third International Right Heart Failure Summit, part 2)

    OpenAIRE

    Maron, Bradley A.

    2014-01-01

    Abstract Despite the importance of preserved right ventricular structure and function with respect to outcome across the spectrum of lung, cardiac, and pulmonary vascular diseases, only recently have organized efforts developed to consider the pulmonary vascular–right ventricular apparatus as a specific unit within the larger context of cardiopulmonary pathophysiology. The Third International Right Heart Failure Summit (Boston, MA) was a multidisciplinary event dedicated to promoting a dialog...

  11. Blueprint for Action: Visioning Summit on the Future of the Workforce in Pediatrics.

    Science.gov (United States)

    Sectish, Theodore C; Hay, William W; Mahan, John D; Mendoza, Fernando S; Spector, Nancy D; Stanton, Bonita; Szilagyi, Peter G; Turner, Teri L; Walker, Leslie R; Slaw, Kenneth

    2015-07-01

    The Federation of Pediatric Organizations engaged members of the pediatric community in an 18-month process to envision the future of the workforce in pediatrics, culminating in a Visioning Summit on the Future of the Workforce in Pediatrics. This article documents the planning process and methods used. Four working groups were based on the 4 domains that are likely to affect the future workforce: Child Health Research and Training, Diversity and Inclusion, Gender and Generations, and Pediatric Training Along the Continuum. These groups identified the issues and trends and prioritized their recommendations. Before the summit, 5 key megatrends cutting across all domains were identified:1. Aligning Education to the Emerging Health Needs of Children and Families 2. Promoting Future Support for Research Training and for Child Health Research 3. Striving Toward Mastery Within the Profession 4. Aligning and Optimizing Pediatric Practice in a Changing Health Care Delivery System 5. Taking Advantage of the Changing Demographics and Expertise of the Pediatric Workforce At the Visioning Summit, we assembled members of each of the working groups, the Federation of Pediatric Organizations Board of Directors, and several invited guests to discuss the 5 megatrends and develop the vision, solutions, and actions for each megatrend. Based on this discussion, we offer 10 recommendations for the field of pediatrics and its leading organizations to consider taking action. Copyright © 2015 by the American Academy of Pediatrics.

  12. The Toxicology Education Summit: building the future of toxicology through education.

    Science.gov (United States)

    Barchowsky, Aaron; Buckley, Lorrene A; Carlson, Gary P; Fitsanakis, Vanessa A; Ford, Sue M; Genter, Mary Beth; Germolec, Dori R; Leavens, Teresa L; Lehman-McKeeman, Lois D; Safe, Stephen H; Sulentic, Courtney E W; Eidemiller, Betty J

    2012-06-01

    Toxicology and careers in toxicology, as well as many other scientific disciplines, are undergoing rapid and dramatic changes as new discoveries, technologies, and hazards advance at a blinding rate. There are new and ever increasing demands on toxicologists to keep pace with expanding global economies, highly fluid policy debates, and increasingly complex global threats to public health. These demands must be met with new paradigms for multidisciplinary, technologically complex, and collaborative approaches that require advanced and continuing education in toxicology and associated disciplines. This requires paradigm shifts in educational programs that support recruitment, development, and training of the modern toxicologist, as well as continued education and retraining of the midcareer professional to keep pace and sustain careers in industry, government, and academia. The Society of Toxicology convened the Toxicology Educational Summit to discuss the state of toxicology education and to strategically address educational needs and the sustained advancement of toxicology as a profession. The Summit focused on core issues of: building for the future of toxicology through educational programs; defining education and training needs; developing the "Total Toxicologist"; continued training and retraining toxicologists to sustain their careers; and, finally, supporting toxicology education and professional development. This report summarizes the outcomes of the Summit, presents examples of successful programs that advance toxicology education, and concludes with strategies that will insure the future of toxicology through advanced educational initiatives.

  13. Pedaling into high gear for bicycle policy in Canada : lessons from bike summit 2008 in Toronto

    International Nuclear Information System (INIS)

    2008-01-01

    The 2008 bike summit provided a forum for the discussion of international and Canadian best practices related to bicycles and bicycling policy. The aim of the summit was to assist communities across Canada to improve conditions for cycling in the urban environment and help to generate a cultural shift towards greater acceptance of cycling on roads. This paper discussed lessons learned during the summit and outlined new methods of improving cycling in communities. The City of London has recently increased the amount of cyclists using its roads by 200 per cent. Cycling infrastructure is more affordable than constructing major public transit or road infrastructure. Savings in healthcare costs will be accrued over time as a result of the healthier lifestyles promoted by regular cycling activity. Bicycle trips can help to alleviate over-demand on heavy transit routes. Encouraging commuters to cycle will also reduce the amounts of greenhouse gases (GHGs) emitted in urban areas. Lane width reductions will help to reduce speeds as drivers are forced to pay more attention when driving. Public bike sharing programs and bike stations are now being used in many North American cities. It was concluded that strong advocacy is needed to ensure the growth and acceptance of cycling in urban centres. 23 figs

  14. Customer Satisfaction Among the Members of the Summit Point Golf and Country Club

    Directory of Open Access Journals (Sweden)

    VERONICA JOY V. BENCITO

    2014-04-01

    Full Text Available This study focused on the customer satisfaction among the members of the Summit Point Golf and Country Club which served as the basis for continuous improvement. It determined the level of customer satisfaction on the services offered by the Summit Point employees in terms of food and beverages, customer service and facilities. Lastly, it also tested the significant differences on the level of customer satisfactions when grouped according to their membership variables of the club. The descriptive type of research was used to assess the operation of the club. Data gathered were analyzed using the weighted mean and ANOVA method. The members of the Summit Point Golf and Country Club are generally satisfied in terms of facilities and amenities, food and beverages and customer service. The hypothesis has no significant difference between the membership profile and level of customer satisfaction in terms of facilities and amenities and customer service is rejected. This means that their responses differ as to their reasons of joining the club, their obtained degree and the frequency of playing in the club.

  15. Summit on Improving the Economics of America's Nuclear Power Plants

    Energy Technology Data Exchange (ETDEWEB)

    Collins, John [Idaho National Lab. (INL), Idaho Falls, ID (United States); Mason, Charles [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2016-09-01

    The Summit on Improving the Economics of America’s Nuclear Power Plants was convened May 19, 2016, by Secretary of Energy Ernest Moniz and co-sponsored by Idaho Senator Mike Crapo to stress the importance of existing nuclear reactors in meet