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.

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

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

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

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.

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

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.

[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.

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.

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.

[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.

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.

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

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...

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…

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

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

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

[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.

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. �

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. 

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.

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. 

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

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)

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...

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.

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.

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.

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

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

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.

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.

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.

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,…

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

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?

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.

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.

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

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.

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...

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.

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.

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.

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...

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

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.)

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.

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.

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

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

[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.

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...

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....

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

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

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.

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.

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.

National Tribal Building Codes Summit

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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.

[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.

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.

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

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.

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...

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.

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.)

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.

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

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.

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.

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.

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.

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

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

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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

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

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…

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.

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...

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.

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

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

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...

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.

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.

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.

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.

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.

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.

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.

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...

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.

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.

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.

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…

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...

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.

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…

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.

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.

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

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

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.

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.

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.

[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.

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...

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.

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.

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.

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.

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.

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.

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.

Accordant summit heights, summit levels and the origin of the ``upper denudation level'' in the Serra do Mar (SE-Brazil, São Paulo): A study of hillslope forms and processes

Science.gov (United States)

Römer, Wolfgang

2008-08-01

In southern São Paulo the Serra do Mar is characterized by three distinct terrain types: 1) highly dissected areas with closely spaced ridges and accordant summit heights; 2) multiconvex hills; and 3) terrains with highly elevated watershed areas, irregular summit heights, and locally subdued relief. The development of this landscape is considered to be the result of the Cenozoic block-faulting and of the influences that are exerted by the differing lithological and structural setting of block-faulted compartments on weathering and erosion processes. In areas characterized by pronounced accordant summits the close coincidence between hillslope angle and the angle of limiting stability against landsliding points to a close adjustment of hillslope gradients and the mechanical properties of the regolith. The relative height of the hillslopes is functionally related to the spacing of the valleys and the gradient of the hillslopes. In areas with a regular spacing of v-shaped valleys and uniform rocks, this leads to the intersection of valley-side slopes in summits and ridges at a certain elevation. This elevation is determined by the length and steepness of the valley-side slopes. Therefore, the heights of the summits are geometrically constrained and are likely to indicate the upper limit of summit heights or an "upper denudation level" that is adjusted by hillslope processes to the incising streams. Accordant summit heights of this type are poor indicators of formerly more extensive denudation surfaces as it is also likely that they are a result of the long-term adjustment of hillslopes to river incision. The steep mountain flanks of block-faulted compartments on the other hand, comprise regolith-covered hillslopes that are closely adjusted to the maximum stable gradient as well as rock-slopes that are controlled by the rock-mass strength. Their summits are usually not accommodated into uniform summit levels. Highly elevated watershed areas exhibiting a subdued

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.

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

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

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.

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

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.

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®

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

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.

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.

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....

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...

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.

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

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).

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.

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.

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.

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.

[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.

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.

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.

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...

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.

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.

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.)

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.

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.

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.

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

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.

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.

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.)

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.

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.

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.

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.

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

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...

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.

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

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...

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

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

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...

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.

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.

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

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.

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

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

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

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...

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 ...

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 ...

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.

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

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

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.

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...

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.)

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.

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.

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.

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

The appeasement effect of a United Nations climate summit on the German public

Science.gov (United States)

Brüggemann, Michael; de Silva-Schmidt, Fenja; Hoppe, Imke; Arlt, Dorothee; Schmitt, Josephine B.

2017-11-01

The annual UN climate summits receive intense global media coverage, and as such could engage local publics around the world, stimulate debate and knowledge about climate politics, and, ultimately, mobilize people to combat climate change. Here we show that, in contrast to these hopes, although the German public were exposed to news about the 2015 Paris summit, they did not engage with it in a more active way. Comparing knowledge and attitudes before, during and after the summit using a three-wave online panel survey (quota sample, N = 1,121), we find that respondents learnt a few basic facts about the conference but they continue to lack basic background knowledge about climate policy. Trust in global climate policy increased a little, but citizens were less inclined to support a leading role for Germany in climate politics. Moreover, they were not more likely to engage personally in climate protection. These results suggest that this global media event had a modest appeasing rather than mobilizing effect.

[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.

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.

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.

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

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

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...

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

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.

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

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...

Two magma bodies beneath the summit of Kilauea Volcano unveiled by isotopically distinct melt deliveries from the mantle

Science.gov (United States)

Pietruszka, Aaron J.; Heaton, Daniel E.; Marske, Jared P.; Garcia, Michael O.

2015-01-01

The summit magma storage reservoir of Kīlauea Volcano is one of the most important components of the magmatic plumbing system of this frequently active basaltic shield-building volcano. Here we use new high-precision Pb isotopic analyses of Kīlauea summit lavas—from 1959 to the active Halema‘uma‘u lava lake—to infer the number, size, and interconnectedness of magma bodies within the volcano's summit reservoir. From 1971 to 1982, the 206Pb/204Pb ratios of the lavas define two separate magma mixing trends that correlate with differences in vent location and/or pre-eruptive magma temperature. These relationships, which contrast with a single magma mixing trend for lavas from 1959 to 1968, indicate that Kīlauea summit eruptions since at least 1971 were supplied from two distinct magma bodies. The locations of these magma bodies are inferred to coincide with two major deformation centers identified by geodetic monitoring of the volcano's summit region: (1) the main locus of the summit reservoir ∼2–4 km below the southern rim of Kīlauea Caldera and (2) a shallower magma body 4 km3 of lava erupted), must therefore be sustained by a nearly continuous supply of new melt from the mantle. The model results show that a minimum of four compositionally distinct, mantle-derived magma batches were delivered to the volcano (at least three directly to the summit reservoir) since 1959. These melt inputs correlate with the initiation of energetic (1959 Kīlauea Iki) and/or sustained (1969–1974 Mauna Ulu, 1983-present Pu‘u ‘Ō‘ō and 2008-present Halema‘uma‘u) eruptions. Thus, Kīlauea's eruptive behavior is partly tied to the delivery of new magma batches from the volcano's source region within the Hawaiian mantle plume.

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 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.

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.

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...

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.

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.

Ground Tilt Time Delays between Kilauea Volcano's Summit and East Rift Zone Caused by Magma Reservoir Buffering

Science.gov (United States)

Haney, M. M.; Patrick, M. R.; Anderson, K. R.

2016-12-01

A cyclic pattern of ground deformation, called a deflation-inflation (DI) cycle, is commonly observed at Kilauea Volcano, Hawai`i. These cycles are an important part of Kilauea's eruptive activity because they directly influence the level of the summit lava lake as well as the effusion rate (and resulting lava flow hazard) at the East Rift Zone eruption site at Pu`u `O`o. DI events normally span several days, and are measured both at the summit and at Pu`u `O`o cone (20 km distance). Signals appear first at the summit and are then observed at Pu`u `O`o after an apparent delay of between 0.5 and 10 hours, which has been previously interpreted as reflecting magma transport time. We propose an alternate explanation, in which the apparent delay is an artifact of buffering by the small magma reservoir thought to exist at Pu`u `O`o. Simple Poiseuille flow modeling demonstrates that this apparent delay can be reproduced by the changing balance of inflow (from the summit) and outflow (to surface lava flows) at the Pu`u `O`o magma reservoir. The apparent delay is sensitive to the geometry of the conduit leaving Pu`u `O`o, feeding surface lava flows. We demonstrate how the reservoir buffering is quantitatively equivalent to a causal low-pass filter, which explains both the apparent delay as well as the smoothed, skewed nature of the signal at Pu`u `O`o relative to the summit. By comparing summit and Pu`u `O`o ground tilt signals over an extended time period, it may be possible to constrain the changing geometry of the shallow magmatic system through time.

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.

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.

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 (NO_x) 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.

Longpath DOAS observations of surface BrO at Summit, Greenland

Directory of Open Access Journals (Sweden)

J. Stutz

2011-09-01

Full Text Available Reactive halogens, and in particular bromine oxide (BrO, have frequently been observed in regions with large halide reservoirs, for example during bromine catalyzed coastal polar ozone depletion events. Much less is known about the presence and impact of reactive halogens in areas without obvious halide reservoirs, such as the polar ice sheets or continental snow.

We report the first LP-DOAS measurements of BrO at Summit research station in the center of the Greenland ice sheet at an altitude of 3200 m. BrO mixing ratios in May 2007 and June 2008 were typically between 1–3 pmol mol⁻¹, with maxima of up to 5 pmol mol⁻¹. These measurements unequivocally show that halogen chemistry is occurring in the remote Arctic, far from known bromine reservoirs, such as the ocean. During periods when FLEXPART retroplumes show that airmasses resided on the Greenland ice sheet for 3 or more days, BrO exhibits a clear diurnal variation, with peak mixing ratios of up to 3 pmol mol⁻¹ in the morning and at night. The diurnal cycle of BrO can be explained by a changing boundary layer height combined with photochemical formation of reactive bromine driven by solar radiation at the snow surface. The shallow stable boundary layer in the morning and night leads to an accumulation of BrO at the surface, leading to elevated BrO despite the expected smaller release from the snowpack during these times of low solar radiation. During the day when photolytic formation of reactive bromine is expected to be highest, efficient mixing into a deeper neutral boundary layer leads to lower BrO mixing ratios than during mornings and nights.

The extended period of contact with the Greenland snowpack combined with the diurnal profile of BrO, modulated by boundary layer height, suggests that photochemistry in the snow is a significant source of BrO measured at Summit during the 2008 experiment. In addition, a rapid transport event

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.

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

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.

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.

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.

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

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.

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

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.

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.

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.

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

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

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

Lava lake activity at the summit of Kīlauea Volcano in 2016

Science.gov (United States)

Patrick, Matthew R.; Orr, Tim R.; Swanson, Donald A.; Elias, Tamar; Shiro, Brian

2018-04-10

The ongoing summit eruption at Kīlauea Volcano, Hawai‘i, began in March 2008 with the formation of the Overlook crater, within Halema‘uma‘u Crater. As of late 2016, the Overlook crater contained a large, persistently active lava lake (250 × 190 meters). The accessibility of the lake allows frequent direct observations, and a robust geophysical monitoring network closely tracks subtle changes at the summit. These conditions present one of the best opportunities worldwide for understanding persistent lava lake behavior and the geophysical signals associated with open-vent basaltic eruptions. In this report, we provide a descriptive and visual summary of lava lake activity during 2016, a year consisting of continuous lava lake activity. The lake surface was composed of large black crustal plates separated by narrow incandescent spreading zones. The dominant motion of the surface was normally from north to south, but spattering produced transient disruptions to this steady motion. Spattering in the lake was common, consisting of one or more sites on the lake margin. The Overlook crater was continuously modified by the deposition of spatter (often as a thin veneer) on the crater walls, with frequent collapses of this adhered lava into the lake. Larger collapses, involving lithic material from the crater walls, triggered several small explosive events that deposited bombs and lapilli around the Halema‘uma‘u Crater rim, but these did not threaten public areas. The lava lake level varied over several tens of meters, controlled primarily by changes in summit magma reservoir pressure (in part driven by magma supply rates) and secondarily by fluctuations in spattering and gas release from the lake (commonly involving gas pistoning). The lake emitted a persistent gas plume, normally averaging 1,000–8,000 metric tons per day (t/d) of sulfur dioxide (SO2), as well as a constant fallout of small juvenile and lithic particles, including Pele’s hair and tears. The

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.

Hospital pharmacy services in teaching hospitals in Nepal: Challenges and the way forward

Directory of Open Access Journals (Sweden)

P Ravi Shankar

2016-01-01

Full Text Available In Nepal, a developing country in South Asia, hospital pharmacies in teaching hospitals faces a number of challenges. Design and location of the pharmacy is inadequate, the pharmacy is often rented out to private parties, there may be a lack of separation of outpatient and inpatient pharmacy services, medicines are not selected based on objective criteria, too many brands are stocked, pharmaceutical care services are not provided, and pharmaceutical promotion is not regulated within the hospital premises. Furthermore, there is often a lack of pharmacy management software to help dispensing, continuing pharmacy education is not provided, medicines are not compounded or packaged in house, there are problems with medicines availability and medicine quality, and drug utilization studies are not linked with initiatives to promote the rational use of medicines. In this article, the authors examine these challenges and put forward possible solutions.

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...

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.

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

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.

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 ...

Medicinal ethnobotany in Huacareta (Chuquisaca, Bolivia).

Science.gov (United States)

Quiroga, Rodrigo; Meneses, Lidia; Bussmann, Rainer W

2012-08-02

The aim of this study was to document the types of diseases treated by the use of medicinal plants, their main applications and also to have a report of the major diseases treated at the Hospital of San Pablo de Huacareta (Chuquisaca Bolivia). We conducted semi-structured interviews on the use medicinal plants with 10 local informants, and categorized the kinds of diseases treated by traditional medicine. We obtained reports of cases treated at the Hospital of Huacareta in order to compare the use frequency of traditional medicine and allopathic medicine for the treatment of recurrent diseases in the area. Our survey identified 258 traditional medicine uses, spanning a total of 13 diseases categories and including 91 native and exotic plant species and one unidentified sample plant type. Gastrointestinal disorders (55%) were most frequently treated with medicinal plants, followed by afflictions of the musculoskeletal system (25%) and dermatological disorders (24%). Hospital information indicates that the most common diseases are acute respiratory infections (47%) and acute diarrheal diseases (37%). The herbal remedies were mostly used in the form of teas and decoctions. The informants used mainly native plant species, although exotic species has been introduced to the pharmacopoeia. The treatment of gastrointestinal disorders is the primary objective of the medical ethnobotany of the inhabitants of Huacareta, while respiratory system diseases are mostly treated in the hospital. Looking at the data from the Hospital records we can infer that gastrointestinal disorders are among the most common diseases in the study area. For most respondents, traditional medicine is a reliable choice for the care of their illnesses. However, the preference of the population for either traditional medicine or allopathic medicine needs to be clarified in future comparative studies to obtain more convincing results. The results presented can be used as a base for subsequent work

Resource allocation on the frontlines of public health preparedness and response: report of a summit on legal and ethical issues.

Science.gov (United States)

Barnett, Daniel J; Taylor, Holly A; Hodge, James G; Links, Jonathan M

2009-01-01

In the face of all-hazards preparedness challenges, local and state health department personnel have to date lacked a discrete set of legally and ethically informed public health principles to guide the distribution of scarce resources in crisis settings. To help address this gap, we convened a Summit of academic and practice experts to develop a set of principles for legally and ethically sound public health resource triage decision-making in emergencies. The invitation-only Summit, held in Washington, D.C., on June 29, 2006, assembled 20 experts from a combination of academic institutions and nonacademic leadership, policy, and practice settings. The Summit featured a tabletop exercise designed to highlight resource scarcity challenges in a public health infectious disease emergency. This exercise served as a springboard for Summit participants' subsequent identification of 10 public health emergency resource allocation principles through an iterative process. The final product of the Summit was a set of 10 principles to guide allocation decisions involving scarce resources in public health emergencies. The principles are grouped into three categories: obligations to community; balancing personal autonomy and community well-being/benefit; and good preparedness practice. The 10 Summit-derived principles represent an attempt to link law, ethics, and real-world public health emergency resource allocation practices, and can serve as a useful starting framework to guide further systematic approaches and future research on addressing public health resource scarcity in an all-hazards context.

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.

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.

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...

Sub-surface structures and collapse mechanisms of summit pit craters

Science.gov (United States)

Roche, O.; van Wyk de Vries, B.; Druitt, T. H.

2001-01-01

Summit pit craters are found in many types of volcanoes and are generally thought to be the product of collapse into an underpressured reservoir caused by magma withdrawal. We investigate the mechanisms and structures associated with summit pit crater formation by scaled analogue experiments and make comparisons with natural examples. Models use a sand plaster mixture as analogue rock over a cylinder of silicone simulating an underpressured magma reservoir. Experiments are carried out using different roof aspect ratios (roof thickness/roof width) of 0.2-2. They reveal two basic collapse mechanisms, dependant on the roof aspect ratio. One occurs at low aspect ratios (≤1), as illustrated by aspect ratios of 0.2 and 1. Outward dipping reverse faults initiated at the silicone margins propagates through the entire roof thickness and cause subsidence of a coherent block. Collapse along the reverse faults is accommodated by marginal flexure of the block and tension fractures at the surface (aspect ratio of 0.2) or by the creation of inward dipping normal faults delimiting a terrace (aspect ratio of 1). At an aspect ratio of 1, overhanging pit walls are the surface expressions of the reverse faults. Experiments at high aspect ratio (>1.2) reveal a second mechanism. In this case, collapse occurs by stopping, which propagates upwards by a complex pattern of both reverse faults and tension fractures. The initial underground collapse is restricted to a zone above the reservoir and creates a cavity with a stable roof above it. An intermediate mechanism occurs at aspect ratios of 1.1-1.2. In this case, stopping leads to the formation of a cavity with a thin and unstable roof, which collapses suddenly. The newly formed depression then exhibits overhanging walls. Surface morphology and structure of natural examples, such as the summit pit craters at Masaya Volcano, Nicaragua, have many of the features created in the models, indicating that the internal structural geometry of

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.

Annual report of the Summit Members' Working Group on Controlled Thermonuclear Fusion (Fusin Working Group (FWG))

Energy Technology Data Exchange (ETDEWEB)

none,

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.

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)

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

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

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

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.

Improving Health, Social Welfare, and Human Development Through Women's Empowerment in Developing Countries: The 2016 Girl Up Leadership Summit, Washington, DC, USA.

Science.gov (United States)

Mendoza, Janel

2016-01-01

The United Nations Foundation's Girl Up campaign, an initiative dedicated to promoting the health, education, and leadership of adolescent girls in developing communities around the world, hosted its annual Girl Up Leadership Summit in Washington, DC from July 11-13, 2016. The summit welcomed more than 275 girl empowerment and women empowerment proponents to take part in leadership training, listen to and learn from influential figures like United Nations Deputy High Commissioner for Human Rights Kate Gilmore and Treasurer of the United States Rosie Rios, as well as engage in an official lobby day in the nation's capital. Topics discussed at the summit ranged from the issue of child marriage and sexual and reproductive health rights to intersectional feminism and the importance of the next generation of global girl advocates. The purpose and, later on, achievement of the conference was the development of such leaders and Girl Up representatives. Summit attendee and Girl Up Campus Leader Janel Mendoza shares her experience as a longstanding Girl Up supporter and reflects on the preeminent conversations held during and following the summit.

Principle and geomorphological applicability of summit level and base level technique using Aster Gdem satellite-derived data and the original software Baz

Directory of Open Access Journals (Sweden)

Akihisa Motoki

2015-05-01

Full Text Available This article presents principle and geomorphological applicability of summit level technique using Aster Gdem satellite-derived topographicdata. Summit level corresponds to thevirtualtopographic surface constituted bylocalhighest points, such as peaks and plateau tops, and reconstitutes palaeo-geomorphology before the drainage erosion. Summit level map is efficient for reconstitution of palaeo-surfaces and detection of active tectonic movement. Base level is thevirtualsurface composed oflocallowest points, as valley bottoms. The difference between summit level and base level is called relief amount. Thesevirtualmapsareconstructed by theoriginalsoftwareBaz. Themacroconcavity index, MCI, is calculated from summit level and relief amount maps. The volume-normalised three-dimensional concavity index, TCI, is calculated from hypsometric diagram. The massifs with high erosive resistance tend to have convex general form and low MCI and TCI. Those with low resistance have concave form and high MCI and TCI. The diagram of TCI vs. MCI permits to distinguish erosive characteristics of massifs according to their constituent rocks. The base level map for ocean bottom detects the basement tectonic uplift which occurred before the formation of the volcanic seamounts.

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

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

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 ...

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.

Evaluation of radiation protection in some nuclear medicine department

International Nuclear Information System (INIS)

Abdelrahim, Yassir Mohammed

2015-12-01

This study was carryout to evaluate the radiation protection in nuclear medicine department in Sudan, accordance with the standards international recommendation and code of practice for radiation protection in nuclear medicine, the evaluation was done for three nuclear medicine departments, included direct measurement of dose rate and the contamination level in some areas, were radiation sources, radiation workers and public are involved. The data was collected and analyzed from the results for three nuclear medicine departments that the average reading of ambient dose rate in : outside the door of imaging room (SPECT) 0.18μSv/h in hospital (1)& and 0.19μSv/h in hospital(2) and 0.19μSv/h hospital(3), inside control of imaging room (SPECT) 27.8μSv/h in hospital(1)& 0.14μSv/h in hospital(2)& 14μSv/h in hospital(3), inside the injection room 28.81μSv/h in hospital(1), 0.36μSv/h in hpspital(2), 0.06μSv/h in hospital(3) outside the door of lap, 0.65μSv/h in hospital(1), 0.13μSv/h in hospital(2) & 0.12μSv/h in hospital(3), inside the hot lap, 9.68μSv/h in hospital(1) & 0.30μSv/h in hospital(2) & 0.85 μSv/h in hospital(3), in outsidee the door of waiting room of injected patient 1.41μSv/h in hospital(1)& 0.16μSv/h in hospital(2) & 1.08μSv/h in hospital(3). Avaerge reading of contamination in: Floor of hot lap 44.50 B/cm"2 hospital(1) & 4.42B/cm"2in hospital(2) & 6.22 B/cm"2 in hospital (3) . on the bench tap 186.30 B/cm"2 hospital(1), 19.91 B/cm"2 in hospital(2) & 8.77B/cm"2 in hospital(3) floor of injection room 12.60 B/cm"2 in hospital(1) & 11.70 B/cm"2 in hospital(2) & 13.73 B/cm"2 hospital(3) & table of injection room 13.00 B/cm"2 in hospital(1)& 11.70 B/cm"2in hospital(2)& 13.73 B/cm"2 in hospital & tble of injection room 13.00 B/cm"2 in hospital(1) & 20.40 B/cm"2 in hospital(2) & 23.23 B/cm"2 B/cm"2 in hospital(3) on the shield of working surface 144.30 B/cm in hospital(1)& 47.00 B/cm"2 in hospital(2) & 52.33 B/cm"2 in hospital(3) , and makes check

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…

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.

[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.

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

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 ...

ACADEMIC TRAINING Physics Technologies in Medicine

CERN Multimedia

Françoise Benz

2002-01-01

10, 11, 12, 13, 14 June LECTURE SERIES from 11.00 to 12.00 hrs - Auditorium, bldg. 500 Physics Technologies in Medicine by G. K. Von Schulthess / Univ. of Z rich, S. Wildermuth, A. Buck / Univ. Hospital Z rich, K. Jäger / Univ. Hospital Basel, R. Kreis / Univ. Hospital Bern Modern medicine is a large consumer of physics technologies. The series of lectures covers medical imaging starting with an overview and the history of medical imaging. Then follows four lectures covering x-ray imaging positron emission tomography imaging blood flow by ultrasound magnetic resonance Monday 10 June 100 Years of Medical Imaging Pr. Gustav K. von Schulthess MD, PhD / University of Zurich History and overview of Medical Imaging Tuesday 11 June X-rays: still going strong Dr. Simon Wildermuth / MD, University Hospital Zurich Multidetector computed tomography: New developments and applications Wednesday 12 June Nuclear Medicine: PET Positron Emission Tomography Dr. Alfred Buck / MD, MSc, University Hospital Zurich Elucidati...

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.

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.

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.

Geologic map of Medicine Lake volcano, northern California

Science.gov (United States)

Donnelly-Nolan, Julie M.

2011-01-01

Medicine Lake volcano forms a broad, seemingly nondescript highland, as viewed from any angle on the ground. Seen from an airplane, however, treeless lava flows are scattered across the surface of this potentially active volcanic edifice. Lavas of Medicine Lake volcano, which range in composition from basalt through rhyolite, cover more than 2,000 km2 east of the main axis of the Cascade Range in northern California. Across the Cascade Range axis to the west-southwest is Mount Shasta, its towering volcanic neighbor, whose stratocone shape contrasts with the broad shield shape of Medicine Lake volcano. Hidden in the center of Medicine Lake volcano is a 7 km by 12 km summit caldera in which nestles its namesake, Medicine Lake. The flanks of Medicine Lake volcano, which are dotted with cinder cones, slope gently upward to the caldera rim, which reaches an elevation of nearly 8,000 ft (2,440 m). The maximum extent of lavas from this half-million-year-old volcano is about 80 km north-south by 45 km east-west. In postglacial time, 17 eruptions have added approximately 7.5 km3 to its total estimated volume of 600 km3, and it is considered to be the largest by volume among volcanoes of the Cascades arc. The volcano has erupted nine times in the past 5,200 years, a rate more frequent than has been documented at all other Cascades arc volcanoes except Mount St. Helens.

Improving Health, Social Welfare, and Human Development Through Women’s Empowerment in Developing Countries: The 2016 Girl Up Leadership Summit, Washington, DC, USA

Science.gov (United States)

Mendoza, Janel

2016-01-01

The United Nations Foundation’s Girl Up campaign, an initiative dedicated to promoting the health, education, and leadership of adolescent girls in developing communities around the world, hosted its annual Girl Up Leadership Summit in Washington, DC from July 11-13, 2016. The summit welcomed more than 275 girl empowerment and women empowerment proponents to take part in leadership training, listen to and learn from influential figures like United Nations Deputy High Commissioner for Human Rights Kate Gilmore and Treasurer of the United States Rosie Rios, as well as engage in an official lobby day in the nation’s capital. Topics discussed at the summit ranged from the issue of child marriage and sexual and reproductive health rights to intersectional feminism and the importance of the next generation of global girl advocates. The purpose and, later on, achievement of the conference was the development of such leaders and Girl Up representatives. Summit attendee and Girl Up Campus Leader Janel Mendoza shares her experience as a longstanding Girl Up supporter and reflects on the preeminent conversations held during and following the summit. PMID:28058195

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…

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

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”.

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...

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'

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.

Summit CO2 emission rates by the CO2/SO2 ratio method at Kīlauea Volcano, Hawaiʻi, during a period of sustained inflation

Science.gov (United States)

Hager, S.A.; Gerlach, T.M.; Wallace, P.J.

2008-01-01

The emission rate of carbon dioxide escaping from the summit of Kīlauea Volcano, Hawaiʻi, proved highly variable, averaging 4900 ± 2000 metric tons per day (t/d) in June–July 2003 during a period of summit inflation. These results were obtained by combining over 90 measurements of COSPEC-derived SO2emission rates with synchronous CO2/SO2 ratios of the volcanic gas plume along the summit COSPEC traverse. The results are lower than the CO2 emission rate of 8500 ± 300 t/d measured by the same method in 1995–1999 during a period of long-term summit deflation [Gerlach, T.M., McGee, K.A., Elias, T., Sutton, A.J. and Doukas, M.P., 2002. Carbon dioxide emission rate of Kīlauea Volcano: Implications for primary magma and the summit reservoir. Journal of Geophysical Research-Solid Earth, 107(B9): art. no.-2189.]. Analysis of the data indicates that the emission rates of the present study likely reflect changes in the magma supply rate and residence time in the summit reservoir. It is also likely that emission rates during the inflation period were heavily influenced by SO2 pulses emitted adjacent to the COSPEC traverse, which biased CO2/SO2 ratios towards low values that may be unrepresentative of the global summit gas plume. We conclude that the SO2 pulses are consequences of summit re-inflation under way since 2003 and that CO2 emission rates remain comparable to, but more variable than, those measured prior to re-inflation.

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.

ACADEMIC TRAINING: Physics Technologies in Medicine

CERN Multimedia

Françoise Benz

2002-01-01

10, 11, 12, 13, 14 June LECTURE SERIES from 11.00 to 12.00 hrs - Auditorium, bldg. 500 Physics Technologies in Medicine by G. K. Von Schulthess / Univ. of Zürich, S. Wildermuth, A. Buck / Univ. Hospital Zürich, K. Jäger / Univ. Hospital Basel, R. Kreis / Univ. Hospital Bern Modern medicine is a large consumer of physics technologies. The series of lectures covers medical imaging starting with an overview and the history of medical imaging. Then follows four lectures covering x-ray imaging positron emission tomography imaging blood flow by ultrasound magnetic resonance Monday 10 June 100 Years of Medical Imaging Pr. Gustav K. von Schulthess MD, PhD / University of Zurich History and overview of Medical Imaging Tuesday 11 June X-rays: still going strong Dr. Simon Wildermuth / MD, University Hospital Zurich Multidetector computed tomography: New developments and applications Wednesday 12 June Nuclear Medicine: PET Positron Emission Tomography Dr. Alfred Buck / MD, MSc, University...

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.

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.)

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

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.

Nuclear medicine in Ghana

International Nuclear Information System (INIS)

Affram, R.K.; Kyere, K.; Amuasi, J.

1991-01-01

The background to the introduction and application of radioisotopes in medicine culminating in the establishment of the nuclear Medicine Unit at the Korle Bu Teaching Hospital, Ghana, has been examined. The Unit has been involved in important clinical researches since early 1970s but routine application in patient management has not always been possible because of cost per test and lack of continuous availability of convertible currency for the purchase of radioisotopes which are not presently produced by the National Nuclear Research Institute at Kwabenya. The capabilities and potentials of the Unit are highlighted and a comparison of Nuclear Medicine techniques to other medical diagnostic and imaging methods have been made. There is no organised instruction in the principles of medical imaging and diagnostic methods at both undergraduate and postgraduate levels in Korle Bu Teaching Hospital which has not promoted the use of Nuclear Medicine techniques. The development of a comprehensive medical diagnostic and imaging services is urgently needed. (author). 18 refs., 3 tabs

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

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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.

Evaluation of radiation protection in nuclear medicine diagnostic procedures

International Nuclear Information System (INIS)

Mohammed, Ezzeldien Mohammed Nour

2013-05-01

This study conducted to evaluate the radiation protection in nuclear medicine diagnostic procedures in four nuclear medicine departments in Sudan. The evaluated procedures followed in these departments were in accordance with the standards, International Recommendations and code of practice for radiation protection in nuclear medicine. The evolution included the optimum design for diagnostic nuclear medicine departments, dealing with radioactive sources, quality assurance and quality control, training and responsibilities for radiation worker taking into account economic factors in Sudan. Evaluation of radiation protection procedures in diagnostic investigations was carried out by taken direct measurements of dose rate and the contamination level in some areas where radiation sources, radiation workers and public are involved. Designated questionnaires covered thirteen areas of radiation protection based on inspection check list for nuclear medicine prepared by the International Atomic Energy Agency (IAEA) and American Association of Physicist in Medicine (AAPM) were used in the evaluation. This questionnaire has been Filled by Radiation Protection Officer (RPO), nuclear medicine technologist, nuclear medicine specialist in the nuclear medicine departments. Four hospitals, two governmental hospital and two private hospitals, have been assisted, the assessment shows that although the diagnostic nuclear medicine department in Sudan are not applying a fully safety and radiation protection procedures, but the level of radiation dose and the contamination level were found within acceptable limits. The private hospital D scored the higher level of protection (85.25%) while the governmental hospital C scored the lower level of protection (59.02%). Finally, this study stated some recommendations that if implemented could improve the level of radiation protection in nuclear medicine department. One of the most important recommendations is that a proper radiation protection

A decade of volcanic construction and destruction at the summit of NW Rota-1 seamount: 2004-2014

Science.gov (United States)

Schnur, Susan R.; Chadwick, William W.; Embley, Robert W.; Ferrini, Vicki L.; de Ronde, Cornel E. J.; Cashman, Katharine V.; Deardorff, Nicholas D.; Merle, Susan G.; Dziak, Robert P.; Haxel, Joe H.; Matsumoto, Haru

2017-03-01

Arc volcanoes are important to our understanding of submarine volcanism because at some sites frequent eruptions cause them to grow and collapse on human timescales. This makes it possible to document volcanic processes. Active submarine eruptions have been observed at the summit of NW Rota-1 in the Mariana Arc. We use remotely operated vehicle videography and repeat high-resolution bathymetric surveys to construct geologic maps of the summit of NW Rota-1 in 2009 and 2010 and relate them to the geologic evolution of the summit area over a 10 year period (2004-2014). We find that 2009 and 2010 were characterized by different eruptive styles, which affected the type and distribution of eruptive deposits at the summit. Year 2009 was characterized by ultraslow extrusion and autobrecciation of lava at a single eruptive vent, producing a large cone of blocky lava debris. In 2010, higher-energy explosive eruptions occurred at multiple closely spaced vents, producing a thin blanket of pebble-sized tephra overlying lava flow outcrops. A landslide that occurred between 2009 and 2010 had a major effect on lithofacies distribution by removing the debris cone and other unconsolidated deposits, revealing steep massive flow cliffs. This relatively rapid alternation between construction and destruction forms one end of a seamount growth and mass wasting spectrum. Intraplate seamounts, which tend to grow larger than arc volcanoes, experience collapse events that are orders of magnitude larger and much less frequent than those occurring at subduction zone settings. Our results highlight the interrelated cyclicity of eruptive activity and mass wasting at submarine arc volcanoes.

The future of general medicine.

Science.gov (United States)

Firth, John

2014-08-01

It is a truth universally acknowledged that there is a problem with general medicine. Physicians have become increasingly specialised over the past 30 years or so, and specialist care has produced increasingly better outcomes for some patients. The patients left behind are looked after by general medicine, where demand is increasing, operational priority within hospitals is low, there is little professional kudos and recruitment is suffering. Three recent reports - Hospitals on the Edge?, the Future Hospital Commission report, and the Shape of Training report - have described the problems, but not articulated compelling solutions. Here, I discuss what is good about general medicine, what is bad and make suggestions for improvement. These involve getting specialities to take responsibility for care of appropriate admissions automatically and without delay, giving general physicians control over the service that they provide, and using well-chosen financial drivers to support movement in the right direction. © 2014 Royal College of Physicians.

Hospitalist career decisions among internal medicine residents.

Science.gov (United States)

Ratelle, John T; Dupras, Denise M; Alguire, Patrick; Masters, Philip; Weissman, Arlene; West, Colin P

2014-07-01

Hospital medicine is a rapidly growing field of internal medicine. However, little is known about internal medicine residents' decisions to pursue careers in hospital medicine (HM). To identify which internal medicine residents choose a career in HM, and describe changes in this career choice over the course of their residency education. Observational cohort using data collected from the annual Internal Medicine In-Training Examination (IM-ITE) survey. 16,781 postgraduate year 3 (PGY-3) North American internal medicine residents who completed the annual IM-ITE survey in 2009-2011, 9,501 of whom completed the survey in all 3 years of residency. Self-reported career plans for individual residents during their postgraduate year 1 (PGY-1), postgraduate year 2 (PGY-2) and PGY-3. Of the 16,781 graduating PGY-3 residents, 1,552 (9.3 %) reported HM as their ultimate career choice. Of the 951 PGY-3 residents planning a HM career among the 9,501 residents responding in all 3 years, 128 (13.5 %) originally made this decision in PGY-1, 192 (20.2 %) in PGY-2, and 631 (66.4 %) in PGY-3. Only 87 (9.1 %) of these 951 residents maintained a career decision of HM during all three years of residency education. Hospital medicine is a reported career choice for an important proportion of graduating internal medicine residents. However, the majority of residents do not finalize this decision until their final year.

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

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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.

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.

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

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

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...

International Summit Consensus Statement: Intellectual Disability Inclusion in National Dementia Plans.

Science.gov (United States)

Watchman, Karen; Janicki, Matthew P; Splaine, Michael; Larsen, Frode K; Gomiero, Tiziano; Lucchino, Ronald

2017-06-01

The World Health Organization (WHO) has called for the development and adoption of national plans or strategies to guide public policy and set goals for services, supports, and research related to dementia. It called for distinct populations to be included within national plans, including adults with intellectual disability (ID). Inclusion of this group is important as having Down's syndrome is a significant risk factor for early-onset dementia. Adults with other ID may have specific needs for dementia-related care that, if unmet, can lead to diminished quality of old age. An International Summit on Intellectual Disability and Dementia, held in Scotland, reviewed the inclusion of ID in national plans and recommended that inclusion goes beyond just description and relevance of ID. Reviews of national plans and reports on dementia show minimal consideration of ID and the challenges that carers face. The Summit recommended that persons with ID, as well as family carers, should be included in consultation processes, and greater advocacy is required from national organizations on behalf of families, with need for an infrastructure in health and social care that supports quality care for dementia.

[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

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.

Nuclear Medicine week in Colombia

International Nuclear Information System (INIS)

Padhy, A.K.

2003-01-01

During the week of 6-12 October 2003 the IAEA organized a Research Coordination Meeting on 'Relationship between lower Respiratory Tract Infection, Gastroesophageal reflux and bronchial Asthma in children' at Hospital San Ignacio in Bogota. Besides there were four workshops in Bogota; workshops on Bone infection and Bone scan in Pediatric ortopaedics at Hospital Militar and Fundacion CardioInfantil, a workshop for Nuclear Medicine Technologists and a workshop on Sentinel Lymph Node mapping and Surgical Gamma Probe Application at Institute of Oncology. A nuclear cardiology workshop was organized in Medellin, and finally crowning them all was the 9th Congress of the Colombian Association of Nuclear Medicine at Cali from 10-12 October, 2003; probably the largest and best Colombian nuclear medicine congress every held in the country. A workshop was also organized in Cali for nuclear medicine technologists in conjunction with the Annual Convention. It was a mix of IAEA's Technical Cooperation and Regular Budget activities along with the activities of Colombian Association of Nuclear Medicine, bringing in absolute synergy to galvanize the entire nuclear medicine community of the country. The week saw nuclear medicine scientists from more than 20 IAEA Member States converging on Colombia to spread the message of nuclear medicine, share knowledge and to foster International understanding and friendship among the nuclear medicine people of the world

[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.

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)

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.

Framing the News on the Summits of Climate Change on Spanish Television

Directory of Open Access Journals (Sweden)

Juan Carlos Aguila Coghlan

2013-05-01

Full Text Available The MDCS Research Group at the Universidad Complutense de Madrid, has analyzed the television coverage of the news in Spain on climate change summits developed in Cancun (2010 and Durban (2011. On a base of 309 news records, 169 and 140 respectively and through a registration protocol specially designed by the team for audiovisual works, we conducted a content analysis of the news corpus. Reference is made to the framing of the news, the social context and the cognitive framework of media formats. The information obtained was processed using SPSS. As a result of this analysis, this paper presents a comparison of the frequencies of some of the variables in the news of the two summits. Compared variables are:  Number of news per day;  No. of “Totales” (A “total” means someone is displayed with its own voice talking; Off Theme, Off Mode, Duration of news, Source of images,  Features of images (stock images, present images, Mood of the Presentation Phrases,  Problem solutions,  Responsibilities in the case of no solution.

Perspectives from the Third International Summit on Medical Nutrition Education and Research.

Science.gov (United States)

Crowley, Jennifer Jean; Laur, Celia; Carter, Harrison David Edward; Jones, Glenys; Ray, Sumantra

2018-01-01

Nutrition is an important component of public health and health care, including in education and research, and in the areas of policy and practice. This statement was the overarching message during the third annual International Summit on Medical Nutrition Education and Research, held at Wolfson College, University of Cambridge, United Kingdom, in August 2017. This summit encouraged attendees to think more broadly about the impact of nutrition policy on health and communities, including the need to visualize the complete food system from "pre-farm to post-fork." Evidence of health issues related to food and nutrition were presented, including the need for translation of knowledge into policy and practice. Methods for this translation included the use of implementation and behavior change techniques, recognizing the needs of health-care professionals, policy makers, and the public. In all areas of nutrition and health, clear and effective messages, supported by open data, information, and actionable knowledge, are also needed along with strong measures of impact centered on an ultimate goal: to improve nutritional health and wellbeing for patients and the public.

INFORMATION AND RECOMMENDATIONS CONCERNING THE ENLARGED G8 SUMMIT MEETING AT EVIAN

CERN Multimedia

2003-01-01

Despite the difficulties that CERN might encounter, the Organization will pursue its activities for the duration of the G8 Summit Meeting. The Management and Division leaders will take the necessary steps to ensure the proper functioning of the Organization, while taking account of the aforementioned difficulties. The Swiss and French authorities have informed CERN of the following general security and traffic arrangements associated with the enlarged G8 summit: a) Road traffic Between 22 May and 6 June traffic on certain roads in the Canton of Geneva (notably on the left bank) and in neighbouring France (mainly Haute-Savoie) will be disrupted and, in some cases, roads closed. As far as border crossings between 22 May and 4 June are concerned, the frontier posts will be divided into three categories (see map): - posts closed to all traffic (diversion signs will be in place), - posts open at certain times, - posts open at all times. N.B. : the road from Prévessin to Mategnin will be closed and traffic div...

Nuclear medicine in China

International Nuclear Information System (INIS)

Wang, Shihchen; Liu, Xiujie

1986-01-01

Since China first applied isotopes to medical research in 1956, over 800 hospitals and research institutions with 4000 staff have taken up nuclear technology. So far, over 120 important biologically active materials have been measured by radioimmunoassay in China, and 44 types of RIA kit have been supplied commercially. More than 50,000 cases of hyperthyroidism have been treated satisfactorily with 131 I. Radionuclide imaging of practically all organs and systems of the human body has been performed, and adrenal imaging and nuclear cardiology have become routine clinical practice in several large hospitals. The thyroid iodine uptake test, renogram tracing and cardiac function studies with a cardiac probe are also commonly used in most Chinese hospitals. The active principles of more than 60 medicinal herbs have been labelled with isotopes in order to study the drug metabolism and mechanism of action. Through the use of labelled neurotransmitters or deoxyglucose, RIA, radioreceptor assay and autoradiography, Chinese researchers have made remarkable achievements in the study of the scientific basis of acupuncture analgesia. In 1980 the Chinese Society of Nuclear Medicine was founded, and since 1981 the Chinese Journal of Nuclear Medicine has been published. Although nuclear medicine in China has already made some progress, when compared with advanced countries, much progress is still to be made. It is hoped that international scientific exchange will be strengthened in the future. (author)

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.

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

Hip fracture in hospitalized medical patients

Directory of Open Access Journals (Sweden)

Zapatero Antonio

2013-01-01

Full Text Available Abstract Background The aim of the present study is to analyze the incidence of hip fracture as a complication of admissions to internal medicine units in Spain. Methods We analyzed the clinical data of 2,134,363 adults who had been admitted to internal medicine wards. The main outcome was a diagnosis of hip fracture during hospitalization. Outcome measures included rates of in-hospital fractures, length of stay and cost. Results A total of 1127 (0.057% admittances were coded with an in-hospital hip fracture. In hospital mortality rate was 27.9% vs 9.4%; p  Conclusions In-hospital hip fracture notably increased mortality during hospitalization, doubling the mean length of stay and mean cost of admission. These are reasons enough to stress the importance of designing and applying multidisciplinary plans focused on reducing the incidence of hip fractures in hospitalized patients.

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.

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.

Pits, rifts and slumps: the summit structure of Piton de la Fournaise

Science.gov (United States)

Carter, Adam; van Wyk de Vries, Benjamin; Kelfoun, Karim; Bachèlery, Patrick; Briole, Pierre

2007-06-01

A clear model of structures and associated stress fields of a volcano can provide a framework in which to study and monitor activity. We propose a volcano-tectonic model for the dynamics of the summit of Piton de la Fournaise (La Reunion Island, Indian Ocean). The summit contains two main pit crater structures (Dolomieu and Bory), two active rift zones, and a slumping eastern sector, all of which contribute to the actual fracture system. Dolomieu has developed over 100 years by sudden large collapse events and subsequent smaller drops that include terrace formation. Small intra-pit collapse scars and eruptive fissures are located along the southern floor of Dolomieu. The western pit wall of Dolomieu has a superficial inward dipping normal fault boundary connected to a deeper ring fault system. Outside Dolomieu, an oval extension zone containing sub-parallel pit-related fractures extends to a maximum distance of 225 m from the pit. At the summit the main trend for eruptive fissures is N80°, normal to the north south rift zone. The terraced structure of Dolomieu has been reproduced by analogue models with a roof to width ratio of approximately 1, suggesting an original magma chamber depth of about 1 km. Such a chamber may continue to act as a storage location today. The east flank has a convex concave profile and is bounded by strike-slip fractures that define a gravity slump. This zone is bound to the north by strike-slip fractures that may delineate a shear zone. The southern reciprocal shear zone is probably marked by an alignment of large scoria cones and is hidden by recent aa lavas. The slump head intersects Dolomieu pit and may slide on a hydrothermally altered layer known to be located at a depth of around 300 m. Our model has the summit activity controlled by the pit crater collapse structure, not the rifts. The rifts become important on the mid-flanks of the cone, away from pit-related fractures. On the east flank the superficial structures are controlled

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.

Nuclear medicine in the Philippines

International Nuclear Information System (INIS)

Villadolid, Leland.

1978-01-01

This article traces the history of nuclear medicine in the country from the time the first radioisotope laboratory was set up by the Philippine General Hospital about 1955, to the not too satisfactory present facilities acquired by hospitals for diagnosis, treatment and investigation of diseases. It is in research, the investigation of disease that is nuclear medicine's most important area. The Philippine Atomic Energy Commission (PAEC) has pioneered in the conducting of courses in the medical uses of radioisotopes. The local training of nuclear manpower has been continued and updated and foreign fellowships are availed of through the cooperation of IAEA. Quite a number are already trained also in the allied fields that support the practice of nuclear medicine. However the brain drain has seriously affected the number of trained staff of medical units. Discussed and presented is the growth of the medical use of radioisotopes which are locally produced by PAEC. In order to benefit from the full advantage that nuclear medicine can do to a majority of Filipinos, the government should extend its financial support in acquiring such facilities to equip strategic hospitals in the country and support training programs. The Philippine has the expertise to start the expansion but only with adequate provision of funds will our capacity turn into reality. (RTD)

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...

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.

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...

[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.

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.

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.

2012 ARPA-E Energy Innovation Summit Keynote Presentation (Arun Majumdar)

Energy Technology Data Exchange (ETDEWEB)

Majumdar, Arun

2012-02-28

The third annual ARPA-E Energy Innovation Summit was held in Washington D.C. in February, 2012. The event brought together key players from across the energy ecosystem - researchers, entrepreneurs, investors, corporate executives, and government officials - to share ideas for developing and deploying the next generation of energy technologies. Director of ARPA-E, Arun Majumdar, gave the final keynote address for Tuesday, February 28th. He discussed APRA-E's role in meeting 21st century energy needs with American innovation.

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)

Assessing Summit Engagement with Other International Organizations in Global Governance

Directory of Open Access Journals (Sweden)

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�

Variation in Emergency Department vs Internal Medicine Excess Charges in the United States.

Science.gov (United States)

Xu, Tim; Park, Angela; Bai, Ge; Joo, Sarah; Hutfless, Susan M; Mehta, Ambar; Anderson, Gerard F; Makary, Martin A

2017-08-01

Uninsured and insured but out-of-network emergency department (ED) patients are often billed hospital chargemaster prices, which exceed amounts typically paid by insurers. To examine the variation in excess charges for services provided by emergency medicine and internal medicine physicians. Retrospective analysis was conducted of professional fee payment claims made by the Centers for Medicare & Medicaid Services for all services provided to Medicare Part B fee-for-service beneficiaries in calendar year 2013. Data analysis was conducted from January 1 to July 31, 2016. Markup ratios for ED and internal medicine professional services, defined as the charges submitted by the hospital divided by the Medicare allowable amount. Our analysis included 12 337 emergency medicine physicians from 2707 hospitals and 57 607 internal medicine physicians from 3669 hospitals in all 50 states. Services provided by emergency medicine physicians had an overall markup ratio of 4.4 (340% excess charges), which was greater than the markup ratio of 2.1 (110% excess charges) for all services performed by internal medicine physicians. Markup ratios for all ED services ranged by hospital from 1.0 to 12.6 (median, 4.2; interquartile range [IQR], 3.3-5.8); markup ratios for all internal medicine services ranged by hospital from 1.0 to 14.1 (median, 2.0; IQR, 1.7-2.5). The median markup ratio by hospital for ED evaluation and management procedure codes varied between 4.0 and 5.0. Among the most common ED services, laceration repair had the highest median markup ratio (7.0); emergency medicine physician review of a head computed tomographic scan had the greatest interhospital variation (range, 1.6-27.7). Across hospitals, markups in the ED were often substantially higher than those in the internal medicine department for the same services. Higher ED markup ratios were associated with hospital for-profit ownership (median, 5.7; IQR, 4.0-7.1), a greater percentage of uninsured patients seen

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.

Nuclear Medicine in a developing country

International Nuclear Information System (INIS)

Wenzel, K.S. von; Rubow, S.M.; Ellmann, A.; Ghoorun, S.

2002-01-01

Namibia is a country with 1,8 million inhabitants, of whom the majority has limited access to first world facilities. Nevertheless, medical services of high standard are offered. A Nuclear Medicine Department was established at Windhoek Central Hospital in 1982. A nuclear physician, two nuclear medicine radiographers and a nursing sister staff the department. Equipment includes a Siemens Orbiter and an Elscint Apex SPX Helix gamma camera. Radiopharmaceuticals are obtained from suppliers in South Africa. Investigations performed include musculoskeletal, liver, hepatobiliary, thyroid, renal studies, ventilation perfusion lung scans as well as the following Nuclear Cardiology studies: Gated blood pool scans, Tc-99m pyrophosphate hot spot scans, Tl-201 myocardial perfusion studies, Tc-99m MIBI myocardial perfusion studies and Tl-201 rest-redistribution studies. Problems experienced at the Windhoek Nuclear Medicine department include: Lack of funding and high cost of equipment and radiopharmaceuticals, lack of understanding of Nuclear Medicine by the hospital management and health administrators, and difficulties in procuring short-lived radiopharmaceuticals. Furthermore, the absence of company representatives and spare parts in Namibia leads to loss of time whenever equipment needs to be repaired. Working as the only nuclear medicine physician in a country also poses major problems. Careful management of resources and information drives have helped to sustain the Nuclear Medicine service despite economic problems in the country. Installation of a tele-link between the department in Windhoek Hospital and Tygerberg Hospital in South Africa has greatly assisted to overcome the problem of isolation and lack of back up from fellow specialists. The IAEA has equipped both departments with Hermes workstations (Nuclear Diagnostics) and a tele-link is maintained via modem. The current software provided with the Hermes system is ideally suited to processing of data such as gated

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

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.

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. ...

Consensus statement of the International Summit on Intellectual Disability and Dementia on valuing the perspectives of persons with intellectual disability.

Science.gov (United States)

Watchman, Karen; Janicki, Matthew P; Udell, Leslie; Hogan, Mary; Quinn, Sam; Beránková, Anna

2018-01-01

The International Summit on Intellectual Disability and Dementia covered a range of issues related to dementia and intellectual disability, including the dearth of personal reflections of persons with intellectual disability affected by dementia. This article reflects on this deficiency and explores some of the personal perspectives gleaned from the literature, from the Summit attendees and from the experiences of persons with intellectual disability recorded or scribed in advance of the two-day Summit meeting. Systemic recommendations included reinforcing the value of the involvement of persons with intellectual disability in (a) research alongside removing barriers to inclusion posed by institutional/ethics review boards, (b) planning groups that establish supports for dementia and (c) peer support. Practice recommendations included (a) valuing personal perspectives in decision-making, (b) enabling peer-to-peer support models, (c) supporting choice in community-dwelling arrangements and (d) broadening availability of materials for persons with intellectual disability that would promote understanding of dementia.

Data that drive: Closing the loop in the learning hospital system.

Science.gov (United States)

Liu, Vincent X; Morehouse, John W; Baker, Jennifer M; Greene, John D; Kipnis, Patricia; Escobar, Gabriel J

2016-11-01

The learning healthcare system describes a vision of US healthcare that capitalizes on science, information technology, incentives, and care culture to drive improvements in the quality of health care. The inpatient setting, one of the most costly and impactful domains of healthcare, is an ideal setting in which to use data and information technology to foster continuous learning and quality improvement. The rapid digitization of inpatient medicine offers incredible new opportunities to use data from routine care to generate new discovery and thus close the virtuous cycle of learning. We use an object lesson-sepsis care within the 21 hospitals of the Kaiser Permanente Northern California integrated healthcare delivery system-to offer insight into the critical elements necessary for developing a learning hospital system. We then describe how a hospital-wide data-driven approach to inpatient care can facilitate improvements in the quality of hospital care. Journal of Hospital Medicine 2016;11:S11-S17. © 2016 Society of Hospital Medicine. © 2016 Society of Hospital Medicine.

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.

Medicinal ethnobotany in Huacareta (Chuquisaca, Bolivia)

Science.gov (United States)

2012-01-01

Background The aim of this study was to document the types of diseases treated by the use of medicinal plants, their main applications and also to have a report of the major diseases treated at the Hospital of San Pablo de Huacareta (Chuquisaca Bolivia). Methods We conducted semi-structured interviews on the use medicinal plants with 10 local informants, and categorized the kinds of diseases treated by traditional medicine. We obtained reports of cases treated at the Hospital of Huacareta in order to compare the use frequency of traditional medicine and allopathic medicine for the treatment of recurrent diseases in the area. Results Our survey identified 258 traditional medicine uses, spanning a total of 13 diseases categories and including 91 native and exotic plant species and one unidentified sample plant type. Gastrointestinal disorders (55%) were most frequently treated with medicinal plants, followed by afflictions of the musculoskeletal system (25%) and dermatological disorders (24%). Hospital information indicates that the most common diseases are acute respiratory infections (47%) and acute diarrheal diseases (37%). The herbal remedies were mostly used in the form of teas and decoctions. The informants used mainly native plant species, although exotic species has been introduced to the pharmacopoeia. Conclusions The treatment of gastrointestinal disorders is the primary objective of the medical ethnobotany of the inhabitants of Huacareta, while respiratory system diseases are mostly treated in the hospital. Looking at the data from the Hospital records we can infer that gastrointestinal disorders are among the most common diseases in the study area. For most respondents, traditional medicine is a reliable choice for the care of their illnesses. However, the preference of the population for either traditional medicine or allopathic medicine needs to be clarified in future comparative studies to obtain more convincing results. The results presented can be

Medicinal ethnobotany in Huacareta (Chuquisaca, Bolivia

Directory of Open Access Journals (Sweden)

Quiroga Rodrigo

2012-08-01

Full Text Available Abstract Background The aim of this study was to document the types of diseases treated by the use of medicinal plants, their main applications and also to have a report of the major diseases treated at the Hospital of San Pablo de Huacareta (Chuquisaca Bolivia. Methods We conducted semi-structured interviews on the use medicinal plants with 10 local informants, and categorized the kinds of diseases treated by traditional medicine. We obtained reports of cases treated at the Hospital of Huacareta in order to compare the use frequency of traditional medicine and allopathic medicine for the treatment of recurrent diseases in the area. Results Our survey identified 258 traditional medicine uses, spanning a total of 13 diseases categories and including 91 native and exotic plant species and one unidentified sample plant type. Gastrointestinal disorders (55% were most frequently treated with medicinal plants, followed by afflictions of the musculoskeletal system (25% and dermatological disorders (24%. Hospital information indicates that the most common diseases are acute respiratory infections (47% and acute diarrheal diseases (37%. The herbal remedies were mostly used in the form of teas and decoctions. The informants used mainly native plant species, although exotic species has been introduced to the pharmacopoeia. Conclusions The treatment of gastrointestinal disorders is the primary objective of the medical ethnobotany of the inhabitants of Huacareta, while respiratory system diseases are mostly treated in the hospital. Looking at the data from the Hospital records we can infer that gastrointestinal disorders are among the most common diseases in the study area. For most respondents, traditional medicine is a reliable choice for the care of their illnesses. However, the preference of the population for either traditional medicine or allopathic medicine needs to be clarified in future comparative studies to obtain more convincing results. The

Digital Geologic Map Database of Medicine Lake Volcano, Northern California

Science.gov (United States)

Ramsey, D. W.; Donnelly-Nolan, J. M.; Felger, T. J.

2010-12-01

Medicine Lake volcano, located in the southern Cascades ~55 km east-northeast of Mount Shasta, is a large rear-arc, shield-shaped volcano with an eruptive history spanning nearly 500 k.y. Geologic mapping of Medicine Lake volcano has been digitally compiled as a spatial database in ArcGIS. Within the database, coverage feature classes have been created representing geologic lines (contacts, faults, lava tubes, etc.), geologic unit polygons, and volcanic vent location points. The database can be queried to determine the spatial distributions of different rock types, geologic units, and other geologic and geomorphic features. These data, in turn, can be used to better understand the evolution, growth, and potential hazards of this large, rear-arc Cascades volcano. Queries of the database reveal that the total area covered by lavas of Medicine Lake volcano, which range in composition from basalt through rhyolite, is about 2,200 km2, encompassing all or parts of 27 U.S. Geological Survey 1:24,000-scale topographic quadrangles. The maximum extent of these lavas is about 80 km north-south by 45 km east-west. Occupying the center of Medicine Lake volcano is a 7 km by 12 km summit caldera in which nestles its namesake, Medicine Lake. The flanks of the volcano, which are dotted with cinder cones, slope gently upward to the caldera rim, which reaches an elevation of nearly 2,440 m. Approximately 250 geologic units have been mapped, only half a dozen of which are thin surficial units such as alluvium. These volcanic units mostly represent eruptive events, each commonly including a vent (dome, cinder cone, spatter cone, etc.) and its associated lava flow. Some cinder cones have not been matched to lava flows, as the corresponding flows are probably buried, and some flows cannot be correlated with vents. The largest individual units on the map are all basaltic in composition, including the late Pleistocene basalt of Yellowjacket Butte (296 km2 exposed), the largest unit on the

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

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...

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

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.

Evaluation of a radioisotope service in a general hospital

International Nuclear Information System (INIS)

Mateil, P.-Y.

1978-12-01

The value of radioisotopes in medicine has become increasingly apparent over the last few years. Nuclear medicine however recent, has nevertheless reached adult hood and doctors appreciate its substantial contribution in the field of diagnosis especially. So far nuclear medicine has been confined to University Hospital Centres, mainly for legal reasons. However the considerable help offered by this discipline is now taken for granted in the medical world and the wholly experimental stage is long past. While this aspect of nuclar medicine still exists, and is still dealt with by the services of University Hospital Centres, radioisotopes are now used to a large extend and on a day-to-day basis in pathology. Owing to pressure of work it is difficult for UH Centres to meet all request for examinations, so would the presence of nuclear medicine Service be justified in general Hospitals. The existence of one such service at the Bayonne HC might help to answer this question. For this reason the activity of the Bayonne HC Nuclear Medicine Service during its first year of practice is examined here. For a better understanding of the position this report first presents the Bayonne Hospital and the place occupied by a nuclear Medicine service in such an establishment. The activity of this service during its first year is then studied and the situation weighed up generally [fr

Attitude and opinion towards essential medicine formulary.

Science.gov (United States)

Sharma, Sangeeta; Kh, Reeta; Chaudhury, R Roy

2010-06-01

The Delhi State Drug Policy was adopted in 1994 following which the first Essential Medicines List (EML) was developed in 1996. The Delhi State Essential Medicines Formulary was brought out in 1997. A need was felt to revise the formulary to match with the EML as the EML is renewed every 2 years. A survey was undertaken to elicit the opinions of the doctors practicing in the state on the usefulness of the formulary before revising and printing the updated version. The survey covered dispensaries, 10-20 bedded hospitals, 100-bedded hospitals and two tertiary care hospitals. Discussions were focused on questionnaires on attitudes toward adopting Essential Medicines Formulary using a 10-point scale. Of the 200 doctors approached, only 90 doctors completed the questionnaire. Sixty-nine respondents (76.6%) had received the copy of the formulary. Most practitioners welcomed the formulary and were satisfied with the coverage and selection of the medicines. Most respondents (76.9%) agreed that a well-developed formulary would improve the quality of the public health care system, although they had reservations about the authority, relevance and effect on professional autonomy. About 74% of the respondents used the formulary in clinical practice as a source of medicine information, which makes its regular revision necessary.

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

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.

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.

[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

[Development and status of intensive care medicine in internal medicine at the Karl Marx University in Leipzig].

Science.gov (United States)

Engelmann, L; Schneider, D

1989-01-15

Issuing from the accomplishments of Köhler for the development of the intensive medicine in internal medicine-in 1964 he performed the first long-term respiration at the then Medical Clinic of the Karl Marx University, in 1969 he institutionalized the young subdiscipline at the clinic, in 1978 he founded the department for intensive medicine and is at work by his decisions concerning the development of young scientists, by the handbook "Intensive Medicine. Internal Medicine and Adjacent Subjects" as well as a member of the presidium of the GDR Society for Internal Medicine for the development of the internal intensive medicine-a description of the development of the department, its achievements and problems is given. The promotion of the intensive medicine by Köhler results, as we think, also from the comprehension that it has the duty to perform a function integrating the subdisciplines, which the modern internal medicine oriented to organs and systems threatens to lose, which, however, makes its self-apprehension, which the patient wishes and the teaching is demanding. From this and from the charge for a highly specialized care of patients who life-threateningly fell ill with internal diseases as well as from the duty to create a scientific forerunning results the stringent necessity of the development of the non-operative, in reality internal intensive medicine in the clinics for internal medicine of the county hospitals and university institutions as well as the greater identification of the internist with the subdiscipline in the district hospitals dealing with multidisciplinary intensive medicine.

Detecting vegetation cover change on the summit of Cadillac Mountain using multi-temporal remote sensing datasets: 1979, 2001, and 2007.

Science.gov (United States)

Kim, Min-Kook; Daigle, John J

2011-09-01

This study examines the efficacy of management strategies implemented in 2000 to reduce visitor-induced vegetation impact and enhance vegetation recovery at the summit loop trail on Cadillac Mountain at Acadia National Park, Maine. Using single-spectral high-resolution remote sensing datasets captured in 1979, 2001, and 2007, pre-classification change detection analysis techniques were applied to measure fractional vegetation cover changes between the time periods. This popular sub-alpine summit with low-lying vegetation and attractive granite outcroppings experiences dispersed visitor use away from the designated trail, so three pre-defined spatial scales (small, 0-30 m; medium, 0-60 m; and large, 0-90 m) were examined in the vicinity of the summit loop trail with visitor use (experimental site) and a site chosen nearby in a relatively pristine undisturbed area (control site) with similar spatial scales. Results reveal significant changes in terms of rates of vegetation impact between 1979 and 2001 extending out to 90 m from the summit loop trail with no management at the site. No significant differences were detected among three spatial zones (inner, 0-30 m; middle, 30-60 m; and outer, 60-90 m) at the experimental site, but all were significantly higher rates of impact compared to similar spatial scales at the control site (all p time period. In addition, the advantages and some limitations of using remote sensing technologies are discussed in detecting vegetation change in this setting and potential application to other recreation settings.

[Occupational aspects of emergency medicine practice in Catalonia: the OPENCAT opinion survey].

Science.gov (United States)

Jacob, Javier; Gené, Emili; Alonso, Gilberto; Rimbau, Pere; Zorrilla, José; Casarramona, Francesc; Netto, Cristina; Sánchez, Pere; Hernández, Ricard; Escalada, Xavier; Miró, Òscar

2017-01-01

To gather information on the contracting and training of members of the Catalan Society of Emergency Medicine (SoCMUE) who work in emergency medicine and services in Catalonia. To survey their opinions on certain aspects of resource availability and working conditions. Cross-sectional descriptive study based on a survey sent to SoCMUE members. We studied the opinions of 5 types of respondent: hospital physicians, out-of-hospital physicians, hospital nurses, out-of-hospital nurses, and emergency medical technicians. Responses were grouped to compare the opinions of physicians and nurses and workers in hospital and prehospital settings. We received 616 responses from 1273 members (48.4% response rate). More physicians than nurses come from outside Catalonia and have contracts specifically linked to emergency care; in addition, physicians have done less postgraduate training in emergency medicine. More hospital staff than prehospital staff have permanent contracts linked to the department where they work. More hospital physicians are specialized in internal medicine than in family and community medicine. The opinion that emergency services are inadequately staffed was widespread. Most respondents believed that patient transport is good or adequate. However, respondents working in prehospital services expressed a lower opinion of transport. Great difficulty in combining work with family (life achieving work-life balance) was expressed by 13.5% overall, and more often by hospital staff. Some type of aggression was experienced by 88.2%; 60% reported the event to superiors. Nurses reported aggression more often than physicians. A police report was filed by 10.1%. Emergency medicine working conditions can be improved in Catalonia according to members of SoCMUE. Relations between groups of professionals are not optimum in some aspects.

[William W. Cadbury and canton hospital].

Science.gov (United States)

Liu, Ze-Sheng; Liu, Ze-En

2004-01-01

William W. Cadbury M.D. was born in Philadelphia, USA and graduated from the Medical College of Pennsylvania University. It was nearly 40 years since he arrived in Canton (Guangzhou) in 1909 and left at retirement age. He taught western medicine in Canton Christian College and worked as a medical doctor in Canton Hospital, the oldest western medical hospital in the Orient. He was regarded as a famous foreign doctor and an excellent professor in internal medicine in the Republic of China. He wrote At the point of Lancet: 100 years of Canton Hospital 1835 - 1935, which recorded the achievement made by American missionary doctors, particularly the pioneers such as Peter Parker M.D. and John G. Kerr. M.D. So far the book is still an important reference for the studies on history of western medicine in China and the history of modern medical exchange between China and other countries.

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.

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

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

[Comparative evaluation of maternity hospitals in Auvergne: from planning to contracting].

Science.gov (United States)

Gerbaud, L; Biolay, S; Venet, M; Pomey, M P; Belgacem, B; Jacquetin, B; Glanddier, P Y

1998-01-01

Two reforms of public hospitals have been launched by the French government in 1991 and 1996 aimed at lowering costs and increasing the quality of services and ultimately the safety of patients. As concerns maternity hospitals, several new rules have been imposed upon. For example, those who performed less than 300 births a year should be closed. The basic idea was to concentrate technical resources and human skills in middle-size and important hospitals for saving money, and simultaneously, raising the safety level for mothers and babies. However, negative adverse effects fastly appeared: to avoid closure, some small maternity homes tried to convince future mothers not to go to well-equipped hospitals, even if their cases appeared complex and their health at risk. An experience of partnership between maternity hospitals (care providers), the Sickness Insurance Fund (the financing body) and the Administration was carried out in the Auvergne region. It was based on the observation of a large number of indicators concerning the activity of hospitals, the size and quality of their equipment, the satisfaction of their patients ... etc ... for designing the rights and duties of each partner. Instead of planning from the summit, a process of mutually-agreed contract was established.

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.

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

Belief in complementary and alternative medicine in the ...

African Journals Online (AJOL)

goold

2014-09-08

Sep 8, 2014 ... and cultural factors associated with these practices. ... Chinese medicine such as herbal medicine, acupuncture ..... and dietary supplement (HDS), particularly in. Asian .... Penang Hospital: pattern and perceptions. Med J.

Effectiveness of medicines authentication technology to detect counterfeit, recalled and expired medicines: a two-stage quantitative secondary care study

Science.gov (United States)

Naughton, Bernard; Roberts, Lindsey; Dopson, Sue; Chapman, Stephen; Brindley, David

2016-01-01

Objectives To identify the authentication and detection rate of serialised medicines using medicines authentication technology. Design and intervention 4192 serialised medicines were entered into a hospital dispensary over two separate 8-week stages in 2015. Medicines were authenticated using secure external database cross-checking, triggered by the scanning of a two-dimensional data matrix with a unit specific 12-digit serial code. 4% of medicines included were preprogrammed with a message to identify the product as either expired, pack recalled, product recalled or counterfeit. Setting A site within a large UK National Health Service teaching hospital trust. Participants Accredited checking staff, pharmacists and dispensers in a pharmacy department. Primary outcome measures Authentication and detection rate of counterfeit expired and recalled medicines. Results The operational detection rate of counterfeit, recalled and expired medicines scanned as a combined group was 81.4% (stage 1 (S1)) and 87% (stage 2 (S2)). The technology's technical detection rate (TDR) was 100%; however, not all medicines were scanned and of those that were scanned not all that generated a warning message were quarantined. Owing to an operational authentication rate (OAR) of 66.3% (over both stages), only 31.8% of counterfeit medicines, 58% of recalled drugs and 64% of expired medicines were detected as a proportion of those entered into the study. Response times (RTs) of 152 ms (S1) and 165 ms (S2) were recorded, meeting the falsified medicines directive-mandated 300 ms limit. Conclusions TDRs and RTs were not a limiting factor in this study. The suboptimal OAR poses significant quality and safety issues with this detection approach. Authentication at the checking stage, however, demonstrated higher OARs. There is a need for further qualitative research to establish the reasons for less than absolute authentication and detection rates in the hospital environment to improve this

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

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

Brief hospitalizations of elderly patients

DEFF Research Database (Denmark)

Strømgaard, Sofie; Rasmussen, Søren Wistisen; Schmidt, Thomas Andersen

2014-01-01

BACKGROUND: Crowded departments are a common problem in Danish hospitals, especially in departments of internal medicine, where a large proportion of the patients are elderly. We therefore chose to investigate the number and character of hospitalizations of elderly patients with a duration of less...

[Verruca planae Chinese medicine treatment].

Science.gov (United States)

Chen, Hai-Ming

2008-08-01

Flat wart on the effectiveness of TCM treatment. Outpatients will be by the "People's Republic of China Chinese medicine industry standards, TCM diagnosis of dermatological diseases efficacy standards, Chen Hou State Administration of Traditional Chinese Medicine 1994-06-28 approved, 1995-01-01 implementation". Randomly divided into two groups. Treatment and control groups. Treatment groups treated with Chinese herbs. The control group were treated with WM. Since the preparation of the unification formula ointment, cuboiling method. Chinese herbal medicine preparation by my hospital room Producer. 5 g pre pack, after treatment for 30 days, clinical observation. The group of Chinese medicine is better than western medicine (86.7% vs 71.7% , P < 0.05). Chinese medicine has some effect flat wart.

Promoting nuclear medicine in developing countries

International Nuclear Information System (INIS)

Ganatra, R.; Nofal, M.

1986-01-01

After a short review of the applications of nuclear medicine in diagnosis and treatment of diseases or in medical research the ways and the means of IAEA's support in helping developing countries to set up nuclear medicine capabilities in their hospitals are described. Some trends and new directions in the field of nuclear medicine and the problems related to the implementation of these techniques in developing countries are presented

Precision Medicine-Nobody Is Average.

Science.gov (United States)

Vinks, A A

2017-03-01

Medicine gets personal and tailor-made treatments are underway. Hospitals have started to advertise their advanced genomic testing capabilities and even their disruptive technologies to help foster a culture of innovation. The prediction in the lay press is that in decades from now we may look back and see 2017 as the year precision medicine blossomed. It is all part of the Precision Medicine Initiative that takes into account individual differences in people's genes, environments, and lifestyles. © 2017 ASCPT.

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.

Welcome to Naval Hospital Jacksonville

Science.gov (United States)

. Transparency in Medicine See How We're Doing Compare Military Health System Hospitals and Clinics TRICARE Online | ICE | OWA | Suicide Prevention Lifeline | 1-800-USA-NAVY | Navy Medicine | Military Health Child Street, Jacksonville, Florida 32214 This is an official U.S. Navy website. This is a Department of

Attitude and opinion towards essential medicine formulary

Science.gov (United States)

Sharma, Sangeeta; Kh, Reeta; Chaudhury, R. Roy

2010-01-01

Objective: The Delhi State Drug Policy was adopted in 1994 following which the first Essential Medicines List (EML) was developed in 1996. The Delhi State Essential Medicines Formulary was brought out in 1997. A need was felt to revise the formulary to match with the EML as the EML is renewed every 2 years. Materials and Methods: A survey was undertaken to elicit the opinions of the doctors practicing in the state on the usefulness of the formulary before revising and printing the updated version. The survey covered dispensaries, 10–20 bedded hospitals, 100-bedded hospitals and two tertiary care hospitals. Discussions were focused on questionnaires on attitudes toward adopting Essential Medicines Formulary using a 10-point scale. Results: Of the 200 doctors approached, only 90 doctors completed the questionnaire. Sixty-nine respondents (76.6%) had received the copy of the formulary. Most practitioners welcomed the formulary and were satisfied with the coverage and selection of the medicines. Most respondents (76.9%) agreed that a well-developed formulary would improve the quality of the public health care system, although they had reservations about the authority, relevance and effect on professional autonomy. Conclusion: About 74% of the respondents used the formulary in clinical practice as a source of medicine information, which makes its regular revision necessary. PMID:20871765

The power of play: Innovations in Getting Active Summit 2011: a science panel proceedings report from the American Heart Association.

Science.gov (United States)

Lieberman, Debra A; Chamberlin, Barbara; Medina, Ernie; Franklin, Barry A; Sanner, Brigid McHugh; Vafiadis, Dorothea K

2011-05-31

To examine the influence active-play video gaming (also referred to as exergaming, exertainment, and active gaming) might have on improving health-related skills, enhancing self-esteem and self-efficacy, promoting social support, and ultimately motivating positive changes in health behaviors, the American Heart Association convened The Power of Play: Innovations in Getting Active Summit. The summit, as well as a follow-up science panel, was hosted by the American Heart Association and Nintendo of America. The science panel discussed the current state of research on active-play video gaming and its potential to serve as a gateway experience that might motivate players to increase the amount and intensity of physical activity in their daily lives. The panel identified the need for continued research on the gateway concept and on other behavioral health outcomes that could result from active-play video games and considered how these games could potentially affect disparate populations. The summit represented an exciting first step in convening healthcare providers, behavioral researchers, and professionals from the active-play video game industry to discuss the potential health benefits of active-play video games. Research is needed to improve understanding of processes of behavior change with active games. Future games and technologies may be designed with the goal to optimize physical activity participation, increase energy expenditure, and effectively address the abilities and interests of diverse and targeted populations. The summit helped the participants gain an understanding of what is known, identified gaps in current research, and supported a dialogue for continued collaboration.

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...

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.

Hip fracture in hospitalized medical patients

OpenAIRE

Zapatero Antonio; Barba Raquel; Canora Jesús; Losa Juan E; Plaza Susana; San Roman Jesús; Marco Javier

2013-01-01

Abstract Background The aim of the present study is to analyze the incidence of hip fracture as a complication of admissions to internal medicine units in Spain. Methods We analyzed the clinical data of 2,134,363 adults who had been admitted to internal medicine wards. The main outcome was a diagnosis of hip fracture during hospitalization. Outcome measures included rates of in-hospital fractures, length of stay and cost. Results A total of 1127 (0.057%) admittances were coded with an in-hosp...

Alpine plant distribution and thermic vegetation indicator on Gloria summits in the central Greater Caucasus

International Nuclear Information System (INIS)

Gigauri, K.; Abdaladze, O.; Nakhutsrishvili, G

2016-01-01

The distribution of plant species within alpine areas is often directly related to climate or climate-influenced ecological factors. Responding to observed changes in plant species, cover and composition on the GLORIA summits in the Central Caucasus, an extensive setup of 1m * 1m permanent plots was established at the treeline-alpine zones and nival ecotone (between 2240 and 3024 m a.s.l.) on the main watershed range of the Central Greater Caucasus nearby the Cross Pass, Kazbegi region, Georgia. Recording was repeated in a representative selection of 64 quadrates in 2008. The local climatic factors - average soil T degree C and growing degree days (GDD) did not show significant increasing trends. For detection of climate warming we used two indices: thermic vegetation indicator S and thermophilization indicator D. They were varying along altitudinal and exposition gradients. The thermic vegetation indicator decrease in all monitoring summits. The abundance rank of the dominant and endemic species did not change during monitoring period. (author)

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 ...

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

State of emergency medicine in Azerbaijan.

Science.gov (United States)

Sule, Harsh; Kazimov, Shirin; Shahmaliyev, Oktay; Sirois, Adam

2008-04-01

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. The Emergency Medicine Development Initiative (EMDI) of the International Medical Corps (IMC) was designed to improve the quality of emergency care in four pilot regional centers in Azerbaijan. The objective of this study was to assess the baseline emergency medical capacity of these four centers. EMDI staff conducted a four-part baseline survey in April 2006 to assess emergency care in Ganja (the second largest city in Azerbaijan), Kurdamir, Shamkir and Yevlakh. Data collection involved interviews with relevant personnel and a retrospective records review in each city. Pre-hospital: The number of ambulance teams per 10,000 inhabitants is below the number required by local regulations. On average, 45% of 27 medications and 37% of 17 pieces of critical equipment were available. Of the emergency procedures, 21% could be performed in the pre-hospital setting. In-hospital: Admission rates were near 100% for the admissions department-an area that is supposed to function as an emergency department would. On average 57% of 40 medications and 42% of 22 pieces of critical equipment were available. Of the emergency procedures, 62% could be performed in the in-hospital setting. The emergency medical system surveyed in Azerbaijan is inefficiently organized, under-financed, poorly equipped and lacks adequately trained staff. Reforms need to be directed towards achieving international standards, while adapting new models for service delivery into the existing framework and improving system capacity as highlighted by this baseline

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 ...

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.

[Knowledge and experience of palliative medicine among general practitioners in Germany].

Science.gov (United States)

Papke, J; Freier, W

2007-12-01

Levels of experience and competence in palliative medicine vary considerably among physicians. The aim of the study was to collect information from specially interested general practitioners on education, pivotal lectures and experience regarding the delivery of palliative care. 92 general practitioners (41 women and 22 men) attending a basic course in palliative medicine were asked to fill in a standardized questionnaire relating to their knowledge and experience of palliative medicine. 63 responded (68%), 54 in general private practice, nine worked in a hospital. The same number worked in urban and in rural health care facilities. The majority of those questioned (53%) gained their first experience in palliative medicine as junior hospital doctors about a quarter (26%) only after starting in private practice. Many of the doctors (31%) admitted to taking more interest in palliative medicine only after having made mistakes, a significant percentage (20%) after the death of a relative. 28% expressed the view that practical courses were an important part in learning about palliative medicine. The implementation of practice-based c tuition of medical students and of continuing education of established general practitioners and hospital physicians in palliative medicine is indispensable.

Developing the science of end-of-life and palliative care research: National Institute of Nursing Research summit.

Science.gov (United States)

Csikai, Ellen L

2011-01-01

A rare opportunity to examine accomplishments and identify ways to advance research in end-of-life and palliative care was offered by the National Institute of Nursing Research (NINR) through a summit meeting held in August 2011. The Science of Compassion: Future Directions in End-of-Life and Palliative Care brought together nationally recognized leaders in end-of-life and palliative care research, including grantees of NINR, as well as more than 700 attendees from all disciplines. It was an exciting affirmation of the importance of moving forward in the field. Presented in this article is a summary of the summit and a call to action for end-of-life and palliative care social workers to engage in seeking funding to conduct needed research and to ensure our unique perspective is represented.

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

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.

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

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

Fiftieth Anniversary at the summit : 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).

CERN Multimedia

2005-01-01

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.

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.

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...

[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.

Evidence acquisition and evaluation for evidence summit on enhancing provision and use of maternal health services through financial incentives.

Science.gov (United States)

Higgs, Elizabeth S; Stammer, Emily; Roth, Rebecca; Balster, Robert L

2013-12-01

Recognizing the need for evidence to inform US Government and governments of the low- and middle-income countries on efficient, effective maternal health policies, strategies, and programmes, the US Government convened the Evidence Summit on Enhancing Provision and Use of Maternal Health Services through Financial Incentives in April 2012 in Washington, DC, USA. This paper summarizes the background and methods for the acquisition and evaluation of the evidence used for achieving the goals of the Summit. The goal of the Summit was to obtain multidisciplinary expert review of literature to inform both US Government and governments of the low- and middle-income countries on evidence-informed practice, policies, and strategies for financial incentives. Several steps were undertaken to define the tasks for the Summit and identify the appropriate evidence for review. The process began by identifying focal questions intended to inform governments of the low-and middle-income countries and the US Government about the efficacy of supply- and demand-side financial incentives for enhanced provision and use of quality maternal health services. Experts were selected representing the research and programme communities, academia, relevant non-governmental organizations, and government agencies and were assembled into Evidence Review Teams. This was followed by a systematic process to gather relevant peer-reviewed literature that would inform the focal questions. Members of the Evidence Review Teams were invited to add relevant papers not identified in the initial literature review to complete the bibliography. The Evidence Review Teams were asked to comply with a specific evaluation framework for recommendations on practice and policy based on both expert opinion and the quality of the data. Details of the search processes and methods used for screening and quality reviews are described.

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.

Consensus statement of the international summit on intellectual disability and Dementia related to post-diagnostic support.

Science.gov (United States)

Dodd, Karen; Watchman, Karen; Janicki, Matthew P; Coppus, Antonia; Gaertner, Claudia; Fortea, Juan; Santos, Flavia H; Keller, Seth M; Strydom, Andre

2017-09-07

Post diagnostic support (PDS) has varied definitions within mainstream dementia services and different health and social care organizations, encompassing a range of supports that are offered to adults once diagnosed with dementia until death. An international summit on intellectual disability and dementia held in Glasgow, Scotland in 2016 identified how PDS applies to adults with an intellectual disability and dementia. The Summit proposed a model that encompassed seven focal areas: post-diagnostic counseling; psychological and medical surveillance; periodic reviews and adjustments to the dementia care plan; early identification of behaviour and psychological symptoms; reviews of care practices and supports for advanced dementia and end of life; supports to carers/ support staff; and evaluation of quality of life. It also explored current practices in providing PDS in intellectual disability services. The Summit concluded that although there is limited research evidence for pharmacological or non-pharmacological interventions for people with intellectual disability and dementia, viable resources and guidelines describe practical approaches drawn from clinical practice. Post diagnostic support is essential, and the model components in place for the general population, and proposed here for use within the intellectual disability field, need to be individualized and adapted to the person's needs as dementia progresses. Recommendations for future research include examining the prevalence and nature of behavioral and psychological symptoms (BPSD) in adults with an intellectual disability who develop dementia, the effectiveness of different non-pharmacological interventions, the interaction between pharmacological and non-pharmacological interventions, and the utility of different models of support.

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

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...

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.

The effects of shared situational awareness on functional and hospital outcomes of hospitalized older adults with heart failure

Directory of Open Access Journals (Sweden)

Lee JH

2014-07-01

Full Text Available Joo H Lee,1 Sun J Kim,2,3 Julia Lam,4 Sulgi Kim,5 Shunichi Nakagawa,6 Ji W Yoo7,8 1Department of Media and Communication, Hanyang University College of Social Sciences, Seoul, Korea; 2Department of Public Health, 3Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Korea; 4University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; 5Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH, USA; 6Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA; 7Center for Senior Health and Longevity, Aurora Health Care, 8Department of Medicine, University of Wisconsin School of Medicine and Public Health, Milwaukee, WI, USA Background: Functional decline of hospitalized older adults is common and triggers health care expenditures. Physical therapy can retard the functional decline that occurs during hospitalization. This study aims to examine whether shared situational awareness (SSA intervention may enhance the benefits of physical therapy for hospitalized older persons with a common diagnosis, heart failure. Method: An SSA intervention that involved daily multidisciplinary meetings was applied to the care of functionally declining older adults admitted to the medicine floor for heart failure. Covariates were matched between the intervention group (n=473 and control group (n=475. Both intervention and control groups received physical therapy for ≥0.5 hours per day. The following three outcomes were compared between groups: 1 disability, 2 transition to skilled nursing facility (SNF, post-acute care setting, and 3 30-day readmission rate. Results: Disability was lower in the intervention group (28% than in the control group (37% (relative risk [RR] =0.74; 95% confidence interval [CI], 0.35–0.97; P=0.026, and transition to SNF was lower in the intervention group (22% than in the control group (30% (RR =0.77; 95% CI, 0.39�

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.

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

Links between nuclear medicine and radiopharmacy

International Nuclear Information System (INIS)

Pelegrin, M.; Francois-Joubert, A.; Chassel, M.L.; Desruet, M.D.; Bolot, C.; Lao, S.

2010-01-01

Radiopharmaceuticals are nowadays under the responsibility of the radio-pharmacist because of their medicinal product status. Radiopharmacy belongs to the hospital pharmacy department, nevertheless, interactions with nuclear medicine department are important: rooms are included or located near nuclear medicine departments in order to respect radiation protection rules, more over staff, a part of the material and some activities are shared between the two departments. Consequently, it seems essential to formalize links between the radiopharmacy and the nuclear medicine department, setting the goals to avoid conflicts and to ensure patients' security. Modalities chosen for this formalization will depend on the establishment's organization. (authors)

Air quality real-time forecast before and during the G-20 Summit 2016 in Hangzhou with the WRF-CMAQ and WRF/Chem systems: Evaluation and Emission Reduction Effects

Science.gov (United States)

The 2016 G-20 Hangzhou summit, the eleventh annual meeting of the G-20 heads of government, will be held during September 3-5, 2016 in Hangzhou, China. For a successful summit, it is important to ensure good air quality. To achieve this goal, governments of Hangzhou and its surr...

Proceedings of the first international summit on intestinal anastomotic leak, Chicago, Illinois, October 4-5, 2012

NARCIS (Netherlands)

Shogan, B.D.; An, G.C.; Schardey, H.M.; Matthews, J.B.; Umanskiy, K.; Fleshman, J.W.; Hoeppner, J.; Fry, D.E.; Garcia-Granereo, E.; Jeekel, H.; Goor, H. van; Dellinger, E.P.; Konda, V.; Gilbert, J.A.; Auner, G.W.; Alverdy, J.C.

2014-01-01

OBJECTIVE: The first international summit on anastomotic leak was held in Chicago in October, 2012 to assess current knowledge in the field and develop novel lines of inquiry. The following report is a summary of the proceedings with commentaries and future prospects for clinical trials and

Nuclear Medicine Practice in Kenya

International Nuclear Information System (INIS)

Ndrirangu, T.T.

2017-01-01

Nuclear medicine is a medical specialty that relies on the use of nuclear technology in the diagnosis and treatment (therapy) of diseases. Nuclear medicine uses the principle that a certain radiopharmaceutical (tracer) will at a certain point in time have a preferential uptake by a particular body, tissue or cell. Unlike other radiation applications for medical use, nuclear medicine uses open (unsealed) sources of radiation. The tracer is introduced into the body of the patient through several routes (oral, intravenous, percutaneous, intradermally, inhalation, intracapsular etc) and s/he becomes the source of radiation. Early diagnosis of diseases coupled with associated timely therapeutic intervention will lead to better prognosis. In a country with an estimated population of 42 million in 2017, Kenya has only two (2) nuclear medicine facilities (units) that is Kenyatta National Hospital - Public facility and Aga Khan University Hospital which is a Private facility. Being a relatively new medical discipline in Kenya, several measures have been taken by the clinical nuclear medicine team to create awareness at various levels. Kenya does not manufacture radiopharmaceuticals. We therefore have to import them from abroad and this makes them quite expensive, and the process demanding. There is no local training in nuclear medicine and staff have to be sent abroad for training, making this quite expensive and cumbersome and the IAEA has been complimenting in this area. With concerted effort by all stakeholders at the individual, national and international level, it is possible for Kenya to effectively sustain clinical nuclear medicine service not only as a diagnostic tool in many disease entities, but also play an increasingly important role in therapy

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.

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 ...

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).

First Conference on African Youth Nuclear Summit 2017: Nuclear for a Sustainable Future

International Nuclear Information System (INIS)

2017-03-01

Kenyan Young Generation in Nuclear (KYGN) hosted the inaugural African Youth Nuclear Summit, dubbed AYNS2017 that took place on the 27th to 30th March, 2017, Nairobi, Kenya. The participants were drawn from academia, research and development institutes, radiation services providers, health institutions, nuclear facilities and regulatory bodies. They shared experiences, exchanged ideas and built networks on issues related to safe application of nuclear science and technology. The theme of the summit was ''Nuclear for a Sustainable future'', which centered on three thematic areas: Nuclear powering Africa, Radiation Protection and safety culture; and application of nuclear science and technology for a sustainable future. The Director General, World Nuclear Association who pointed out that nuclear energy had made a major contribution to world energy output and was set to increase by two and half time by 2040. The importance of nuclear science and technology for a sustainable socio-economic development in Africa shared and highlight on many areas IAEA has helped member states in improving the life of its populations. The main activities of project 60 whose focus is to strengthen the nuclear security culture in East and Central Africa through improved regulation, training, capacity and awareness were highlighted

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…

Characteristics of the summit lakes of Ambae volcano and their potential for generating lahars

Directory of Open Access Journals (Sweden)

P. Bani

2009-08-01

Full Text Available Volcanic eruptions through crater lakes often generate lahars, causing loss of life and property. On Ambae volcano, recent eruptive activities have rather tended to reduce the water volume in the crater lake (Lake Voui, in turn, reducing the chances for outburst floods. Lake Voui occupies a central position in the summit caldera and is well enclosed by the caldera relief. Eruptions with significantly higher magnitude than that of 1995 and 2005 are required for an outburst. A more probable scenario for lahar events is the overflow from Lake Manaro Lakua bounded on the eastern side by the caldera wall. Morphology and bathymetry analysis have been used to identify the weakest point of the caldera rim from which water from Lake Manaro Lakua may overflow to initiate lahars. The 1916 disaster described on south-east Ambae was possibly triggered by such an outburst from Lake Manaro Lakua. Taking into account the current level of Lake Manaro Lakua well below a critical overflow point, and the apparently low potential of Lake Voui eruptions to trigger lahars, the Ambae summit lakes may not be directly responsible for numerous lahar deposits identified around the Island.

Recommendations for the safety preparation of sterile medicines in medical wards

Directory of Open Access Journals (Sweden)

Ana M.ª Martín de Rosales Cabrera

2014-01-01

Full Text Available Objective: To develop a recommendations guide about the preparation of sterile medicines in medical wards, and to figure out the current situation of different Spanish hospitals, regarding the preparation of sterile medicines outside the pharmacy. Methods: The autors reviewed the available international guidelines in order to summarize the main quality recommendations. To know about the current situation in Spanish hospitals, a 30 questions survey was designed and spread to 500 different hospitals. Answers were analysed with Survey monkey® platform in the period February-July 2012. Results: Based on the literature review, the authors agreed a recommendations list for the safe preparation of sterile medicines in medical wards, which was structured in 8 sections. Regarding the survey results, 8.4% of the hospitals answered, showing a great variability among centres in the quality requirements for sterile compounding outside the pharmacy. It should be pointed out the lack of assigned areas for drug preparation in wards, the lack of protocols to discern which kind of medicines can be compounded in wards as well as the poor recommendations about garment and aseptic technique. Conclusions: The authors confirm the absence of qualified practice standards to be applied in the preparation of sterile medicines in medical wards, as well as the great variability of diary practice. The implementation of quality and safety recommendations in the preparation of sterile medicines in medical wards may contribute to improve patient safety.

Relationship between hospital financial performance and publicly reported outcomes.

Science.gov (United States)

Nguyen, Oanh Kieu; Halm, Ethan A; Makam, Anil N

2016-07-01

Hospitals that have robust financial performance may have improved publicly reported outcomes. To assess the relationship between hospital financial performance and publicly reported outcomes of care, and to assess whether improved outcome metrics affect subsequent hospital financial performance. Observational cohort study. Hospital financial data from the Office of Statewide Health Planning and Development in California in 2008 and 2012 were linked to data from the Centers for Medicare and Medicaid Services Hospital Compare website. Hospital financial performance was measured by net revenue by operations, operating margin, and total margin. Outcomes were 30-day risk-standardized mortality and readmission rates for acute myocardial infarction (AMI), congestive heart failure (CHF), and pneumonia (PNA). Among 279 hospitals, there was no consistent relationship between measures of financial performance in 2008 and publicly reported outcomes from 2008 to 2011 for AMI and PNA. However, improved hospital financial performance (by any of the 3 measures) was associated with a modest increase in CHF mortality rates (ie, 0.26% increase in CHF mortality rate for every 10% increase in operating margin [95% confidence interval: 0.07%-0.45%]). Conversely, there were no significant associations between outcomes from 2008 to 2011 and subsequent financial performance in 2012 (P > 0.05 for all). Robust financial performance is not associated with improved publicly reported outcomes for AMI, CHF, and PNA. Financial incentives in addition to public reporting, such as readmissions penalties, may help motivate hospitals with robust financial performance to further improve publicly reported outcomes. Reassuringly, improved mortality and readmission rates do not necessarily lead to loss of revenue. Journal of Hospital Medicine 2016;11:481-488. © 2016 Society of Hospital Medicine. © 2016 Society of Hospital Medicine.

"Humanities in medicine".

Science.gov (United States)

Odenbach, V

1999-01-01

Progress in medicine and medical technology along with economic constraints have led to increasing structural change in the hospital sector over the past years. As a result of these changes, the social needs of the patients are in danger of being eclipsed by the requirements of the optimization of hospital processes. Cultural activities can be a meaningful way to offset such changes. They stimulate individuals, promote well-being and prompt discussion. Cultural activities in hospitals are directed at patients, hospital employees and people in the community. In Germany, the 'National Association for Culture and Health MediArt' founded in 1995 has been responsible for the UNESCO project "Art in Hospitals" 1988-1997. This paper provides a snapshot of German hospitals that have integrated cultural activities in an exemplary fashion. The activities include such events as 'international cultural days', 'theatre groups', 'dance workshops', 'clinclowns'. Participants include professionals, employees, patients and visitors from the community. The activities are organized by individuals and/or cultural departments created to act as 'health centres' for musical, theatrical, dance and plastic art events.

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

76 FR 49764 - Notice of FERC Staff Attendance at the Entergy ICT Transmission Planning Summit and Entegry...

Science.gov (United States)

2011-08-11

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Notice of FERC Staff Attendance at the Entergy ICT Transmission Planning Summit and Entegry Regional State Committee Meeting The Federal Energy.... Their attendance is part of the Commission's ongoing outreach efforts. Entergy ICT Transmission Planning...

Internal medicine board certification and career pathways in Japan.

Science.gov (United States)

Koike, Soichi; Matsumoto, Masatoshi; Ide, Hiroo; Kawaguchi, Hideaki; Shimpo, Masahisa; Yasunaga, Hideo

2017-05-08

Establishing and managing a board certification system is a common concern for many countries. In Japan, the board certification system is under revision. The purpose of this study was to describe present status of internal medicine specialist board certification, to identify factors associated with maintenance of board certification and to investigate changes in area of practice when physicians move from hospital to clinic practice. We analyzed 2010 and 2012 data from the Survey of Physicians, Dentists and Pharmacists. We conducted logistic regression analysis to identify factors associated with the maintenance of board certification between 2010 and 2012. We also analyzed data on career transition from hospitals to clinics for hospital physicians with board certification. It was common for physicians seeking board certification to do so in their early career. The odds of maintaining board certification were lower in women and those working in locations other than academic hospitals, and higher in physicians with subspecialty practice areas. Among hospital physicians with board certification who moved to clinics between 2010 and 2012, 95.8% remained in internal medicine or its subspecialty areas and 87.7% maintained board certification but changed their practice from a subspecialty area to more general internal medicine. Revisions of the internal medicine board certification system must consider different physician career pathways including mid-career moves while maintaining certification quality. This will help to secure an adequate number and distribution of specialists. To meet the increasing demand for generalist physicians, it is important to design programs to train specialists in general practice.

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.

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

Radiological impact of diagnostic nuclear medicine technology on the Quebec population (patients and workers) in 1989

International Nuclear Information System (INIS)

Renaud, L.; Blanchette, J.

1992-01-01

Using the results of a six month survey on the doses received by non-monitored hospital workers from diagnostic nuclear medicine patients (DNMP) in three hospitals and published statistics on Quebec's workers and hospitals, an evaluation of the radiological impact of DNMP has been calculated on the Quebec's population. In 1989, diagnostic nuclear medicine gave an average of 6.4 mSv/act or a total of 2,800 sv-man. The diagnostic nuclear medicine technologists' community received 0.4 Sv-man and the non-monitored hospital workers 1.7 Sv-man from the DNMP in the same year. (author)

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.

Experience with Nuclear Medicine Information System

Directory of Open Access Journals (Sweden)

Bilge Volkan-Salanci

2012-12-01

Full Text Available Objective: Radiology information system (RIS is basically evolved for the need of radiologists and ignores the vital steps needed for a proper work flow of Nuclear Medicine Department. Moreover, CT/MRI oriented classical PACS systems are far from satisfying Nuclear Physicians like storing dynamic data for reprocessing and quantitative analysis of colored images. Our purpose was to develop a workflow based Nuclear Medicine Information System (NMIS that fulfills the needs of Nuclear Medicine Department and its integration to hospital PACS system. Material and Methods: Workflow in NMIS uses HL7 (health level seven and steps include, patient scheduling and retrieving information from HIS (hospital information system, radiopharmacy, acquisition, digital reporting and approval of the reports using Nuclear Medicine specific diagnostic codes. Images and dynamic data from cameras of are sent to and retrieved from PACS system (Corttex© for reprocessing and quantitative analysis. Results: NMIS has additional functions to the RIS such as radiopharmaceutical management program which includes stock recording of both radioactive and non-radioactive substances, calculation of the radiopharmaceutical dose for individual patient according to body weight and maximum permissible activity, and calculation of radioactivity left per unit volume for each radionuclide according their half lives. Patient scheduling and gamma camera patient work list settings were arranged according to specific Nuclear Medicine procedures. Nuclear Medicine images and reports can be retrieved and viewed from HIS. Conclusion: NMIS provides functionality to standard RIS and PACS system according to the needs of Nuclear Medicine. (MIRT 2012;21:97-102

What Medicines Are and What They Do (For Kids)

Science.gov (United States)

... First Aid & Safety Doctors & Hospitals Videos Recipes for Kids Kids site Sitio para niños How the Body Works ... Medicines Are and What They Do KidsHealth / For Kids / What Medicines Are and What They Do What's ...

Hospital clinical pharmacy services in Vietnam.

Science.gov (United States)

Trinh, Hieu T; Nguyen, Huong T L; Pham, Van T T; Ba, Hai L; Dong, Phuong T X; Cao, Thao T B; Nguyen, Hanh T H; Brien, Jo-Anne

2018-04-07

Background Clinical pharmacy is key to the quality use of medicines. While there are different approaches in different countries, international perspectives may inform health service development. The Vietnamese Ministry of Health introduced a legal regulation of clinical pharmacy services in December 2012. Objective To describe the services, and to explore reported barriers and facilitators in implementing clinical pharmacy activities in Vietnamese hospitals after the introduction of Vietnamese Ministry of Health legal regulation. Setting Thirty-nine hospitals in Hanoi, Vietnam, including 22 provincial and 17 district hospitals. Method A mixed methods study was utilized. An online questionnaire was sent to the hospitals. In-depth interviews were conducted with pairs of nominated pharmacists at ten of these hospitals. The questionnaire focused on four areas: facilities, workforce, policies and clinical pharmacy activities. Main outcome measure Proportion of clinical pharmacy activities in hospitals. Themes in clinical pharmacy practice. Results 34/39 (87%) hospitals had established clinical pharmacy teams. Most activities were non-patient-specific (87%) while the preliminary patient-specific clinical pharmacy services were available in only 8/39 hospitals (21%). The most common non-patient-specific activities were providing medicines information (97%), reporting adverse drug reactions (97%), monitoring medication usage (97%). The patient specific activities varied widely between hospitals and were ad hoc. The main challenges reported were: lack of workforce and qualified clinical pharmacists. Conclusion While most hospitals had hospital-based pharmacy activities, the direct patient care was limited. Training, education and an expanded work forces are needed to improve clinical pharmacy services.

State of emergency medicine in Rwanda 2015: an innovative trainee and trainer model.

Science.gov (United States)

Mbanjumucyo, Gabin; DeVos, Elizabeth; Pulfrey, Simon; Epino, Henry M

2015-01-01

The 1994 Rwandan war and genocide left more than 1 million people dead; millions displaced; and the country's economic, social, and health infrastructure destroyed. Despite remaining one of the poorest countries in the world, Rwanda has made remarkable gains in health, social, and economic development over the last 20 years, but modern emergency care has been slow to progress. Rwanda has recently established the Human Resources for Health program to rapidly build capacity in multiple sectors of its healthcare delivery system, including emergency medicine. This project involves multiple medical and surgical residencies, nursing programs, allied health professional trainings, and hospital administrative support. A real strength of the program is that trainers work with international faculty at Rwanda's referral hospital, but also as emergency medicine specialty trainers when returning to their respective district hospitals. Rwanda's first emergency medicine trainees are playing a unique and important role in the implementation of emergency care systems and education in the country's district hospitals. While there has been early vital progress in building emergency medicine's foundations in Rwanda, there remains much work to be done. This will be accomplished with careful planning and strong commitment from the country's healthcare and emergency medicine leaders.

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.

Properties of horizontally oriented ice crystals observed by polarization lidar over summit, Greenland

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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.

Case assessments for nuclear medicine registrars

International Nuclear Information System (INIS)

Farlow, D.

1994-01-01

Westmead Hospital set some of the recent nuclear medicine cases for registrar training. These case assessments have been completed by the registrars and he thought it might be interesting for the general nuclear medicine community to attempt the cases themselves and compare their answers with the model reports and patient follow-ups. Edited versions of two cases and model answers are presented. 35 refs

The Perils of Complementary Alternative Medicine

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Michael J. Bayme

2014-07-01

Full Text Available More than 11,000 articles lauding alternative medicine appear in the PubMed database, but there are only a few articles describing the complications of such care. Two patients suffering from complications of alternative medicine were treated in our hospital: one patient developed necrotizing fasciitis after acupuncture, and the second developed an epidural hematoma after chiropractic manipulation. These complications serve as a clarion call to the Israeli Health Ministry, as well as to health ministries around the world, to include complementary medicine under its inspection and legislative authority.

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.

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.

Teaching emergency medicine with workshops improved medical student satisfaction in emergency medicine education

Directory of Open Access Journals (Sweden)

Sricharoen P

2015-02-01

Full Text Available Pungkava Sricharoen,1 Chaiyaporn Yuksen,1 Yuwares Sittichanbuncha,1 Kittisak Sawanyawisuth2,3 1Department of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; 2Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; 3The Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH, Khon Kaen University, Khon Kaen, Thailand Background: There are different teaching methods; such as traditional lectures, bedside teaching, and workshops for clinical medical clerkships. Each method has advantages and disadvantages in different situations. Emergency Medicine (EM focuses on emergency medical conditions and deals with several emergency procedures. This study aimed to compare traditional teaching methods with teaching methods involving workshops in the EM setting for medical students. Methods: Fifth year medical students (academic year of 2010 at Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand participated in the study. Half of students received traditional teaching, including lectures and bedside teaching, while the other half received traditional teaching plus three workshops, namely, airway workshop, trauma workshop, and emergency medical services workshop. Student evaluations at the end of the clerkship were recorded. The evaluation form included overall satisfaction, satisfaction in overall teaching methods, and satisfaction in each teaching method. Results: During the academic year 2010, there were 189 students who attended the EM rotation. Of those, 77 students (40.74% were in the traditional EM curriculum, while 112 students were in the new EM curriculum. The average satisfaction score in teaching method of the new EM curriculum group was higher than the traditional EM curriculum group (4.54 versus 4.07, P-value <0.001. The top three highest average satisfaction scores in the new EM curriculum group were trauma

out-patient prescribing practices at mbagathi district hospital-nairobi

African Journals Online (AJOL)

2013-12-01

Dec 1, 2013 ... Objective: To assess medicine use practices by using WHO prescribing and patient care indicators in .... from the hospital administration and ethics approval ..... additional funds to purchase medicines and medical supplies.

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)

Building a sustainable clinical academic workforce to meet the future healthcare needs of Australia and New Zealand: report from the first summit meeting.

Science.gov (United States)

Windsor, J; Searle, J; Hanney, R; Chapman, A; Grigg, M; Choong, P; Mackay, A; Smithers, B M; Churchill, J A; Carney, S; Smith, J A; Wainer, Z; Talley, N J; Gladman, M A

2015-09-01

The delivery of healthcare that meets the requirements for quality, safety and cost-effectiveness relies on a well-trained medical workforce, including clinical academics whose career includes a specific commitment to research, education and/or leadership. In 2011, the Medical Deans of Australia and New Zealand published a review on the clinical academic workforce and recommended the development of an integrated training pathway for clinical academics. A bi-national Summit on Clinical Academic Training was recently convened to bring together all relevant stakeholders to determine how best to do this. An important part understood the lessons learnt from the UK experience after 10 years since the introduction of an integrated training pathway. The outcome of the summit was to endorse strongly the recommendations of the medical deans. A steering committee has been established to identify further stakeholders, solicit more information from stakeholder organisations, convene a follow-up summit meeting in late 2015, recruit pilot host institutions and engage the government and future funders. © 2015 Royal Australasian College of Physicians.

[Nutritional status and risk in hospitalized children].

Science.gov (United States)

Hankard, R; Bloch, J; Martin, P; Randrianasolo, H; Bannier, M F; Machinot, S; Cézard, J P

2001-11-01

A few studies report malnutrition in hospitalized patients. This one-day cross-sectional survey performed in January 1999 assessed nutritional status and protein-energy intake in a pediatric population hospitalized in medicine or surgery units. Every child older than six months, hospitalized for more than 48 h and free of nutritional support (parenteral, enteral, or special regimens for metabolic diseases) was included. Fifty-eight children among the 183 present the day of the study met the inclusion criteria and were included in the statistical analysis. They were hospitalized in medicine (48%), psychiatry (31%) and surgery (21%). The body mass index (BMI) was below -2 standard deviations (DS) in 21% of them. Excluding patients with anorexia nervosa, BMI was +2 SD, or in between these limits in respectively 12, 14 and 74%. Energy intake measured at the hospital was below 75% of the recommended dietary allowances in two-thirds of the children whether malnourished or not. Fifty percent of the malnourished children had been referred to a dietician the day of the study. Malnutrition is frequent in a population of hospitalized children. Energy intake and referral to a dietician are insufficient.

Mapping of medicine data with k-means and apriori combinations based on patient diagnosis

Science.gov (United States)

Dharshinni, N. P.; Mawengkang, H.; Nasution, M. K. M.

2018-03-01

Medicine is one of the items needed by sick society, the high influence of medicine on service and the economy in hospitals, requires mapping and planning the optimal need for medicines according to the conditions, because 50% -60% of hospital income is sourced from medicine sales. The purpose of this study was to find patterns of doctor’s prescription medicine association with sales data using an apriori algorithm based on data grouping using a k-means algorithm. The results of the experiments show that medicine prescription data with medicine sales have significant differences so that the data can not be used as materials for medicine planning, this is due to some indication of one of the unavailability of medicine caused by mapping inaccuracy so that the planning of medicine requirements is not optimal. The results of this analysis can be used as input materials in decision making, so the planning needs of medicines can be in accordance with the development of patient disease patterns.

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.

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.

The Danish database for acute and emergency hospital contacts

Directory of Open Access Journals (Sweden)

Lassen AT

2016-10-01

Full Text Available Annmarie T Lassen,1 Henrik Jørgensen,2 Hanne Blæhr Jørsboe,3,4 Annette Odby,5 Mikkel Brabrand,6 Jacob Steinmetz,7 Julie Mackenhauer,8 Hans Kirkegaard,8 Christian Fynbo Christiansen9 1Department of Emergency Medicine, Odense University Hospital, Odense, 2Department of Surgery, Hospital of Northern Sjaelland, Hilleroed, 3Department of Emergency Medicine, Nykobing F Hospital, 4Department of Hospital Administration, Nykobing F Hospital, Nykøbing Falster, 5The Danish Clinical Registers, Registry Support Centre for Health Quality and Informatics, Aarhus, 6Department of Emergency Medicine, Hospital of South West Jutland, Esbjerg, 7Department of Anaesthesia, Rigshospitalet, Copenhagen University Hospital, Copenhagen, 8Research Center for Emergency Medicine, Aarhus University, 9Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark Aim for database: Aim of the Danish database for acute and emergency hospital contacts (DDAEHC is to monitor the quality of care for all unplanned hospital contacts in Denmark (acute and emergency contacts.Study population: The DDAEHC is a nationwide registry that completely covers all acute and emergency somatic hospital visits at individual level regardless of presentation site, presenting complaint, and department designation since January 1, 2013.Main variables: The DDAEHC includes ten quality indicators – of which two are outcome indicators and eight are process indicators. Variables used to compute these indicators include among others day and time of hospital contact, vital status, ST-elevation myocardial infarction diagnosis, date and time of relevant procedure (percutaneous coronary intervention, coronary angiography, X-ray of wrist, and gastrointestinal surgery as well as time for triage and physician judgment. Data are currently gathered from The Danish National Patient Registry, two existing databases (Danish Stroke Register and Danish Database for Emergency Surgery, and will

Patient assessment of effectiveness and satisfaction with traditional medicine, globalized complementary and alternative medicines, and allopathic medicines for cancer in Pakistan.

Science.gov (United States)

Tovey, Philip; Broom, Alex; Chatwin, John; Hafeez, Muhammad; Ahmad, Salma

2005-09-01

Virtually no research has been conducted on patient assessments of traditional medicines and allopathic medicines for cancer care in poorer countries marked by pluralistic medical environments. Pakistan represents an excellent case for such a study because of the coexistence of culturally and historically specific indigenous traditional medicine, the strong presence of allopathic medicine, and, to a lesser extent, the availability of some globalized complementary and alternative medicines. To gain a preliminary understanding of cancer patients' perceptions of effectiveness and satisfaction with traditional medicine, globalized complementary and alternative medicine, and allopathy in the context of a pluralistic medical environment. Structured survey of 362 cancer patients, from diverse regions in the Punjab province and Northwest Frontier province, who were being treated in 4 different hospitals in Lahore, Pakistan. Use of traditional medicine remains high among cancer patients, with traditional healers used by the majority of those surveyed. Although patients' perceptions of the overall effectiveness of traditional medicines for treating cancer are low, those patients who do use traditional medicines still have high levels of satisfaction with these modalities. This is distinct from levels of satisfaction with, and perceptions of effectiveness of, Western cancer treatments, which were synonymous in this group of patients. Important differences in patient perceptions were found within groups (eg, between different forms of traditional healers) as well as between them. This study showed considerable support for complementary and alternative medicine/traditional medicine but also significant variation in usage of and perceptions of local traditional medicines. More research needs to be done to explore the social processes underlying this variation in cancer patients' preferences for particular traditional medicines.

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