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Sample records for hrp exploration medical

  1. Human Research Program (HRP) Exploration Medical Capability (ExMC) Standing Review Panel (SRP)

    Science.gov (United States)

    Cintron, Nitza; Dutson, Eric; Friedl, Karl; Hyman, William; Jemison, Mae; Klonoff, David

    2009-01-01

    The SRP believes strongly that regularly performed in-flight crew assessments are needed in order to identify a change in health status before a medical condition becomes clinically apparent. It is this early recognition in change that constitutes the foundation of the "occupational health model" expounded in the HRP Requirements Document as a key component of the HRP risk mitigation strategy that will enable its objective of "prevention and mitigation of human health and performance risks". A regular crew status examination of physiological and clinical performance is needed. This can be accomplished through instrumented monitoring of routine embedded tasks. The SRP recommends addition of a new gap to address this action under Category 3.0 Mitigate the Risk. This new gap is closely associated with Task 4.19 which addresses the lack of adequate biomedical monitoring capabilities for performing periodic clinical status evaluations and contingency medical monitoring. A corollary to these gaps is the critical emphasis on preventive medicine, not only during pre- and post-flight phases of a mission as is the current practice, but continued into the in-flight phases of exploration class missions.

  2. Exploration Medical Capability - Technology Watch

    Science.gov (United States)

    Krihak, Michael; Watkins, Sharmila; Barr, Yael; Barsten, Kristina; Fung, Paul; Baumann, David

    2011-01-01

    The objectives of the Technology Watch process are to identify emerging, high-impact technologies that augment current ExMC development efforts, and to work with academia, industry, and other government agencies to accelerate the development of medical care and research capabilities for the mitigation of potential health issues that could occur during space exploration missions. The establishment of collaborations with these entities is beneficial to technology development, assessment and/or insertion. Such collaborations also further NASA s goal to provide a safe and healthy environment for human exploration. The Tech Watch project addresses requirements and capabilities identified by knowledge and technology gaps that are derived from a discrete set of medical conditions that are most likely to occur on exploration missions. These gaps are addressed through technology readiness level assessments, market surveys, collaborations and distributed innovation opportunities. Ultimately, these gaps need to be closed with respect to exploration missions, and may be achieved through technology development projects. Information management is a key aspect to this process where Tech Watch related meetings, research articles, collaborations and partnerships are tracked by the HRP s Exploration Medical Capabilities (ExMC) Element. In 2011, ExMC will be introducing the Tech Watch external website and evidence wiki that will provide access to ExMC technology and knowledge gaps, technology needs and requirements documents.

  3. Exploration Medical System Demonstration (EMSD) Project

    Science.gov (United States)

    Chin, Duane

    2012-01-01

    The Exploration Medical System Demonstration (EMSD) is a project under the Exploration Medical Capability (ExMC) element managed by the Human Research Program (HRP). The vision for the EMSD is to utilize ISS as a test bed to show that several medical technologies needed for an exploration mission and medical informatics tools for managing evidence and decision making can be integrated into a single system and used by the on-orbit crew in an efficient and meaningful manner. Objectives: a) Reduce and even possibly eliminate the time required for on-orbit crew and ground personnel (which include Surgeon, Biomedical Engineer (BME) Flight Controller, and Medical Operations Data Specialist) to access and move medical data from one application to another. b) Demonstrate that the on-orbit crew has the ability to access medical data/information using an intuitive and crew-friendly software solution to assist/aid in the treatment of a medical condition. c) Develop a common data management framework and architecture that can be ubiquitously used to automate repetitive data collection, management, and communications tasks for all crew health and life sciences activities.

  4. The Space Medicine Exploration Medical Condition List

    Science.gov (United States)

    Watkins, Sharmi; Barr, Yael; Kerstman, Eric

    2011-01-01

    Exploration Medical Capability (ExMC) is an element of NASA s Human Research Program (HRP). ExMC's goal is to address the risk of the "Inability to Adequately Recognize or Treat an Ill or Injured Crewmember." This poster highlights the approach ExMC has taken to address this risk. The Space Medicine Exploration Medical Condition List (SMEMCL) was created to define the set of medical conditions that are most likely to occur during exploration space flight missions. The list was derived from the International Space Station Medical Checklist, the Shuttle Medical Checklist, in-flight occurrence data from the Lifetime Surveillance of Astronaut Health, and NASA subject matter experts. The list of conditions was further prioritized for eight specific design reference missions with the assistance of the ExMC Advisory Group. The purpose of the SMEMCL is to serve as an evidence-based foundation for the conditions that could affect a crewmember during flight. This information is used to ensure that the appropriate medical capabilities are available for exploration missions.

  5. Exploration Medical System Demonstration

    Science.gov (United States)

    Rubin, D. A.; Watkins, S. D.

    2014-01-01

    BACKGROUND: Exploration class missions will present significant new challenges and hazards to the health of the astronauts. Regardless of the intended destination, beyond low Earth orbit a greater degree of crew autonomy will be required to diagnose medical conditions, develop treatment plans, and implement procedures due to limited communications with ground-based personnel. SCOPE: The Exploration Medical System Demonstration (EMSD) project will act as a test bed on the International Space Station (ISS) to demonstrate to crew and ground personnel that an end-to-end medical system can assist clinician and non-clinician crew members in optimizing medical care delivery and data management during an exploration mission. Challenges facing exploration mission medical care include limited resources, inability to evacuate to Earth during many mission phases, and potential rendering of medical care by non-clinicians. This system demonstrates the integration of medical devices and informatics tools for managing evidence and decision making and can be designed to assist crewmembers in nominal, non-emergent situations and in emergent situations when they may be suffering from performance decrements due to environmental, physiological or other factors. PROJECT OBJECTIVES: The objectives of the EMSD project are to: a. Reduce or eliminate the time required of an on-orbit crew and ground personnel to access, transfer, and manipulate medical data. b. Demonstrate that the on-orbit crew has the ability to access medical data/information via an intuitive and crew-friendly solution to aid in the treatment of a medical condition. c. Develop a common data management framework that can be ubiquitously used to automate repetitive data collection, management, and communications tasks for all activities pertaining to crew health and life sciences. d. Ensure crew access to medical data during periods of restricted ground communication. e. Develop a common data management framework that

  6. Review of HRP Positions

    Energy Technology Data Exchange (ETDEWEB)

    Center for Reliability Studies

    2007-01-01

    The Department of Energy (DOE) Human Reliability Program (HRP), published as 10 CFR Part 712, is currently being reviewed and revised to address concerns identified during its implementation. Although these ''page changes'' primarily incorporate clarification of terms and language, the following discussion relates to broadening the definition of positions that require HRP certification that is found in {section}712.10.

  7. Exploration Medical System Trade Study Tools Overview

    Science.gov (United States)

    Mindock, J.; Myers, J.; Latorella, K.; Cerro, J.; Hanson, A.; Hailey, M.; Middour, C.

    2018-01-01

    ExMC is creating an ecosystem of tools to enable well-informed medical system trade studies. The suite of tools address important system implementation aspects of the space medical capabilities trade space and are being built using knowledge from the medical community regarding the unique aspects of space flight. Two integrating models, a systems engineering model and a medical risk analysis model, tie the tools together to produce an integrated assessment of the medical system and its ability to achieve medical system target requirements. This presentation will provide an overview of the various tools that are a part of the tool ecosystem. Initially, the presentation's focus will address the tools that supply the foundational information to the ecosystem. Specifically, the talk will describe how information that describes how medicine will be practiced is captured and categorized for efficient utilization in the tool suite. For example, the talk will include capturing what conditions will be planned for in-mission treatment, planned medical activities (e.g., periodic physical exam), required medical capabilities (e.g., provide imaging), and options to implement the capabilities (e.g., an ultrasound device). Database storage and configuration management will also be discussed. The presentation will include an overview of how these information tools will be tied to parameters in a Systems Modeling Language (SysML) model, allowing traceability to system behavioral, structural, and requirements content. The discussion will also describe an HRP-led enhanced risk assessment model developed to provide quantitative insight into each capability's contribution to mission success. Key outputs from these various tools, to be shared with the space medical and exploration mission development communities, will be assessments of medical system implementation option satisfaction of requirements and per-capability contributions toward achieving requirements.

  8. Medical Simulations for Exploration Medicine

    Science.gov (United States)

    Reyes, David; Suresh, Rahul; Pavela, James; Urbina, Michelle; Mindock, Jennifer; Antonsen, Erik

    2018-01-01

    Medical simulation is a useful tool that can be used to train personnel, develop medical processes, and assist cross-disciplinary communication. Medical simulations have been used in the past at NASA for these purposes, however they are usually created ad hoc. A stepwise approach to scenario development has not previously been used. The NASA Exploration Medical Capability (ExMC) created a medical scenario development tool to test medical procedures, technologies, concepts of operation and for use in systems engineering (SE) processes.

  9. Overview of an Integrated Medical System for Exploration Missions

    Science.gov (United States)

    Watkins, Sharmila; Rubin, David

    2013-01-01

    The Exploration Medical Capability (ExMC) element of the NASA Human Research Program (HRP) is charged with addressing the risk of unacceptable health and mission outcomes due to limitations of inflight medical capabilities. The Exploration Medical System Demonstration (EMSD) is a project within the ExMC element aimed at reducing this risk by improving the medical capabilities available for exploration missions. The EMSD project will demonstrate, on the ground and on ISS, the integration of several components felt to be essential to the delivery of medical care during long ]duration missions outside of low Earth orbit. The components of the EMSD include the electronic medical record, assisted medical procedure software, medical consumables tracking technology and RFID ] tagged consumables, video conferencing capability, ultrasound device and probes (ground demonstration only), peripheral biosensors, and the software to allow communication among the various components (middleware). This presentation seeks to inform our international partners of the goals and objectives of the EMSD and to foster collaboration opportunities related to this and future projects.

  10. Exploring medical identity theft.

    Science.gov (United States)

    Mancilla, Desla; Moczygemba, Jackie

    2009-09-16

    The crime of medical identity theft is a growing concern in healthcare institutions. A mixed-method study design including a two-stage electronic survey, telephone survey follow-up, and on-site observations was used to evaluate current practices in admitting and registration departments to reduce the occurrence of medical identity theft. Survey participants were chief compliance officers in acute healthcare organizations and members of the Health Care Compliance Association. Study results indicate variance in whether or how patient identity is confirmed in healthcare settings. The findings of this study suggest that information systems need to be designed for more efficient identity management. Admitting and registration staff must be trained, and compliance with medical identity theft policies and procedures must be monitored. Finally, biometric identity management solutions should be considered for stronger patient identification verification.

  11. Exploration Medical System Demonstration Project

    Science.gov (United States)

    Chin, D. A.; McGrath, T. L.; Reyna, B.; Watkins, S. D.

    2011-01-01

    A near-Earth Asteroid (NEA) mission will present significant new challenges including hazards to crew health created by exploring a beyond low earth orbit destination, traversing the terrain of asteroid surfaces, and the effects of variable gravity environments. Limited communications with ground-based personnel for diagnosis and consultation of medical events require increased crew autonomy when diagnosing conditions, creating treatment plans, and executing procedures. Scope: The Exploration Medical System Demonstration (EMSD) project will be a test bed on the International Space Station (ISS) to show an end-to-end medical system assisting the Crew Medical Officers (CMO) in optimizing medical care delivery and medical data management during a mission. NEA medical care challenges include resource and resupply constraints limiting the extent to which medical conditions can be treated, inability to evacuate to Earth during many mission phases, and rendering of medical care by a non-clinician. The system demonstrates the integration of medical technologies and medical informatics tools for managing evidence and decision making. Project Objectives: The objectives of the EMSD project are to: a) Reduce and possibly eliminate the time required for a crewmember and ground personnel to manage medical data from one application to another. b) Demonstrate crewmember's ability to access medical data/information via a software solution to assist/aid in the treatment of a medical condition. c) Develop a common data management architecture that can be ubiquitously used to automate repetitive data collection, management, and communications tasks for all crew health and life sciences activities. d) Develop a common data management architecture that allows for scalability, extensibility, and interoperability of data sources and data users. e) Lower total cost of ownership for development and sustainment of peripheral hardware and software that use EMSD for data management f) Provide

  12. Integrated Medical Model – Chest Injury Model

    Data.gov (United States)

    National Aeronautics and Space Administration — The Exploration Medical Capability (ExMC) Element of NASA's Human Research Program (HRP) developed the Integrated Medical Model (IMM) to forecast the resources...

  13. The Pathway to a Safe and Effective Medication Formulary for Exploration Spaceflight

    Science.gov (United States)

    Daniels, V. R.; Bayuse, T. M.; Mulcahy, R. A.; Mcguire, R. K. M.; Antonsen, E. L.

    2017-01-01

    PURPOSE: Exploration space missions pose several challenges to providing a comprehensive medication formulary designed to accommodate the size and space limitations of the spacecraft; while addressing the individual medications needs and preferences of the Crew; the negative outcome of a degrading inventory over time, the inability to resupply before expiration dates; and the need to properly forecast the best possible medication candidates to treat conditions that will occur in the future. METHODS: The Pharmacotherapeutics Discipline has partnered with the Exploration Medical Capabilities (ExMC) Element to develop and propose a research pathway that is comprehensively focused on evidence-based models and theories, as well as on new diagnostic tools and treatments or preventive measures aimed at closure of the Med02 “Pharmacy” Gap; defined in the Human Research Program’s (HRP) risk-based research strategy. The Med02 Gap promotes the challenge to identify a strategy to ensure that medications used to treat medical conditions during exploration space missions are available, safe, and effective. It is abundantly clear that pharmaceutical intervention is an essential component of risk management planning for astronaut healthcare during exploration space. However, the quandary still remains of how to assemble a formulary that is comprehensive enough to prevent or treat anticipated medical events; and is also chemically stable, safe, and robust enough to have sufficient potency to last for the duration of an exploration space mission. In cases where that is not possible, addressing this Gap requires exploration of novel drug development techniques, dosage forms, and dosage delivery platforms that enhance chemical stability as well as therapeutic effectiveness. RESULTS: The proposed research pathway outlines the steps, processes, procedures, and a research portfolio aimed at identifying a capability that will provide a safe and effective pharmacy for any specific

  14. Systems Engineering for Space Exploration Medical Capabilities

    Science.gov (United States)

    Mindock, Jennifer; Reilly, Jeffrey; Rubin, David; Urbina, Michelle; Hailey, Melinda; Hanson, Andrea; Burba, Tyler; McGuire, Kerry; Cerro, Jeffrey; Middour, Chris; hide

    2017-01-01

    Human exploration missions that reach destinations beyond low Earth orbit, such as Mars, will present significant new challenges to crew health management. For the medical system, lack of consumable resupply, evacuation opportunities, and real-time ground support are key drivers toward greater autonomy. Recognition of the limited mission and vehicle resources available to carry out exploration missions motivates the Exploration Medical Capability (ExMC) Element's approach to enabling the necessary autonomy. The Element's work must integrate with the overall exploration mission and vehicle design efforts to successfully provide exploration medical capabilities. ExMC is applying systems engineering principles and practices to accomplish its goals. This paper discusses the structured and integrative approach that is guiding the medical system technical development. Assumptions for the required levels of care on exploration missions, medical system goals, and a Concept of Operations are early products that capture and clarify stakeholder expectations. Model-Based Systems Engineering techniques are then applied to define medical system behavior and architecture. Interfaces to other flight and ground systems, and within the medical system are identified and defined. Initial requirements and traceability are established, which sets the stage for identification of future technology development needs. An early approach for verification and validation, taking advantage of terrestrial and near-Earth exploration system analogs, is also defined to further guide system planning and development.

  15. HRP's Healthcare Spin-Offs Through Computational Modeling and Simulation Practice Methodologies

    Science.gov (United States)

    Mulugeta, Lealem; Walton, Marlei; Nelson, Emily; Peng, Grace; Morrison, Tina; Erdemir, Ahmet; Myers, Jerry

    2014-01-01

    Spaceflight missions expose astronauts to novel operational and environmental conditions that pose health risks that are currently not well understood, and perhaps unanticipated. Furthermore, given the limited number of humans that have flown in long duration missions and beyond low Earth-orbit, the amount of research and clinical data necessary to predict and mitigate these health and performance risks are limited. Consequently, NASA's Human Research Program (HRP) conducts research and develops advanced methods and tools to predict, assess, and mitigate potential hazards to the health of astronauts. In this light, NASA has explored the possibility of leveraging computational modeling since the 1970s as a means to elucidate the physiologic risks of spaceflight and develop countermeasures. Since that time, substantial progress has been realized in this arena through a number of HRP funded activates such as the Digital Astronaut Project (DAP) and the Integrated Medical Model (IMM). Much of this success can be attributed to HRP's endeavor to establish rigorous verification, validation, and credibility (VV&C) processes that ensure computational models and simulations (M&S) are sufficiently credible to address issues within their intended scope. This presentation summarizes HRP's activities in credibility of modeling and simulation, in particular through its outreach to the community of modeling and simulation practitioners. METHODS: The HRP requires all M&S that can have moderate to high impact on crew health or mission success must be vetted in accordance to NASA Standard for Models and Simulations, NASA-STD-7009 (7009) [5]. As this standard mostly focuses on engineering systems, the IMM and DAP have invested substantial efforts to adapt the processes established in this standard for their application to biological M&S, which is more prevalent in human health and performance (HHP) and space biomedical research and operations [6,7]. These methods have also generated

  16. Conceptual Drivers for an Exploration Medical System

    Science.gov (United States)

    Antonsen, Erik; Hanson, Andrea; Shah, Ronak; Reed, Rebekah; Canga, Michael

    2016-01-01

    Interplanetary spaceflight, such as NASA's proposed three-year mission to Mars, provides unique and novel challenges when compared with human spaceflight to date. Extended distance and multi-year missions introduce new elements of operational complexity and additional risk. These elements include: inability to resupply medications and consumables, inability to evacuate injured or ill crew, uncharted psychosocial conditions, and communication delays that create a requirement for some level of autonomous medical capability. Because of these unique challenges, the approaches used in prior programs have limited application to a Mars mission. On a Mars mission, resource limitations will significantly constrain available medical capabilities, and require a paradigm shift in the approach to medical system design and risk mitigation for crew health. To respond to this need for a new paradigm, the Exploration Medical Capability (ExMC) Element is assessing each Mars mission phase-transit, surface stay, rendezvous, extravehicular activity, and return-to identify and prioritize medical needs for the journey beyond low Earth orbit (LEO). ExMC is addressing both planned medical operations, and unplanned contingency medical operations that meld clinical needs and research needs into a single system. This assessment is being used to derive a gap analysis and studies to support meaningful medical capabilities trades. These trades, in turn, allow the exploration medical system design to proceed from both a mission centric and ethics-based approach, and to manage the risks associated with the medical limitations inherent in an exploration class mission. This paper outlines the conceptual drivers used to derive medical system and vehicle needs from an integrated vision of how medical care will be provided within this paradigm. Keywords: (Max 6 keywords: exploration, medicine, spaceflight, Mars, research, NASA)

  17. Exploration Medical Cap Ability System Engineering Overview

    Science.gov (United States)

    McGuire, K.; Mindock, J.

    2018-01-01

    Deep Space Gateway and Transport missions will change the way NASA currently practices medicine. The missions will require more autonomous capability compared to current low Earth orbit operations. For the medical system, lack of consumable resupply, evacuation opportunities, and real-time ground support are key drivers toward greater autonomy. Recognition of the limited mission and vehicle resources available to carry out exploration missions motivates the Exploration Medical Capability (ExMC) Element's approach to enabling the necessary autonomy. The ExMC Systems Engineering team's mission is to "Define, develop, validate, and manage the technical system design needed to implement exploration medical capabilities for Mars and test the design in a progression of proving grounds." The Element's work must integrate with the overall exploration mission and vehicle design efforts to successfully provide exploration medical capabilities. ExMC is using Model-Based System Engineering (MBSE) to accomplish its integrative goals. The MBSE approach to medical system design offers a paradigm shift toward greater integration between vehicle and the medical system, and directly supports the transition of Earth-reliant ISS operations to the Earth-independent operations envisioned for Mars. This talk will discuss how ExMC is using MBSE to define operational needs, decompose requirements and architecture, and identify medical capabilities needed to support human exploration. How MBSE is being used to integrate across disciplines and NASA Centers will also be described. The medical system being discussed in this talk is one system within larger habitat systems. Data generated within the medical system will be inputs to other systems and vice versa. This talk will also describe the next steps in model development that include: modeling the different systems that comprise the larger system and interact with the medical system, understanding how the various systems work together, and

  18. Exploration Medical Capability (ExMC) Projects

    Science.gov (United States)

    Wu, Jimmy; Watkins, Sharmila; Baumann, David

    2010-01-01

    During missions to the Moon or Mars, the crew will need medical capabilities to diagnose and treat disease as well as for maintaining their health. The Exploration Medical Capability Element develops medical technologies, medical informatics, and clinical capabilities for different levels of care during space missions. The work done by team members in this Element is leading edge technology, procedure, and pharmacological development. They develop data systems that protect patient's private medical information, aid in the diagnosis of medical conditions, and act as a repository of relevant NASA life sciences experimental studies. To minimize the medical risks to crew health the physicians and scientists in this Element develop models to quantify the probability of medical events occurring during a mission. They define procedures to treat an ill or injured crew member who does not have access to an emergency room and who must be cared for in a microgravity environment where both liquids and solids behave differently than on Earth. To support the development of these medical capabilities, the Element manages the development of medical technologies that prevent, monitor, diagnose, and treat an ill or injured crewmember. The Exploration Medical Capability Element collaborates with the National Space Biomedical Research Institute (NSBRI), the Department of Defense, other Government-funded agencies, academic institutions, and industry.

  19. Defining Medical Capabilities for Exploration Missions

    Science.gov (United States)

    Hailey, M.; Antonsen, E.; Blue, R.; Reyes, D.; Mulcahy, R.; Kerstman, E.; Bayuse, T.

    2018-01-01

    Exploration-class missions to the moon, Mars and beyond will require a significant change in medical capability from today's low earth orbit centric paradigm. Significant increases in autonomy will be required due to differences in duration, distance and orbital mechanics. Aerospace medicine and systems engineering teams are working together within ExMC to meet these challenges. Identifying exploration medical system needs requires accounting for planned and unplanned medical care as defined in the concept of operations. In 2017, the ExMC Clinicians group identified medical capabilities to feed into the Systems Engineering process, including: determining what and how to address planned and preventive medical care; defining an Accepted Medical Condition List (AMCL) of conditions that may occur and a subset of those that can be treated effectively within the exploration environment; and listing the medical capabilities needed to treat those conditions in the AMCL. This presentation will discuss the team's approach to addressing these issues, as well as how the outputs of the clinical process impact the systems engineering effort.

  20. Career exploration behavior of Korean medical students

    OpenAIRE

    Hyejin An; Seung-Hee Lee

    2017-01-01

    Purpose This study is to analyze the effects of medical students? social support and career barriers on career exploration behavior mediated by career decision-making self-efficacy. Methods We applied the t-test to investigate the difference among the variables based on gender and admission types. Also, we performed path analysis to verify the effect of perceived career barriers and social support on career exploration behavior with career decision efficacy as a mediator. Results First, we no...

  1. Genome-wide identification of HrpL-regulated genes in the necrotrophic phytopathogen Dickeya dadantii 3937.

    Directory of Open Access Journals (Sweden)

    Shihui Yang

    Full Text Available BACKGROUND: Dickeya dadantii is a necrotrophic pathogen causing disease in many plants. Previous studies have demonstrated that the type III secretion system (T3SS of D. dadantii is required for full virulence. HrpL is an alternative sigma factor that binds to the hrp box promoter sequence of T3SS genes to up-regulate their expression. METHODOLOGY/PRINCIPAL FINDINGS: To explore the inventory of HrpL-regulated genes of D. dadantii 3937 (3937, transcriptome profiles of wild-type 3937 and a hrpL mutant grown in a T3SS-inducing medium were examined. Using a cut-off value of 1.5, significant differential expression was observed in sixty-three genes, which are involved in various cellular functions such as type III secretion, chemotaxis, metabolism, regulation, and stress response. A hidden Markov model (HMM was used to predict candidate hrp box binding sites in the intergenic regions of 3937, including the promoter regions of HrpL-regulated genes identified in the microarray assay. In contrast to biotrophic phytopathgens such as Pseudomonas syringae, among the HrpL up-regulated genes in 3937 only those within the T3SS were found to contain a hrp box sequence. Moreover, direct binding of purified HrpL protein to the hrp box was demonstrated for hrp box-containing DNA fragments of hrpA and hrpN using the electrophoretic mobility shift assay (EMSA. In this study, a putative T3SS effector DspA/E was also identified as a HrpL-upregulated gene, and shown to be translocated into plant cells in a T3SS-dependent manner. CONCLUSION/SIGNIFICANCES: We provide the genome-wide study of HrpL-regulated genes in a necrotrophic phytopathogen (D. dadantii 3937 through a combination of transcriptomics and bioinformatics, which led to identification of several effectors. Our study indicates the extent of differences for T3SS effector protein inventory requirements between necrotrophic and biotrophic pathogens, and may allow the development of different strategies for

  2. Exploration Medical System Technical Architecture Overview

    Science.gov (United States)

    Cerro, J.; Rubin, D.; Mindock, J.; Middour, C.; McGuire, K.; Hanson, A.; Reilly, J.; Burba, T.; Urbina, M.

    2018-01-01

    The Exploration Medical Capability (ExMC) Element Systems Engineering (SE) goals include defining the technical system needed to support medical capabilities for a Mars exploration mission. A draft medical system architecture was developed based on stakeholder needs, system goals, and system behaviors, as captured in an ExMC concept of operations document and a system model. This talk will discuss a high-level view of the medical system, as part of a larger crew health and performance system, both of which will support crew during Deep Space Transport missions. Other mission components, such as the flight system, ground system, caregiver, and patient, will be discussed as aspects of the context because the medical system will have important interactions with each. Additionally, important interactions with other aspects of the crew health and performance system are anticipated, such as health & wellness, mission task performance support, and environmental protection. This talk will highlight areas in which we are working with other disciplines to understand these interactions.

  3. Career exploration behavior of Korean medical students

    Directory of Open Access Journals (Sweden)

    Hyejin An

    2017-09-01

    Full Text Available Purpose This study is to analyze the effects of medical students’ social support and career barriers on career exploration behavior mediated by career decision-making self-efficacy. Methods We applied the t-test to investigate the difference among the variables based on gender and admission types. Also, we performed path analysis to verify the effect of perceived career barriers and social support on career exploration behavior with career decision efficacy as a mediator. Results First, we noted statistically significant gender and admission type difference in social support, career barriers and career exploration behaviors. Second, social support and career barriers were found to influence career exploration behavior as a mediating variable for career decision-making self-efficacy. Conclusion Social support and career barriers as perceived by medical students influenced their career exploration behavior, with their decision-making self-efficacy serving as a full mediator. Therefore, this study has educational implications for career program development and educational training for career decision-making self-efficacy.

  4. Career exploration behavior of Korean medical students.

    Science.gov (United States)

    An, Hyejin; Lee, Seung-Hee

    2017-09-01

    This study is to analyze the effects of medical students' social support and career barriers on career exploration behavior mediated by career decision-making self-efficacy. We applied the t-test to investigate the difference among the variables based on gender and admission types. Also, we performed path analysis to verify the effect of perceived career barriers and social support on career exploration behavior with career decision efficacy as a mediator. First, we noted statistically significant gender and admission type difference in social support, career barriers and career exploration behaviors. Second, social support and career barriers were found to influence career exploration behavior as a mediating variable for career decision-making self-efficacy. Social support and career barriers as perceived by medical students influenced their career exploration behavior, with their decision-making self-efficacy serving as a full mediator. Therefore, this study has educational implications for career program development and educational training for career decision-making self-efficacy.

  5. Exploring female GPs' perceptions about medical leadership.

    Science.gov (United States)

    Price, Karen; Clearihan, Lynette

    2015-06-01

    Women are increasingly entering the Australian general practice workforce. This study aims to explore female general practitioners' (GPs') perceptions of possible barriers to leadership and professional roles in the workforce. A purposive, convenience sample of 30 female GPs in active practice was approached in February, 2012. An anonymous, pa-per-based, semi-quantitative survey sought to identify participation and leadership confidence within general practice in a number of professional roles. The top two barriers participants identified for after-hours medical meetings were energy to attend and geographical location. For after-hours care, the top two barriers identified were energy and self-motivation. Few participants aspired to 'leadership' activities. 'Medical mentoring' was most likely to attract them into leadership. It is important female GPs' perspectives are explored in general practice. This small survey suggests further studies are needed in the importance of energy limitations and lack of self-confidence in restricting female GPs' capacity to fully engage in professional roles.

  6. Exploring Factors Affecting Emergency Medical Services Staffs' Decision about Transporting Medical Patients to Medical Facilities

    OpenAIRE

    Ebrahimian, Abbasali; Seyedin, Hesam; Jamshidi-Orak, Roohangiz; Masoumi, Gholamreza

    2014-01-01

    Transfer of patients in medical emergency situations is one of the most important missions of emergency medical service (EMS) staffs. So this study was performed to explore affecting factors in EMS staffs’ decision during transporting of patients in medical situations to medical facilities. The participants in this qualitative study consisted of 18 EMS staffs working in prehospital care facilities in Tehran, Iran. Data were gathered through semistructured interviews. The data were analyzed u...

  7. SD Bioline malaria antigen Pf (HRP-2/pLHD) for assessing efficacy ...

    African Journals Online (AJOL)

    Pan African Medical Journal. Journal Home · ABOUT ... Higher proportions of false positive cases were observed on the HRP-2 band irrespective of patient parasite densities during the follow up but these were barely seen on the pLDH band.

  8. Immunocytochemical localization of HrpA and HrpZ supports a role for the Hrp pilus in the transfer of effector proteins from Pseudomonas syringae pv. tomato across the host plant cell wall.

    Science.gov (United States)

    Brown, I R; Mansfield, J W; Taira, S; Roine, E; Romantschuk, M

    2001-03-01

    The Hrp pilus, composed of HrpA subunits, is an essential component of the type III secretion system in Pseudomonas syringae. We used electron microscopy (EM) and immunocytochemistry to examine production of the pilus in vitro from P. syringae pv. tomato strain DC3000 grown under hrp-inducing conditions on EM grids. Pili, when labeled with antibodies to HrpA, developed rapidly in a nonpolar manner shortly after the detection of the hrpA transcript and extended up to 5 microm into surrounding media. Structures at the base of the pilus were clearly differentiated from the basal bodies of flagella. The HrpZ protein, also secreted via the type III system, was found by immunogold labeling to be associated with the pilus in vitro. Accumulation and secretion of HrpA and HrpZ were also examined quantitatively after the inoculation of wild-type DC3000 and hrpA and hrpZ mutants into leaves of Arabidopsis thaliana. The functional pilus crossed the plant cell wall to generate tracks of immunogold labeling for HrpA and HrpZ. Mutants that produced HrpA but did not assemble pili were nonpathogenic, did not secrete HrpA protein, and were compromised for the accumulation of HrpZ. A model is proposed in which the rapidly elongating Hrp pilus acts as a moving conveyor, facilitating transfer of effector proteins from bacteria to the plant cytoplasm across the formidable barrier of the plant cell wall.

  9. Exploring a motivation of medical staff.

    Science.gov (United States)

    Goncharuk, Anatoliy G

    2018-06-08

    This paper aims to identify the true motivators (needs) of medical staff, compare them with the current labor incentives, and detect possible differences in motivators for main groups of medical staff. Observing personnel of 5 hospitals and students of the medical institute by special questionnaires, the author confirmed the hypothesis of different motivators for groups of medical staff with different ages, professions, and gender. The author used special questionnaires to collect the data. Study results confirmed the hypothesis of different motivators for groups of medical staff with different ages, professions, and gender. The author also found significant differences between the motivation of Ukrainian health workers and their colleagues from other countries. The main conclusion is that no matter how we would like to satisfy gender and age equality, all people are individual and what is good for an elderly male doctor cannot be acceptable for a young female nurse. Therefore, forming the motivation system for employees of medical institutions, it is necessary to take into account the age, gender, professions, and other characteristics of each employee. In this way, we can achieve the highest health-care performance. Copyright © 2018 John Wiley & Sons, Ltd.

  10. A Strategic Approach to Medical Care for Exploration Missions

    Science.gov (United States)

    Canga, Michael A.; Shah, Ronak V.; Mindock, Jennifer A.; Antonsen, Erik L.

    2016-01-01

    Exploration missions will present significant new challenges to crew health, including effects of variable gravity environments, limited communication with Earth-based personnel for diagnosis and consultation for medical events, limited resupply, and limited ability for crew return. Providing health care capabilities for exploration class missions will require system trades be performed to identify a minimum set of requirements and crosscutting capabilities, which can be used in design of exploration medical systems. Medical data, information, and knowledge collected during current space missions must be catalogued and put in formats that facilitate querying and analysis. These data are used to inform the medical research and development program through analysis of risk trade studies between medical care capabilities and system constraints such as mass, power, volume, and training. Medical capability as a quantifiable variable is proposed as a surrogate risk metric and explored for trade space analysis that can improve communication between the medical and engineering approaches to mission design. The resulting medical system design approach selected will inform NASA mission architecture, vehicle, and subsystem design for the next generation of spacecraft.

  11. Exploring Factors Affecting Emergency Medical Services Staffs' Decision about Transporting Medical Patients to Medical Facilities.

    Science.gov (United States)

    Ebrahimian, Abbasali; Seyedin, Hesam; Jamshidi-Orak, Roohangiz; Masoumi, Gholamreza

    2014-01-01

    Transfer of patients in medical emergency situations is one of the most important missions of emergency medical service (EMS) staffs. So this study was performed to explore affecting factors in EMS staffs' decision during transporting of patients in medical situations to medical facilities. The participants in this qualitative study consisted of 18 EMS staffs working in prehospital care facilities in Tehran, Iran. Data were gathered through semistructured interviews. The data were analyzed using a content analysis approach. The data analysis revealed the following theme: "degree of perceived risk in EMS staffs and their patients." This theme consisted of two main categories: (1) patient's condition' and (2) the context of the EMS mission'. The patent's condition category emerged from "physical health statuses," "socioeconomic statuses," and "cultural background" subcategories. The context of the EMS mission also emerged from two subcategories of "characteristics of the mission" and EMS staffs characteristics'. EMS system managers can consider adequate technical, informational, financial, educational, and emotional supports to facilitate the decision making of their staffs. Also, development of an effective and user-friendly checklist and scoring system was recommended for quick and easy recognition of patients' needs for transportation in a prehospital situation.

  12. Exploring Factors Affecting Emergency Medical Services Staffs’ Decision about Transporting Medical Patients to Medical Facilities

    Directory of Open Access Journals (Sweden)

    Abbasali Ebrahimian

    2014-01-01

    Full Text Available Transfer of patients in medical emergency situations is one of the most important missions of emergency medical service (EMS staffs. So this study was performed to explore affecting factors in EMS staffs’ decision during transporting of patients in medical situations to medical facilities. The participants in this qualitative study consisted of 18 EMS staffs working in prehospital care facilities in Tehran, Iran. Data were gathered through semistructured interviews. The data were analyzed using a content analysis approach. The data analysis revealed the following theme: “degree of perceived risk in EMS staffs and their patients.” This theme consisted of two main categories: (1 patient’s condition’ and (2 the context of the EMS mission’. The patent’s condition category emerged from “physical health statuses,” “socioeconomic statuses,” and “cultural background” subcategories. The context of the EMS mission also emerged from two subcategories of “characteristics of the mission” and EMS staffs characteristics’. EMS system managers can consider adequate technical, informational, financial, educational, and emotional supports to facilitate the decision making of their staffs. Also, development of an effective and user-friendly checklist and scoring system was recommended for quick and easy recognition of patients’ needs for transportation in a prehospital situation.

  13. Involvement of hrpX and hrpG in the Virulence of Acidovorax citrulli Strain Aac5, Causal Agent of Bacterial Fruit Blotch in Cucurbits

    Directory of Open Access Journals (Sweden)

    Xiaoxiao Zhang

    2018-03-01

    Full Text Available Acidovorax citrulli causes bacterial fruit blotch, a disease that poses a global threat to watermelon and melon production. Despite its economic importance, relatively little is known about the molecular mechanisms of pathogenicity and virulence of A. citrulli. Like other plant-pathogenic bacteria, A. citrulli relies on a type III secretion system (T3SS for pathogenicity. On the basis of sequence and operon arrangement analyses, A. citrulli was found to have a class II hrp gene cluster similar to those of Xanthomonas and Ralstonia spp. In the class II hrp cluster, hrpG and hrpX play key roles in the regulation of T3SS effectors. However, little is known about the regulation of the T3SS in A. citrulli. This study aimed to investigate the roles of hrpG and hrpX in A. citrulli pathogenicity. We found that hrpG or hrpX deletion mutants of the A. citrulli group II strain Aac5 had reduced pathogenicity on watermelon seedlings, failed to induce a hypersensitive response in tobacco, and elicited higher levels of reactive oxygen species in Nicotiana benthamiana than the wild-type strain. Additionally, we demonstrated that HrpG activates HrpX in A. citrulli. Moreover, transcription and translation of the type 3-secreted effector (T3E gene Aac5_2166 were suppressed in hrpG and hrpX mutants. Notably, hrpG and hrpX appeared to modulate biofilm formation. These results suggest that hrpG and hrpX are essential for pathogenicity, regulation of T3Es, and biofilm formation in A. citrulli.

  14. Exploring the potential use of augmented reality in medical education

    OpenAIRE

    Orraryd, Pontus

    2017-01-01

    Human anatomy is traditionally taught using textbooks and dissections. With the advent of computer graphics, using 3D applications have started to see much more use in medical educations around the world. Today, technology such as Augmented Reality and Virtual Reality are on everybody’s lips, and many are now curious what we can do with this new technology. This thesis explores how Augmented Reality can be used in medical education to teach human anatomy. Two application prototypes were devel...

  15. Exploring the tensions of being and becoming a medical educator.

    Science.gov (United States)

    Sethi, Ahsan; Ajjawi, Rola; McAleer, Sean; Schofield, Susie

    2017-03-23

    Previous studies have identified tensions medical faculty encounter in their roles but not specifically those with a qualification in medical education. It is likely that those with postgraduate qualifications may face additional tensions (i.e., internal or external conflicts or concerns) from differentiation by others, greater responsibilities and translational work against the status quo. This study explores the complex and multi-faceted tensions of educators with qualifications in medical education at various stages in their career. The data described were collected in 2013-14 as part of a larger, three-phase mixed-methods research study employing a constructivist grounded theory analytic approach to understand identity formation among medical educators. The over-arching theoretical framework for the study was Communities of Practice. Thirty-six educators who had undertaken or were undertaking a postgraduate qualification in medical education took part in semi-structured interviews. Participants expressed multiple tensions associated with both becoming and being a healthcare educator. Educational roles had to be juggled with clinical work, challenging their work-life balance. Medical education was regarded as having lower prestige, and therefore pay, than other healthcare career tracks. Medical education is a vast speciality, making it difficult as a generalist to keep up-to-date in all its areas. Interestingly, the graduates with extensive experience in education reported no fears, rather asserting that the qualification gave them job variety. This is the first detailed study exploring the tensions of educators with postgraduate qualifications in medical education. It complements and extends the findings of the previous studies by identifying tensions common as well as specific to active students and graduates. These tensions may lead to detachment, cynicism and a weak sense of identity among healthcare educators. Postgraduate programmes in medical education

  16. Exploring emotional intelligence in a Caribbean medical school.

    Science.gov (United States)

    Sa, B; Baboolal, N; Williams, S; Ramsewak, S

    2014-03-01

    To explore the emotional intelligence (EI) in medical students in a Caribbean medical school and investigate its association with gender, age, year of study and ethnicity. A cross-sectional design using convenient sampling of 304 years two to five undergraduate medical students at the School of Medicine, the University of the West Indies (UWI), St Augustine campus, was conducted. The Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT-V2.0) was administered to test four branches of EI: perceiving emotions, facilitating thought, understanding emotions and managing emotions. Data were analysed using SPSS version 19. T-test, analysis of variance (ANOVA) and r (product moment correlation) were calculated to establish the effects of selected variables (gender, age, year of study and ethnicity) on total and sub-scales EI scores and tested against 0.05 and 0.01 significance levels. The total mean score for EI fell within the average according to MSCEIT standards. Gender analysis showed significantly higher scores for males and for younger age groups (maturity and emotional stability. It would be valuable to widen this study by including other UWI campuses and offshore medical schools in the Caribbean. This preliminary study examined a sample of medical students from a well-established Caribbean medical school. Since EI is considered to be important in the assessment and training of medical undergraduates, consideration should be given to introducing interventions aimed at increasing EI.

  17. 10 CFR 712.11 - General requirements for HRP certification.

    Science.gov (United States)

    2010-01-01

    ..., “Drug-Free Federal Workplace Testing Implementation Program,” for DOE employees; (9) An initial alcohol... the HRP and complete initial instruction on the importance of security, safety, reliability, and... the Manager, the NNSA Administrator, his or her designee, or the appropriate Lead Program Secretarial...

  18. The clinicide phenomenon: an exploration of medical murder.

    Science.gov (United States)

    Kaplan, Robert

    2007-08-01

    The aim of this paper is to explore the phenomenon of clinicide. The study of medical killers is barely in its infancy. Clinicide is the unnatural death of multiple patients in the course of treatment by a doctor. Serial medical killing is a relatively new phenomenon. The role model is Dr Marcel Petiot, the worst serial killer in French history. More recently, Dr Harold Shipman was Britain's worst serial killer and in the United States and Zimbabwe, Dr Michael Swango killed 60 patients. A number of doctors have such high patient death rates that it cannot be ignored. At some level, these doctors have an awareness of what they are doing, countered by an overweening refusal to acknowledge the implications or desist from further treatment. Treatment killer offences usually occur on the basis of serial mental illness, but may include the contentious area of euthanasia killing. Doctors have frequently been accomplices in state repression, brutality and genocide in direct contravention to their sanctioned role to relieve suffering and save life. They have become mass murderers on an exponential scale, making any comparison with a doctor killing his own patients almost risible. Many clinicidal doctors have extreme narcissistic personalities, a grandiose view of their own capability and inability to accept that they could be criticized or need assistance from other doctors. Such doctors develop a God-complex, getting a vicarious thrill out of ending suffering and by determining when a person dies.

  19. Alternative Sigma Factor HrpL of Pectobacterium carotovorum 35 is Important for the Development of Soft-rot Symptoms

    Directory of Open Access Journals (Sweden)

    Hyo-Song Nam

    2011-08-01

    Full Text Available A bacterial artificial chromosome library of Pectobacterium carotovorum 35 was constructed to characterize the genome and to sequence its hrp region. The hrp cluster of P. carotovorum 35 consisted of 26 open reading frames in five operons. A promoter-based green fluorescent protein technology was used to identify the genes regulated by the alternative sigma factor, HrpL, in P. carotovorum 35. The majority of the selected clones contained the hrpJ operon promoter sequence, which harbors a hrp box, but no putative hrp boxes were detected within the promoter sequences of two other hrpL-regulated genes encoding for pectate lyase and large repetitive protein. Although the promoters of five other hrp operons also contained hrp boxes, their expression was not HrpL-dependent in the promoter-based selection in E. coli. However, transcriptional analysis showed that expression from all operons harboring hrp boxes, except for the hrpN operon, was reduced significantly in the hrpL mutant. The severity of soft-rot symptoms when the hrpL mutant was applied to the surface of tobacco leaves, mimicking natural infection, was greatly attenuated. These results indicate that the hrpL gene of P. carotovorum 35 may be involved in the development of soft-rot symptoms.

  20. Exploring the use of smartphones and tablets by medical House ...

    African Journals Online (AJOL)

    The Ministry of Health in Ghana has an e-Health strategy, with the aim of integrating such resources into ... into medical practice can be improved by integration with the medical curriculum and accepted practice ..... The likelihood of this being.

  1. Teaching medical students to express empathy by exploring patient emotions and experiences in standardized medical encounters.

    Science.gov (United States)

    Ruiz-Moral, Roger; Pérula de Torres, Luis; Monge, Diana; García Leonardo, Cristina; Caballero, Fernando

    2017-09-01

    To increase medical students' ability to detect contextual and emotional cues and to respond empathetically to patients. a training course in communication skills and patient-centered care with different teaching activities (didactic, reflective and interactive: workshops and encounters with simulated patients) was delivered to third-year medical students just before their clerkships. The program was evaluated by an external observer (OE) and simulated patients (SP) in 2 or 3 videotaped encounters. Students improved significantly from baseline to 3rd interview in all communicative skills and domains explored both in OE (32.4%) and SP (38.3%) measurement. At the end of the course students detected significantly more clues and made more empathetic expressions. The course seems to improve the ability of students to explore the illness experience, showing more empathy in a more genuine way. This was carried out in consultations lasting 10min. The program is effective and feasible to be applied as a regular formative activity. Further research is needed to assess whether this training program is applicable to students in more advanced educational levels and if it has any additional outcomes. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. NASA HRP Immunology Discipline - Use of Terrestrial Analogs

    Science.gov (United States)

    Crucian, Brian

    2014-01-01

    Due to the cost and operational constraints, as well as technical implementation limitations, it is desirous to perform relevant space physiology investigations first in terrestrial 'space analogs'. This is particularly true for initial investigations, which may then provide appropriate focus for subsequent flight investigations, or for mechanistic investigations that simply cannot be performed during spaceflight. Appropriate analog choice is extremely important. There are a wide variety of terrestrial space analogs, each relevant to a particular physiological discipline (or disciplines) and each with a particular fidelity (or lack thereof) to spaceflight, and each with unique operational constraints. The HRP Immunology Discipline is tasked with managing the HRP Risk concerning clinical risk for Astronaut crews related to spaceflight-associated immune dysregulation. Such dysregulation has been documented to occur during spaceflight, and found to persist for the duration of a 6-month ISS mission. Studies continue to characterize the onorbit phenomenon, but it generally consists of diminished immunocyte function, dysregulated cytokine profiles, and persistent herpesvirus reactivation. Causes are thought to synergistically include microgravity, psychological or physiological stress, radiation, and/or circadian misalignment. An appropriate terrestrial analog for immune dysregulation would replicate as many of these influences as possible. Such analogs may include clinostat or bioreactor cell culture (microgravity), hindlimb suspension (stress, fluid shifts, hypokinesis), or human deployment to remote or extreme environments (isolation, stress, circadian). Also, the laboratory setting may be used as an analog, or to augment analogs, such as sleep deprivation/misalignment or human centrifugation to replicate gravitational stress. As an appropriate example of a NASA Disciplines use of Terrestrial space analogs, this talk will discuss spaceflight associated immune

  3. Nurses' experiences and perspectives on medication safety practices: an explorative qualitative study

    NARCIS (Netherlands)

    Smeulers, Marian; Onderwater, Astrid T.; van Zwieten, Myra C. B.; Vermeulen, Hester

    2014-01-01

    To explore nurses' experiences with and perspectives on preventing medication administration errors. Insight into nurses' experiences with and perspectives on preventing medication administration errors is important and can be utilised to tailor and implement safety practices. A qualitative

  4. Exploring the Influence of Context on Feedback at Medical School: A Video-Ethnography Study

    Science.gov (United States)

    Urquhart, L. M.; Ker, J. S.; Rees, C. E.

    2018-01-01

    Feedback in medical education is complicated by the multiple contexts within which learning occurs. However, feedback research in medical education has typically focused on information provided by tutors to students with limited exploration of the influence of context. This research seeks to address this gap by exploring the influence of multiple…

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

    Science.gov (United States)

    Nixon, Michael Simon; Vendelø, Morten Thanning

    2016-06-20

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

  6. Exploring the situational motivation of medical specialists: a qualitative study.

    Science.gov (United States)

    van der Burgt, Stéphanie M E; Kusurkar, Rashmi A; Croiset, Gerda; Peerdeman, Saskia M

    2018-02-26

    The aim was to obtain insight into the factors in the work environment that motivate or demotivate a medical specialist during his/her working day. A qualitative ethnographic design was used, and a constructivist approach was adopted with the Self-Determination theory of motivation as a framework. Six medical specialists from VU University Medical Center in the Netherlands, recruited through convenience, snowball, and purposive sampling, were shadowed for one day each. Data were transcribed and open-coded. Themes were finalized through discussion and consensus. Sixty hours of observation data identified motivating and demotivating factors categorized into four themes that are important for specialists' motivation. Informational technology issues are demotivating factors. Working with colleagues can be both a motivating and demotivating factor, e.g., filling in for each other through feelings of relatedness was motivating. Being in control of one's planning through feelings of autonomy was motivating. Furthermore, patient care and teaching, especially in combination, stimulated specialists' motivation. Regarding the design of the study, we found that situational motivation is indeed observable. The basic psychological needs autonomy, competence, and relatedness are important for specialists' motivation. Investing in a more motivating, open, transparent, and basic-needs- supportive work environment for medical specialists is necessary. Keywords: Continuing professional development, motivation, medical specialists, self-determination theory, qualitative research.

  7. Exploration of Global Health Careers Across the Medical Fields.

    Science.gov (United States)

    Barthélemy, Ernest; Mallol, Vanessa; Hannaford, Alisse; Pean, Christian; Kutua, Rehema; de Haydu, Christopher; Anandaraja, Natasha; Asgary, Ramin; Elahi, Ebrahim; Hexom, Braden; Landrigan, Philip; Shirazian, Taraneh; Katz, Craig

    Despite expansion of interest among American medical students in global health (GH), academic medical centers face multiple obstacles to the development of structured GH curricula and career guidance. To meet these demands we sought to provide a systematic analysis of the accounts of GH experts. We developed a collaborative, interview-based, qualitative analysis of GH experiences across six career-related themes that are relevant to medical students interested in GH: justification, medical education, economics, research prospects, law and ethics, and work-life balance. Seven GH faculty members were interviewed for 30-90 minutes using sample questions as guidelines. We applied a grounded theory approach to analyze the interview transcripts to discover an emerging theory pertinent to GH trainees. Regarding justification, 4 respondents defined GH as work with the underserved irrespective of geographic location; 5 respondents found sustainability imperative; and all respondents believe GH creates better physicians. Respondents identified many physician competencies developed through GH medical education, with 5 respondents agreeing that work with underserved populations has transformative potential. Concerning economics, 3 respondents acknowledged GH's popularity among trainees, resulting in increased training opportunities, and 2 respondents emphasized an associated deficiency in program quality. All respondents described career models across specialties. Four respondents noted funding challenges when discussing research prospects. Within the theme of laws and ethics, 4 respondents perceived inadequate accountability, and 6 respondents identified ways to create accountability. Finally, 6 respondents recognized family demands can compromise one's GH career and thus work-life balance. Despite diverse perspectives on the meaning and sustainability of GH work, this analysis provides a nascent framework that may inform curricular development for GH trainees. Suggestions

  8. Phenol Removal from Industrial Wastewater by HRP Enzyme

    Directory of Open Access Journals (Sweden)

    Iran Alemzadeh

    2009-01-01

    Full Text Available In this research, horseradish peroxidase for phenol removal was utilized. First, the process was studied at the laboratory scale using a synthetic phenol solution (1-10 mM. Results showed that horseradish peroxidase (HRP could effectively remove phenolic compounds from wastewater and that the catalytic capability of the enzyme was maintained for a wide range of pH, temperature, and aromatic concentration levels. The performance conditions were optimized for at lease 95% and 100% removal of phenolic compounds for both actual and synthetic wastewaters under high and low phenol concentrations (1 and 10 mM. The phenolic wastewater used was an olive mill effluent with a phenol concentration of 1221 mg/L (13 mM and a pH value of 3.5. At the end of the reaction, the phenolic compounds changed to insoluble polymers and precipitated. Each enzyme/wastewater system was optimized for the following chemical dosages: hydrogen peroxide, enzyme, polyethylene glycol (PEG, and buffer. Furthermore, the reaction time to achieve at least 95% phenol removal was determined. According to the results, COD and BOD reduced to 58% and 78%, respectively. Experimental results showed an increase in H2O2 concentration beyond the optimum dose resulting from enzyme inactivation, thus reducing the phenol removal efficiency. On the other hand, increasing the enzyme, PEG, and/or reaction time beyond the optimum values resulted in only a marginal increase in removal efficiency.

  9. Harm reduction program use, psychopathology and medical severity in patients with methadone maintenance treatment.

    Science.gov (United States)

    Martínez-Luna, Nieves Gudelia; Rodríguez-Cintas, Laia; Esojo, Abderraman; Palma-Álvarez, Raúl Felipe; Robles-Martínez, María; Grau-López, Lara; Perea, Marta; Roncero, Carlos

    2018-01-15

    Methadone maintenance programs (MMP) for opioid dependence treatment have been widely used due to their effective therapeutic outcomes. Harm reduction programs (HRP) are complementary programs for severe patients with high risk behaviors and when abstinence is not possible. This study aims to compare patients in MMP that use HRP (MMP-HRP) and patients in MMP who do not use HRP (MMP-NO HRP). The sample was composed of 143 patients (MMP-HRP = 42 vs. MMP-NO HRP = 101). An additional subanalysis was performed with patients under 45 years of age (n = 116; MMP-HRP = 38 vs. MMP-NO HRP = 78). All patients were assessed with an ad hoc socio-demographic questionnaire, EuropASI, SCID-I, and SCID-II. Results show that MMP-HRP patients were younger with more frequent use of intravenous drugs and with a high prevalence of Cluster B personality disorders. MMP-NO HRP patients had lower methadone doses compared to MMP-HRP patients and preferred to use drugs by smoked route more frequently. In the subanalysis of patients under 45, MMP-HRP patients were younger, had a higher prevalence of liver diseases, more intravenous drug use, greater severity on the drug use scale, less social and family support in the suescales of EUROP-ASI than compared to patients under 45 years in the group MMP-NO HRP. In conclusion, MMP-HRP patients are younger compared to MMP-NO HRP patients, they also receive higher doses of methadone and had more intravenous use. The above findings imply that the early onset of high risk drug use and long-term exposure to heroin have more severe outcomes such as higher comorbidities (e.g. infectious diseases, medical and psychiatric disorders), and consequently, these patients are a more vulnerable group with a worse prognosis.

  10. Exploring the experiences and coping strategies of international medical students

    Directory of Open Access Journals (Sweden)

    Malau-Aduli Bunmi S

    2011-06-01

    Full Text Available Abstract Background Few studies have addressed the challenges that international medical students face and there is a dearth of information on the behavioural strategies these students adopt to successfully progress through their academic program in the face of substantial difficulties of language barrier, curriculum overload, financial constraints and assessment tasks that require high proficiency in communication skills. Methods This study was designed primarily with the aim of enhancing understanding of the coping strategies, skill perceptions and knowledge of assessment expectations of international students as they progress through the third and fourth years of their medical degree at the School of Medicine, University of Tasmania, Australia. Results Survey, focus group discussion and individual interviews revealed that language barriers, communication skills, cultural differences, financial burdens, heavy workloads and discriminatory bottlenecks were key factors that hindered their adaptation to the Australian culture. Quantitative analyses of their examination results showed that there were highly significant (p Conclusions Despite the challenges, these students have adopted commendable coping strategies and progressed through the course largely due to their high sense of responsibility towards their family, their focus on the goal of graduating as medical doctors and their support networks. It was concluded that faculty needs to provide both academic and moral support to their international medical students at three major intervention points, namely point of entry, mid way through the course and at the end of the course to enhance their coping skills and academic progression. Finally, appropriate recommendations were made.

  11. Becoming an Educational Leader--Exploring Leadership in Medical Education

    Science.gov (United States)

    Bolander Laksov, Klara; Tomson, Tanja

    2017-01-01

    Research on educational leadership emphasizes the importance of having institutional leaders heavily involved with advanced instructional programming. Best practices for developing educational leadership in higher education health care and medical faculties have to be better understood. Within the framework of a seminar series, researchers and…

  12. An exploration into the awareness and perceptions of medical ...

    African Journals Online (AJOL)

    factors in a multicultural society influence the consultation, and to suggest adaptations for teaching. Methods. Focus group discussions were conducted with final-year medical students in the Family Medicine rotation. Some of the students had viewed a video of a consultation with an isiZulu-speaking patient, and completed ...

  13. Behavioral Exploration of Career and Specialty Choice in Medical Students

    Science.gov (United States)

    Borges, Nicole J.

    2007-01-01

    Understanding the process by which students naturally construct and internalize their educational experiences relating to career development is important to career counseling. The author investigated how exploratory behaviors during a community-based field experience course contributed to the vocational development of 1st-year medical students.…

  14. An exploration into the awareness and perceptions of medical ...

    African Journals Online (AJOL)

    effect on how patients present to healthcare providers.[1] Such ... Focus group discussions were conducted with final-year medical students in the Family Medicine rotation. ... and patients in cross-cultural consultations, the potential knowledge and experience gap that exists across cultures, and an awareness of the need for.

  15. Exploring Jahrom Medical University students' attitudes towards the ...

    African Journals Online (AJOL)

    Introduction: Self- evaluation is the process of designing, building and maintaining human behaviors that can lead to maturity and perfection. Therefore, the aim of this study is to examine Jahrom Medical University students' attitudes towards the Islamic self-assessment in 2015. Method: This cross-sectional and descriptive ...

  16. Polymeric Medical Sutures: An Exploration of Polymers and Green Chemistry

    Science.gov (United States)

    Knutson, Cassandra M.; Schneiderman, Deborah K.; Yu, Ming; Javner, Cassidy H.; Distefano, Mark D.; Wissinger, Jane E.

    2017-01-01

    With new K-12 national science standards emerging, there is an increased need for experiments that integrate engineering into the context of society. Here we describe a chemistry experiment that combines science and engineering principles while introducing basic polymer and green chemistry concepts. Using medical sutures as a platform for…

  17. Nanobody Based Immunoassay for Human Soluble Epoxide Hydrolase Detection Using Polymeric Horseradish Peroxidase (PolyHRP) for Signal Enhancement: The Rediscovery of PolyHRP?

    Science.gov (United States)

    Li, Dongyang; Cui, Yongliang; Morisseau, Christophe; Gee, Shirley J; Bever, Candace S; Liu, Xiangjiang; Wu, Jian; Hammock, Bruce D; Ying, Yibin

    2017-06-06

    Soluble epoxide hydrolase (sEH) is a potential pharmacological target for treating hypertension, vascular inflammation, cancer, pain, and multiple cardiovascular related diseases. A variable domain of the heavy chain antibody (termed single domain antibody (sdAb), nanobody, or VHH) possesses the advantages of small size, high stability, ease of genetic manipulation, and ability for continuous manufacture, making such nanobody a superior choice as an immunoreagent. In this work, we developed an ultrasensitive nanobody based immunoassay for human sEH detection using polymeric horseradish peroxidase (PolyHRP) for signal enhancement. Llama nanobodies against human sEH were used as the detection antibody in sandwich enzyme linked immunosorbent assays (ELISA) with polyclonal anti-sEH as the capture antibody. A conventional sandwich ELISA using a horseradish peroxidase (HRP) labeled anti-hemeagglutinin (HA) tag as the tracer showed a marginal sensitivity (0.0015 optical density (OD)·mL/ng) and limit of detection (LOD) of 3.02 ng/mL. However, the introduction of the PolyHRP as the tracer demonstrated a 141-fold increase in the sensitivity (0.21 OD·mL/ng) and 57-fold decrease in LOD (0.05 ng/mL). Systematic comparison of three different tracers in four ELISA formats demonstrated the overwhelming advantage of PolyHRP as a label for nanobody based immunoassay. This enhanced sEH immunoassay was further evaluated in terms of selectivity against other epoxide hydrolases and detection of the target protein in human tissue homogenate samples. Comparison with an enzyme activity based assay and a Western blot for sEH detection reveals good correlation with the immunoassay. This work demonstrates increased competiveness of nanobodies for practical sEH protein detection utilizing PolyHRP. It is worthwhile to rediscover the promising potential of PolyHRP in nanobody and other affinity based methods after its low-profile existence for decades.

  18. An explorative study of school performance and antipsychotic medication

    NARCIS (Netherlands)

    van der Schans, J.; Vardar, S; Cicek, R.; Bos, H. J.; Hoekstra, P. J.; de Vries, T. W.; Hak, E.

    2016-01-01

    Background: Antipsychotic therapy can reduce severe symptoms of psychiatric disorders, however, data on school performance among children on such treatment are lacking. The objective was to explore school performance among children using antipsychotic drugs at the end of primary education. Methods:

  19. Medical and technology requirements for human solar system exploration missions

    Science.gov (United States)

    Nicogossian, Arnauld; Harris, Leonard; Couch, Lana; Sulzman, Frank; Gaiser, Karen

    1989-01-01

    Measures that need to be taken to cope with the health problems posed by zero gravity and radiation in manned solar system exploration missions are discussed. The particular systems that will be used aboard Space Station Freedom are addressed, and relevant human factors problems are examined. The development of a controlled ecological life support system is addressed.

  20. An Evidence Based Approach to Designing Medical Support for Long Duration, Interplanetary Missions

    Science.gov (United States)

    Watkins, S. D.; McGrath, T. L.; Bauman, D. K.; Wu, J. H.; Barsten, K. N.; Barr, Y. R.; Kerstman, E. L.

    2011-01-01

    The Exploration Medical Capability (ExMC) element is one of six elements under NASA's Human Research Program (HRP). The goal of the ExMC element is to address the risk of the "inability to adequately recognize or treat an ill or injured crewmember." This poster highlights the evidence-based approach that the ExMC element has taken to address this goal, and the ExMC element's current areas of interest.

  1. Explore and experience: mobile augmented reality for medical training.

    Science.gov (United States)

    Albrecht, Urs-Vito; Noll, Christoph; von Jan, Ute

    2013-01-01

    In medicine, especially in basic education, it may sometimes be inappropriate to integrate real patients into classes due to ethical issues that must be avoided. Nevertheless, the quality of medical education may suffer without the use of real cases. This is especially true of medical specialties such as legal medicine: survivors of a crime are already subjected to procedures that constitute a severe emotional burden and may cause additional distress even without the added presence of students. Using augmented reality based applications may alleviate this ethical dilemma by giving students the possibility to practice the necessary skills based on virtual but nevertheless almost realistic cases. The app "mARble®" that is presented in this paper follows this approach. The currently available learning module for legal medicine gives users an opportunity to learn about various wound patterns by virtually overlaying them on their own skin and is applicable in different learning settings. Preliminary evaluation results covering learning efficiency and emotional components of the learning process are promising. Content modules for other medical specialtiesare currently under construction.

  2. Using A Model-Based Systems Engineering Approach For Exploration Medical System Development

    Science.gov (United States)

    Hanson, A.; Mindock, J.; McGuire, K.; Reilly, J.; Cerro, J.; Othon, W.; Rubin, D.; Urbina, M.; Canga, M.

    2017-01-01

    NASA's Human Research Program's Exploration Medical Capabilities (ExMC) element is defining the medical system needs for exploration class missions. ExMC's Systems Engineering (SE) team will play a critical role in successful design and implementation of the medical system into exploration vehicles. The team's mission is to "Define, develop, validate, and manage the technical system design needed to implement exploration medical capabilities for Mars and test the design in a progression of proving grounds." Development of the medical system is being conducted in parallel with exploration mission architecture and vehicle design development. Successful implementation of the medical system in this environment will require a robust systems engineering approach to enable technical communication across communities to create a common mental model of the emergent engineering and medical systems. Model-Based Systems Engineering (MBSE) improves shared understanding of system needs and constraints between stakeholders and offers a common language for analysis. The ExMC SE team is using MBSE techniques to define operational needs, decompose requirements and architecture, and identify medical capabilities needed to support human exploration. Systems Modeling Language (SysML) is the specific language the SE team is utilizing, within an MBSE approach, to model the medical system functional needs, requirements, and architecture. Modeling methods are being developed through the practice of MBSE within the team, and tools are being selected to support meta-data exchange as integration points to other system models are identified. Use of MBSE is supporting the development of relationships across disciplines and NASA Centers to build trust and enable teamwork, enhance visibility of team goals, foster a culture of unbiased learning and serving, and be responsive to customer needs. The MBSE approach to medical system design offers a paradigm shift toward greater integration between

  3. Accuracy of PfHRP2 versus Pf-pLDH antigen detection by malaria rapid diagnostic tests in hospitalized children in a seasonal hyperendemic malaria transmission area in Burkina Faso.

    Science.gov (United States)

    Maltha, Jessica; Guiraud, Issa; Lompo, Palpouguini; Kaboré, Bérenger; Gillet, Philippe; Van Geet, Chris; Tinto, Halidou; Jacobs, Jan

    2014-01-13

    In most sub-Saharan African countries malaria rapid diagnostic tests (RDTs) are now used for the diagnosis of malaria. Most RDTs used detect Plasmodium falciparum histidine-rich protein-2 (PfHRP2), though P. falciparum-specific parasite lactate dehydrogenase (Pf-pLDH)-detecting RDTs may have advantages over PfHRP2-detecting RDTs. Only few data are available on the use of RDTs in severe illness and the present study compared Pf-pLDH to PfHRP2-detection. Hospitalized children aged one month to 14 years presenting with fever or severe illness were included over one year. Venous blood samples were drawn for malaria diagnosis (microscopy and RDT), culture and complete blood count. Leftovers were stored at -80 °C and used for additional RDT analysis and PCR. An RDT targeting both PfHRP2 and Pf-pLDH was performed on all samples for direct comparison of diagnostic accuracy with microscopy as reference method. PCR was performed to explore false-positive RDT results. In 376 of 694 (54.2%) included children, malaria was microscopically confirmed. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value were 100.0, 70.9, 69.4 and 100.0%, respectively for PfHRP2-detection and 98.7, 94.0, 91.6 and 99.1%, respectively for Pf-pLDH-detection. Specificity and PPV were significantly lower for PfHRP2-detection (p <0.001). For both detection antigens, specificity was lowest for children one to five years and in the rainy season. PPV for both antigens was highest in the rainy season, because of higher malaria prevalence. False positive PfHRP2 results were associated with prior anti-malarial treatment and positive PCR results (98/114 (86.0%) samples tested). Among children presenting with severe febrile illness in a seasonal hyperendemic malaria transmission area, the present study observed similar sensitivity but lower specificity and PPV of PfHRP2 compared to Pf-pLDH-detection. Further studies should assess the diagnostic accuracy and safety of an

  4. Storyboard for the Medical System Concept of Operations for Mars Exploration Missions

    Science.gov (United States)

    Antonsen, Eric; Hailey, Melinda; Reyes, David; Rubin, David; Urbina, Michelle

    2017-01-01

    This storyboard conceptualizes one scenario of an integrated medical system during a Mars exploration mission. All content is for illustrative purposes only and neither defines nor implies system design requirement.

  5. An explorative study of school performance and antipsychotic medication.

    Science.gov (United States)

    van der Schans, J; Vardar, S; Çiçek, R; Bos, H J; Hoekstra, P J; de Vries, T W; Hak, E

    2016-09-21

    Antipsychotic therapy can reduce severe symptoms of psychiatric disorders, however, data on school performance among children on such treatment are lacking. The objective was to explore school performance among children using antipsychotic drugs at the end of primary education. A cross-sectional study was conducted using the University Groningen pharmacy database linked to academic achievement scores at the end of primary school (Dutch Cito-test) obtained from Statistics Netherlands. Mean Cito-test scores and standard deviations were obtained for children on antipsychotic therapy and reference children, and statistically compared using analyses of covariance. In addition, differences in subgroups as boys versus girls, ethnicity, household income, and late starters (start date within 12 months of the Cito-test) versus early starters (start date > 12 months before the Cito-test) were tested. In all, data from 7994 children could be linked to Cito-test scores. At the time of the Cito-test, 45 (0.6 %) were on treatment with antipsychotics. Children using antipsychotics scored on average 3.6 points lower than the reference peer group (534.5 ± 9.5). Scores were different across gender and levels of household income (p starters were significantly higher than starters within 12 months (533.7 ± 1.7 vs. 524.1 ± 2.6). This first exploration showed that children on antipsychotic treatment have lower school performance compared to the reference peer group at the end of primary school. This was most noticeable for girls, but early starters were less affected than later starters. Due to the observational cross-sectional nature of this study, no causality can be inferred, but the results indicate that school performance should be closely monitored and causes of underperformance despite treatment warrants more research.

  6. Thermometric sensing of peroxide in organic media. Application to monitor the stability of RBP-retinol-HRP complex.

    Science.gov (United States)

    Ramanathan, K; Jönsson, B R; Danielsson, B

    2000-08-01

    The stability of horseradish peroxidase (HRP) in aqueous and organic solvents is applied to develop a simple thermometric procedure to detect the binding of retinoic acid-HRP conjugate to retinol binding protein (RBP). Butanone peroxide (BP) in organic phase and hydrogen peroxide in aqueous phase is detected thermometrically on a HRP column, immobilized by cross-linking with glutaraldehyde on controlled pore glass (CPG). Acetone, acetonitrile, methanol, and 2-butanol are used for detection of BP, in the flow injection analysis (FIA) mode. A linear range between 1 and 50 mM BP is obtained in all the organic solvents with a precision of 5-7% (CV%). The magnitude and nature of the thermometric response is significantly different in each organic solvent. The stability of HRP in the organic phase is used to study the stability of a retinoic acid-HRP conjugate bound to immobilized RBP. The response of HRP (to 20 mM BP) in the retinoic acid-HRP conjugate is used as an indicator of the stability of the RBP-retinoic acid-HRP complex, after challenges with various organic/aqueous solvents. Both immobilized HRP and RBP are stable at least for 6 months. The effect of o-phenylene diamine on the thermometric response of HRP is also investigated. A scheme for the design of a thermometric retinol (vitamin A) biosensor is proposed.

  7. [Exploring the dark continent: medical image and brain].

    Science.gov (United States)

    Garcia-Molina, A; Ensenat, A

    2017-04-01

    Until the late 19th century, direct observation of the central nervous system was practically impossible. The discovery of X-rays in 1895 and their subsequent application in the field of medicine brought about a shift of paradigm that completely revolutionised the way in which neurology was practised. The possibility of viewing the inside of the brain had a pronounced impact on clinical practice, and enriched the diagnosis and treatment of brain pathologies in a manner that was unimaginable up until then. The aim of this study is to describe the birth and development of medical imaging of the brain, from the discovery of X-rays and the early days of radiography to the appearance of computerised tomography and magnetic resonance in the 60s, both of which are techniques that were to change the world of diagnostic imaging forever. This brief overview of the history of radiology also includes the origins of angiography and other techniques that are no longer in use, but which were ground-breaking innovations in their time, such as ventriculography or pneumoencephalography. The procedures and techniques described in this article made it possible to view the inside of the brain, thereby facilitating the diagnosis and treatment of a number of neurological processes.

  8. Taiwanese Medical Students' Narratives of Intercultural Professionalism Dilemmas: Exploring Tensions between Western Medicine and Taiwanese Culture

    Science.gov (United States)

    Ho, Ming-Jung; Gosselin, Katherine; Chandratilake, Madawa; Monrouxe, Lynn V.; Rees, Charlotte E.

    2017-01-01

    In an era of globalization, cultural competence is necessary for the provision of quality healthcare. Although this topic has been well explored in non-Western cultures within Western contexts, the authors explore how Taiwanese medical students trained in Western medicine address intercultural professionalism dilemmas related to tensions between…

  9. Plasmodium falciparum HRP2 ELISA for analysis of dried blood spot samples in rural Zambia.

    Science.gov (United States)

    Gibson, Lauren E; Markwalter, Christine F; Kimmel, Danielle W; Mudenda, Lwiindi; Mbambara, Saidon; Thuma, Philip E; Wright, David W

    2017-08-23

    Dried blood spots are commonly used for sample collection in clinical and non-clinical settings. This method is simple, and biomolecules in the samples remain stable for months at room temperature. In the field, blood samples for the study and diagnosis of malaria are often collected on dried blood spot cards, so development of a biomarker extraction and analysis method is needed. A simple extraction procedure for the malarial biomarker Plasmodium falciparum histidine-rich protein 2 (HRP2) from dried blood spots was optimized to achieve maximum extraction efficiency. This method was used to assess the stability of HRP2 in dried blood spots. Furthermore, 328 patient samples made available from rural Zambia were analysed for HRP2 using the developed method. These samples were collected at the initial administration of artemisinin-based combination therapy and at several points following treatment. An average extraction efficiency of 70% HRP2 with a low picomolar detection limit was achieved. In specific storage conditions HRP2 was found to be stable in dried blood spots for at least 6 months. Analysis of patient samples showed the method to have a sensitivity of 94% and a specificity of 89% when compared with microscopy, and trends in HRP2 clearance after treatment were observed. The dried blood spot ELISA for HRP2 was found to be sensitive, specific and accurate. The method was effectively used to assess biomarker clearance characteristics in patient samples, which prove it to be ideal for gaining further insight into the disease and epidemiological applications.

  10. [Exploration and analysis of the thought of medical education in the Shanghai New Chinese Medical College].

    Science.gov (United States)

    Li, Ming; Shang, Li; Bing, Shoulan

    2014-11-01

    Shanghai New Chinese Medical College set up by Zhu Nanshan and his sons, Zhu Xiaonan and Zhu Hegao, was a medical college of traditional Chinese medicine (TCM) with the most innovative spirit in modern time. Its affiliated research institute held the principle of "realizing the scientific truth of TCM, training TCM advanced talents", marking the beginning of the pioneering of "scientific TCM". The educational plan, clinical research and academic organization based on "carrying forward the quintessence of Chinese culture, absorbing and digesting the new knowledge" showed a certain influence at home and abroad. The College advocated the combination of communicating with famous physicians and the study of theory, cultivation of students' organization and academic society, launching of journals, and organizing students' research associations was aiming at the satisfaction of the social needs and teaching orientation. Its running experience provided useful reference for modern TCM medical education.

  11. Medical students' note-taking in a medical biochemistry course: an initial exploration.

    Science.gov (United States)

    Morrison, Elizabeth H; McLaughlin, Calvin; Rucker, Lloyd

    2002-04-01

    Beginning medical students spend numerous hours every week attending basic science lectures and taking notes. Medical faculty often wonder whether they should give students pre-printed instructors' notes before lectures. Proponents of this strategy argue that provided notes enhance learning by facilitating the accurate transmission of information, while opponents counter that provided notes inhibit students' cognitive processing or even discourage students from attending lectures. Little if any research has directly addressed medical students' note-taking or the value of providing instructors' notes. The educational literature does suggest that taking lecture notes enhances university students' learning. University students perform best on post-lecture testing if they review a combination of provided notes and their own personal notes, particularly if the provided notes follow a 'skeletal' format that encourages active note-taking.

  12. Analysis of Erwinia chrysanthemi EC16 pelE::uidA, pelL::uidA, and hrpN::uidA mutants reveals strain-specific atypical regulation of the Hrp type III secretion system.

    Science.gov (United States)

    Ham, Jong Hyun; Cui, Yaya; Alfano, James R; Rodríguez-Palenzuela, Pablo; Rojas, Clemencia M; Chatterjee, Arun K; Collmer, Alan

    2004-02-01

    The plant pathogen Erwinia chrysanthemi produces a variety of factors that have been implicated in its ability to cause soft-rot diseases in various hosts. These include HrpN, a harpin secreted by the Hrp type III secretion system; PelE, one of several major pectate lyase isozymes secreted by the type II system; and PelL, one of several secondary Pels secreted by the type II system. We investigated these factors in E. chrysanthemi EC16 with respect to the effects of medium composition and growth phase on gene expression (as determined with uidA fusions and Northern analyses) and effects on virulence. pelE was induced by polygalacturonic acid, but pelL was not, and hrpN was expressed unexpectedly in nutrient-rich King's medium B and in minimal salts medium at neutral pH. In contrast, the effect of medium composition on hrp expression in E. chrysanthemi CUCPB1237 and 3937 was like that of many other phytopathogenic bacteria in being repressed in complex media and induced in acidic pH minimal medium. Northern blot analysis of hrpN and hrpL expression by the wild-type and hrpL::omegaCmr and hrpS::omegaCmr mutants revealed that hrpN expression was dependent on the HrpL alternative sigma factor, whose expression, in turn, was dependent on the HrpS putative sigma54 enhancer binding protein. The expression of pelE and hrpN increased strongly in late logarithmic growth phase. To test the possible role of quorum sensing in this expression pattern, the expI/expR locus was cloned in Escherichia coli on the basis of its ability to direct production of acyl-homoserine lactone and then used to construct expI mutations in pelE::uidA, pelL::uidA, and hrpN::uidA Erwinia chrysanthemi strains. Mutation of expI had no apparent effect on the growth-phase-dependent expression of hrpN and pelE, or on the virulence of E. chrysanthemi in witloof chicory leaves. Overexpression of hrpN in E. chrysanthemi resulted in approximately 50% reduction of lesion size on chicory leaves without an

  13. Subchronic mild noise stress increases HRP permeability in rat small intestine in vitro.

    Science.gov (United States)

    Bijlsma, P B; van Raaij, M T; Dobbe, C J; Timmerman, A; Kiliaan, A J; Taminiau, J A; Groot, J A

    2001-05-01

    Recently we reported an increased trans- and paracellular protein permeability in rat small intestine after acute cold restraint stress. In the present study, we applied randomized 95- or 105-dB white noise pulses during 45 min/h, 12 h/day, duration 8 days, as a milder, but more chronic stressor to male rats. At 8 days before the noise experiments, 50% of the animals were cannulated in the vena cava for blood sampling during the experimental period. The other 50% of the animals were sacrificed at Day 9, segments of ileum were mounted in Ussing chambers and perfused at 37 degrees C. Horseradish peroxidase (HRP) was added mucosally, serosal appearance was detected enzymatically and tissues were fixed for electron microscopy. In the animals exposed to 95-dB noise, plasma corticosterone levels were enhanced twofold compared to controls, and ileal HRP flux was enhanced twofold. Electron micrographs of tissue from stressed or control animals showed no detectable paracellular staining of HRP. Quantification of HRP-containing endosomes in enterocytes revealed a twofold increase in endosome number in the animals exposed to 95-db noise indicating that the increased HRP permeability was primarily due to increased endocytosis. In contrast to the animals exposed to 95-dB noise, rats exposed to 105-dB noise showed no increase in corticosterone levels and ileal HRP fluxes were not significantly different from controls. We conclude that mild subchronic noise stress may cause a decrease in intestinal barrier function by increased transcytosis of luminal antigens.

  14. Leadership and followership in the healthcare workplace: exploring medical trainees' experiences through narrative inquiry

    OpenAIRE

    Gordon, Lisi J.; Rees, Charlotte E.; Ker, Jean S.; Cleland, Jennifer

    2015-01-01

    This research was part of LJG’s PhD research which was generously funded by NHS Education for Scotland through SMERC. OBJECTIVES: To explore medical trainees' experiences of leadership and followership in the interprofessional healthcare workplace. DESIGN: A qualitative approach using narrative interviewing techniques in 11 group and 19 individual interviews with UK medical trainees. SETTING: Multisite study across four UK health boards. PARTICIPANTS: Through maximum variation sampling, 65...

  15. A qualitative study exploring issues related to medication management in residential aged care facilities

    Directory of Open Access Journals (Sweden)

    Ahmad Nizaruddin M

    2017-11-01

    Full Text Available Mariani Ahmad Nizaruddin, Marhanis-Salihah Omar, Adliah Mhd-Ali, Mohd Makmor-Bakry Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia Background: Globally, the population of older people is on the rise. As families are burdened with the high cost of care for aging members, demand is increasing for medical care and nursing homes. Thus, medication management is crucial to ensure that residents in a care center benefit and assist the management of the care center in reducing the burden of health care. This study is aimed to qualitatively explore issues related to medication management in residential aged care facilities (RACFs.Participants and methods: A total of 11 stakeholders comprising health care providers, administrators, caretakers and residents were recruited from a list of registered government, nongovernmental organization and private RACFs in Malaysia from September 2016 to April 2017. An exploratory qualitative study adhering to Consolidated Criteria for Reporting Qualitative Studies was conducted. In-depth interview was conducted with consent of all participants, and the interviews were audio recorded for later verbatim transcription. Observational analysis was also conducted in a noninterfering manner.Results and discussion: Three themes, namely medication use process, personnel handling medications and culture, emerged in this study. Medication use process highlighted an unclaimed liability for residents’ medication by the RACFs, whereas personnel handling medications were found to lack sufficient training in medication management. Culture of the organization did affect the medication safety and quality improvement. The empowerment of the residents in their medication management was limited. There were unclear roles and responsibility of who manages the medication in the nongovernment-funded RACFs, although they were well structured in the private nursing homes.Conclusion: There are important issues

  16. A qualitative study exploring issues related to medication management in residential aged care facilities.

    Science.gov (United States)

    Ahmad Nizaruddin, Mariani; Omar, Marhanis-Salihah; Mhd-Ali, Adliah; Makmor-Bakry, Mohd

    2017-01-01

    Globally, the population of older people is on the rise. As families are burdened with the high cost of care for aging members, demand is increasing for medical care and nursing homes. Thus, medication management is crucial to ensure that residents in a care center benefit and assist the management of the care center in reducing the burden of health care. This study is aimed to qualitatively explore issues related to medication management in residential aged care facilities (RACFs). A total of 11 stakeholders comprising health care providers, administrators, caretakers and residents were recruited from a list of registered government, nongovernmental organization and private RACFs in Malaysia from September 2016 to April 2017. An exploratory qualitative study adhering to Consolidated Criteria for Reporting Qualitative Studies was conducted. In-depth interview was conducted with consent of all participants, and the interviews were audio recorded for later verbatim transcription. Observational analysis was also conducted in a noninterfering manner. Three themes, namely medication use process, personnel handling medications and culture, emerged in this study. Medication use process highlighted an unclaimed liability for residents' medication by the RACFs, whereas personnel handling medications were found to lack sufficient training in medication management. Culture of the organization did affect the medication safety and quality improvement. The empowerment of the residents in their medication management was limited. There were unclear roles and responsibility of who manages the medication in the nongovernment-funded RACFs, although they were well structured in the private nursing homes. There are important issues related to medication management in RACFs which require a need to establish policy and guidelines.

  17. Trend of Medical Tourism Publications: An Attempt to Explore the Involved Academic Disciplines and Interests.

    Science.gov (United States)

    Rokni, Ladan; Park, Sam-Hun

    2018-02-01

    Medical tourism suffers from the lack of a consensus regarding the involved categories. This study aimed to address this gap from the academic disciplines and publications perspective. Totally 1954 citations were identified through a formula of keyword search of SCOPUS. In order to classify the various subject areas, we followed the international standard classification of education (ISCED) developed by UNESCO. Moreover, the trends of publications were identified based on their popularity between 2000 and 2017. The category with the most interests on publication about medical tourism was 'health and welfare', followed by 'social science'. Even though various disciplines were involved in the medical tourism, it seems that a downward trend has been experienced since 2015. The identified key trends of medical tourism publications will benefit researchers exploring the categories of medical tourism or health travel. The results contribute to advance the state of knowledge from the academic perspective.

  18. The Effect of Combined Treatment with the (ProRenin Receptor Blocker HRP and Quinapril in Type 1 Diabetic Rats

    Directory of Open Access Journals (Sweden)

    Gábor Kökény

    2017-04-01

    Full Text Available Background/Aims: Diabetic nephropathy remains a major clinical problem. The effects of prorenin might be adverse, but the literature data are controversial. We compared the renal effects of the (prorenin receptor ((PRR blockade and angiotensin converting enzyme (ACE inhibition on the progression of diabetic nephropathy in rats. Methods: Diabetes (DM was induced by ip. streptozotocin administration in adult male Sprague-Dawley rats, followed by eight weeks of treatment with the (PRR blocker „handle region” decoy peptide (HRP, 0,1 mg/kg/day or with the ACE inhibitor Quinapril (Q, 50 mg/kg/day and grouped as follows: 1. Control (n=10; 2. DM (n=8; 3. DM+HRP (n=6; 4. DM+Q (n=10; 5. DM+Q+HRP (n=10. Renal functional parameters, histology and gene expressions were evaluated. Results: HRP reduced glomerulosclerosis and podocyte desmin expression, but did not affect proteinuria and tubular ERK(1/2 phosphorylation. Both Q and Q+HRP treatment reduced proteinuria, glomerular and tubular damage, tubular TGF-ß1 expression and ERK(1/2 phosphorylation to the same extent. Conclusion: The effects of HRP were partially beneficial on diabetic kidney lesions as HRP reduced damage but did not improve tubular damage and failed to reduce ERK(1/2 phosphorylation in rats. The combination of HRP with Quinapril had no additive effects over Quinapril monotherapy on the progression of diabetic nephropathy.

  19. Exploring the potential of video technologies for collaboration in emergency medical care

    DEFF Research Database (Denmark)

    Söderholm, Hanna M.; Sonnenwald, Diane H.; Manning, James E.

    2008-01-01

    conferencing techniques. This may be of benefit in diagnosing and treating patients in emergency situations where specialized medical expertise is not locally available. The experimental design and results concerning information behavior are presented in the article "Exploring the Potential of Video...

  20. Early assessment of medical devices in development for company decision making : An exploration of best practices

    NARCIS (Netherlands)

    Markiewicz, Katarzyna; Van Til, Janine; IJzerman, Maarten

    2017-01-01

    To improve successful development and clinical use of medical technologies, it is suggested that manufacturers should start collecting evidence on devices effectiveness and eficiency early in their development. The aim of this study was to explore whether and how Dutch manufacturers perform an early

  1. Exploring factors affecting undergraduate medical students' study strategies in the clinical years: a qualitative study.

    NARCIS (Netherlands)

    Al Kadri, H.M.; Al-Moamary, M.S.; Elzubair, M.; Magzoub, M.E.; AlMutairi, A.; Roberts, C.; Vleuten, C.P.M. van der

    2011-01-01

    The aim of this study is to explore the effects of clinical supervision, and assessment characteristics on the study strategies used by undergraduate medical students during their clinical rotations. We conducted a qualitative phenomenological study at King Saud Bin Abdulaziz University for Health

  2. Nurses' experiences and perspectives on medication safety practices: an explorative qualitative study.

    Science.gov (United States)

    Smeulers, Marian; Onderwater, Astrid T; van Zwieten, Myra C B; Vermeulen, Hester

    2014-04-01

    To explore nurses' experiences with and perspectives on preventing medication administration errors. Insight into nurses' experiences with and perspectives on preventing medication administration errors is important and can be utilised to tailor and implement safety practices. A qualitative interview study of 20 nurses in an academic medical centre was conducted between March and December of 2011. Three themes emerged from this study: (1) nurses' roles and responsibilities in medication safety: aside from safe preparation and administration, the clinical reasoning of nurses is essential for medication safety; (2) nurses' ability to work safely: knowledge of risks and nurses' work circumstances influence their ability to work safely; and (3) nurses' acceptance of safety practices: advantages, feasibility and appropriateness are important incentives for acceptance of a safety practice. Nurses' experiences coincide with the assumption that they are in a pre-eminent position to enable safe medication management; however, their ability to adequately perform this role depends on sufficient knowledge to assess the risks of medication administration and on the circumstances in which they work. Safe medication management requires a learning climate and professional practice environment that enables further development of professional nursing skills and knowledge. © 2014 John Wiley & Sons Ltd.

  3. Medical migration: A qualitative exploration of the atypical path of Japanese international medical graduates.

    Science.gov (United States)

    Heist, Brian S; Torok, Haruka Matsubara

    2018-01-01

    International Medical Graduates (IMGs) are commonly understood to move from low to high resource countries with motivations including improved financial situations and cultures of emigration. A presumable exception to the above themes would be the Japanese IMG population. The aim of this study was to develop an understanding of the Japanese IMG experience. Using a grounded theory approach, we interviewed 19 Japanese IMGs working in the US and 16 Japanese IMGs working in Japan who had completed US clinical training. Questions addressed decision-making to pursue US clinical training, goals for the training, and career decision-making upon completing the training. Data collection and constant comparative analysis were conducted iteratively to identify emerging themes. The emerging model of the Japanese IMG experience is focused around pivotal experiences that often include dissatisfaction with the quality of Japanese clinical training and personal exposures to US clinical education. Further decision-making in the pursuit of US residency is influenced by educator training quality, and clinical training and career opportunities. The desire to improve Japanese clinical training commonly influences career decision-making after US training. The Japanese IMG experience contrasts numerous perceptions of international physician migration and, in turn, enhances understanding of this paradigm.

  4. HRP facility for fabrication of ITER vertical target divertor full scale plasma facing units

    International Nuclear Information System (INIS)

    Visca, Eliseo; Roccella, S.; Candura, D.; Palermo, M.; Rossi, P.; Pizzuto, A.; Sanguinetti, G.P.; Mancini, A.; Verdini, L.; Cacciotti, E.; Cerri, V.; Mugnaini, G.; Reale, A.; Giacomi, G.

    2015-01-01

    Highlights: • R&D activities for the manufacturing of ITER divertor high heat flux plasma-facing components (HHFC). • ENEA and Ansaldo have jointly manufactured several actively cooled monoblock mock-ups and prototypical components. • ENEA and ANSALDO NUCLEARE jointly participate to the European program for the qualification of the manufacturing technology for the ITER divertor IVT. • Successful manufacturing by HRP (Hot Radial Pressing) of first full-scale full-W armored IVT qualification prototype. - Abstract: ENEA and Ansaldo Nucleare S.p.A. (ANN) have being deeply involved in the European development activities for the manufacturing of the ITER Divertor Inner Vertical Target (IVT) plasma-facing components. During normal operation the heat flux deposited on the bottom segment of divertor is 5–10 MW/m 2 but the capability to remove up to 20 MW/m 2 during transient events of 10 s must also be demonstrated. In order to fulfill ITER requirements, ENEA has set up and widely tested a manufacturing process, named Hot Radial Pressing (HRP). The last challenge is now to fabricate full-scale prototypes of the IVT, aimed to be qualified for the next step, i.e. the series production. On the basis of the experience of manufacturing hundreds of small mock-ups, ENEA designed and installed a new suitable HRP facility. The objective of getting a final shaped plasma facing unit (PFU) that satisfies these requirements is an ambitious target because tolerances set by ITER/F4E are very tight. The setting-up of the equipment started with the fabrication of full scale and representative ‘dummies’ in which stainless steel instead of CFC or W was used for monoblocks. The results confirmed that dimensions were compliant with the required tolerances. The paper reports a brief description of the innovative HRP equipment and the dimensional check results after HRP of the first full-scale full-W PFU.

  5. HRP facility for fabrication of ITER vertical target divertor full scale plasma facing units

    Energy Technology Data Exchange (ETDEWEB)

    Visca, Eliseo, E-mail: eliseo.visca@enea.it [Unità Tecnica Fusione, ENEA C. R. Frascati, via E. Fermi 45, IT-00044 Frascati (Roma) (Italy); Roccella, S. [Unità Tecnica Fusione, ENEA C. R. Frascati, via E. Fermi 45, IT-00044 Frascati (Roma) (Italy); Candura, D.; Palermo, M. [Ansaldo Nucleare S.p.A., Corso Perrone 25, IT-16152 Genova (Italy); Rossi, P.; Pizzuto, A. [Unità Tecnica Fusione, ENEA C. R. Frascati, via E. Fermi 45, IT-00044 Frascati (Roma) (Italy); Sanguinetti, G.P. [Ansaldo Nucleare S.p.A., Corso Perrone 25, IT-16152 Genova (Italy); Mancini, A.; Verdini, L.; Cacciotti, E.; Cerri, V.; Mugnaini, G.; Reale, A.; Giacomi, G. [Unità Tecnica Fusione, ENEA C. R. Frascati, via E. Fermi 45, IT-00044 Frascati (Roma) (Italy)

    2015-10-15

    Highlights: • R&D activities for the manufacturing of ITER divertor high heat flux plasma-facing components (HHFC). • ENEA and Ansaldo have jointly manufactured several actively cooled monoblock mock-ups and prototypical components. • ENEA and ANSALDO NUCLEARE jointly participate to the European program for the qualification of the manufacturing technology for the ITER divertor IVT. • Successful manufacturing by HRP (Hot Radial Pressing) of first full-scale full-W armored IVT qualification prototype. - Abstract: ENEA and Ansaldo Nucleare S.p.A. (ANN) have being deeply involved in the European development activities for the manufacturing of the ITER Divertor Inner Vertical Target (IVT) plasma-facing components. During normal operation the heat flux deposited on the bottom segment of divertor is 5–10 MW/m{sup 2} but the capability to remove up to 20 MW/m{sup 2} during transient events of 10 s must also be demonstrated. In order to fulfill ITER requirements, ENEA has set up and widely tested a manufacturing process, named Hot Radial Pressing (HRP). The last challenge is now to fabricate full-scale prototypes of the IVT, aimed to be qualified for the next step, i.e. the series production. On the basis of the experience of manufacturing hundreds of small mock-ups, ENEA designed and installed a new suitable HRP facility. The objective of getting a final shaped plasma facing unit (PFU) that satisfies these requirements is an ambitious target because tolerances set by ITER/F4E are very tight. The setting-up of the equipment started with the fabrication of full scale and representative ‘dummies’ in which stainless steel instead of CFC or W was used for monoblocks. The results confirmed that dimensions were compliant with the required tolerances. The paper reports a brief description of the innovative HRP equipment and the dimensional check results after HRP of the first full-scale full-W PFU.

  6. Predictive Psychiatric Genetic Testing in Minors: An Exploration of the Non-Medical Benefits.

    Science.gov (United States)

    Manzini, Arianna; Vears, Danya F

    2018-03-01

    Predictive genetic testing for susceptibility to psychiatric conditions is likely to become part of standard practice. Because the onset of most psychiatric diseases is in late adolescence or early adulthood, testing minors could lead to early identification that may prevent or delay the development of these disorders. However, due to their complex aetiology, psychiatric genetic testing does not provide the immediate medical benefits that current guidelines require for testing minors. While several authors have argued non-medical benefits may play a crucial role in favour of predictive testing for other conditions, little research has explored such a role in psychiatric disorders. This paper outlines the potential non-medical benefits and harms of psychiatric genetic testing in minors in order to consider whether the non-medical benefits could ever make such testing appropriate. Five non-medical themes arise in the literature: psychological impacts, autonomy/self-determination, implications of the biomedical approach, use of financial and intellectual resources, and discrimination. Non-medical benefits were prominent in all of them, suggesting that psychiatric genetic testing in minors may be appropriate in some circumstances. Further research needs to empirically assess these potential non-medical benefits, incorporate minors in the debate, and include normative reflection to evaluate the very purposes and motivations of psychiatric genetic testing in minors.

  7. Educational Debt in the Context of Career Planning: A Qualitative Exploration of Medical Student Perceptions.

    Science.gov (United States)

    Phillips, Julie P; Wilbanks, Deana M; Salinas, Diana F; Doberneck, Diane M

    2016-01-01

    Phenomenon: Medical students in the United States face increasing educational debt because medical education costs have risen while public investment in higher education has declined. Contemporary students borrow more money and accumulate debt far surpassing that of previous generations of physicians, and both interest rates and terms of loan repayment have changed significantly in the last decade. As a result, the experiences of medical students differ from the experiences of physician educators. Little is known about how contemporary medical students view their debt in the context of career planning. Understanding contemporary U.S. medical students' lived experiences of educational debt is important, because high debt levels may affect medical students' well-being and professional development. The study's purpose was to explore contemporary students' views of their debt in the context of career planning. In 2012, 2nd-year medical students enrolled in a health policy course at one medical school were invited to write an essay about how debt influences their career choices. The authors analyzed 132 essays using immersion and crystallization and iterative, team-based coding. Code-recode strategies, member checking, and reflexivity ensured validity and rigor. Three themes emerged about the meaning of debt: debt symbolizes lack of social investment, debt reinforces a sense of entitlement, and debt is a collective experience. Four approaches to debt management emerged: anticipation, avoidance, acceptance, and disempowerment. Insights: Medical students' views of debt are more complex than previously reported. Medical educators should recognize that many students experience debt as a stressor, acknowledge students' emotions about debt, and invite discussion about the culture of entitlement in medical education and how this culture affects students' professionalism. At the same time, educators should emphasize that students have many repayment options and that regardless

  8. An exploration of the dynamics and influences upon second medical opinion consultations in cancer care.

    Science.gov (United States)

    Philip, Jennifer; Gold, Michelle; Schwarz, Max; Komesaroff, Paul

    2011-03-01

    The aim of this study was to explore the dynamics within second medical opinion consultations in patients with cancer. Semi-structured interviews were held with four oncologists and were subjected to a thematic analysis to define the broad issues. These formed the basis of a survey distributed to Australian medical oncologists. Overall 65 surveys were returned representing an overall response rate of 30% (10% and 63% electronic and hardcopy response rates, respectively). The dynamics in giving second medical opinions are influenced by the collegiate relationships of the doctors. Nearly two-thirds of oncologists believed that the first doctors' treatment and recommendations influenced the outcome of the second opinion, more than one-third believed the outcome was influenced by the relationship between the two doctors, and 41% believed the public nature of a second opinion was influential. In each case, these figures were more than double their assessments of patients' beliefs of these influences. Care was taken not to criticise the primary doctor. Second medical opinions provide an opportunity for oncologists to review medical care and engage in enhanced communication with patients who have additional needs. These consultations do not, however, occur in a vacuum but are influenced by the need to attend to relationships between the patient and their primary doctor and between the doctors themselves. The second medical opinion is embedded within a network of relationships and within the illness journey. © 2010 Blackwell Publishing Asia Pty Ltd.

  9. Erwinia amylovora expresses fast and simultaneously hrp/dsp virulence genes during flower infection on apple trees.

    Directory of Open Access Journals (Sweden)

    Doris Pester

    Full Text Available BACKGROUND: Pathogen entry through host blossoms is the predominant infection pathway of the gram-negative bacterium Erwinia amylovora leading to manifestation of the disease fire blight. Like in other economically important plant pathogens, E. amylovora pathogenicity depends on a type III secretion system encoded by hrp genes. However, timing and transcriptional order of hrp gene expression during flower infections are unknown. METHODOLOGY/PRINCIPAL FINDINGS: Using quantitative real-time PCR analyses, we addressed the questions of how fast, strong and uniform key hrp virulence genes and the effector dspA/E are expressed when bacteria enter flowers provided with the full defense mechanism of the apple plant. In non-invasive bacterial inoculations of apple flowers still attached to the tree, E. amylovora activated expression of key type III secretion genes in a narrow time window, mounting in a single expression peak of all investigated hrp/dspA/E genes around 24-48 h post inoculation (hpi. This single expression peak coincided with a single depression in the plant PR-1 expression at 24 hpi indicating transient manipulation of the salicylic acid pathway as one target of E. amylovora type III effectors. Expression of hrp/dspA/E genes was highly correlated to expression of the regulator hrpL and relative transcript abundances followed the ratio: hrpA>hrpN>hrpL>dspA/E. Acidic conditions (pH 4 in flower infections led to reduced virulence/effector gene expression without the typical expression peak observed under natural conditions (pH 7. CONCLUSION/SIGNIFICANCE: The simultaneous expression of hrpL, hrpA, hrpN, and the effector dspA/E during early floral infection indicates that speed and immediate effector transmission is important for successful plant invasion. When this delicate balance is disturbed, e.g., by acidic pH during infection, virulence gene expression is reduced, thus partly explaining the efficacy of acidification in fire blight

  10. Perspectives of healthcare practitioners: An exploration of interprofessional communication using electronic medical records.

    Science.gov (United States)

    Bardach, Shoshana H; Real, Kevin; Bardach, David R

    2017-05-01

    Contemporary state-of-the-art healthcare facilities are incorporating technology into their building design to improve communication and patient care. However, technological innovations may also have unintended consequences. This study seeks to better understand how technology influences interprofessional communication within a hospital setting based in the United States. Nine focus groups were conducted including a range of healthcare professions. The focus groups explored practitioners' experiences working on two floors of a newly designed hospital and included questions about the ways in which technology shaped communication with other healthcare professionals. All focus groups were recorded, transcribed, and coded to identify themes. Participant responses focused on the electronic medical record, and while some benefits of the electronic medical record were discussed, participants indicated use of the electronic medical record has resulted in a reduction of in-person communication. Different charting approaches resulted in barriers to communication between specialties and reduced confidence that other practitioners had received one's notes. Limitations in technology-including limited computer availability, documentation complexity, and sluggish sign-in processes-also were identified as barriers to effective and timely communication between practitioners. Given the ways in which technology shapes interprofessional communication, future research should explore how to create standardised electronic medical record use across professions at the optimal level to support communication and patient care.

  11. The nervus terminalis ganglion in Anguilla rostrata: an immunocytochemical and HRP histochemical analysis.

    Science.gov (United States)

    Grober, M S; Bass, A H; Burd, G; Marchaterre, M A; Segil, N; Scholz, K; Hodgson, T

    1987-12-08

    Immunocytochemistry and retrograde horseradish peroxidase (HRP) transport were used to study the ganglion of the nervus terminalis in the American eel, Anguilla rostrata. Luteinizing hormone releasing hormone (LHRH) like immunoreactivity was found in large, ganglion-like cells located ventromedially at the junction of the telencephalon and olfactory bulb and in fibers within the retina and olfactory epithelium. HRP transport from the retina demonstrated direct connections with both the ipsi- and contralateral populations of these ganglion-like cells. Given the well-documented role of both olfaction and vision during migratory and reproductive phases of the life cycle of eels, the robust nature of a nervus terminalis system in these fish may present a unique opportunity to study the behavioral correlates of structure-function organization in a discrete population of ganglion-like cells.

  12. The post-transcriptional regulator rsmA/csrA activates T3SS by stabilizing the 5' UTR of hrpG, the master regulator of hrp/hrc genes, in Xanthomonas.

    Directory of Open Access Journals (Sweden)

    Maxuel O Andrade

    2014-02-01

    Full Text Available The RsmA/CsrA family of the post-transcriptional regulators of bacteria is involved in the regulation of many cellular processes, including pathogenesis. In this study, we demonstrated that rsmA not only is required for the full virulence of the phytopathogenic bacterium Xanthomonas citri subsp. citri (XCC but also contributes to triggering the hypersensitive response (HR in non-host plants. Deletion of rsmA resulted in significantly reduced virulence in the host plant sweet orange and a delayed and weakened HR in the non-host plant Nicotiana benthamiana. Microarray, quantitative reverse-transcription PCR, western-blotting, and GUS assays indicated that RsmA regulates the expression of the type 3 secretion system (T3SS at both transcriptional and post-transcriptional levels. The regulation of T3SS by RsmA is a universal phenomenon in T3SS-containing bacteria, but the specific mechanism seems to depend on the interaction between a particular bacterium and its hosts. For Xanthomonads, the mechanism by which RsmA activates T3SS remains unknown. Here, we show that RsmA activates the expression of T3SS-encoding hrp/hrc genes by directly binding to the 5' untranslated region (UTR of hrpG, the master regulator of the hrp/hrc genes in XCC. RsmA stabilizes hrpG mRNA, leading to increased accumulation of HrpG proteins and subsequently, the activation of hrp/hrc genes. The activation of the hrp/hrc genes by RsmA via HrpG was further supported by the observation that ectopic overexpression of hrpG in an rsmA mutant restored its ability to cause disease in host plants and trigger HR in non-host plants. RsmA also stabilizes the transcripts of another T3SS-associated hrpD operon by directly binding to the 5' UTR region. Taken together, these data revealed that RsmA primarily activates T3SS by acting as a positive regulator of hrpG and that this regulation is critical to the pathogenicity of XCC.

  13. The hnRNP A1 homolog Hrp36 is essential for normal development ...

    Indian Academy of Sciences (India)

    2012-08-11

    Aug 11, 2012 ... Here we show that loss of both copies of hrp36 gene slows down development with .... larvae, pupae and adults were reared at 18°C or 24°C or. 30°C (±1°C) on ... of three days old 20 male and 20 female flies were set up: (a) wild type ... dissected out in Poels' salt solution (PSS; Lakhotia and. Tapadia ...

  14. How we created a peer-designed specialty-specific selective for medical student career exploration.

    Science.gov (United States)

    Keating, Elizabeth M; O'Donnell, Erin P; Starr, Stephanie R

    2013-01-01

    In recent years, medical students have recognized and advocated for opportunities to explore various specialties earlier in their medical education. A brief literature review, however, reveals little consensus on the best approach to introduce students to different fields during their preclinical years. We present one of the first reports of a student-led effort to design and implement a preclinical specialty-specific elective. At Mayo Medical School, for two consecutive years the student president of the Pediatric Interest Group has created a peer-designed weeklong group elective ("selective") experience consisting of workshops, faculty and resident panel discussions, and clinical shadowing experiences based on a student needs assessment. Each year, more than 25% of the first- and second-year medical student body participated. The majority of students who completed the selective agreed that this experience heightened their interests and expanded their knowledge about pediatrics. The pediatric group selective has provided students with important resources for their medical education and future careers. Students found the group selective beneficial to their learning experience and recommend continuing to offer it in the future.

  15. Managing Complexity: Exploring Decision Making on Medication by Young Adults with ADHD.

    Science.gov (United States)

    Druedahl, Louise C; Kälvemark Sporrong, Sofia

    2018-04-19

    Attention-deficit hyperactivity disorder (ADHD) causes difficulties with hyperactivity, impulsivity and inattention. Treatment of ADHD includes both medication and non-pharmacological options. Knowledge of treatment preferences by young adults with ADHD is sparse. The objective of this study was to explore the beliefs and experiences of young adults with ADHD related to their medication treatment decisions. Data were collected in Denmark in 2016 through a focus group and individual in-depth interviews. Conventional content analysis was used. Ten young adults with ADHD (22-to 29-year-old) participated. Three major themes were identified: (1) the patient’s right to choose concerning ADHD medicine; (2) the patient’s decision of whether or not to treat ADHD with medication; and (3) factors affecting the patient’s decision on whether to take ADHD medication or not. The latter theme contained 15 factors, which were distributed across three levels: individual, between-individuals, and societal. The dominant factors were increasing quality of life and improving oneself e.g., improving social skills. For counselling at the pharmacy and by prescribers, it is important to be aware of the different factors that affect young adult patients’ decisions on whether to take ADHD medication or not. This knowledge will aid to understand reasons for non-adherence and to determine appropriate treatment for the individual patient.

  16. Formal Development of the HRP Prover - Part 1: Syntax and Semantics

    International Nuclear Information System (INIS)

    Sivertsen, Terje

    1996-01-01

    This report describes the formal development of a new version of the HRP Prover. The new version of the tool will have functionality almost identical to the current version, but is developed in accordance to established principles for applying algebraic specification in formal software development. The development project provides results of relevance to the formal development of a wide range of language-oriented tools, including programming language compilers, as well as to the automatic generation of code from specifications. Since the overall scope of this report is the analysis of algebraic specifications, emphasis is given to topics related to what is usually understood as the ''front end'' of compilers. This includes lexical and syntax analysis of the specifications, static semantics through type checking, and dynamic semantics through evaluation. All the different phases are specified in algebraic specification and supported by the current version of the HRP Prover. In subsequent work, the completed parts of the new version will complement the tool support in the development. The work presented will be followed up by formal specification of theorem proving and transformation, as well as code generation into conventional programming languages. The new version of the HRP Prover is incrementally developed in coherence with the specifications produced in these activities. At the same time, the development of the tool demonstrates the efficient use of the methodology through real application on an increasingly important class of software. (author)

  17. Human myeloperoxidase (MPO) and horseradish peroxidase (HRP) catalyzed oxidation of phenol

    International Nuclear Information System (INIS)

    Ross, D.; Eastmond, D.A.; Ruzo, L.O.; Smith, M.T.

    1986-01-01

    MPO-catalyzed conversion of phenolic metabolites of benzene may be involved in benzene-induced myelotoxicity. The authors have studied the metabolism and protein binding of phenol - the major metabolite of benzene - during peroxidatic oxidation. The major metabolite observed during MPO- and HRP- catalyzed oxidation was characterized as 4,4 biphenol using HPLC and combined GC-MS. When glutathione (GSH) was added to the incubation mixtures, two additional compounds were observed during HPLC analysis which were characterized as GSH-conjugates of 4,4-diphenoquinone by fast atom bombardment MS and by NMR. ESR spectroscopy showed that both MPO-and HRP-catalyzed oxidation of phenol proceeded via the generation of free radical intermediates. Using 14 C-phenol, both MPO- and HRP-catalyzed oxidations resulted in the production of species which bound covalently to boiled liver microsomal protein. The increase in binding correlated well with removal of substrate. Thus, peroxidatic oxidation of phenolic metabolites of benzene in the bone marrow may be involved in benzene-induced myelotoxicity

  18. Integrated Medical Model Overview

    Science.gov (United States)

    Myers, J.; Boley, L.; Foy, M.; Goodenow, D.; Griffin, D.; Keenan, A.; Kerstman, E.; Melton, S.; McGuire, K.; Saile, L.; hide

    2015-01-01

    The Integrated Medical Model (IMM) Project represents one aspect of NASA's Human Research Program (HRP) to quantitatively assess medical risks to astronauts for existing operational missions as well as missions associated with future exploration and commercial space flight ventures. The IMM takes a probabilistic approach to assessing the likelihood and specific outcomes of one hundred medical conditions within the envelope of accepted space flight standards of care over a selectable range of mission capabilities. A specially developed Integrated Medical Evidence Database (iMED) maintains evidence-based, organizational knowledge across a variety of data sources. Since becoming operational in 2011, version 3.0 of the IMM, the supporting iMED, and the expertise of the IMM project team have contributed to a wide range of decision and informational processes for the space medical and human research community. This presentation provides an overview of the IMM conceptual architecture and range of application through examples of actual space flight community questions posed to the IMM project.

  19. Immobilization of HRP in Mesoporous Silica and Its Application for the Construction of Polyaniline Modified Hydrogen Peroxide Biosensor

    Directory of Open Access Journals (Sweden)

    Chien-Chung Chen

    2009-06-01

    Full Text Available Polyaniline (PANI, an attractive conductive polymer, has been successfully applied in fabricating various types of enzyme-based biosensors. In this study, we have employed mesoporous silica SBA-15 to stably entrap horseradish peroxidase (HRP, and then deposited the loaded SBA-15 on the PANI modified platinum electrode to construct a GA/SBA-15(HRP/PANI/Pt biosensor. The mesoporous structures and morphologies of SBA-15 with or without HRP were characterized. Enzymatic protein assays were employed to evaluate HRP immobilization efficiency. Our results demonstrated that the constructed biosensor displayed a fine linear correlation between cathodic response and H2O2 concentration in the range of 0.02 to 18.5 mM, with enhanced sensitivity. In particular, the current approach provided the PANI modified biosensor with improved stability for multiple measurements.

  20. Dual peer mentoring program for undergraduate medical students: exploring the perceptions of mentors and mentees.

    Science.gov (United States)

    Abdolalizadeh, Parya; Pourhassan, Saeed; Gandomkar, Roghayeh; Heidari, Farrokh; Sohrabpour, Amir Ali

    2017-01-01

    Background: Despite the advantages of dual peer mentoring, there are a few reports of implementing and evaluating such programs for medical students. This study aimed at exploring the perceptions of mentors and mentees about the dual peer mentoring program for the first year undergraduate medical students of Tehran University of Medical Sciences. Methods: This qualitative study was conducted at the end of the first year of implementing the mentoring program. All mentees and mentors were invited to participate in focus group discussions. Data were analyzed using a qualitative content analysis. Results: All mentors ( n= 12 ) and a group of mentees ( n= 21 ) participated in focus group discussion sessions. We provided a variety of supports for the mentees including academic and psychosocial support and positive relationship; as a result, some developments occurred to the mentors We also explored participants' views on some unique aspects of the program such as student-authorized, dual mentoring, and role model sessions. Conclusion: Our participants found the mentoring program beneficial in various academic achievements and psychosocial supports for both the mentors and the mentees. Dual peer mentoring program can be an alternative to school administered programs.

  1. Exploring the Top-Cited and Most Influential Articles in Medical Education.

    Science.gov (United States)

    Azer, Samy A

    2016-01-01

    The citations received by a scientific publication have been used as a proxy measurement of scientific quality and in ranking researchers. Although these practices have been observed in several institutes, careful assessment of top-cited articles may provide more insight into exploring their characteristics. The aim of this study was to analyze the top-cited articles in medical education identified by Azer 2015 and explore the characteristics of these articles that can provide insight into their assessment. The most frequently cited articles identified by searching the Web of Science under the category "Education, Scientific Discipline" were included in the analysis. The following issues were further analyzed: 1) comparing the mean yearly citations received by articles published before the year 2000 and those published after, 2) assessing whether there was a correlation between the number of grants, number of authors, number of institutes, or number of countries involved and the number of citations received, 3) assessing the number of female representation in authorship, 4) assessing the representation of none-medical staff in the authorship, and 5) exploring any association between top authors identified and those who were awarded the Karolinska Institutet Prize for research in medical education. Although there was no correlation between the number of citations and the number of years since publications, the mean number of citations received by articles published before the year 2000 varied from zero to 18.2 ± 16.6, whereas for those published after the year 2000 the mean varied from 2.0 ± 2.1 to 35.3 ± 26.8. No correlation was found between the number of citations obtained and number of grants, number of authors, number of institutes, or number of countries involved. Females comprised 50% of the total number of authors. However, no correlation was found between the number of females in authorship and the number of citations obtained. Similarly, the number of

  2. Study on Enhancement Principle and Stabilization for the Luminol-H2O2-HRP Chemiluminescence System.

    Directory of Open Access Journals (Sweden)

    Lihua Yang

    Full Text Available A luminol-H2O2-HRP chemiluminescence system with high relative luminescent intensity (RLU and long stabilization time was investigated. First, the comparative study on the enhancement effect of ten compounds as enhancers to the luminol-H2O2-HRP chemiluminescence system was carried out, and the results showed that 4-(imidazol-1-ylphenol (4-IMP, 4-iodophenol (4-IOP, 4-bromophenol (4-BOP and 4-hydroxy-4'-iodobiphenyl (HIOP had the best performance. Based on the experiment, the four enhancers were dissolved in acetone, acetonitrile, methanol, and dimethylformamide (DMF with various concentrations, the results indicated that 4-IMP, 4-IOP, 4-BOP and HIOP dissolved in DMF with the concentrations of 0.2%, 3.2%, 1.6% and 3.2% could get the highest RLU values. Subsequently, the influences of pH, ionic strength, HRP, 4-IMP, 4-IOP, 4-BOP, HIOP, H2O2 and luminol on the stabilization of the luminol-H2O2-HRP chemiluminescence system were studied, and we found that pH value, ionic strength, 4-IMP, 4-IOP, 4-BOP, HIOP, H2O2 and luminol have little influence on luminescent stabilization, while HRP has a great influence. In different ranges of HRP concentration, different enhancers should be selected. When the concentration is within the range of 0~6 ng/mL, 4-IMP should be selected. When the concentration of HRP ranges from 6 to 25 ng/mL, 4-IOP was the best choice. And when the concentration is within the range of 25~80 ng/mL, HIOP should be selected as the enhancer. Finally, the three well-performing chemiluminescent enhanced solutions (CESs have been further optimized according to the three enhancers (4-IMP, 4-IOP and HIOP in their utilized HRP concentration ranges.

  3. Nurses Exploring the Spirituality of Their Patients With Cancer: Participant Observation on a Medical Oncology Ward.

    Science.gov (United States)

    van Meurs, Jacqueline; Smeets, Wim; Vissers, Kris C P; Groot, Marieke; Engels, Yvonne

    2017-07-19

    Attention for spirituality should be an integral part of professionals' caregiving. Particularly, nurses caring for patients with cancer might have opportunities to give attention to this dimension. The aim of this study was to gain insight in the way and extent to which nurses during daily caregiving observe and explore spiritual issues of hospitalized patients with cancer. We performed an ethnographic study with participant observation. Data were collected in 2015 during 4 shifts at the medical oncology department of a university hospital. The researcher, a spiritual care provider (chaplain) wearing the same kind of uniform as the nurses, observed the nurses, participated in their actions, and interviewed them after the shift. Although the patients did send many implicit and explicit messages concerning spiritual issues, the nurses did not explore them. If noticed, 3 barriers for exploring spiritual issues were mentioned by the nurses: lack of time, conflict with their mindset, and being reserved to talk about such issues. During their daily caregiving to patients with a life-threatening illness, nurses have many opportunities to explore spiritual issues, but they do not often recognize them. If they do, they tend not to explore the spiritual issues. Communication training for nurses is necessary to develop skills for exploring the spiritual dimension in patients with cancer. In such training, attention to the misconception that such a conversation requires a lot of time and for recognizing signals from patients inviting an exploration of their concerns is necessary.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

  4. Exploring the practical themes for medical education social accountability in Iran.

    Science.gov (United States)

    Ahmady, Soleiman; Akbari Lakeh, Maryam

    2015-01-01

    The purpose of this paper is to explore themes for enhancing socially accountability in medical education. Medical education in Iran experience new challenges due to the enormous influence of changes in technology, development of new methods of teaching and learning, student requirements, patient management, financial credit constraints, and social and economic developments. For responding to these, use of strategic thinking in order to make appropriate decisions is the only solution. Strategic plans need to formulate practical guides which can help accountable to people's reasonable expectations. For this qualitative study, along with the 14(th)national conference on Medical Education in Iran, the opinions of experts were obtained during seven expert panels' group discussions, each lasting four hours and including 10 participants. Data were collected by audiotapes, which were then transcribed. Data analyzed using a thematic content analysis approach. Peer and member checking during analysis and data triangulation from other recent studies were used to increase the findings' trustworthiness. Among more than hundred meaning units groups identified the following eight main themes as affecting the social accountable medical education in Iran: organization of responsive education councils; development of community based courses; development in field training; organization of educational processes; homogeneity in educational rules and regulations; budget management, educational outcomes; educational programs in departments and groups. This study have found the main themes that might affecting social accountable medical education in Iran, where Iranian policymakers should consider those when plan to make changes in medical education and could potentially adopt the proven useful policies and strategies of other countries.

  5. An exploration of changes in cognitive and emotional empathy among medical students in the Caribbean

    Science.gov (United States)

    Youssef, Farid F.; Nunes, Paula; Sa, Bidyadhar; Williams, Stella

    2014-01-01

    Objectives: This study explored the empathy profile of students across five years of medical training. In addition the study examined whether the Jefferson Scale for Physician Empathy correlated with a measure of cognitive empathy, the Reading the Mind in the Eyes Test and a measure of affective empathy, the Toronto Empathy Questionnaire. Methods: The study was a comparative cross-sectional design at one Caribbean medical school. Students were contacted in class, participation was voluntary and empathy was assessed using all three instruments Descriptive statistics were calculated and differences between groups evaluated using non-parametric tests. Results: Overall 669 students participated (response rate, 67%). There was a significant correlation between the Jefferson Scale of Physician Empathy and the Toronto Empathy Questionnaire (P = 0.48), both scales indicating a decline in medical student empathy scores over time. There was, however, little correlation between scores from the Reading the Mind in the Eyes Test and the Jefferson Scale of Physician Empathy. Female students demonstrated significantly higher scores on all three measures. Conclusions: Medical students’ lower empathy scores during their final years of training appear to be due to a change in the affective component of empathy. These findings may reflect an adaptive neurobiological response to the stressors associated with encountering new clinical situations. Attention should be paid not only to providing empathy training for students but also to teaching strategies for improved cognitive processing capacity when they are encountering new and challenging circumstances. PMID:25341229

  6. Five different types of framing effects in medical situation: a preliminary exploration.

    Science.gov (United States)

    Peng, Jiaxi; Li, Hongzheng; Miao, Danmin; Feng, Xi; Xiao, Wei

    2013-02-01

    Considerable reports concerned the framing effect in medical situations. But quite few of them noticed to explore the differences among the various kinds of framing effects. In the present study, five different types of framing effects were examined and the effect sizes of them were compared. Medical decision making problems concerning medicine effect evaluation, patient's compliance, treatment and doctor options selection were established. All the problems were described in both positive and negative frames. 500 undergraduates as participants were randomly divided into ten groups. Participants from each group were asked to finish one decision making task. ALL THE FRAMES THAT WERE EXAMINED LEADED TO SIGNIFICANT FRAMING EFFECTS: When the Asia Disease Problem was described in a positive frame, the participants preferred the conservative frame than the risky one, while if in a negative frame, the preference reversed (P make more positive evaluations, compared with described as "of 100 patients taking this kind of medicine, 30 patients didn't become better" (P frame and the former one resulted in a better compliance (P framing effect was also tested to be significant (P framing effects were small to big in effect size. Medical decision making can be affected by frame descriptions. Attentions should be paid on the standardization of description in medical practice.

  7. Leadership and followership in the healthcare workplace: exploring medical trainees’ experiences through narrative inquiry

    Science.gov (United States)

    Gordon, Lisi J; Rees, Charlotte E; Ker, Jean S; Cleland, Jennifer

    2015-01-01

    Objectives To explore medical trainees’ experiences of leadership and followership in the interprofessional healthcare workplace. Design A qualitative approach using narrative interviewing techniques in 11 group and 19 individual interviews with UK medical trainees. Setting Multisite study across four UK health boards. Participants Through maximum variation sampling, 65 medical trainees were recruited from a range of specialties and at various stages of training. Participants shared stories about their experiences of leadership and followership in the healthcare workplace. Methods Data were analysed using thematic and narrative analysis. Results We identified 171 personal incident narratives about leadership and followership. Participants most often narrated experiences from the position of follower. Their narratives illustrated many factors that facilitate or inhibit developing leadership identities; that traditional medical and interprofessional hierarchies persist within the healthcare workplace; and that wider healthcare systems can act as barriers to distributed leadership practices. Conclusions This paper provides new understandings of the multiple ways in which leadership and followership is experienced in the healthcare workplace and sets out recommendations for future leadership educational practices and research. PMID:26628525

  8. Exploring stakeholders' views of medical education research priorities: a national survey.

    Science.gov (United States)

    Dennis, Ashley A; Cleland, Jennifer A; Johnston, Peter; Ker, Jean S; Lough, Murray; Rees, Charlotte E

    2014-11-01

    Setting research priorities is important when exploring complex issues with limited resources. Only two countries (Canada and New Zealand) have previously conducted priority-setting exercises for medical education research (MER). This study aimed to identify the views of multiple stakeholders on MER priorities in Scotland. This study utilised a two-stage design to explore the views of stakeholders across the medical education continuum using online questionnaires. In Stage 1, key informants outlined their top three MER priorities and justified their choices. In Stage 2, participants rated 21 topics generated in Stage 1 according to importance and identified or justified their top priorities. A combination of qualitative (i.e. framework analysis) and quantitative (e.g. exploratory factor analysis) data analyses were employed. Views were gathered from over 1300 stakeholders. A total of 21 subthemes (or priority areas) identified in Stage 1 were explored further in Stage 2. The 21 items loaded onto five factors: the culture of learning together in the workplace; enhancing and valuing the role of educators; curriculum integration and innovation; bridging the gap between assessment and feedback, and building a resilient workforce. Within Stage 2, the top priority subthemes were: balancing conflicts between service and training; providing useful feedback; promoting resiliency and well-being; creating an effective workplace learning culture; selecting and recruiting doctors to reflect need, and ensuring that curricula prepare trainees for practice. Participant characteristics were related to the perceived importance of the factors. Finally, five themes explaining why participants prioritised items were identified: patient safety; quality of care; investing for the future; policy and political agendas, and evidence-based education. This study indicates that, across the spectrum of stakeholders and geography, certain MER priorities are consistently identified. These

  9. Exploring the usefulness of comprehensive care plans for children with medical complexity (CMC: a qualitative study

    Directory of Open Access Journals (Sweden)

    Adams Sherri

    2013-01-01

    Full Text Available Abstract Background The Medical Home model recommends that Children with Special Health Care Needs (CSHCN receive a medical care plan, outlining the child’s major medical issues and care needs to assist with care coordination. While care plans are a primary component of effective care coordination, the creation and maintenance of care plans is time, labor, and cost intensive, and the desired content of the care plan has not been studied. The purpose of this qualitative study was to understand the usefulness and desired content of comprehensive care plans by exploring the perceptions of parents and health care providers (HCPs of children with medical complexity (CMC. Methods This qualitative study utilized in-depth semi-structured interviews and focus groups. HCPs (n = 15 and parents (n = 15 of CMC who had all used a comprehensive care plan were recruited from a tertiary pediatric academic health sciences center. Themes were identified through grounded theory analysis of interview and focus group data. Results A multi-dimensional model of perceived care plan usefulness emerged. The model highlights three integral aspects of the care plan: care plan characteristics, activating factors and perceived outcomes of using a care plan. Care plans were perceived as a useful tool that centralized and focused the care of the child. Care plans were reported to flatten the hierarchical relationship between HCPs and parents, resulting in enhanced reciprocal information exchange and strengthened relationships. Participants expressed that a standardized template that is family-centered and includes content relevant to both the medical and social needs of the child is beneficial when integrated into overall care planning and delivery for CMC. Conclusions Care plans are perceived to be a useful tool to both health care providers and parents of CMC. These findings inform the utility and development of a comprehensive care plan template as well as a model of how

  10. Exploring reflective 'critical incident' documentation of professionalism lapses in a medical undergraduate setting

    Directory of Open Access Journals (Sweden)

    McLachlan John C

    2009-07-01

    Full Text Available Abstract Background Measuring professionalism in undergraduate medical students is a difficult process, and no one method has currently emerged as the definitive means of assessment in this field. Student skills in reflection have been shown to be highly important in the development of professional behaviours. By studying student reflections on lapses in professional judgement, recorded as 'critical incidents', it is possible to explore themes which are significant for the development of professional behaviour in an undergraduate setting. Methods We examined critical incident reporting combined with optional written student reflection as a method for exploring professionalism in undergraduate medical students. 228 students split between Year 1 and 2 of one academic year of undergraduate medicine were studied retrospectively and a grounded theory approach to analysis was employed. Results This year generated 16 critical incident reports and corresponding student reflections, all of which were considered. In addition to identifying the nature of the critical incidents, 3 principal themes emerged. These were the impact and consequences of the report having been made, student reactions to the events (both positive and negative, and student responses regarding future actions. Conclusion This study indicates that unprofessional behaviour can be identified and challenged by both the faculty and the students involved, and suggests that positive behavioural changes might be made with the aim of preventing future occurrences. We provide a low cost approach of measuring and recording professional behaviour.

  11. Autonomous, In-Flight Crew Health Risk Management for Exploration-Class Missions: Leveraging the Integrated Medical Model for the Exploration Medical System Demonstration Project

    Science.gov (United States)

    Butler, D. J.; Kerstman, E.; Saile, L.; Myers, J.; Walton, M.; Lopez, V.; McGrath, T.

    2011-01-01

    The Integrated Medical Model (IMM) captures organizational knowledge across the space medicine, training, operations, engineering, and research domains. IMM uses this knowledge in the context of a mission and crew profile to forecast risks to crew health and mission success. The IMM establishes a quantified, statistical relationship among medical conditions, risk factors, available medical resources, and crew health and mission outcomes. These relationships may provide an appropriate foundation for developing an in-flight medical decision support tool that helps optimize the use of medical resources and assists in overall crew health management by an autonomous crew with extremely limited interactions with ground support personnel and no chance of resupply.

  12. An exploration of contextual dimensions impacting goals of care conversations in postgraduate medical education.

    Science.gov (United States)

    Roze des Ordons, Amanda L; Lockyer, Jocelyn; Hartwick, Michael; Sarti, Aimee; Ajjawi, Rola

    2016-03-21

    Postgraduate medical trainees are not well prepared difficult conversations about goals of care with patients and families in the acute care clinical setting. While contextual nuances within the workplace can impact communication, research to date has largely focused on individual communication skills. Our objective was to explore contextual factors that influence conversations between trainees and patients/families about goals of care in the acute care setting. We conducted an exploratory qualitative study involving five focus groups with Internal Medicine trainees (n = 20) and a series of interviews with clinical faculty (n = 11) within a single Canadian centre. Thematic framework analysis was applied to categorize the data and identify themes and subthemes. Challenges and factors enabling goals of care conversations emerged within individual, interpersonal and system dimensions. Challenges included inadequate preparation for these conversations, disconnection between trainees, faculty and patients, policies around documentation, the structure of postgraduate medical education, and resource limitations; these challenges led to missed opportunities, uncertainty and emotional distress. Enabling factors were awareness of the importance of goals of care conversations, support in these discussions, collaboration with colleagues, and educational initiatives enabling skill development; these factors have resulted in learning, appreciation, and an established foundation for future educational initiatives. Contextual factors impact how postgraduate medical trainees communicate with patients/families about goals of care. Attention to individual, interpersonal and system-related factors will be important in designing educational programs that help trainees develop the capacities needed for challenging conversations.

  13. Social media and medical education: Exploring the potential of Twitter as a learning tool.

    Science.gov (United States)

    Jalali, Alireza; Sherbino, Jonathan; Frank, Jason; Sutherland, Stephanie

    2015-04-01

    This study set out to explore the ways in which social media can facilitate learning in medical education. In particular we were interested in determining whether the use of Twitter during an academic conference can promote learning for participants. The Twitter transcript from the annual International Conference on Residency Education (ICRE) 2013 was qualitatively analysed for evidence of the three overarching cognitive themes: (1) preconceptions, (2) frameworks, and (3) metacognition/refl ection in regard to the National Research Council ’ s (NRC) How People Learn framework . Content analysis of the Twitter transcript revealed evidence of the three cognitive themes as related to how people learn. Twitter appears to be most effective at stimulating individuals ’ preconceptions, thereby engaging them with the new material acquired during a medical education conference. The study of social media data, such as the Twitter data used in this study, is in its infancy. Having established that Twitter does hold signifi cant potential as a learning tool during an academic conference, we are now in a better position to more closely examine the spread, depth, and sustainability of such learning during medical education meetings.

  14. Exploring the implications of the influence of organisational culture on work-life balance practices: evidence from Nigerian medical doctors

    OpenAIRE

    Adisa, Toyin Ajibade; Modi, Chima; Osabutey, Ellis L. C.

    2017-01-01

    Purpose - Whilst significant evidence of western work-life balance (WLB) challenges exists, studies that explore Sub-Saharan Africa (SSA) are scarce. This article explores how organisational culture in Nigerian medical organisations influences doctors’ WLB and examines the implications of supportive and unsupportive cultures on doctors’ WLB. \\ud \\ud Methodology - The paper uses qualitative data gleaned from semi-structured interviews of 60 medical doctors across the six geo-political zones of...

  15. Formation of target-specific binding sites in enzymes: solid-phase molecular imprinting of HRP

    Science.gov (United States)

    Czulak, J.; Guerreiro, A.; Metran, K.; Canfarotta, F.; Goddard, A.; Cowan, R. H.; Trochimczuk, A. W.; Piletsky, S.

    2016-05-01

    Here we introduce a new concept for synthesising molecularly imprinted nanoparticles by using proteins as macro-functional monomers. For a proof-of-concept, a model enzyme (HRP) was cross-linked using glutaraldehyde in the presence of glass beads (solid-phase) bearing immobilized templates such as vancomycin and ampicillin. The cross-linking process links together proteins and protein chains, which in the presence of templates leads to the formation of permanent target-specific recognition sites without adverse effects on the enzymatic activity. Unlike complex protein engineering approaches commonly employed to generate affinity proteins, the method proposed can be used to produce protein-based ligands in a short time period using native protein molecules. These affinity materials are potentially useful tools especially for assays since they combine the catalytic properties of enzymes (for signaling) and molecular recognition properties of antibodies. We demonstrate this concept in an ELISA-format assay where HRP imprinted with vancomycin and ampicillin replaced traditional enzyme-antibody conjugates for selective detection of templates at micromolar concentrations. This approach can potentially provide a fast alternative to raising antibodies for targets that do not require high assay sensitivities; it can also find uses as a biochemical research tool, as a possible replacement for immunoperoxidase-conjugates.Here we introduce a new concept for synthesising molecularly imprinted nanoparticles by using proteins as macro-functional monomers. For a proof-of-concept, a model enzyme (HRP) was cross-linked using glutaraldehyde in the presence of glass beads (solid-phase) bearing immobilized templates such as vancomycin and ampicillin. The cross-linking process links together proteins and protein chains, which in the presence of templates leads to the formation of permanent target-specific recognition sites without adverse effects on the enzymatic activity. Unlike

  16. General practitioners' perceptions of the effectiveness of medical interventions: an exploration of underlying constructs

    Directory of Open Access Journals (Sweden)

    Marteau Theresa M

    2010-02-01

    Full Text Available Abstract Background Many interventions shown to be effective through clinical trials are not readily implemented in clinical practice. Unfortunately, little is known regarding how clinicians construct their perceptions of the effectiveness of medical interventions. This study aims to explore general practitioners' perceptions of the nature of 'effectiveness'. Methods The design was qualitative in nature using the repertory grid technique to elicit the constructs underlying the perceived effectiveness of a range of medical interventions. Eight medical interventions were used as stimuli (diclophenac to reduce acute pain, cognitive behaviour therapy to treat depression, weight loss surgery to achieve weight loss, diet and exercise to prevent type 2 diabetes, statins to prevent heart disease, stopping smoking to prevent heart disease, nicotine replacement therapy to stop smoking, and stop smoking groups to stop smoking. The setting involved face-to-face interviews followed by questionnaires in London Primary Care Trusts. Participants included a random sample of 13 general practitioners. Results Analysis of the ratings showed that the constructs clustered around two dimensions: low patient effort versus high patient effort (dimension one, and small impact versus large impact (dimension two. Dimension one represented constructs such as 'success requires little motivation', 'not a lifestyle intervention', and 'health-care professional led intervention'. Dimension two represented constructs such as 'weak and/or minimal evidence of effectiveness', 'small treatment effect for users', 'a small proportion of users will benefit' and 'not cost-effective'. Constructs within each dimension were closely related. Conclusions General practitioners judged the effectiveness of medical interventions by considering two broad dimensions: the extent to which interventions involve patient effort, and the size of their impact. The latter is informed by trial evidence, but

  17. Compact Neutron Generators for Medical, Home Land Security, and Planetary Exploration

    CERN Document Server

    Reijonen, Jani

    2005-01-01

    The Plasma and Ion Source Technology Group at Lawrence Berkeley National Laboratory has developed various types of advanced D-D (neutron energy 2.5 MeV), D-T (14 MeV) and T-T (0 - 9 MeV) neutron generators for wide range of applications. These applications include medical (Boron Neutron Capture Therapy), homeland security (Prompt Gamma Activation Analysis, Fast Neutron Activation Analysis and Pulsed Fast Neutron Transmission Spectroscopy) and planetary exploration in form of neutron based, sub-surface hydrogen detection systems. These neutron generators utilize RF induction discharge to ionize the deuterium/tritium gas. This discharge method provides high plasma density for high output current, high atomic species from molecular gases, long life operation and versatility for various discharge chamber geometries. Three main neutron generator developments are discussed here: high neutron output co-axial neutron generator for BNCT applications, point neutron generator for security applications, compact and sub-c...

  18. Exploring talent development environments –inspirations to medical education at doctoral level

    DEFF Research Database (Denmark)

    Christensen, Mette Krogh; Lund, Ole; Mørcke, Anne Mette

    Introduction: Doctoral students may be considered some of our most talented students. In order to maintain high quality in doctoral education we should be aware of optimizing the talent development environment in which the students develop their competencies. In this paper we explore the features...... has been on cognitive skills of individual talents and to a minor degree on institutional conditions and constraints within talent development environments. However, recent studies on talent development in sport recognize ‘talent’ as a social construction (1) and institutional and environmental...... features playing a decisive role in talent development (2). Our research question is: do concepts and models for talent development environments in sport apply to medical education at doctoral level? Considering the uniqueness of the two domains (they refer to different overall social fields: education...

  19. Exploring the transition of undergraduate medical students into a clinical clerkship using organizational socialization theory.

    Science.gov (United States)

    Atherley, Anique E; Hambleton, Ian R; Unwin, Nigel; George, Colette; Lashley, Paula M; Taylor, Charles G

    2016-04-01

    Transitions in medical education are emotionally and socially dynamic; this may affect learning. Students transitioning from preclinical to clinical training may experience negative consequences. Less is understood about students' experiences during transitions within clinical training and influential factors. The authors used organizational socialization theory to explore a transition within the clinical years. Final-year medical students experienced a nine-week internal medicine clerkship; willing students participated. Students (n = 101; 97 %) completed a questionnaire with open-ended questions at the beginning and end of the clerkship and participated in six consecutive focus groups, until data saturation occurred (n = 37). Data were thematically analyzed. Socialization was challenging. Many students experienced difficulty developing relationships with team members. Students with a positive attitude experienced a smoother transition. Many students were uncertain of their roles, concerned about the workload and desired guidance to meet clerkship demands. This transition resulted in varied outcomes from enjoyment, increased confidence and student development through to disinterest. Transitions within clinical training are complex. Faculty should focus on adequate socialization in a new clerkship as this may facilitate a smoother transition. This may necessitate orientations, staff training, and formal student support. Further research is needed on the impact of these recommendations on learning and well-being.

  20. Exploring the consequences of combining medical students with and without a background in biomedical sciences.

    Science.gov (United States)

    Ellaway, Rachel H; Bates, Amanda; Girard, Suzanne; Buitenhuis, Deanna; Lee, Kyle; Warton, Aidan; Russell, Steve; Caines, Jill; Traficante, Eric; Graves, Lisa

    2014-07-01

    Medical schools have tended to admit students with strong backgrounds in the biomedical sciences. Previous studies have shown that those with backgrounds in the social sciences can be as successful in medical school as those with science backgrounds. However, the experience of being a 'non-science' student over time has not been well described. A mixed-methods study was developed and run with the aim of elucidating the personal experiences of science and non-science students at our institution. Data were generated from a student survey that focused on participants' self-identification as science or non-science students, and on their sense of preparedness and stress, and from a series of student focus groups exploring participants' experiences of science and non-science issues in all aspects of their training. Descriptive statistics were generated for structured survey data. Focus group data and unstructured survey data were analysed to identify common themes. End-of-module and end-of-year examination data for the four class cohorts in the programme were also analysed to compare science and non-science student performance over time. There were clear differences between the experiences and performance of science and non-science students. We found dichotomies in students' self-reported sense of preparedness and stress levels, and marked differences in their examination performance, which diminished over time to converge around the third year of their studies. Combining science and non-science students in the same class affected the students to different extents and in different ways. The potential disruption of mixing science and non-science students diminished as their levels of performance converged. The psychosocial stress experienced by non-science students and the challenges it posed, in both their academic and their personal lives, have implications for how such students should be supported, and how curricula can be configured to afford quality learning for all

  1. Re-exploration after open heart surgery at the madras medical mission, chennai, India.

    Science.gov (United States)

    Okonta, Ke; Rajan, S

    2011-04-01

    Re-explorations after open-heart surgery is a necessity in this Cardiac Center when a patient is obviously bleeding or shows features of cardiovascular instability. Timely intervention may reduce morbidity and mortality. This study aims to correlate the indications with the operative findings for re-explorations after open-heart surgeries as a way of justifying early surgical intervention. Between May2005 and April2011, 10,083 open-heart surgeries were performed in the Adult Cardiac Surgical Unit of the department of cardiac surgery, Institute of Cardiovascular Diseases, Madras Medical Mission, Chennai, India. The demographic data, the initial diagnoses, the types of surgery, the indications for re-exploration, the intraoperative findings, the timing, the estimated blood loss and treatment for the 362 patients who had reexploration were analysed using the Predictive Analysis Soft -ware(PASW)18. Out of the 10,083 patients who had cardiac operation within the period of study, three hundred and sixty two (3.6%) patients had re-exploration shortly after the operation. Males were 311(85.9%) while 51(14.1%) were female patients with mean age of 56.7+12.5years .The mean time interval between the primary surgery and the re-exploratory operation was 2.31+1.47hours and the mean chest tube drainage before re-exploration was 770.9+28.8ml. Coronary Artery Diseases (CAD) was the initial diagnosis 258 (71.3%) patients and Coronary Artery Bypass(CABG) operation was the initial surgery in 254(70.2%)patients, CABG and valve in 12(3.3%)patients, Valve surgery alone in 70(19.3%) patients, Bentall procedure(homograft aortic root replacement)in 13(3.6%) patients, others such as off-pump coronary artery bypass, Dor procedure(patch restoration of left ventricle by incising the aneurysm without excising it), pericardiectomy and thromboembelectomy in 13(3.6%). The indications for re-exploration were post operative haemorrhage in 283(78.2%) patients, Cardiac tamponade in 41(11.3%)patients

  2. Risk of Adverse Health Outcomes and Decrements in Performance Due to In-flight Medical Conditions

    Science.gov (United States)

    Antonsen,Erik

    2017-01-01

    The drive to undertake long-duration space exploration missions at greater distances from Earth gives rise to many challenges concerning human performance under extreme conditions. At NASA, the Human Research Program (HRP) has been established to investigate the specific risks to astronaut health and performance presented by space exploration, in addition to developing necessary countermeasures and technology to reduce risk and facilitate safer, more productive missions in space (NASA Human Research Program 2009). The HRP is divided into five subsections, covering behavioral health, space radiation, habitability, and other areas of interest. Within this structure is the ExMC Element, whose research contributes to the overall development of new technologies to overcome the challenges of expanding human exploration and habitation of space. The risk statement provided by the HRP to the ExMC Element states: "Given that medical conditions/events will occur during human spaceflight missions, there is a possibility of adverse health outcomes and decrements in performance in mission and for long term health" (NASA Human Research Program 2016). Within this risk context, the Exploration Medical Capabilities (ExMC) Element is specifically concerned with establishing evidenced-based methods of monitoring and maintaining astronaut health. Essential to completing this task is the advancement in techniques that identify, prevent, and treat any health threats that may occur during space missions. The ultimate goal of the ExMC Element is to develop and demonstrate a pathway for medical system integration into vehicle and mission design to mitigate the risk of medical issues. Integral to this effort is inclusion of an evidence-based medical and data handling system appropriate for long-duration, exploration-class missions. This requires a clear Concept of Operations, quantitative risk metrics or other tools to address changing risk throughout a mission, and system scoping and system

  3. Visual analytics in healthcare education: exploring novel ways to analyze and represent big data in undergraduate medical education.

    Science.gov (United States)

    Vaitsis, Christos; Nilsson, Gunnar; Zary, Nabil

    2014-01-01

    Introduction. The big data present in the medical curriculum that informs undergraduate medical education is beyond human abilities to perceive and analyze. The medical curriculum is the main tool used by teachers and directors to plan, design, and deliver teaching and assessment activities and student evaluations in medical education in a continuous effort to improve it. Big data remains largely unexploited for medical education improvement purposes. The emerging research field of visual analytics has the advantage of combining data analysis and manipulation techniques, information and knowledge representation, and human cognitive strength to perceive and recognize visual patterns. Nevertheless, there is a lack of research on the use and benefits of visual analytics in medical education. Methods. The present study is based on analyzing the data in the medical curriculum of an undergraduate medical program as it concerns teaching activities, assessment methods and learning outcomes in order to explore visual analytics as a tool for finding ways of representing big data from undergraduate medical education for improvement purposes. Cytoscape software was employed to build networks of the identified aspects and visualize them. Results. After the analysis of the curriculum data, eleven aspects were identified. Further analysis and visualization of the identified aspects with Cytoscape resulted in building an abstract model of the examined data that presented three different approaches; (i) learning outcomes and teaching methods, (ii) examination and learning outcomes, and (iii) teaching methods, learning outcomes, examination results, and gap analysis. Discussion. This study identified aspects of medical curriculum that play an important role in how medical education is conducted. The implementation of visual analytics revealed three novel ways of representing big data in the undergraduate medical education context. It appears to be a useful tool to explore such data

  4. Visual analytics in healthcare education: exploring novel ways to analyze and represent big data in undergraduate medical education

    Directory of Open Access Journals (Sweden)

    Christos Vaitsis

    2014-11-01

    Full Text Available Introduction. The big data present in the medical curriculum that informs undergraduate medical education is beyond human abilities to perceive and analyze. The medical curriculum is the main tool used by teachers and directors to plan, design, and deliver teaching and assessment activities and student evaluations in medical education in a continuous effort to improve it. Big data remains largely unexploited for medical education improvement purposes. The emerging research field of visual analytics has the advantage of combining data analysis and manipulation techniques, information and knowledge representation, and human cognitive strength to perceive and recognize visual patterns. Nevertheless, there is a lack of research on the use and benefits of visual analytics in medical education.Methods. The present study is based on analyzing the data in the medical curriculum of an undergraduate medical program as it concerns teaching activities, assessment methods and learning outcomes in order to explore visual analytics as a tool for finding ways of representing big data from undergraduate medical education for improvement purposes. Cytoscape software was employed to build networks of the identified aspects and visualize them.Results. After the analysis of the curriculum data, eleven aspects were identified. Further analysis and visualization of the identified aspects with Cytoscape resulted in building an abstract model of the examined data that presented three different approaches; (i learning outcomes and teaching methods, (ii examination and learning outcomes, and (iii teaching methods, learning outcomes, examination results, and gap analysis.Discussion. This study identified aspects of medical curriculum that play an important role in how medical education is conducted. The implementation of visual analytics revealed three novel ways of representing big data in the undergraduate medical education context. It appears to be a useful tool to

  5. Exploration

    International Nuclear Information System (INIS)

    Lohrenz, J.

    1992-01-01

    Oil and gas exploration is a unique kind of business. Businesses providing a vast and ever-changing panoply of products to markets are a focus of several disciplines' energetic study and analysis. The product inventory problem is robust, pertinent, and meaningful, and it merits the voluminous and protracted attention received from keen business practitioners. Prototypical business practitioners, be they trained by years of business hurly-burly, or sophisticated MBAs with arrays of mathematical algorithms and computers, are not normally prepared, however, to recognize the unique nature of exploration's inventories. Put together such a business practitioner with an explorationist and misunderstandings, hidden and open, are inevitable and predictably rife. The first purpose of this paper is to articulate the inherited inventory handling paradigms of business practitioners in relation to exploration's inventories. To do so, standard pedagogy in business administration is used and a case study of an exploration venture is presented. A second purpose is to show the burdens that the misunderstandings create. The result is not just business plans that go awry, but public policies that have effects opposite from those intended

  6. Technological review of the HRP manufacturing process R and D activity

    International Nuclear Information System (INIS)

    Visca, Eliseo; Pizzuto, A.; Gavila, P.; Riccardi, B.; Roccella, S.; Candura, D.; Sanguinetti, G.P.

    2013-01-01

    Highlights: • R and D activities for the manufacturing of ITER divertor high heat flux plasma-facing components (HHFC). • ENEA and Ansaldo have jointly manufactured several actively cooled monoblock mock-ups and prototypical components. • Successful manufacturing by HRP (hot radial pressing) and PBC (pre-brazed casting) of both W and CFC armoured small and medium scale mockups. • ENEA-ANSALDO participate to the European programme for the qualification of the manufacturing technology for the ITER divertor IVT. • A qualification divertor inner vertical target prototype successfully tested at ITER relevant thermal heat fluxes. -- Abstract: ENEA and Ansaldo Nucleare S.p.A. have been deeply involved in the European International Thermonuclear Experimental Reactor (ITER) R and D activities for the manufacturing of high heat flux plasma-facing components (HHFC), and in particular for the inner vertical target (IVT) of the ITER divertor. This component has to be manufactured by using both armour and structural materials whose properties are defined by ITER. Their physical properties prevent the use of standard joining techniques. The reference armour materials are tungsten and carbon/carbon fibre composite (CFC). The cooling pipe is made of copper alloy (CuCrZr-IG). During the last years ENEA and Ansaldo have jointly manufactured several actively cooled monoblock mock-ups and prototypical components of different length, geometry and materials, by using innovative processes: HRP (hot radial pressing) and PBC (pre-brazed casting). The history of the technical issues solved during the R and D phase and the improvements implemented to the assembling tools and equipments are reviewed in the paper together with the testing results. The optimization of the processes started from the successful manufacturing of both W and CFC armoured small scale mockups thermal fatigue tested in the worst ITER operating condition (20 MW/m 2 ) through the achievement of record

  7. Technological review of the HRP manufacturing process R and D activity

    Energy Technology Data Exchange (ETDEWEB)

    Visca, Eliseo, E-mail: eliseo.visca@enea.it [Associazione EURATOM-ENEA sulla Fusione, C.R. Frascati, Via E. Fermi 45, IT-00044 Frascati (Italy); Pizzuto, A. [Associazione EURATOM-ENEA sulla Fusione, C.R. Frascati, Via E. Fermi 45, IT-00044 Frascati (Italy); Gavila, P.; Riccardi, B. [Fusion For Energy, C. Josep Pla 2, ES-08019 Barcelona (Spain); Roccella, S. [Associazione EURATOM-ENEA sulla Fusione, C.R. Frascati, Via E. Fermi 45, IT-00044 Frascati (Italy); Candura, D.; Sanguinetti, G.P. [Ansaldo Nucleare S.p.A., Corso Perrone 25, IT-16121 Genova (Italy)

    2013-10-15

    Highlights: • R and D activities for the manufacturing of ITER divertor high heat flux plasma-facing components (HHFC). • ENEA and Ansaldo have jointly manufactured several actively cooled monoblock mock-ups and prototypical components. • Successful manufacturing by HRP (hot radial pressing) and PBC (pre-brazed casting) of both W and CFC armoured small and medium scale mockups. • ENEA-ANSALDO participate to the European programme for the qualification of the manufacturing technology for the ITER divertor IVT. • A qualification divertor inner vertical target prototype successfully tested at ITER relevant thermal heat fluxes. -- Abstract: ENEA and Ansaldo Nucleare S.p.A. have been deeply involved in the European International Thermonuclear Experimental Reactor (ITER) R and D activities for the manufacturing of high heat flux plasma-facing components (HHFC), and in particular for the inner vertical target (IVT) of the ITER divertor. This component has to be manufactured by using both armour and structural materials whose properties are defined by ITER. Their physical properties prevent the use of standard joining techniques. The reference armour materials are tungsten and carbon/carbon fibre composite (CFC). The cooling pipe is made of copper alloy (CuCrZr-IG). During the last years ENEA and Ansaldo have jointly manufactured several actively cooled monoblock mock-ups and prototypical components of different length, geometry and materials, by using innovative processes: HRP (hot radial pressing) and PBC (pre-brazed casting). The history of the technical issues solved during the R and D phase and the improvements implemented to the assembling tools and equipments are reviewed in the paper together with the testing results. The optimization of the processes started from the successful manufacturing of both W and CFC armoured small scale mockups thermal fatigue tested in the worst ITER operating condition (20 MW/m{sup 2}) through the achievement of record

  8. Exploring cultural and linguistic influences on clinical communication skills: a qualitative study of International Medical Graduates.

    Science.gov (United States)

    Verma, Anju; Griffin, Ann; Dacre, Jane; Elder, Andrew

    2016-06-10

    International Medical Graduates (IMGs) are known to perform less well in many postgraduate medical examinations when compared to their UK trained counterparts. This "differential attainment" is observed in both knowledge-based and clinical skills assessments. This study explored the influence of culture and language on IMGs clinical communication skills, in particular, their ability to seek, detect and acknowledge patients' concerns in a high stakes postgraduate clinical skills examination. Hofstede's cultural dimensions framework was used to look at the impact of culture on examination performance. This was a qualitative, interpretative study using thematic content analysis of video-recorded doctor-simulated patient consultations of candidates sitting the MRCP(UK) PACES examination, at a single examination centre in November 2012. The research utilised Hofstede's cultural dimension theory, a framework for comparing cultural factors amongst different nations, to help understand the reasons for failure. Five key themes accounted for the majority of communication failures in station 2, "history taking" and station 4, "communication skills and ethics" of the MRCP(UK) PACES examination. Two themes, the ability to detect clues and the ability to address concerns, related directly to the overall construct managing patients' concerns. Three other themes were found to impact the whole consultation. These were building relationships, providing structure and explanation and planning. Hofstede's cultural dimensions may help to contextualise some of these observations. In some cultures doctor and patient roles are relatively inflexible: the doctor may convey less information to the patient (higher power distance societies) and give less attention to building rapport (high uncertainty avoidance societies.) This may explain why cues and concerns presented by patients were overlooked in this setting. Understanding cultural differences through Hofstede's cultural dimensions theory

  9. A survey exploring the knowledge and perceptions of senior medical students in Nepal toward generic medicines

    Directory of Open Access Journals (Sweden)

    Sudesh Gyawali

    2016-08-01

    Full Text Available Background: The accurate knowledge of generic medicine issues among future prescribers will enhance the prescribing of cost-effective medicines. This study aimed to explore the knowledge and perception of senior medical students about the generic medicines. Methodology: A cross-sectional study was conducted among 237 senior medical students (final year students and interns using a validated self-administered questionnaire. The collected data were analyzed using Statistical Package for the Social Sciences version 20 for windows and comparison of difference was done using linear by linear association. A p value of less than 0.05 was taken as statistically significant. Results: The average age (standard deviation of the respondents was 23.54 (1.39 years. Almost 5% of respondents correctly answered the question regarding the regulatory limits for bioequivalence. Almost two-thirds of respondents correctly agreed that generic medicine is bioequivalent to a brand-name medicine, and 79.3% and 72.5% of respondents correctly agreed that the medicine should be present in the same dosage form and same dose, respectively, as the brand-name medicines. However, almost half of the respondents had impression that brand-name medicines are required to meet higher safety standard than generic medicines. Almost 90% of respondents felt that advertisement by the drug companies would influence the use of brand-name medicine and they need more information about generic medicine. Conclusion: This study highlights the negative perception and knowledge deficit among the respondents. The students’ responses to almost all the statements were almost similar to the respondents’ academic year (final year students and interns, gender and nationality.

  10. Diagnosing severe falciparum malaria in parasitaemic African children: a prospective evaluation of plasma PfHRP2 measurement.

    Directory of Open Access Journals (Sweden)

    Ilse C E Hendriksen

    Full Text Available In African children, distinguishing severe falciparum malaria from other severe febrile illnesses with coincidental Plasmodium falciparum parasitaemia is a major challenge. P. falciparum histidine-rich protein 2 (PfHRP2 is released by mature sequestered parasites and can be used to estimate the total parasite burden. We investigated the prognostic significance of plasma PfHRP2 and used it to estimate the malaria-attributable fraction in African children diagnosed with severe malaria.Admission plasma PfHRP2 was measured prospectively in African children (from Mozambique, The Gambia, Kenya, Tanzania, Uganda, Rwanda, and the Democratic Republic of the Congo aged 1 month to 15 years with severe febrile illness and a positive P. falciparum lactate dehydrogenase (pLDH-based rapid test in a clinical trial comparing parenteral artesunate versus quinine (the AQUAMAT trial, ISRCTN 50258054. In 3,826 severely ill children, Plasmadium falciparum PfHRP2 was higher in patients with coma (p = 0.0209, acidosis (p<0.0001, and severe anaemia (p<0.0001. Admission geometric mean (95%CI plasma PfHRP2 was 1,611 (1,350-1,922 ng/mL in fatal cases (n = 381 versus 1,046 (991-1,104 ng/mL in survivors (n = 3,445, p<0.0001, without differences in parasitaemia as assessed by microscopy. There was a U-shaped association between log(10 plasma PfHRP2 and risk of death. Mortality increased 20% per log(10 increase in PfHRP2 above 174 ng/mL (adjusted odds ratio [AOR] 1.21, 95%CI 1.05-1.39, p = 0.009. A mechanistic model assuming a PfHRP2-independent risk of death in non-malaria illness closely fitted the observed data and showed malaria-attributable mortality less than 50% with plasma PfHRP2≤174 ng/mL. The odds ratio (OR for death in artesunate versus quinine-treated patients was 0.61 (95%CI 0.44-0.83, p = 0.0018 in the highest PfHRP2 tertile, whereas there was no difference in the lowest tertile (OR 1.05; 95%CI 0.69-1.61; p = 0.82. A limitation of the study is that some

  11. Exploring Canadian Physicians' Experiences Providing Medical Assistance in Dying: A Qualitative Study.

    Science.gov (United States)

    Khoshnood, Narges; Hopwood, Marie-Clare; Lokuge, Bhadra; Kurahashi, Allison; Tobin, Anastasia; Isenberg, Sarina; Husain, Amna

    2018-05-15

    MAiD allows a practitioner to administer or prescribe medication for the purpose of ending a patient's life. In 2016, Canada was the latest country, following several European countries and American states, to legalize physician-assisted death. Although some studies report on physician attitudes towards MAiD or describe patient characteristics, there are few that explore the professional challenges faced by physicians who provide MAiD. To explore the professional challenges faced by Canadian physicians who provide MAiD. Sixteen physicians from across Canada who provide MAiD completed in-depth, semi-structured telephone interviews. An inductive thematic analysis approach guided data collection and the iterative, interpretive analysis of interview transcripts. Three members of the research team systematically co-coded interview transcripts and the emerging themes were developed with the broader research team. NVivo was used to manage the coded data. Participants described three challenges associated with providing MAiD: 1) their relationships with other MAiD providers were enhanced and relationships with objecting colleagues were sometimes strained, 2) they received inadequate financial compensation for time, and, 3) they experienced increased workload, resulting in sacrifices to personal time. Although these providers did not intend to stop providing MAiD at the time of the interview, they indicated their concerns about whether they would be able to sustain this service over time. Physicians described relationship, financial, and workload challenges to providing MAiD. We provide several recommendations to address these challenges and help ensure the sustainability of MAiD in countries that provide this service. Copyright © 2018. Published by Elsevier Inc.

  12. Exploring the attitudes of medical faculty members and students in Pakistan towards plagiarism: a cross sectional survey

    Science.gov (United States)

    Rathore, Farooq Azam; Zia, Ahmad Marjan; Mavrinac, Martina; Farooq, Fareeha

    2015-01-01

    Objective. The objective of this survey was to explore the attitudes towards plagiarism of faculty members and medical students in Pakistan. Methods. The Attitudes Toward Plagiarism questionnaire (ATP) was modified and distributed among 550 medical students and 130 faculty members in 7 medical colleges of Lahore and Rawalpindi. Data was entered in the SPSS v.20 and descriptive statistics were analyzed. The questionnaire was validated by principal axis factoring analysis. Results. Response rate was 93% and 73%, respectively. Principal axis factoring analysis confirmed one factor structure of ATP in the present sample. It had an acceptable Cronbach’s alpha value of 0.73. There were 421 medical students (218 (52%) female, 46% 3rd year MBBS students, mean age of 20.93 ± 1.4 years) and 95 faculty members (54.7% female, mean age 34.5 ± 8.9 years). One fifth of the students (19.7%) trained in medical writing (19.7%), research ethics (25.2%) or were currently involved in medical writing (17.6%). Most of the faculty members were demonstrators (66) or assistant professors (20) with work experience between 1 and 10 years. Most of them had trained in medical writing (68), research ethics (64) and were currently involved in medical writing (64). Medical students and faculty members had a mean score of 43.21 (7.1) and 48.4 (5.9) respectively on ATP. Most of the respondents did not consider that they worked in a plagiarism free environment and reported that self-plagiarism should not be punishable in the same way as plagiarism. Opinion regarding leniency in punishment of younger researchers who were just learning medical writing was divided. Conclusions. The general attitudes of Pakistani medical faculty members and medical students as assessed by ATP were positive. We propose training in medical writing and research ethics as part of the under and post graduate medical curriculum. PMID:26157615

  13. Immobilization of HRP Enzyme on Layered Double Hydroxides for Biosensor Application

    Directory of Open Access Journals (Sweden)

    Zouhair M. Baccar

    2011-01-01

    Full Text Available We present a new biosensor for hydrogen peroxide (H2O2 detection. The biosensor was based on the immobilization of horseradish peroxidase (HRP enzyme on layered double hydroxides- (LDH- modified gold surface. The hydrotalcite LDH (Mg2Al was prepared by coprecipitation in constant pH and in ambient temperature. The immobilization of the peroxidase on layered hybrid materials was realized via electrostatic adsorption autoassembly process. The detection of hydrogen peroxide was successfully observed in PBS buffer with cyclic voltammetry and the chronoamperometry techniques. A limit detection of 9 μM of H2O2 was obtained with a good reproducibility. We investigate the sensitivity of our developed biosensor for H2O2 detection in raw milk.

  14. May I see your ID, please? An explorative study of the professional identity of undergraduate medical education leaders.

    Science.gov (United States)

    Sundberg, Kristina; Josephson, Anna; Reeves, Scott; Nordquist, Jonas

    2017-02-01

    The mission of undergraduate medical education leaders is to strive towards the enhancement of quality of medical education and health care. The aim of this qualitative study is, with the help of critical perspectives, to contribute to the research area of undergraduate medical education leaders and their identity formation; how can the identity of undergraduate medical education leaders be defined and further explored from a power perspective? In this explorative study, 14 educational leaders at a medical programme in Scandinavia were interviewed through semi-structured interviews. The data was analysed through Moustakas' structured, phenomenological analysis approach and then pattern matched with Gee's power-based identity model. Educational leaders identify themselves more as mediators than leaders and do not feel to any larger extent that their professional identity is authorised by the university. These factors potentially create difficulties when trying to communicate with medical teachers, often also with a weaker sense of professional identity, about medical education. The perceptions of the professional identity of undergraduate medical education leaders provide us with important notions on the complexities on executing their important mission to develop medical education: their perceptions of ambiguity towards the process of trying to lead teachers toward educational development and a perceived lack of authorisation of their work from the university level. These are important flaws to observe and correct when improving the context in which undergraduate medical education leaders are trying to develop and improve undergraduate medical programmes. A practical outcome of the results of this study is the facilitation of design of faculty development programmes for educational leaders in undergraduate medial education.

  15. Poly(ADP-ribose) Glycohydrolase and Poly(ADP-ribose)-interacting Protein Hrp38 Regulate Pattern Formation during Drosophila Eye Development

    Science.gov (United States)

    Ji, Yingbiao; Jarnik, Michael; Tulin, Alexei V.

    2013-01-01

    Drosophila Hrp38, a homolog of human hnRNP A1, has been shown to regulate splicing, but its function can be modified by poly(ADP-ribosyl)ation. Notwithstanding such findings, our understanding of the roles of poly(ADP-ribosyl)ated Hrp38 on development is limited. Here, we have demonstrated that Hrp38 is essential for fly eye development based on a rough-eye phenotype with disorganized ommatidia observed in adult escapers of the hrp38 mutant. We also observed that Poly(ADP-ribose) Glycohydrolase (Parg) loss-of-function, which caused increased Hrp38 poly(ADP-ribosyl)ation, also resulted in the rough-eye phenotype with disrupted ommatidial lattice and reduced number of photoreceptor cells. In addition, ectopic expression of DE-cadherin, which is required for retinal morphogenesis, fully rescued the rough-eye phenotype of the hrp38 mutant. Similarly, Parg mutant eye clones had decreased expression level of DE-cadherin with orientation defects, which is reminiscent of DE-cadherin mutant eye phenotype. Therefore, our results suggest that Hrp38 poly(ADP-ribosyl)ation controls eye pattern formation via regulation of DE-cadherin expression, a finding which has implications for understanding the pathogenic mechanisms of Hrp38-related Fragile X syndrome and PARP1-related retinal degeneration diseases. PMID:23711619

  16. Exploring multiple sources of climatic information within personal and medical diaries, Bombay 1799-1828

    Science.gov (United States)

    Adamson, George

    2016-04-01

    Private diaries are being recognised as an important source of information on past climatic conditions, providing place-specific, often daily records of meteorological information. As many were not intended for publication, or indeed to be read by anyone other than the author, issues of observer bias are lower than some other types of documentary sources. This paper comprises an exploration of the variety of types of climatic information can be mined from a single document or set of documents. The focus of the analysis is three private and one medical diary kept by British colonists in Bombay, western India, during the first decades of the nineteenth century. The paper discusses the potential of the diaries for reconstruction of precipitation, temperature and extreme events. Ad-hoc temperature observations collected by the four observers prove to be particularly fruitful for reconstructing monthly extreme temperatures, with values comparable to more systematic observations collected during the period. This leads to a tentative conclusion that extreme temperatures in Bombay were around 5°C lower during the period than today, a difference likely predominantly attributable to the urban heat island effect.

  17. Qualitative descriptive study exploring schizophrenia and the everyday effect of medication-induced weight gain.

    Science.gov (United States)

    Vandyk, Amanda Digel; Baker, Cynthia

    2012-08-01

    Weight gain and obesity are serious side effects of the medications used to manage psychotic disorders and successful, long-term weight loss interventions are not yet available. One reason for this may be that current interventions are designed without consideration of the patient's perspective. The purpose of this study was to explore the subjective experience of weight and lifestyle from the perspective of people with schizophrenia. A qualitative, constructivist research design was used and conversational interviews were conducted with 18 purposefully recruited participants from an outpatient clinic at a psychiatric hospital in Eastern Ontario. Data were analysed according to the method of constant comparison and three central themes emerged: a life altering diagnosis, weight management as complex, and today's experiences shape tomorrow's outcomes. Weight management was seen as difficult yet important to the participants. The findings of this study provide insight into the views and opinions of the participants regarding weight and lifestyle and may be used to support the design of tailored heath initiatives for persons with mental illness. © 2012 The Authors. International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.

  18. A qualitative study to explore communication skills in veterinary medical education.

    Science.gov (United States)

    Hamood, Wendy J; Chur-Hansen, Anna; McArthur, Michelle L

    2014-10-11

    To explore and gain an understanding of what "clinical communication skills" mean to veterinarians working in private practice and what implications this might have for veterinary medical education. Qualitative research methods were used to purposefully sample a range of veterinary practitioners from a pool of South Australian veterinary practices who were interviewed to determine their understanding of what communication skills mean in the context of veterinary practice. Interviews were conducted with fourteen veterinary practitioners. Participants were sampled from a range of ages, veterinary schools of graduation plus urban and rural locations. Interview transcripts were analysed for themes, definitions and contexts. Participants' accounts included a number of skills which they considered to be "communication". Some of the definitions of these skills parallel communication skills and competencies for human medicine on which communication skills training incorporated into veterinary curricula to date have largely been based. However, the veterinarians in this study also raised interesting contextual differences unique to the veterinary profession, such as communication with the animal, selling service, discussing money in relation to decisions for care, and communicating about euthanasia. Veterinary practitioners require high level communication skills. Education and training in veterinary medicine may be better tailored to reflect the unique context of the veterinary profession.

  19. Content and discontent: a qualitative exploration of obstacles to elearning engagement in medical students.

    Science.gov (United States)

    Reid, Helen J; Thomson, Clare; McGlade, Kieran J

    2016-07-22

    Elearning is ubiquitous in healthcare professions education. Its equivalence to 'traditional' educational delivery methods is well established. There is a research imperative to clarify when and how to use elearning most effectively to mitigate the potential of it becoming merely a 'disruptive technology.' Research has begun to broadly identify challenges encountered by elearning users. In this study, we explore in depth the perceived obstacles to elearning engagement amongst medical students. Sensitising concepts of achievement emotions and the cognitive demands of multi-tasking highlight why students' deeply emotional responses to elearning may be so important in their learning. This study used focus groups as a data collection tool. A purposeful sample of 31 participated. Iterative data gathering and analysis phases employed a constant comparative approach to generate themes firmly grounded in participant experience. Key themes that emerged from the data included a sense of injustice, passivity and a feeling of being 'lost at sea'. The actual content of the elearning resource provided important context. The identified themes have strong emotional foundations. These responses, interpreted through the lens of achievement emotions, have not previously been described. Appreciation of their importance is of benefit to educators involved in curriculum development or delivery.

  20. Compact Neutron Generators for Medical Home Land Security and Planetary Exploration

    International Nuclear Information System (INIS)

    Reijonen, J.

    2005-01-01

    The Plasma and Ion Source Technology Group at Lawrence Berkeley National Laboratory has developed various types of advanced D-D (neutron energy 2.5 MeV), D-T (14 MeV) and T-T (0-9 MeV) neutron generators for wide range of applications. These applications include medical (Boron Neutron Capture Therapy), homeland security (Prompt Gamma Activation Analysis, Fast Neutron Activation Analysis and Pulsed Fast Neutron Transmission Spectroscopy) and planetary exploration with a sub-surface material characterization on Mars. These neutron generators utilize RF induction discharge to ionize the deuterium/tritium gas. This discharge method provides high plasma density for high output current, high atomic species from molecular gases, long life operation and versatility for various discharge chamber geometries. Four main neutron generator developments are discussed here: high neutron output co-axial neutron generator for BNCT applications, point neutron generator for security applications, compact and sub-compact axial neutron generator for elemental analysis applications. Current status of the neutron generator development with experimental data will be presented

  1. Exploring Perception and Use of Everyday Language and Medical Terminology among International Medical Graduates in a Medical ESP Course in Australia

    Science.gov (United States)

    Dahm, Maria R.

    2011-01-01

    Language and communication skills are among the greatest challenges that non-native-English speaking international medical graduates (IMGs) face in English medical consultations. Especially when patients use unfamiliar everyday expressions or attach different meanings to medical terminology, the communicative burden on doctor-patient communication…

  2. A mixed methods exploration of family involvement in medical care for older adults with serious mental illness.

    Science.gov (United States)

    Aschbrenner, Kelly A; Pepin, Renee; Mueser, Kim T; Naslund, John A; Rolin, Stephanie A; Faber, Marjan J; Bartels, Stephen J

    2014-01-01

    Many older persons with serious mental illness (SMI) suffer from high rates of comorbid medical conditions. Although families play a critical role in psychiatric illness management among adults with SMI, their contributions to improving health outcomes in this population has received little attention. This study explored family involvement in medical care for older adults with SMI. This mixed methods study involved analysis of quantitative data collected from older adults with SMI and cardiovascular risk (n = 28) participating in a pilot study of an intervention designed to improve patient-centered primary care augmented by qualitative interviews with their relatives (n = 13) to explore family involvement in medical care. Approximately 89% of older adults with SMI reported family involvement in at least one aspect of their medical care (e.g., medication reminders, medical decision making). However, many family members reported that they were rarely involved in their relative's medical visits, and most did not perceive a need to be involved during routine care. Family members identified obesity as their relative's primary health concern and many wanted guidance from providers on effective strategies for supporting weight loss. Although many family members did not perceive a need to be involved in their relative's routine medical visits, they expressed interest in talking with providers about how to help their relative change unhealthy behaviors. Educating patients, families, and providers about the potential benefits of family involvement in medical care, including routine medical visits for persons with SMI and cardiovascular health risk may promote patient- and family-centered collaboration in this high-risk population.

  3. Contribution of Sudanese medical diaspora to the healthcare delivery system in Sudan: exploring options and barriers.

    Science.gov (United States)

    Abdalla, Fayrouz Mohammed; Omar, Maye Abu; Badr, Elsheikh Elsiddig

    2016-06-30

    Medical diaspora options, including the engagement of expatriate physicians in development efforts within their home country, are being called for to reverse the effects of brain drain from developing countries. This paper presents the results of a study exploring the potential contributions for the Sudanese Medial Diaspora Options to the healthcare delivery system (HCDS) in Sudan, focusing on the options of temporal and permanent returns and the likely obstacles faced in their implementation. This was a cross-sectional study using a mixed methods design including quantitative and qualitative approaches. For the quantitative approach, the study, which focused on the possible contribution of the diaspora to healthcare delivery in Sudan, was based on an online survey using random purposive and snowballing sampling techniques involving 153 Sudanese physicians working in Saudi Arabia and other Gulf States, the United Kingdom, the Republic of Ireland, and the United States of America. The qualitative approach involved in-depth interviews with returnee physicians and key informants in Sudan, focusing on the return experiences, the barriers for return, and the options to improve future contributions. Despite contributions of the Sudanese medical diaspora being of a small scale considering the size of the phenomenon, as well as infrequent and not appropriately organized, their inputs to academia and the links built with overseas institutions and specialist clinical services were nevertheless remarkable. The main barrier to temporal return was inappropriate organization by the local counterparts, while those for permanent return of physicians were poor work environment, insufficient financial payment, unsecured accommodation, and offspring education. The study identified short-term return as a feasible option considering the country's current conditions. Proper coordination mechanisms for short-term returns and facilitation of permanent return through stakeholders

  4. H2O2 sensing using HRP modified catalyst-free ZnO nanorods synthesized by RF sputtering

    Science.gov (United States)

    Srivastava, Amit; Kumar, Naresh; Singh, Priti; Singh, Sunil Kumar

    2017-06-01

    Catalyst-free ( 00 l) oriented ZnO nanorods (NRs) -based biosensor for the H2O2 sensing has been reported. The (002) oriented ZnO NRs as confirmed by X-ray diffraction were successfully grown on indium tin oxide (ITO) coated glass substrate by radio frequency (RF) sputtering technique without using any catalyst. Horseradish peroxidase (HRP) enzyme was immobilized on ZnO NRs by physical adsorption technique to prepare the biosensor. In this HRP/ZnO NR/ITO bioelectrode, nafion solution was added to form a tight membrane on surface. The prepared bioelectrode has been used for biosensing measurements by electrochemical analyzer. The electrochemical studies reveal that the prepared HRP/ZnO NR/ITO biosensor is highly sensitive to the detection of H2O2 over a linear range of 0.250-10 μM. The ZnO NR-based biosensor showed lower value of detection limit (0.125 μM) and higher sensitivity (13.40 µA/µM cm2) towards H2O2. The observed value of higher sensitivity attributed to larger surface area of ZnO nanostructure for effective loading of HRP besides its high electron communication capability. In addition, the biosensor also shows lower value of enzyme's kinetic parameter (Michaelis-Menten constant, K m) of 0.262 μM which indicates enhanced enzyme affinity of HRP to H2O2. The reported biosensor may be useful for various applications in biosensing, clinical, food, and beverage industry.

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

    Science.gov (United States)

    Bergstresser, Kara

    2017-01-01

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

  6. Serving an Indigenous community: Exploring the cultural competence of medical students in a rural setting

    OpenAIRE

    Wong, Chin Hoong; Chen, Lee Ping; Koh, Kwee Choy; Chua, Siew Houy; Jong, Darren Chee Hiung; Mohd Fauzi, Nurliyana Mardhiah; Lim, Sue Yin

    2017-01-01

    Since 2013, medical students from the International Medical University (IMU) in Malaysia have been providing primary healthcare services, under the supervision of faculty members, to the indigenous people living in Kampung Sebir. The project has allowed the students to learn experientially within a rural setting. This study aims to examine the cultural competence of IMU medical students through an examination of their perspective of the indigenous people who they serve and the role of this co...

  7. PecS and PecT coregulate the synthesis of HrpN and pectate lyases, two virulence determinants in Erwinia chrysanthemi 3937.

    Science.gov (United States)

    Nasser, William; Reverchon, Sylvie; Vedel, Regine; Boccara, Martine

    2005-11-01

    Erwinia chrysanthemi strain 3937 is a necrotrophic bacterial plant pathogen. Pectinolytic enzymes and, in particular, pectate lyases play a key role in soft rot symptoms; however, the efficient colonization of plants by E. chrysanthemi requires additional factors. These factors include HrpN (harpin), a heat-stable, glycine-rich hydrophilic protein, which is secreted by the type III secretion system. We investigated the expression of hrpN in E. chrysanthemi 3937 in various environmental conditions and different regulatory backgrounds. Using lacZ fusions, hrpN expression was markedly influenced by the carbon source, osmolarity, growth phase, and growth substrate. hrpN was repressed when pectinolysis started and negatively regulated by the repressors of pectate lyase synthesis, PecS and PecT. Primer extension data and in vitro DNA-protein interaction experiments support a model whereby PecS represses hrpN expression by binding to the hrpN regulatory region and inhibiting transcript elongation. The results suggest coordinated regulation of HrpN and pectate lyases by PecS and PecT. A putative model of the synthesis of these two virulence factors in E. chrysanthemi during pathogenesis is presented.

  8. Perceived stress at transition to workplace: a qualitative interview study exploring final-year medical students’ needs

    Directory of Open Access Journals (Sweden)

    Moczko TR

    2016-01-01

    Full Text Available Tobias R Moczko,1,2,* Till J Bugaj,1,* Wolfgang Herzog,1 Christoph Nikendei1 1Department for General Internal and Psychosomatic Medicine, University Hospital of Heidelberg, Heidelberg, 2School of Medicine, Faculty of Health, Witten/Herdecke University, Witten, Germany *These authors contributed equally to this work Objectives: This study was designed to explore final-year medical students’ stressors and coping strategies at the transition to the clinical workplace. Methods: In this qualitative study, semi-standardized interviews with eight final-year medical students (five male, three female; aged 25.9±1.4 years were conducted during their internal medicine rotation. After verbatim transcription, a qualitative content analysis of students’ impressions of stress provoking and easing factors during final-year education was performed. Results: Students’ statements regarding burdens and dealing with stress were classified into four main categories: A perceived stressors and provoking factors, B stress-induced consequences, C personal and external resources for preventing and dealing with stress, and D final-year students’ suggestions for workplace improvement. Conclusion: Final-year medical students perceived different types of stress during their transition to medical wards, and reported both negative consequences and coping resources concerning perceived stress. As supervision, feedback, and coping strategies played an important role in the students’ perception of stress, final-year medical education curricula development should focus on these specifically. Keywords: undergraduate medical education, stress prevention, final-year medical education, workplace learning, qualitative research

  9. An Exploration of Healthcare Inventory and Lean Management in Minimizing Medical Supply Waste in Healthcare Organizations

    Science.gov (United States)

    Hicks, Rodney

    2013-01-01

    The purpose of this study was to understand how lean thinking and inventory management technology minimize expired medical supply waste in healthcare organizations. This study was guided by Toyota's theory of lean and Mintzberg's theory of management development to explain why the problem of medical supply waste exists. Government…

  10. Comparison of the performance of the borax buffer-based HRP-enhanced reagent and the 'Lumi-Phos 530' chemiluminescence systems in the detection of biotinylated DNA.

    Science.gov (United States)

    Cercek, B; Roby, K; Siaw, M

    1995-01-01

    A comparison of two chemiluminescence methods, the borax buffer-based HRP-enhanced reagent and Lumi-Phos 530, applied to the detection of a biotinylated 30-mer DNA slot blotted onto a nylon membrane, is presented. A streptavidin-HRP and streptavidin-ALP mediated detection system was used. The HRP-enhanced system is up to 15-fold greater with respect to the signal/background ratios than the Lumi-Phos 530 system at 0.5 microgram biotinylated DNA with at least a two-fold improvement in detection sensitivity for 0.5 ng biotinylated DNA.

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

    Science.gov (United States)

    Nixon, Michael; Kousgaard, Marius Brostrøm

    2016-07-07

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

  12. An exploration of the biomedical optics course construction of undergraduate biomedical engineering program in medical colleges

    Science.gov (United States)

    Guo, Shijun; Lyu, Jie; Zhang, Peiming

    2017-08-01

    In this paper, the teaching goals, teaching contents and teaching methods in biomedical optics course construction are discussed. From the dimension of teaching goals, students should master the principle of optical inspection on the human body, diagnosis and treatment of methodology and instruments, through the study of the theory and practice of this course, and can utilize biomedical optics methods to solve practical problems in the clinical medical engineering practice. From the dimension of teaching contents, based on the characteristics of biomedical engineering in medical colleges, the organic integration of engineering aspects, medical optical instruments, and biomedical aspects dispersed in human anatomy, human physiology, clinical medicine fundamental related to the biomedical optics is build. Noninvasive measurement of the human body composition and noninvasive optical imaging of the human body were taken as actual problems in biomedical optics fields. Typical medical applications such as eye optics and laser medicine were also integrated into the theory and practice teaching. From the dimension of teaching methods, referencing to organ-system based medical teaching mode, optical principle and instrument principle were taught by teachers from school of medical instruments, and the histological characteristics and clinical actual need in areas such as digestive diseases and urinary surgery were taught by teachers from school of basic medicine or clinical medicine of medical colleges. Furthermore, clinical application guidance would be provided by physician and surgeons in hospitals.

  13. Exploring the uncharted territory of social media: the next frontier of medical education in nephrology.

    Science.gov (United States)

    Desai, Tejas; Sridharan, Sivakumar; Parada, Xavier; Claure-Del Granado, Rolando; Orantes, Carlos; Madariaga, Hector; Penmatsa, Krishnam Raju; Basu, Gopal; Arce Amare, Fernanda

    2018-04-01

    Social media is gaining popularity amongst both medical educators and life-long learners. One of the most popular social media platforms used by the medical community is Twitter, which is popular amongst physicians, students and patients, and particularly in medical societies. Major international and regional societies commonly use Twitter to amplify their reach beyond what their live annual meetings can achieve. There has been a unique and notable effort by Nephrology societies to craft a structured social media strategy that results in the broadest reach to the community of nephrology providers. We report on the first three such experiments performed by three separate nephrology organizations.

  14. Exploring the association between parental rearing styles and medical students' critical thinking disposition in China.

    Science.gov (United States)

    Huang, Lei; Wang, Zhaoxin; Yao, Yuhong; Shan, Chang; Wang, Haojie; Zhu, Mengyi; Lu, Yuan; Sun, Pengfei; Zhao, Xudong

    2015-05-14

    Critical thinking is an essential ability for medical students. However, the relationship between parental rearing styles and medical students' critical thinking disposition has rarely been considered. The aim of this study was to investigate whether parental rearing styles were significant predictors of critical thinking disposition among Chinese medical students. 1,075 medical students from the first year to the fifth year attending one of three medical schools in China were recruited via multistage stratified cluster sampling. The Chinese Critical Thinking Disposition Inventory(CTDI-CV) and The Egna Minnen av Barndoms Uppfostran (EMBU) questionnaire were applied to collect data and to conduct descriptive analysis. Stepwise multiple linear regression was used to analyze the data. The critical thinking disposition average mean score was 287.44 with 632 participants (58.79%) demonstrating positive critical thinking disposition. Stepwise multiple linear regression analysis revealed that the rearing styles of fathers, including "overprotection", "emotional warmth and understanding", "rejection" and "over-interference" were significant predictors of medical students' critical thinking disposition that explained 79.0% of the variance in critical thinking ability. Rearing styles of mothers including "emotional warmth and understanding", "punishing" and "rejection" were also found to be significant predictors, and explained 77.0% of the variance. Meaningful association has been evidenced between parental rearing styles and Chinese medical students' critical thinking disposition. Parental rearing styles should be considered as one of the many potential determinant factors that contribute to the cultivation of medical students' critical thinking capability. Positive parental rearing styles should be encouraged in the cultivation of children's critical thinking skills.

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

    Science.gov (United States)

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

    2017-01-01

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

  16. Medical students volunteering in hospital: a novel method of exploring and recording the patient experience

    Directory of Open Access Journals (Sweden)

    Monica Lorraina Hytiris

    2017-05-01

    Full Text Available Background: Patient experience is increasingly recognised as an important feature of healthcare quality improvement. However, many of the methods implemented for its collection have significant limitations and reliability issues. This article describes how a UK healthcare organisation worked with medical student volunteers to build capacity for the collection of patient feedback in evidence-informed ways, and summarises student reflections on this process. Aims: To improve the quantity and quality of inpatient feedback, and in doing so provide new learning opportunities for medical students. Conclusions: Patient feedback gathered by volunteers is beneficial to the service and to medical student volunteers. As the feedback gathered is ward-specific, opportunities are created for practice improvements to be identified and acted on. It is feasible for medical students to be trained effectively as volunteers in gathering patient care experiences with adequate support mechanisms in place. Implications for practice: •\tHealthcare services should consider the use of personnel independent of the care team for the collection of patient feedback •\tPatient feedback needs to be shared with practitioners in a timely manner •\tMedical schools should consider this type of volunteering as a unique opportunity for medical students to improve understanding of patients’ experiences of healthcare, and of how care can be person-centred

  17. A Qualitative Exploration of the Help-Seeking Behaviors of Students Who Experience Psychological Distress Around Assessment at Medical School.

    Science.gov (United States)

    Winter, Rachel I; Patel, Rakesh; Norman, Robert I

    2017-08-01

    Medical students are at high risk of experiencing psychological distress at medical school and developing mental ill-health during professional practice. Despite efforts by faculty to raise awareness about this risk, many students choose to suffer in silence in the face of psychological distress. The aim of this study was to explore drivers that prompted help-seeking behavior and barriers that prevented individuals prioritizing their well-being around the time of high-stakes assessment at medical school. Semi-structured interviews were conducted with fifty-seven students who failed high-stakes assessment at two UK medical schools, exploring their experience of academic difficulty and perceptions about causes. A thematic analysis of twenty transcripts that met inclusion criteria was completed to identify key factors that influenced participants' decisions around seeking help for their psychological distress, and in some cases, mental health problems. Twenty participants who specifically described a deterioration in their mental health around the time of assessment were included in this study. Barriers to seeking help in these instances included: normalization of symptoms or situation; failure to recognize a problem existed; fear of stigmatisation; overt symptoms of mental distress; and misconceptions about the true nature of the medical school, for example beliefs about a punitive response from the school if they failed. Drivers for seeking help appropriately included: building trust with someone in order to confide in them later on, and self-awareness about the need to maintain good mental health. There are various drivers and barriers for students' help seeking behaviors when experiencing psychological distress around the time of assessment, particularly self-awareness about the problem and prioritisation of well-being. Students who fail to recognize their own deteriorating mental health are at risk of academic failure and medical schools need to develop

  18. Exploring Barriers to Medication Safety in an Ethiopian Hospital Emergency Department: A Human Factors Engineering Approach

    Directory of Open Access Journals (Sweden)

    Ephrem Abebe

    2018-02-01

    Full Text Available Objective: To describe challenges associated with the medication use process and potential medication safety hazards in an Ethiopian hospital emergency department using a human factors approach. Methods: We conducted a qualitative study employing observations and semi-structured interviews guided by the Systems Engineering Initiative for Patient Safety model of work system as an analytical framework. The study was conducted in the emergency department of a teaching hospital in Ethiopia. Study participants included resident doctors, nurses, and pharmacists. We performed content analysis of the qualitative data using accepted procedures. Results: Organizational barriers included communication failures, limited supervision and support for junior staff contributing to role ambiguity and conflict. Compliance with documentation policy was minimal. Task related barriers included frequent interruptions and work-related stress resulting from job requirements to continuously prioritize the needs of large numbers of patients and family members. Person related barriers included limited training and work experience. Work-related fatigue due to long working hours interfered with staff’s ability to document and review medication orders. Equipment breakdowns were common as were non-calibrated or poorly maintained medical devices contributing to erroneous readings. Key environment related barriers included overcrowding and frequent interruption of staff’s work. Cluttering of the work space compounded the problem by impeding efforts to locate medications, medical supplies or medical charts. Conclusions: Applying a systems based approach allows a context specific understanding of medication safety hazards in EDs from low-income countries. When developing interventions to improve medication and overall patient safety, health leaders should consider the interactions of the different factors. Conflict of Interest We declare no conflicts of interest or

  19. Health aspects of Arctic exploration – Alaska's medical history based on the research files of Dr. Robert Fortuine

    Directory of Open Access Journals (Sweden)

    Kathleen Murray

    2013-08-01

    Full Text Available Background . Robert Fortuine provided basic medical care to Alaska Native people, chronicled the Health Aspects of Arctic Exploration and through a number of influential publications, was the first to thoroughly document and analyse Alaska's Medical History. This overview of his published work will provide the reader with a detailed overview, so that they can begin to explore Dr. Fortuine's many published works in more detail. Objective . This review will explore Alaska's Medical History and the Health Aspects of Arctic Exploration through the research files and the 10 most significant publications of Dr. Robert Fortuine. Design . Review of Dr. Fortuine's major works and the master bibliography has over 3,000 references and 81 subjects. The master bibliography is a merger of 55 separate bibliographies, which provides a wealth of bibliographic information. This paper will describe his 10 most significant publications, 2 of which began as a journal issue. Results . Dr. Fortuine was a prolific writer throughout his career, publishing 134 articles and books. He wrote papers and books on Alaska's medical history, tuberculosis and health care delivery from Russian–America through the Public Health Service efforts in the territory and then the State of Alaska. The master bibliography has over 3,000 references and 81 subjects. This list has a significant number of entries for tuberculosis with almost one-third of the entries including this heading. Others dwell on the history of “pre-contact” health, the history of Alaska Native health care, the history of the Alaska Department of Health, especially the tuberculosis programme, the role of the US Public Health Service and traditional medicine. He completely reviewed every Governors’ and the US Surgeon General's reports in regard to Alaska content. This paper describes his 10 most significant publications. Conclusions . Robert Fortuine's published works offer a wealth of information and insight

  20. Exploring the Unmet Needs of the Patient in the Outpatient Respiratory Medical Clinic

    DEFF Research Database (Denmark)

    Jensen, Lone Birgitte; Brinkkjær, Ulf; Larsen, Kristian

    2015-01-01

    Aim. Developing a theoretical framework explaining patients’ behaviour and actions related to unmet needs during interactions with health care professionals in hospital-based outpatient respiratory medical clinics. Background. The outpatient respiratory medical clinic plays a prominent role in many...... patients’ lives regarding treatment and counselling increasing the need for a better understanding of patients’ perspective to the counselling of the health care professionals. Design. The study is exploratory and based on Charmaz’s interpretation of grounded theory. Methods. The study included 65 field...... observations with a sample of 43 patients, 11 doctors, and 11 nurses, as well as 30 interviews with patients, conducted through theoretical sampling from three outpatient respiratory medical clinics in Denmark. Findings. The patients’ efforts to share their significant stories triggered predominantly...

  1. Sea, sun, sand and …. selecting surgery: an exploration of health, medical and wellness tourist's mobility

    Directory of Open Access Journals (Sweden)

    Robert S. Bristow

    2015-11-01

    Full Text Available Mass tourism facilities depend on repeat visitors as well as attracting new first time tourists. As these traditional sun and sand holiday destinations mature, tourism promoters are bundling opportunities to attract a different kind of tourist. Since many of these resorts are all-inclusive facilities and include a Spa, one potential expansion may be to market to health, medical or wellness tourists. Geographic research in travel and tourism has found that individuals either repeat visits to the same destination or diversify their choices. This paper highlights the decision-making process of tourists and how it may be related to the niche market of health, wellness, and medical tourism. It uses data from a survey that gathered the travel patterns and motivations, and socio-demographics of medical tourists. Consumers who exhibit different travel behavior rank hospital accreditation and American hospital affiliation more important than those who repeat travel behavior

  2. Exploring the Case for a Global Alliance for Medical Diagnostics Initiative

    Directory of Open Access Journals (Sweden)

    Melissa L. Mugambi

    2017-01-01

    Full Text Available In recent years, the private and public sectors have increased investments in medical diagnostics for low- and middle-income countries (LMICs. Despite these investments, numerous barriers prevent the adoption of existing diagnostics and discourage the development and introduction of new diagnostics in LMICs. In the late 1990s, the global vaccine community had similar challenges, as vaccine coverage rates stagnated and the introduction of new vaccines was viewed as a distraction to delivering existing vaccines. To address these challenges, the international community came together and formed the Global Alliance for Vaccines Initiative (GAVI. Sixteen years after the formation of GAVI, we see evidence of a healthier global vaccine landscape. We discuss how GAVI’s four guiding principles (product, health systems strengthening, financing and market shaping might apply to the advancement of medical diagnostics in LMICs. We present arguments for the international community and existing organizations to establish a Global Alliance for Medical Diagnostics Initiative (GAMDI.

  3. Medical Students' Development of Ethical Judgment - Exploring the Learners' Perspectives using a mixed methods approach.

    Science.gov (United States)

    Langer, Thorsten; Jazmati, Danny; Jung, Ole; Schulz, Christian; Schnell, Martin W

    2016-01-01

    Objective: Contemporary healthcare requires physicians to have well developed ethical judgment skills in addition to excellent clinical skills. However, no consensus has been reached on how to best teach ethical judgment skills during medical training. Previous studies revealed inconclusive results and applied varying theoretical frameworks. To date, the students' perspectives on their development in ethical judgment has received less attention. Better insights in the learners' experiences can help to improve educational interventions in medical ethics. Methods: A vignette featuring a challenging case with opposing views between a patient's parents and a physician followed by a questionnaire was presented to a cohort of medical students at a German medical school at three points in time during their medical training (Year 1, 2 and 5). The questionnaire included closed and open-ended questions addressing the participant's preferred, hypothetical actions, their reasoning as well as the resources informing their reasoning. Content analysis was used for qualitative data; frequencies and percentages were used to describe quantitative findings. Results: The response rate remained stable (28%) over the study period. Participants' responses changed overtime. Accepting parents' autonomy in the decision-making process was the majority standpoint of students in year 1 and 2 and became less often cited in year 5 (Year 1/2/5: 68/67/48%). On the contrary, not readily following the parents' decision for medical reasons was a minority standpoint in year 1 and became more prevalent over time (year 1/2/5: 12/17/42%). Judgments were only partly based on ethics training. Instead, participants drew on experiences from their clinical clerkships and their personal lives. Throughout the study, participants did not feel well-prepared to make a judgment in the case (Average 2.7 on a Likert-Scale; 1=very well prepared, 4=very poor). Conclusions: Over the course of their medical training, the

  4. Medical Students’ Development of Ethical Judgment – Exploring the Learners’ Perspectives using a mixed methods approach

    Science.gov (United States)

    Langer, Thorsten; Jazmati, Danny; Jung, Ole; Schulz, Christian; Schnell, Martin W.

    2016-01-01

    Objective: Contemporary healthcare requires physicians to have well developed ethical judgment skills in addition to excellent clinical skills. However, no consensus has been reached on how to best teach ethical judgment skills during medical training. Previous studies revealed inconclusive results and applied varying theoretical frameworks. To date, the students’ perspectives on their development in ethical judgment has received less attention. Better insights in the learners’ experiences can help to improve educational interventions in medical ethics. Methods: A vignette featuring a challenging case with opposing views between a patient’s parents and a physician followed by a questionnaire was presented to a cohort of medical students at a German medical school at three points in time during their medical training (Year 1, 2 and 5). The questionnaire included closed and open-ended questions addressing the participant’s preferred, hypothetical actions, their reasoning as well as the resources informing their reasoning. Content analysis was used for qualitative data; frequencies and percentages were used to describe quantitative findings. Results: The response rate remained stable (28%) over the study period. Participants’ responses changed overtime. Accepting parents’ autonomy in the decision-making process was the majority standpoint of students in year 1 and 2 and became less often cited in year 5 (Year 1/2/5: 68/67/48%). On the contrary, not readily following the parents’ decision for medical reasons was a minority standpoint in year 1 and became more prevalent over time (year 1/2/5: 12/17/42%). Judgments were only partly based on ethics training. Instead, participants drew on experiences from their clinical clerkships and their personal lives. Throughout the study, participants did not feel well-prepared to make a judgment in the case (Average 2.7 on a Likert-Scale; 1=very well prepared, 4=very poor). Conclusions: Over the course of their medical

  5. The future of practical skills in undergraduate medical education - an explorative Delphi-Study.

    Science.gov (United States)

    Dannenberg, Katja Anne; Stroben, Fabian; Schröder, Therese; Thomas, Anke; Hautz, Wolf E

    2016-01-01

    64% of young medical professionals in Germany do not feel adequately prepared for the practical requirements of the medical profession. The goal of "outcome-orientated training" is to structure medical curricula based on the skills needed when entering the workforce after completing undergraduate medical education, and thus to bridge the gap between the skills graduates have attained and those necessary for a career in the medical profession. Outcome frameworks (OFs) are used for this purpose. In preparation for developing the National Competence-Based Catalogue of Learning Objectives for Medicine (NKLM) - the German OF - the "Consensus Statement of Practical Skills in Undergraduate Medical Education" (which structures the teaching and acquisition of practical skills in Germany and which strongly influenced the "Clinical-Practical Skills" chapter of the NKLM) was published in 2011. It is not uncommon for at least a decade to elapse between the definition and implementation of an OF and the students' graduation, which can further increase the gap between necessary and acquired skills. Thus, the purpose of this paper is to posit theses for future development in healthcare and to apply these theses to a current OF. Partially structured interviews with experts were used to generate theses pertaining to general, future development in healthcare. These theses were assessed by physician experts based on the likelihood of implementation by the year 2025. The 288 learning goals of the consensus statement were assessed for their relevance for medical education in the interim. 11 theses were generated for the development of medicine, and these theses were assessed and discussed by 738 experts. These theses include the increase in diseases associated with old age, the increasing significance of interprofessional cooperation, and the growing prevalence of telemedicine applications. Of the 288 learning goals of the consensus statement, 231 of the goals were assessed as relevant

  6. The future of practical skills in undergraduate medical education – an explorative Delphi-Study

    Directory of Open Access Journals (Sweden)

    Dannenberg, Katja Anne

    2016-08-01

    Full Text Available Background: 64% of young medical professionals in Germany do not feel adequately prepared for the practical requirements of the medical profession. The goal of “outcome-orientated training” is to structure medical curricula based on the skills needed when entering the workforce after completing undergraduate medical education, and thus to bridge the gap between the skills graduates have attained and those necessary for a career in the medical profession. Outcome frameworks (OFs are used for this purpose. In preparation for developing the National Competence-Based Catalogue of Learning Objectives for Medicine (NKLM – the German OF – the “Consensus Statement of Practical Skills in Undergraduate Medical Education” (which structures the teaching and acquisition of practical skills in Germany and which strongly influenced the “Clinical-Practical Skills” chapter of the NKLM was published in 2011.It is not uncommon for at least a decade to elapse between the definition and implementation of an OF and the students’ graduation, which can further increase the gap between necessary and acquired skills. Thus, the purpose of this paper is to posit theses for future development in healthcare and to apply these theses to a current OF. Methodology: Partially structured interviews with experts were used to generate theses pertaining to general, future development in healthcare. These theses were assessed by physician experts based on the likelihood of implementation by the year 2025. The 288 learning goals of the consensus statement were assessed for their relevance for medical education in the interim. Results: 11 theses were generated for the development of medicine, and these theses were assessed and discussed by 738 experts. These theses include the increase in diseases associated with old age, the increasing significance of interprofessional cooperation, and the growing prevalence of telemedicine applications. Of the 288 learning goals of

  7. Exploring behavioural determinants relating to health professional reporting of medication errors: a qualitative study using the Theoretical Domains Framework.

    Science.gov (United States)

    Alqubaisi, Mai; Tonna, Antonella; Strath, Alison; Stewart, Derek

    2016-07-01

    Effective and efficient medication reporting processes are essential in promoting patient safety. Few qualitative studies have explored reporting of medication errors by health professionals, and none have made reference to behavioural theories. The objective was to describe and understand the behavioural determinants of health professional reporting of medication errors in the United Arab Emirates (UAE). This was a qualitative study comprising face-to-face, semi-structured interviews within three major medical/surgical hospitals of Abu Dhabi, the UAE. Health professionals were sampled purposively in strata of profession and years of experience. The semi-structured interview schedule focused on behavioural determinants around medication error reporting, facilitators, barriers and experiences. The Theoretical Domains Framework (TDF; a framework of theories of behaviour change) was used as a coding framework. Ethical approval was obtained from a UK university and all participating hospital ethics committees. Data saturation was achieved after interviewing ten nurses, ten pharmacists and nine physicians. Whilst it appeared that patient safety and organisational improvement goals and intentions were behavioural determinants which facilitated reporting, there were key determinants which deterred reporting. These included the beliefs of the consequences of reporting (lack of any feedback following reporting and impacting professional reputation, relationships and career progression), emotions (fear and worry) and issues related to the environmental context (time taken to report). These key behavioural determinants which negatively impact error reporting can facilitate the development of an intervention, centring on organisational safety and reporting culture, to enhance reporting effectiveness and efficiency.

  8. Improving Provenance Data Interaction for Visual Storytelling in Medical Imaging Data Exploration

    NARCIS (Netherlands)

    Amabili, L.; Kosinka, J.; van Meersbergen, M.A.J.; van Ooijen, P. M. A.; Roerdink, J. B. T. M.; Svetachov, P.; Yu, L.; Johansson, Jimmy; Sadlo, Filip; Schreck, Tobias

    2018-01-01

    Effective collaborative work in diagnostic medical imaging is not trivial due to the large amounts of complex data involved, a (non-linear) workflow involving experts in different domains, and a lack of versatility in the current tools employed in healthcare. In this paper, we aim to introduce how

  9. Exploring the potential of video technologies for collaboration in emergency medical care

    DEFF Research Database (Denmark)

    Sonnenwald, Diane H.; Söderholm, Hanna M.; Manning, James E.

    2008-01-01

    videoconferencing techniques. This may be of benefit in diagnosing and treating patients in emergency situations where specialized medical expertise is not locally available. The 3D telepresence technology does not yet exist, and there is a need to understand its potential before resources are spent on its...

  10. Data Mining and Domain Knowledge: An Exploration of Methods to Advance Medical Research

    Science.gov (United States)

    Engle, Kelley M.

    2013-01-01

    Researchers in the medical domain consider the double-blind placebo controlled clinical trial the gold standard. The data for these clinical trials are collected for a specifically defined hypothesis and there is very little in the realm of secondary data analyses conducted. The underlying purpose of this work is to demonstrate the value and…

  11. Incorporating E-learning in teaching English language to medical students: exploring its potential contributions

    Science.gov (United States)

    Navidinia, Hossein; Zare Bidaki, Majid; Hekmati, Nargess

    2016-01-01

    Background: The spread of technology has influenced different aspects of human life, and teaching and learning are not exceptions. This study aimed to examine the potential contribution of the use of technology in teaching English language to medical students. Methods: This qualitative-action research study was conducted in Birjand University of Medical Sciences (BUMS), with 60 medical students taking a general English course in the Fall Semester of 2015. The class favored different tools and multimedia facilities such as a tube channel, e-dictionaries, educational films, and etextbooks to enhance students’ learning. In addition, the class had a weblog in which students could upload assignments and receive feedback from peers and the instructors. Results: The results revealed that e-learning could enhance students’ language proficiency and facilitate the teaching process. Learners preferred to use more e-dictionaries to learn the meaning of the new words, watch English medical films to boost their speaking and listening skills, and use the electronic version of their textbook as they could carry it wherever they wanted. Conclusion: The students preferred this method of learning English as they became more independent by using the electronic facilities. They found that learning English did not have a fixed institutionalized method, and e-learning activities could provide them with authentic input for language learning even outside of the classroom. PMID:28491837

  12. Resetting the compass: exploring the implicit messages of orientation to a community-engaged medical school

    Directory of Open Access Journals (Sweden)

    Rachel Helen Ellaway

    2017-02-01

    Conclusion: Orientation to undergraduate medical training can be successfully linked to a school’s social mission, but in doing so it can send complex and unintended messages to the participants that may be perceived quite differently based on their circumstances and expectations.

  13. Exploring the potential uses of value-added metrics in the context of postgraduate medical education.

    Science.gov (United States)

    Gregory, Simon; Patterson, Fiona; Baron, Helen; Knight, Alec; Walsh, Kieran; Irish, Bill; Thomas, Sally

    2016-10-01

    Increasing pressure is being placed on external accountability and cost efficiency in medical education and training internationally. We present an illustrative data analysis of the value-added of postgraduate medical education. We analysed historical selection (entry) and licensure (exit) examination results for trainees sitting the UK Membership of the Royal College of General Practitioners (MRCGP) licensing examination (N = 2291). Selection data comprised: a clinical problem solving test (CPST); a situational judgement test (SJT); and a selection centre (SC). Exit data was an applied knowledge test (AKT) from MRCGP. Ordinary least squares (OLS) regression analyses were used to model differences in attainment in the AKT based on performance at selection (the value-added score). Results were aggregated to the regional level for comparisons. We discovered significant differences in the value-added score between regional training providers. Whilst three training providers confer significant value-added, one training provider was significantly lower than would be predicted based on the attainment of trainees at selection. Value-added analysis in postgraduate medical education potentially offers useful information, although the methodology is complex, controversial, and has significant limitations. Developing models further could offer important insights to support continuous improvement in medical education in future.

  14. Incorporating E-learning in teaching English language to medical students: exploring its potential contributions.

    Science.gov (United States)

    Navidinia, Hossein; Zare Bidaki, Majid; Hekmati, Nargess

    2016-01-01

    Background: The spread of technology has influenced different aspects of human life, and teaching and learning are not exceptions. This study aimed to examine the potential contribution of the use of technology in teaching English language to medical students. Methods: This qualitative-action research study was conducted in Birjand University of Medical Sciences (BUMS), with 60 medical students taking a general English course in the Fall Semester of 2015. The class favored different tools and multimedia facilities such as a tube channel, e-dictionaries, educational films, and etextbooks to enhance students' learning. In addition, the class had a weblog in which students could upload assignments and receive feedback from peers and the instructors. Results: The results revealed that e-learning could enhance students' language proficiency and facilitate the teaching process. Learners preferred to use more e-dictionaries to learn the meaning of the new words, watch English medical films to boost their speaking and listening skills, and use the electronic version of their textbook as they could carry it wherever they wanted. Conclusion: The students preferred this method of learning English as they became more independent by using the electronic facilities. They found that learning English did not have a fixed institutionalized method, and e-learning activities could provide them with authentic input for language learning even outside of the classroom.

  15. Exploration of a leadership competency model for medical school faculties in Korea.

    Science.gov (United States)

    Lee, Yong Seok; Oh, Dong Keun; Kim, Myungun; Lee, Yoon Seong; Shin, Jwa Seop

    2010-12-01

    To adapt to rapid and turbulent changes in the field of medicine, education, and society, medical school faculties need appropriate leadership. To develop leadership competencies through education, coaching, and mentoring, we need a leadership competency model. The purpose of this study was to develop a new leadership competency model that is suitable for medical school faculties in Korea. To collect behavioral episodes with regard to leadership, we interviewed 54 subjects (faculties, residents, nurses) and surveyed 41 faculties with open-ended questionnaires. We classified the behavioral episodes based on Quinn and Cameron's leadership competency model and developed a Likert scale questionnaire to perform a confirmatory factor analysis. Two hundred seven medical school faculties responded to the questionnaire. The competency clusters that were identified by factor analysis were professionalism, citizenship, leadership, and membership to an organization. Accordingly, each cluster was linked with a dimension: self, society, team (that he/she is leading), and organization (to which he/she belongs). The clusters of competencies were: professional ability, ethics/morality, self-management, self-development, and passion; public interest, networking, social participation, and active service; motivating, caring, promoting teamwork, nurturing, conflict management, directing, performance management, and systems thinking; organizational orientation, collaboration, voluntary participation, and cost-benefit orientation. This competency model that fits medical school faculties in Korea can be used to design and develop selection plans, education programs, feedback tools, diagnostic evaluation tools, and career plan support programs.

  16. Exploring individual user differences in the 2D/3D interaction with medical image data

    NARCIS (Netherlands)

    Zudilova-Seinstra, E.; van Schooten, B.; Suinesiaputra, A.; van der Geest, R.; van Dijk, B.; Reiber, J.; Sloot, P.

    2010-01-01

    User-centered design is often performed without regard to individual user differences. In this paper, we report results of an empirical study aimed to evaluate whether computer experience and demographic user characteristics would have an effect on the way people interact with the visualized medical

  17. Exploring individual user differences in the 2D/3D interaction with medical image data

    NARCIS (Netherlands)

    Zudilova-Seinstra, Elena; van Schooten, B.W.; Suinesiaputra, Avan; van der Geest, Rob; van Dijk, Elisabeth M.A.G.; Reiber, Johan; Sloot, Peter

    2009-01-01

    User-centered design is often performed without regard to individual user differences. In this paper, we report results of an empirical study aimed to evaluate whether computer experience and demographic user characteristics would have an effect on the way people interact with the visualized medical

  18. The exploration of medical resources utilization among inguinal hernia repair in Taiwan diagnosis-related groups.

    Science.gov (United States)

    Yan, Yu-Hua; Kung, Chih-Ming; Chen, Yi

    2017-11-09

    This study centered on differences in medical costs, using the Taiwan diagnosis-related groups (Tw-DRGs) on medical resource utilization in inguinal hernia repair (IHR) in hospitals with different ownership to provide suitable reference information for hospital administrators. The 2010-2011 data for three hospitals under different ownership were extracted from the Taiwan National Health Insurance claims database. A retrospective method was applied to analyze the age, sex, length of stay, diagnosis and surgical procedure code, and the change in financial risk of medical costs in IHR cases after introduction of Tw-DRGs. The study calculated the cost using Tw-DRG payment principles, and compared it with estimated inpatient medical costs calculated using the fee-for-service policy. There were 723 IHR cases satisfying the Tw-DRGs criteria. Cost control in the medical care corporation hospital (US$764.2/case) was more efficient than that in the public hospital (US$902.7/case) or nonprofit proprietary hospital (US$817.1/case) surveyed in this study. For IHR, anesthesiologists in the public hospital preferred to use general anesthesia (86%), while those in the two other hospitals tended to administer spinal anesthesia. We also discovered the difference in anesthesia cost was high, at US$80.2/case on average. Because the Tw-DRG-based reimbursement system produces varying hospital costs, hospital administrators should establish a financial risk assessment system as early as possible to improve healthcare quality and financial management efficiency. This would then benefit the hospital, patient, and Bureau of National Health Insurance.

  19. The exploration of medical resources utilization among inguinal hernia repair in Taiwan diagnosis-related groups

    Directory of Open Access Journals (Sweden)

    Yu-Hua Yan

    2017-11-01

    Full Text Available Abstract Background This study centered on differences in medical costs, using the Taiwan diagnosis-related groups (Tw-DRGs on medical resource utilization in inguinal hernia repair (IHR in hospitals with different ownership to provide suitable reference information for hospital administrators. Methods The 2010–2011 data for three hospitals under different ownership were extracted from the Taiwan National Health Insurance claims database. A retrospective method was applied to analyze the age, sex, length of stay, diagnosis and surgical procedure code, and the change in financial risk of medical costs in IHR cases after introduction of Tw-DRGs. The study calculated the cost using Tw-DRG payment principles, and compared it with estimated inpatient medical costs calculated using the fee-for-service policy. Results There were 723 IHR cases satisfying the Tw-DRGs criteria. Cost control in the medical care corporation hospital (US$764.2/case was more efficient than that in the public hospital (US$902.7/case or nonprofit proprietary hospital (US$817.1/case surveyed in this study. For IHR, anesthesiologists in the public hospital preferred to use general anesthesia (86%, while those in the two other hospitals tended to administer spinal anesthesia. We also discovered the difference in anesthesia cost was high, at US$80.2/case on average. Conclusions Because the Tw-DRG-based reimbursement system produces varying hospital costs, hospital administrators should establish a financial risk assessment system as early as possible to improve healthcare quality and financial management efficiency. This would then benefit the hospital, patient, and Bureau of National Health Insurance.

  20. Integrated Medical Model Project - Overview and Summary of Historical Application

    Science.gov (United States)

    Myers, J.; Boley, L.; Butler, D.; Foy, M.; Goodenow, D.; Griffin, D.; Keenan, A.; Kerstman, E.; Melton, S.; McGuire, K.; hide

    2015-01-01

    Introduction: The Integrated Medical Model (IMM) Project represents one aspect of NASA's Human Research Program (HRP) to quantitatively assess medical risks to astronauts for existing operational missions as well as missions associated with future exploration and commercial space flight ventures. The IMM takes a probabilistic approach to assessing the likelihood and specific outcomes of one hundred medical conditions within the envelope of accepted space flight standards of care over a selectable range of mission capabilities. A specially developed Integrated Medical Evidence Database (iMED) maintains evidence-based, organizational knowledge across a variety of data sources. Since becoming operational in 2011, version 3.0 of the IMM, the supporting iMED, and the expertise of the IMM project team have contributed to a wide range of decision and informational processes for the space medical and human research community. This presentation provides an overview of the IMM conceptual architecture and range of application through examples of actual space flight community questions posed to the IMM project. Methods: Figure 1 [see document] illustrates the IMM modeling system and scenario process. As illustrated, the IMM computational architecture is based on Probabilistic Risk Assessment techniques. Nineteen assumptions and limitations define the IMM application domain. Scenario definitions include crew medical attributes and mission specific details. The IMM forecasts probabilities of loss of crew life (LOCL), evacuation (EVAC), quality time lost during the mission, number of medical resources utilized and the number and type of medical events by combining scenario information with in-flight, analog, and terrestrial medical information stored in the iMED. In addition, the metrics provide the integrated information necessary to estimate optimized in-flight medical kit contents under constraints of mass and volume or acceptable level of mission risk. Results and Conclusions

  1. Exploring Clinical Rotation Competence Improvements after Interpersonal Skills Development in At-Risk Medical Students

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    Sri Linuwih Menaldi

    2014-12-01

    Full Text Available AbstractPrior to admission, medical students were subject to psychological tests to measure their logical thinking skills and personality, hence predicting their ability to complete their studies. The results showed 56,45% of medical students obtained recommendation category 4 (doubtful and 5 (not recommended, two categories which are considered to be at-risk group with a very small probability of completing their studies. These results predicted that students in the mentioned groups will have difficulties in achieving the clinical competence level required by the Indonesian Doctors’ Competency Standard (IDCS. The aim of the study was to investigate clinical competency achievement by at-risk medical students in the third year, after following interpersonal skills development training program on July 2011. This research used qualitative study design through psychological examination, written self-reflection and in-depth interview after the training. Interpersonal skills development training for at-risk medical students gave positive effects to theircharacter development for the helping profession. It was concluded that interpersonal skills training could help improve medical student’s achievement of clinical competence especially for at-risk group in their clinical rotations stage.Keywords: medical students, at-risk group, interpersonal skills, clinical competence AbstrakPada mahasiswa kedokteran yang baru masuk dilakukan pemeriksaan psikologis untuk memperoleh gambaran penalaran dan kepribadian untuk memprediksi kemampuan mahasiswa dalam menyelesaikan pendidikan. Berdasarkan pemeriksaan tersebut diperoleh 56,45% mahasiswa dengan hasil uji psikometrik kategori rekomendasi 4 (diragukan dan 5 (tidak disarankan yang disebut sebagai kelompok at-risk. Kelompok at risk memiliki peluang keberhasilan rendah untuk menyelesaikan pendidikan dan akan mengalami kesulitan mencapai kompetensi klinik sesuai Standar Kompetensi Dokter Indonesia. Tujuan

  2. Beyond good and evil: exploring medical trainee use of social media.

    Science.gov (United States)

    George, Daniel R; Green, Michael J

    2012-01-01

    Medicine has struggled to integrate a new generation of social media technologies. Rather than focusing on the promise of these emerging tools, the academic literature is replete with admonishments of how social media pose a danger to medical professionals, and guidelines regarding social media are written with expectations of misuse rather than consideration of positive application. To better learn how new technology might be integrated into professional lives, it is imperative to seek perspectives from younger trainees who have already begun navigating the unique professional and ethical dilemmas posed by social media and might assist in identifying innovative uses of existing tools. The views and practices of current trainees can provide important insight into the proactive role social media can play in the delivery of more effective health care during an era in which social media usage is invariably increasing for medical professionals and patients.

  3. Exploring the possibility for business model innovation in Laerdal Medical using Virtual Reality

    OpenAIRE

    Ullestad, Freddie; Søndenaa, Thomas

    2017-01-01

    Master's thesis in Business administration: Executive MBA The purpose of this paper is to check how Virtual Reality patient simulation as a disruptive technology may give opportunities for established companies, such as Laerdal Medical, to create innovative business models in the nursing and healthcare education market. The goal of the new and innovative business model would be to maintain and further strengthen existing business, when faced with threats from established and potential new ...

  4. High altitude medicine education in China: exploring a new medical education reform.

    Science.gov (United States)

    Luo, Yongjun; Luo, Rong; Li, Weiming; Huang, Jianjun; Zhou, Qiquan; Gao, Yuqi

    2012-03-01

    China has the largest plateau in the world, which includes the whole of Tibet, part of Qinghai, Xinjiang, Yunnan, and Sichuan. The plateau area is about 257.2×10(4) km(2), which accounts for about 26.8% of the total area of China. According to data collected in 2006, approximately twelve million people were living at high altitudes, between 2200 to 5200 m high, on the Qinghai-Tibetan Plateau. Therefore, there is a need for medical workers who are trained to treat individuals living at high altitudes. To train undergraduates in high altitude medicine, the College of High Altitude Military Medicine was set up at the Third Military Medical University (TMMU) in Chongqing in 1999. This is the only school to teach high altitude medicine in China. Students at TMMU study natural and social sciences, basic medical sciences, clinical medical sciences, and high altitude medicine. In their 5(th) year, students work as interns at the General Hospital of Tibet Military Command in Lhasa for 3 months, where they receive on-site teaching. The method of on-site teaching is an innovative approach for training in high altitude medicine for undergraduates. Three improvements were implemented during the on-site teaching component of the training program: (1) standardization of the learning progress; (2) integration of formal knowledge with clinical experience; and (3) coaching students to develop habits of inquiry and to engage in ongoing self-improvement to set the stage for lifelong learning. Since the establishment of the innovative training methods in 2001, six classes of high altitude medicine undergraduates, who received on-site teaching, have graduated and achieved encouraging results. This evidence shows that on-site teaching needs to be used more widely in high altitude medicine education.

  5. Sea, sun, sand and …. selecting surgery: an exploration of health, medical and wellness tourist's mobility

    OpenAIRE

    Robert S. Bristow; Wen-Tsann Yang

    2015-01-01

    Mass tourism facilities depend on repeat visitors as well as attracting new first time tourists. As these traditional sun and sand holiday destinations mature, tourism promoters are bundling opportunities to attract a different kind of tourist. Since many of these resorts are all-inclusive facilities and include a Spa, one potential expansion may be to market to health, medical or wellness tourists. Geographic research in travel and tourism has found that individuals either repeat visits to t...

  6. Serving an Indigenous community: Exploring the cultural competence of medical students in a rural setting

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    Chin Hoong Wong

    2017-06-01

    Full Text Available Since 2013, medical students from the International Medical University (IMU in Malaysia have been providing primary healthcare services, under the supervision of faculty members, to the indigenous people living in Kampung Sebir. The project has allowed the students to learn experientially within a rural setting. This study aims to examine the cultural competence of IMU medical students through an examination of their perspective of the indigenous people who they serve and the role of this community service in their personal and professional development. Students who participated in the project were required to complete a questionnaire after each community engagement activity to help them reflect on the above areas. We analysed the responses of students from January to December 2015 using a thematic analysis approach to identify overarching themes in the students’ responses. Students had differing perceptions of culture and worldviews when compared to the indigenous people. However, they lacked the self-reflection skills necessary to understand how such differences can affect their relationship with the indigenous people. Because of this, the basis of their engagement with the indigenous community (as demonstrated by their views of community service is focused on their agenda of promoting health from a student’s perspective rather than connecting and building relationships first. Students also lacked the appreciation that building cultural competency is a continuous process. The results show that the medical students have a developing cultural competence. The project in Kampung Sebir is an experiential learning platform of great value to provide insights into and develop the cultural competency of participating students. This study also reflects on the project itself, and how the relationship with stakeholders, the competence and diversity of academic staff, and the support of the university can contribute toward training in cultural

  7. Exploring UK medical and social work students' legal literacy: comparisons, contrasts and implications.

    Science.gov (United States)

    Preston-Shoot, Michael; McKimm, Judy

    2013-05-01

    To ensure acceptable practice standards both doctors and social workers should draw on relevant legal rules when reaching professional judgements concerning, for instance, children requiring protection, people with severe mental distress and adults at risk, information sharing, consent to intervention and service user involvement in their care and treatment. Many practitioners use the law to maintain high standards of professionalism. However, research has uncovered limited awareness of legal rules and poor standards of health and social care. Academic benchmarks and practice requirements for health and social care professions centrally position legal knowledge for secure decision-making. Model curricula exist. However, the outcomes of the taught curriculum on students' confidence in their legal knowledge and skills have been relatively overlooked. This article introduces the concept of legal literacy, a distillation of knowledge, understanding, skills and values that enables practitioners to connect relevant legal rules with their professional practice, to appreciate the roles and duties of other practitioners and to communicate effectively across organisational boundaries. It presents the outcomes for a 2006-2009 study of 1154 UK medical and 638 social work students of their law learning for practice, response rates of 46% and 68%. Significant differences were found between medical and social work students' attitudes towards the law, and in their self-ratings of legal knowledge and skills. Confidence levels were low and anxiety high, especially among medical students, although law teaching had some positive outcomes on knowledge and skill development. Social work and medical students associated different themes with the law, the latter especially foregrounding ethics, negligence and liability, which could affect inter-professional working. Students are not fully prepared for legally literate practice, with a consequent need to review the time allocated for, and

  8. Behaviour of medical students in seeking mental and physical health care: exploration and comparison with psychology students.

    Science.gov (United States)

    Brimstone, Renee; Thistlethwaite, Jill E; Quirk, Frances

    2007-01-01

    Doctors are often reluctant to seek health care through the usual channels and tend to self-diagnose and prescribe. Medical students learn attitudes and values from clinician role models and may also adopt behaviour patterns that lead them to seek help for physical and mental health problems from informal sources. This study aimed to explore the behaviour of students in seeking health care for physical and mental health problems, comparing medical with psychology students, and to understand what barriers to conventional routes of seeking health care may affect this. We administered a questionnaire asking for demographic details and responses to 2 vignettes in which a student from the respondent's discipline was experiencing firstly symptoms of a mental health problem and secondly symptoms of a physical health problem. Data were analysed with spss and univariate anovas to examine differences between respondents. A total of 172 students at the psychology and medical schools at James Cook University in Australia participated. We identified a number of barriers affecting student behaviour in seeking help, which included worries about knowing the doctor they could consult at the university health centre or having future dealings with him or her, and cost of treatment. There were differences between the 2 groups of students. There are several barriers for both psychology and medical students to accessing appropriate professional mental health care. Medical students also experience barriers to attaining appropriate physical health care when needed. Psychology and medical students were more likely to seek advice informally from friends and/or family with regard to mental health care.

  9. Exploring the ideas and expectations of German medical students towards career choices and the speciality of psychiatry.

    Science.gov (United States)

    Baller, Frauke A E; Ludwig, Karin V; Kinas-Gnadt Olivares, Clara L; Graef-Calliess, Iris-Tatjana

    2013-08-01

    The aim of this study was to explore the ideas and expectations of medical students toward their career choices and the speciality of psychiatry. A total of 323 students of the Hannover Medical School filled in a questionnaire about their career choices, preferred medical specialization, factors of influence on career choices and attitude towards psychiatry. The three most important factors of influence appeared to be: (1) work-life balance, (2) flexible working hours, (3) career prospects. Although expectations towards the professional life of psychiatrists were quite positive among the students, there was only a small number of students (n = 53 of 318 respondents, 17%) interested in specializing in psychiatry. Important reasons for choosing psychiatry included personal experience with somatic or mental health issues and practical experience in psychiatry. Most of the students experienced clinical exposure to psychiatry but at a much later period in the curriculum. For a career choice of psychiatry as a speciality it seems to be important to start psychiatric education in medical school early. The positive aspects of the professional life in psychiatry, such as flexible working hours, career prospects and good work-life balance should be more emphasized.

  10. Socialization, Indifference, and Convenience: Exploring the Uptake of Influenza Vaccine Among Medical Students and Early Career Doctors.

    Science.gov (United States)

    Edge, Rhiannon; Goodwin, Dawn; Isba, Rachel; Keegan, Thomas

    2017-11-01

    The Chief Medical Officer recommends that all health care workers receive an influenza vaccination annually. High vaccination coverage is believed to be the best protection against the spread of influenza within a hospital, although uptake by health care workers remains low. We conducted semistructured interviews with seven medical students and nine early career doctors, to explore the factors informing their influenza vaccination decision making. Data collection and analysis took place iteratively, until theoretical saturation was achieved, and a thematic analysis was performed. Socialization was important although its effects were attenuated by participants' previous experiences and a lack of clarity around the risks and benefits of vaccination. Many participants did not have strong intentions regarding vaccination. There was considerable disparity between an individual's opinion of the vaccine, their intentions, and their vaccination status. The indifference demonstrated here suggests few are strongly opposed to the vaccination-there is potential to increase vaccination coverage.

  11. Factors influencing the perception of roughness in manual exploration: Do medical gloves reduce cutaneous sensibility?

    OpenAIRE

    Mylon, P.T.; Buckley-Johnstone, L.; Lewis, R.; Carre, M.J.; Martin, N.

    2015-01-01

    A new roughness perception test was designed to evaluate cutaneous sensibility. Blindfolded subjects explored a sample of sandpaper using one of two methods: stroking the sample (dynamic method) or applying pressure (static method). A range of samples of various grades were presented in a random order, and subjects scored each one in terms of perceived roughness. Each subject performed the test in three conditions – wearing latex and nitrile examination gloves and bare-handed. Mean normalised...

  12. Exploration of preferred learning styles in medical education using VARK modal

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    Laxman Khanal

    2014-09-01

    Full Text Available Learning styles is a term used to refer to the methods of gathering, processing, interpreting, organizing and thinking about information. Students have different learning styles, which is the reason for the diversity seen in classrooms in regards to how students acquire information. Claxton and Murrell had divided the learning styles into the following four categories: personality models, information-processing models, social-interaction models, and instructional preferences models. VARK (an acronym for Visual, Aural, Read/write and Kinesthetic, different way of learning styles is a learning inventory categorized into the ‘instructional preference’ modal. Many studies were done using the VARK inventory among the medical education but the preferred mode of learning was variable in different parts of the world. The relationship of age, gender and academic performance with the mode of learning was also not consistent. So this article tried to conclude the preferred mode of learning and relationship of mode of learning with gender and other factors by analyzing the previous studies done using VARK questionnaire among the medical students in daily teaching and learning environment. Pub Med and Google Scholar were used as a search engine to find the article. Altogether 20 full text research papers were retrieved and reviewed. In the most of part of the world the studies showed that multimodal learning style was the predominant one over unimodal. Further in multimodal quadmodal was the most preferred one followed by other presentation. In the unimodal presentation most preferred one is kinesthetic type of learning along with visual, aural and read write in less extent. Age factors had no lucid relationship with the learning style though some variations were observed with age.This review was expected to be useful as scientific evidence in the field of medical education and also as a reference for further research.

  13. Exploration of the perceptions of emergency physicians and interns regarding the medical documentation practices of interns.

    Science.gov (United States)

    Isoardi, Jonathon; Spencer, Lyndall; Sinnott, Michael; Nicholls, Kim; O'Connor, Angela; Jones, Fleur

    2013-08-01

    The primary objective of the present study was to learn the factors that influence the documentation practices of ED interns. A second objective was to identify the expectations of emergency physicians (EPs) towards the medical record documentation of ED interns. A qualitative design was adopted using semi-structured interviews in convenience samples drawn from both groups. Eighteen interviews were conducted with intern volunteers and 10 with EP volunteers. One (5%) intern and two (20%) EPs had received medical documentation training. Factors that encouraged interns' documentation included: patient acuity (the more critical the condition, the more comprehensive the documentation) and the support of senior colleagues. Inhibiting factors included uncertainty about how much to write, and the shift being worked (interns indicated they wrote less at night). Factors of consequence to senior personnel included the apparent reluctance of interns to document management plans. They noted that interns frequently confine their notes to assessment, investigations and treatments, whereas EPs preferred records that demonstrated intern thought processes and included such matters as future actions to follow immediate treatment. A positive theme that emerged included the high level of support interns received from their senior colleagues. Another theme, the influence of patient acuity, held both positive and negative implications for intern writing practices. The lack of formal training is an impediment to the production of useful medical records by ED interns. One solution proposed by both interns and senior personnel was the introduction of the subject into intern education programmes. © 2013 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  14. Exploring virtual worlds for scenario-based repeated team training of cardiopulmonary resuscitation in medical students.

    Science.gov (United States)

    Creutzfeldt, Johan; Hedman, Leif; Medin, Christopher; Heinrichs, Wm LeRoy; Felländer-Tsai, Li

    2010-09-03

    Contemporary learning technologies, such as massively multiplayer virtual worlds (MMVW), create new means for teaching and training. However, knowledge about the effectiveness of such training is incomplete, and there are no data regarding how students experience it. Cardiopulmonary resuscitation (CPR) is a field within medicine in high demand for new and effective training modalities. In addition to finding a feasible way to implement CPR training, our aim was to investigate how a serious game setting in a virtual world using avatars would influence medical students' subjective experiences as well as their retention of knowledge. An MMVW was refined and used in a study to train 12 medical students in CPR in 3-person teams in a repeated fashion 6 months apart. An exit questionnaire solicited reflections over their experiences. As the subjects trained in 4 CPR scenarios, measurements of self-efficacy, concentration, and mental strain were made in addition to measuring knowledge. Engagement modes and coping strategies were also studied. Parametric and nonparametric statistical analyses were carried out according to distribution of the data. The majority of the subjects reported that they had enjoyed the training, had found it to be suitable, and had learned something new, although several asked for more difficult and complex scenarios as well as a richer virtual environment. The mean values for knowledge dropped during the 6 months from 8.0/10 to 6.25/10 (P = .002). Self-efficacy increased from before to after each of the two training sessions, from 5.9/7 to 6.5/7 (P = .01) after the first and from 6.0/7 to 6.7/7 (P = .03) after the second. The mean perceived concentration value increased from 54.2/100 to 66.6/100 (P = .006), and in general the mental strain was found to be low to moderate (mean = 2.6/10). Using scenario-based virtual world team training with avatars to train medical students in multi-person CPR was feasible and showed promising results. Although we

  15. EXPLORING SERVICE QUALITY IMPACTS ON CUSTOMER SATISFACTION IN MILITARY MEDICAL CENTRES: MODERATING ROLE OF PERCEIVED VALUE

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    Azman Ismail

    2016-12-01

    Full Text Available Much has been written about service quality impacts on customer satisfaction. However, little research on this perspective has been carried out in military settings. The aim of this study is to examine the relationship between service quality and customer satisfaction, and moderating effects of perceived value in military medical centre. A survey method was employed and data was collected from customers at medical centers under the administration of Malaysian army organization. Analysis was performed using SmartPLS path model analysis. The results show two important findings: first, the interaction between four service quality components (i.e., tangible, reliability, responsiveness and assurance and customers’ perceived value were significantly correlated with customer satisfaction. Second, the interaction between one service quality component (i.e., tangible were not significantly correlated with customer satisfaction. In overall, this result confirms that effect of tangible, reliability, responsiveness and assurance on customer satisfaction has been moderated by customers’ perceived value. Conversely, effect empathy on customer satisfaction has not been moderated by customers’ perceived value. Further, this study offers discussion, implications and conclusion.

  16. Exploring DeepMedic for the purpose of segmenting white matter hyperintensity lesions

    Science.gov (United States)

    Lippert, Fiona; Cheng, Bastian; Golsari, Amir; Weiler, Florian; Gregori, Johannes; Thomalla, Götz; Klein, Jan

    2018-02-01

    DeepMedic, an open source software library based on a multi-channel multi-resolution 3D convolutional neural network, has recently been made publicly available for brain lesion segmentations. It has already been shown that segmentation tasks on MRI data of patients having traumatic brain injuries, brain tumors, and ischemic stroke lesions can be performed very well. In this paper we describe how it can efficiently be used for the purpose of detecting and segmenting white matter hyperintensity lesions. We examined if it can be applied to single-channel routine 2D FLAIR data. For evaluation, we annotated 197 datasets with different numbers and sizes of white matter hyperintensity lesions. Our experiments have shown that substantial results with respect to the segmentation quality can be achieved. Compared to the original parametrization of the DeepMedic neural network, the timings for training can be drastically reduced if adjusting corresponding training parameters, while at the same time the Dice coefficients remain nearly unchanged. This enables for performing a whole training process within a single day utilizing a NVIDIA GeForce GTX 580 graphics board which makes this library also very interesting for research purposes on low-end GPU hardware.

  17. The Need for Medical Geology in Space Exploration: Implications for the Journey to Mars and Beyond

    Science.gov (United States)

    Harrington, A. D.; Zeigler, R. A.; McCubbin, F. M.

    2018-01-01

    The previous manned missions to the Moon represent milestones in human ingenuity, perseverance, and intellectual curiosity. They also highlight a major hazard for future human exploration of the Moon and beyond: surface dust. Not only did the dust cause mechanical and structural integrity issues with the suits, the dust "storm" generated upon reentrance into the crew cabin caused "lunar hay fever" and "almost blindness". It was further reported that the allergic response to the dust worsened with each exposure. The lower gravity environment exacerbated the exposure, requiring the astronauts to wear their helmet within the module in order to avoid breathing the irritating particles. Due to the prevalence of these high exposures, the Human Research Roadmap developed by NASA identifies the Risk of Adverse Health and Performance Effects of Celestial Dust Exposure as an area of concern. Extended human exploration will further increase the probability of inadvertent and repeated exposures to celestial dusts. Going forward, hazard assessments of celestial dusts will be determined through sample return efforts prior to astronaut deployment. However, even then the returned samples could also put the Curators, technicians, and scientists at risk during processing and examination.

  18. Exploring the relationship between stress and acne: a medical student’s perspective

    Directory of Open Access Journals (Sweden)

    Maleki A

    2018-04-01

    Full Text Available Aryan Maleki, Noorulain Khalid Faculty of Medicine, Barts and The London School of Medicine and Dentistry, London, UKWe read with great interest the paper by Zari and Alrahmani1 investigating the relationship between stress and acne among female medical students. These findings are relevant as around 20% of young people are affected by moderate-to-severe acne, and indeed acne severity is associated with increased risks of anxiety, depression and suicidal ideation.2 The authors identified that “stress severity strongly correlated with an increase in acne severity,” and suggested that stress likely has an important role in the pathogenesis of acne.1 However, the paper could have been taken further to better establish the true extent of this relationship, and ultimately whether certain patients will benefit from clinical interventions based on their perceived stress scale. View the original paper by Zari and Alrahmani.

  19. Caminata del robot humanoide RH-2 en la plataforma de simulación OpenHRP

    OpenAIRE

    Torre Doblas, Carlos de

    2010-01-01

    En primer lugar, en este proyecto se trabajará con el simulador OpenHRP3, intentando comprender su funcionamiento interno (carga de archivos, lenguajes, funcionalidades, etc.). También se adaptará el modelo del robot humanoide Rh-2 al entorno del mismo, pudiendo así realizar simulaciones. La verdadera finalidad de este proyecto, y en lo que se ha hecho especial incapié, es simular el robot sosteniendo una caja, validando así las fuerzas que sienten las distintas partes del cuerpo en los momen...

  20. Exploring Rural Disparities in Medical Diagnoses Among Veterans With Transgender-related Diagnoses Utilizing Veterans Health Administration Care.

    Science.gov (United States)

    Bukowski, Leigh A; Blosnich, John; Shipherd, Jillian C; Kauth, Michael R; Brown, George R; Gordon, Adam J

    2017-09-01

    Research shows transgender individuals experience pronounced health disparities compared with their nontransgender peers. Yet, there remains insufficient research about health differences within transgender populations. This study seeks to fill this gap by exploring how current urban/rural status is associated with lifetime diagnosis of mood disorder, alcohol dependence disorder, illicit drug abuse disorder, tobacco use, posttraumatic stress disorder, human immunodeficiency virus, and suicidal ideation or attempt among veterans with transgender-related diagnoses. This study used a retrospective review of The Department of Veterans Affairs (VA) administrative data for transgender patients who received VA care from 1997 through 2014. Transgender patients were defined as individuals that had a lifetime diagnosis of any of 4 International Classification of Diseases-9 diagnosis codes associated with transgender status. Independent multivariable logistic regression models were used to explore associations of rural status with medical conditions. Veterans with transgender-related diagnoses residing in small/isolated rural towns had increased odds of tobacco use disorder (adjusted odds ratio=1.39; 95% confidence intervals, 1.09-1.78) and posttraumatic stress disorder (adjusted odds ratio=1.33; 95% confidence intervals, 1.03-1.71) compared with their urban transgender peers. Urban/rural status was not significantly associated with other medical conditions of interest. This study contributes the first empirical investigations of how place of residence is associated with medical diagnoses among veterans with transgender-related diagnoses. The importance of place as a determinant of health is increasingly clear, but for veterans with transgender-related diagnoses this line of research is currently limited. The addition of self-reported sex identity data within VA electronic health records is one way to advance this line of research.

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

    Directory of Open Access Journals (Sweden)

    Duplantie Julie

    2007-01-01

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

  2. Exploring emerging learning needs: a UK-wide consultation on environmental sustainability learning objectives for medical education.

    Science.gov (United States)

    Walpole, Sarah C; Mortimer, Frances; Inman, Alice; Braithwaite, Isobel; Thompson, Trevor

    2015-12-24

    This study aimed to engage wide-ranging stakeholders and develop consensus learning objectives for undergraduate and postgraduate medical education. A UK-wide consultation garnered opinions of healthcare students, healthcare educators and other key stakeholders about environmental sustainability in medical education. The policy Delphi approach informed this study. Draft learning objectives were revised iteratively during three rounds of consultation: online questionnaire or telephone interview, face-to-face seminar and email consultation. Twelve draft learning objectives were developed based on review of relevant literature. In round one, 64 participants' median ratings of the learning objectives were 3.5 for relevance and 3.0 for feasibility on a Likert scale of one to four. Revisions were proposed, e.g. to highlight relevance to public health and professionalism. Thirty three participants attended round two. Conflicting opinions were explored. Added content areas included health benefits of sustainable behaviours. To enhance usability, restructuring provided three overarching learning objectives, each with subsidiary points. All participants from rounds one and two were contacted in round three, and no further edits were required. This is the first attempt to define consensus learning objectives for medical students about environmental sustainability. Allowing a wide range of stakeholders to comment on multiple iterations of the document stimulated their engagement with the issues raised and ownership of the resulting learning objectives.

  3. Using visual art and collaborative reflection to explore medical attitudes toward vulnerable persons.

    Science.gov (United States)

    Kidd, Monica; Nixon, Lara; Rosenal, Tom; Jackson, Roberta; Pereles, Laurie; Mitchell, Ian; Bendiak, Glenda; Hughes, Lisa

    2016-01-01

    Vulnerable persons often face stigma-related barriers while seeking health care. Innovative education and professional development methods are needed to help change this. We describe an interdisciplinary group workshop designed around a discomfiting oil portrait, intended to trigger provocative conversations among health care students and practitioners, and we present our mixed methods analysis of participant reflections. After the workshop, participants were significantly more likely to endorse the statements that the observation and interpretive skills involved in viewing visual art are relevant to patient care and that visual art should be used in medical education to improve students' observational skills, narrative skills, and empathy with their patients. Subsequent to the workshop, significantly more participants agreed that art interpretation should be required curriculum for health care students. Qualitative comments from two groups from two different education and professional contexts were examined for themes; conversations focused on issues of power, body image/self-esteem, and lessons for clinical practice. We argue that difficult conversations about affective responses to vulnerable persons are possible in a collaborative context using well-chosen works of visual art that can stand in for a patient.

  4. Exploring the factors that influence physician technostress from using mobile electronic medical records.

    Science.gov (United States)

    Liu, Chung-Feng; Cheng, Tain-Junn; Chen, Chin-Tung

    2017-10-25

    This paper proposes an integrated model for investigating how physicians' perceived individual and technology characteristics affect their technological stress (technostress) that is derived from using mobile electronic medical records (MEMRs). Individual characteristics comprise constructs of mobile self-efficacy and technology dependence, whereas perceived technology characteristics comprise constructs of perceived usefulness, complexity, and reliability. We employed the survey method to collect 158 valid questionnaires from physicians working at three branch hospitals to determine perceptions regarding MEMRs, yielding a response rate of 33.62%. Partial least squares, a structural equation modeling technique, was used for model examination and hypothesis testing. The results show that physicians have a low perception of MEMR dependence and technostress. Furthermore, physicians' perceived MEMR technology dependency, mobile self-efficacy, and complexity were proven to significantly affect physician technostress when using MEMRs, whereas perceived usefulness and reliability were not. The explanatory power of the research model reached 67.8%. The results of this study provide valuable insights and significant knowledge for technostress in health care, particularly from academic and practical perspectives.

  5. Using visual art and collaborative reflection to explore medical attitudes toward vulnerable persons

    Directory of Open Access Journals (Sweden)

    Monica Kidd

    2016-04-01

    Full Text Available Background: Vulnerable persons often face stigma-related barriers while seeking health care. Innovative education and professional development methods are needed to help change this. Method: We describe an interdisciplinary group workshop designed around a discomfiting oil portrait, intended to trigger provocative conversations among health care students and practitioners, and we present our mixed methods analysis of participant reflections. Results: After the workshop, participants were significantly more likely to endorse the statements that the observation and interpretive skills involved in viewing visual art are relevant to patient care and that visual art should be used in medical education to improve students’ observational skills, narrative skills, and empathy with their patients.  Subsequent to the workshop, significantly more participants agreed that art interpretation should be required curriculum for health care students. Qualitative comments from two groups from two different education and professional contexts were examined for themes; conversations focused on issues of power, body image/self-esteem, and lessons for clinical practice.    Conclusions: We argue that difficult conversations about affective responses to vulnerable persons are possible in a collaborative context using well-chosen works of visual art that can stand in for a patient.

  6. Exploring the use of tablet PCs in veterinary medical education: opportunity or obstacle?

    Science.gov (United States)

    Wang, Hong; Rush, Bonnie R; Wilkerson, Melinda; van der Merwe, Deon

    2014-01-01

    A tablet PC is a laptop computer with a touch screen and a digital pen or stylus that can be used for handwritten notes and drawings. The use of tablet PCs has been investigated in many disciplines such as engineering, mathematics, science, and education. The purpose of this article is to explore student and faculty attitudes toward and experiences with tablet PCs 6 years after the implementation of a tablet PC program in the College of Veterinary Medicine (CVM) at Kansas State University (K-State). This study reports that the use of tablet PCs has enhanced students' learning experiences through learner-interface interaction, learner-content interaction, learner-instructor interaction, and learner-learner interaction. This study also identifies digital distraction as the major negative experience with tablet PCs during class time. The tablet PC program provides CVM faculty the potential to pursue technology integration strategies that support expected learning outcomes and provides students the potential to develop self-monitoring and self-discipline skills that support learning with digital technologies.

  7. Email communication at the medical primary–secondary care interface: a qualitative exploration

    Science.gov (United States)

    Sampson, Rod; Barbour, Rosaline; Wilson, Philip

    2016-01-01

    Background There is little published research into the influence of email communication between primary and secondary care clinicians on patient care. Aim To explore the use of email communication between clinicians across the primary– secondary care interface, and how this may relate to patient care. Design and setting A qualitative study involving primary and secondary care services in the NHS Highland Health Board area, Scotland. Ten GPs and 12 hospital consultants were purposively sampled to reflect diversity. Method Eligible clinicians were invited to take part in a semi-structured interview. Data were analysed using a thematic analysis approach. Results Key themes that emerged for clinicians included general perceptions of email; using email in practice (managing workload, impact on patient journeys, and ‘quick answers’); system issues (variability and governance); relational aspects; and email skills. Conclusion Email communication between primary and secondary care clinicians generally has a positive impact on patient access to specialist expertise. Governance issues around the use of clinical email need to be defined. There may currently be a two-tier health service for those patients (and their GPs) requiring ‘quick answers’. PMID:27162209

  8. Email communication at the medical primary-secondary care interface: a qualitative exploration.

    Science.gov (United States)

    Sampson, Rod; Barbour, Rosaline; Wilson, Philip

    2016-07-01

    There is little published research into the influence of email communication between primary and secondary care clinicians on patient care. To explore the use of email communication between clinicians across the primary- secondary care interface, and how this may relate to patient care. A qualitative study involving primary and secondary care services in the NHS Highland Health Board area, Scotland. Ten GPs and 12 hospital consultants were purposively sampled to reflect diversity. Eligible clinicians were invited to take part in a semi-structured interview. Data were analysed using a thematic analysis approach. Key themes that emerged for clinicians included general perceptions of email; using email in practice (managing workload, impact on patient journeys, and 'quick answers'); system issues (variability and governance); relational aspects; and email skills. Email communication between primary and secondary care clinicians generally has a positive impact on patient access to specialist expertise. Governance issues around the use of clinical email need to be defined. There may currently be a two-tier health service for those patients (and their GPs) requiring 'quick answers'. © British Journal of General Practice 2016.

  9. On the utility of 3D hand cursors to explore medical volume datasets with a touchless interface.

    Science.gov (United States)

    Lopes, Daniel Simões; Parreira, Pedro Duarte de Figueiredo; Paulo, Soraia Figueiredo; Nunes, Vitor; Rego, Paulo Amaral; Neves, Manuel Cassiano; Rodrigues, Pedro Silva; Jorge, Joaquim Armando

    2017-08-01

    Analyzing medical volume datasets requires interactive visualization so that users can extract anatomo-physiological information in real-time. Conventional volume rendering systems rely on 2D input devices, such as mice and keyboards, which are known to hamper 3D analysis as users often struggle to obtain the desired orientation that is only achieved after several attempts. In this paper, we address which 3D analysis tools are better performed with 3D hand cursors operating on a touchless interface comparatively to a 2D input devices running on a conventional WIMP interface. The main goals of this paper are to explore the capabilities of (simple) hand gestures to facilitate sterile manipulation of 3D medical data on a touchless interface, without resorting on wearables, and to evaluate the surgical feasibility of the proposed interface next to senior surgeons (N=5) and interns (N=2). To this end, we developed a touchless interface controlled via hand gestures and body postures to rapidly rotate and position medical volume images in three-dimensions, where each hand acts as an interactive 3D cursor. User studies were conducted with laypeople, while informal evaluation sessions were carried with senior surgeons, radiologists and professional biomedical engineers. Results demonstrate its usability as the proposed touchless interface improves spatial awareness and a more fluent interaction with the 3D volume than with traditional 2D input devices, as it requires lesser number of attempts to achieve the desired orientation by avoiding the composition of several cumulative rotations, which is typically necessary in WIMP interfaces. However, tasks requiring precision such as clipping plane visualization and tagging are best performed with mouse-based systems due to noise, incorrect gestures detection and problems in skeleton tracking that need to be addressed before tests in real medical environments might be performed. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Technology Development to Support Human Health and Performance in Exploration Beyond Low Earth Orbit

    Science.gov (United States)

    Kundrot, C.E.; Steinberg, S. L.; Charles, J. B.

    2011-01-01

    In the course of defining the level of risks and mitigating the risks for exploration missions beyond low Earth orbit, NASA s Human Research Program (HRP) has identified the need for technology development in several areas. Long duration missions increase the risk of serious medical conditions due to limited options for return to Earth; no resupply; highly limited mass, power, volume; and communication delays. New space flight compatible medical capabilities required include: diagnostic imaging, oxygen concentrator, ventilator, laboratory analysis (saliva, blood, urine), kidney stone diagnosis & treatment, IV solution preparation and delivery. Maintenance of behavioral health in such an isolated, confined and extreme environment requires new sensory stimulation (e.g., virtual reality) technology. Unobtrusive monitoring of behavioral health and treatment methods are also required. Prolonged exposure to weightlessness deconditions bone, muscle, and the cardiovascular system. Novel exercise equipment or artificial gravity are necessary to prevent deconditioning. Monitoring of the degree of deconditioning is required to ensure that countermeasures are effective. New technologies are required in all the habitable volumes (e.g., suit, capsule, habitat, exploration vehicle, lander) to provide an adequate food system, and to meet human environmental standards for air, water, and surface contamination. Communication delays require the crew to be more autonomous. Onboard decision support tools that assist crew with real-time detection and diagnosis of vehicle and habitat operational anomalies will enable greater autonomy. Multi-use shield systems are required to provide shielding from solar particle events. The HRP is pursuing the development of these technologies in laboratories, flight analog environments and the ISS so that the human health and performance risks will be acceptable with the available resources.

  11. At the precipice: a prospective exploration of medical students' expectations of the pre-clerkship to clerkship transition.

    Science.gov (United States)

    Soo, Jason; Brett-MacLean, Pamela; Cave, Marie-Therese; Oswald, Anna

    2016-03-01

    Medical learners face many challenging transitions. We prospectively explored students' perceptions of their upcoming transition to clerkship and their future professional selves. In 2013, 160/165 end-of-second-year medical students wrote narrative reflections and 79/165 completed a questionnaire on their perceptions of their upcoming transition to clerkship. Narratives were separately analyzed by four authors and then discussed to identify a final thematic framework using parsimonious category construction. We identified two overarching themes: (1) "Looking back": experiences which had helped students feel prepared for clerkship with subthemes focused on of patient care, shadowing, classroom teaching and the pre-clerkship years as foundational knowledge, (2) "Looking forward": anticipating the clerkship experience and the journey of becoming a physician with subthemes focused on death and dying, hierarchy, work-life balance, interactions with patients, concerns about competency and career choice. Questionnaire data revealed incongruities around expectations of minimal exposure to death and dying, little need for independent study and limited direct patient responsibility. We confirmed that internal transformations are happening in contemplative time even before clerkship. By prospectively exploring pre-clerkship students' perceptions of the transition to clerkship training we identified expectations and misconceptions that could be addressed with future curricular interventions. While students are aware of and anticipating their learning needs it is not as clear that they realise how much their future learning will depend on their own inner resources. We suggest that more attention be paid to professional identity formation and the development of the physician as a person during these critical transitions.

  12. [Nursing workplace bullying and turnover intention: an exploration of associated factors at a medical center in Southern Taiwan].

    Science.gov (United States)

    Tsai, Shiau-Ting; Han, Chin-Hua; Chen, Li-Fang; Chou, Fan-Hao

    2014-06-01

    The chronic shortage of nursing staffs in hospitals continues to increasingly and negatively impact the ability of medical care systems to deliver effective care and ensure the safety of patients. Bullying is one factor known to exacerbate turnover in the nursing workplace. This study explores workplace bullying and turnover intention among nurses working at a medical center in Southern Taiwan. A cross-sectional and correlation research design was conducted using the Negative Acts Questionnaire-Revised (NAQ-R) and the Turnover Intention Questionnaire. A convenience, purposive sample of 708 nurses was recruited. Inclusion criteria included: holding an RN license, able to communicate in both Mandarin and Hokkienese, >6 months of clinical experience, and an NAQ-R score higher than 23. Data were analyzed using SPSS19.0 software. Approximately 85% of participants had experienced some degree of workplace bullying during the previous 6-month period. The trend of the turnover intention tended to the right at a high degree. A moderate, positive, and significant correlation was found between turnover intention and bullying total scores (r=.39, pturnover intention (15.10%). Based on our findings, we suggest that nurses should enhance their awareness of the negative consequences of workplace bullying. Furthermore, hospitals should implement appropriate mechanisms to decrease the phenomenon of inter-staff bullying, improve the nursing workplace environment, and reduce the rate of turnover intention.

  13. A dialogical exploration of the grey zone of health and illness: medical science, anthropology, and Plato on alcohol consumption.

    Science.gov (United States)

    Bonner, Kieran

    2009-01-01

    This paper takes a phenomenological hermeneutic orientation to explicate and explore the notion of the grey zone of health and illness and seeks to develop the concept through an examination of the case of alcohol consumption. The grey zone is an interpretive area referring to the irremediable zone of ambiguity that haunts even the most apparently resolute discourse. This idea points to an ontological indeterminacy, in the face of which decisions have to be made with regard to the health of a person (e.g., an alcoholic), a system (e.g., the health system), or a society. The fundamental character of this notion will be developed in relation to the discourse on health and the limitations of different disciplinary practices. The case of alcohol consumption will be used to tease out the grey zone embedded in the different kinds of knowledge made available through the disciplinary traditions of medical science, with its emphasis on somatic well-being, and anthropology, with its focus on communal well-being. This tension or grey zone embedded in different knowledge outcomes will be shown to have a discursive parallel with the dialogue between the Athenian, the Spartan, and the Cretan in Plato's Laws. Making use of the dialogical approach as described by Gadamer, the Athenian's particular resolution of the tension will be explored as a case study to demonstrate the necessarily particular analysis involved in a grey zone resolution.

  14. Health research priorities in medical thesis at National University of Piura, 2010-2014

    Directory of Open Access Journals (Sweden)

    Nelson Purizaca-Rosillo

    2016-02-01

    Full Text Available OBJETIVES To determine the frequency of thesis to obtain the medical degree at the NationalUniversity of Piura (UNP whose aim was framed within the Peru's nationaland/or Piura's regionalHRP from 201Oto 2014. MATERIAL AND METHODS A cross-sectionalstudy was conducted.All thesis to obtain the medicaldegree registered at the library of the UNP and the specialized library of the human medicine faculty from 2010 to 2014 were included.According the aim of the thesis,it was determinedif it was related toa nationalor regionalHRP.We searched through Google Scholar if the thesis that met witha HRP hadbeen published in a scientific joumal. RESULTS 150 thesis were found in the study period. Only 15 (10% thesis hadas the main objective a nationalHRP and 1 (0.6% a regionalHRP.Besides,none of the thesis had been published. CONCLUSIONS Thereis a low frequency of medicalthesis that were framed within a nationaland/or regionalHRP.

  15. Virtual patient cases: to use or not to use? Exploring creators' attitudes against their use in the undergraduate medical curriculum

    Directory of Open Access Journals (Sweden)

    Areti Z. Karasmani

    2017-11-01

    Full Text Available Background: The problems and difficulties in students' education that arise from the existing undergraduate curriculum at the medical school of Aristotle University of Thessaloniki (AUTH urged the academic staff members to the pursuance of new pedagogic approaches that could revitalize medical education practice. The educational programs "mEducator", "ePBLnet" and "Ariadne" that run at AUTH laid the foundations for the development of a plenty of virtual patient (VP cases. A VP is an innovative computer simulation method that can motivate students to occupy themselves with their studies and perfect their skills. Unfortunately, despite the indisputable advantages of embedding VPs to the lessons, their utilization is neglected during the educational process at AUTH. Objective: The purpose of this study was to explore the reasons for which VP authors do not use their own VP cases. Why even VP authors avoid VPs' exploitation and in this way they forsake the insistent efforts they made through the rigorous process of VPs' creation? Methods: After study' s authorization, 35 academic staff members, who had previously developed their own VPs, signed an informed consent and fulfilled a specially designed questionnaire, mainly consisted of closed questions (answer: yes/no about the possible causes of VPs' dereliction. Results: Some 77% of participants granted that they do not utilize their own VP cases. Almost 56% of them admitted that the lack of proper infrastructures (computers, projectors and Internet connection in the lecture rooms impede VPs' use. Specifically, some 33% acknowledged the absence of access to the Internet as the only reason of VPs' abandonment. Almost 52% claimed that they do not have enough time in the courses for covering the great curriculum. Moreover, almost 30% sustained that the great number of students in the lessons enables all of them to conduct a fruitful discussion. Almost 15% asserted that they do not exploit VPs due to the

  16. Common fur and mystacial vibrissae parallel sensory pathways: 14C 2-deoxyglucose and WGA-HRP studies in the rat

    International Nuclear Information System (INIS)

    Sharp, F.R.; Gonzalez, M.F.; Morgan, C.W.; Morton, M.T.; Sharp, J.W.

    1988-01-01

    Stimulation of mystacial vibrissae in rows A,B, and C increased (14C) 2-deoxyglucose (2DG) uptake in spinal trigeminal nucleus pars caudalis (Sp5c) mostly in ventral portions of laminae III-IV with less activation of II and V. Stimulation of common fur above the whiskers mainly activated lamina II, with less activation in deeper layers. The patterns of activation were compatible with an inverted head, onion skin Sp5c somatotopy. Wheatgerm Agglutinin-Horseradish Peroxidase (WGA-HRP) injections into common fur between mystacial vibrissae rows A-B and B-C led to anterograde transganglionic labeling only of Sp5c, mainly of lamina II with less label in layer V, and very sparse label in III and IV. WGA-HRP skin injections appear to primarily label small fibers, which along with larger fibers, were metabolically activated during common fur stimulation. Mystacial vibrissae stimulation increased 2DG uptake in ventral ipsilateral spinal trigeminal nuclei pars interpolaris (Sp5i) and oralis (Sp5o) and principal trigeminal sensory nucleus (Pr5). Common fur stimulation above the whiskers slightly increased 2DG uptake in ventral Sp5i, Sp5o, and possibly Pr5. The most dorsal aspect of the ventroposteromedial (VPM) nucleus of thalamus was activated contralateral to whisker stimulation. Stimulation of the common fur dorsal to the whiskers activated a region of dorsal VPM caudal to the VPM region activated during whisker stimulation. This is consistent with previous data showing that ventral whiskers and portions of the face are represented rostrally in VPM, and more dorsal whiskers and dorsal portions of the face are represented progressively more caudally in VPM. Mystacial vibrissae stimulation activated the contralateral primary sensory SI barrelfield cortex and a separate region in the second somatosensory SII cortex

  17. Anterograde axonal transport and intercellular transfer of WGA-HRP in trigeminal-innervated sensory receptors of rat incisive papilla.

    Science.gov (United States)

    Chan, K Y; Byers, M R

    1985-04-08

    The ultrastructure and identification of WGA-HRP-labeled sensory receptors in the rat incisive papilla (the most anterior part of hard palate) were studied using semiserial thin sections. Various sensory receptors were organized according to three locations: dome region (ventral), chemosensory corpuscle region (medial to orifice of incisive canal), and lateral labium (apposing the incisive canal). In the dome region, the sensory receptors were localized in three sensory zones that were associated with surface ridges (one medial and two lateral). In each of these zones, intraepithelial receptor axons and Merkel receptors occurred in the epithelium, while simple unencapsulated corpuscles, glomerular-Meissner corpuscles, and incisive (encapsulated) corpuscles occurred in the lamina propria. In the chemosensory corpuscle region, chemosensory corpuscles and intraepithelial receptor axons were located in the epithelium, and incisive corpuscles were present in the lamina propria. In the lateral labium, only intraepithelial receptor axons were prominent. In all these sensory receptors, the preterminal axons and axon terminals were labeled with the tracer protein. In addition, some nonneuronal cells closely associated with the axon terminals were selectively labeled, e.g., terminal Schwann cells, lamellar Schwann cells, Merkel cells, corpuscular basal cells and chemosensory cells. Other adjacent cells were not labeled, e.g., unspecialized epithelial cells, capsular cells, corpuscular sustentacular cells, and fibroblasts. In both labeled axons and cells, WGA-HRP was incorporated into vesicles, tubules, and vacuolar organelles. The specific intercellular transfer of tracer protein may indicate trophic interactions between axon terminals and support cells in sensory receptors. The specific organization of multiple sensory receptors in the rat incisive papilla may provide a useful alternative system for studying somatosensory physiology.

  18. 10 CFR 712.36 - Medical assessment process.

    Science.gov (United States)

    2010-01-01

    ... and psychological evaluation. HRP medical assessments and psychological evaluations may not be... psychological assessment (test) approved by the Director, Office of Health and Safety or his or her designee and... psychological assessment (test) approved by the Director, Office of Health and Safety or his or her designee. (4...

  19. Exploring the Role of Neuroticism and Insecure Attachment in Health Anxiety, Safety-Seeking Behavior Engagement, and Medical Services Utilization

    Directory of Open Access Journals (Sweden)

    Fotios Anagnostopoulos

    2016-06-01

    Full Text Available The purpose of this study was to explore an extended interpersonal model of health anxiety, according to which health-anxious individuals are trapped in a vicious circle of health-related reassurance-seeking, alienation from others, and worry about health, while somatic absorption with body sensations, insecure attachment, neuroticism, safety-seeking behaviors, and medical services utilization were also included in the model. Data were collected from 196 Greek university students using standardized instruments. Results indicated that anxious attachment was directly related to absorption (β = .163, p < .05 and alienation (β = .204, p < .05, while avoidant attachment was directly related to absorption (β = −.344, p < .001, reassurance-seeking (β = −.130, p < .05, and alienation (β = .148, p < .05. Neuroticism was positively and significantly associated with all dimensions of health anxiety. Absorption, alienation, and anxious attachment were related to medical services utilization, which, in turn, was related to safety-seeking behaviors (β = .200, p < .01. Neuroticism and anxious attachment were also indirectly and positively associated with worry. Moreover, absorption was positively related to worry and reassurance-seeking, worry was positively related to reassurance-seeking, and alienation was positively related to worry. Study results highlight the key role that interpersonal (e.g., alienation from others and perceptual factors (e.g., the tendency to focus on bodily sensations can play in health anxiety maintenance, and the importance of anxious and avoidant attachment in safety-seeking behavior engagement. Implications of the results and suggestions for future research and practice are outlined.

  20. Manufacturing and testing of W/Cu mono-block small scale mock-up for EAST by HIP and HRP technologies

    Energy Technology Data Exchange (ETDEWEB)

    Li, Qiang [Institute of Plasma Physics, Chinese Academy of Sciences (ASIPP), Hefei, Anhui (China); Qin, Sigui [Advanced Technology and Materials Co., Ltd, Beijing (China); Wang, Wanjing; Qi, Pan [Institute of Plasma Physics, Chinese Academy of Sciences (ASIPP), Hefei, Anhui (China); Roccella, Selanna; Visca, Eliseo [Associazione EURATOM-ENEA sulla Fusione, Frascati (Italy); Liu, Guohui [Advanced Technology and Materials Co., Ltd, Beijing (China); Luo, Guang-Nan, E-mail: liqiang577@ipp.ac.cn [Institute of Plasma Physics, Chinese Academy of Sciences (ASIPP), Hefei, Anhui (China)

    2013-10-15

    ITER-like W/Cu mono-block plasma-facing components (PFCs) will be used in vertical target regions of the experimental advanced superconducting tokamak (EAST) divertor. The first W/Cu mono-block small scale mock-up with five W mono-blocks has been manufactured successfully by technological combination of hot isostatic pressing (HIP) and hot radial pressing (HRP). The joining of a W mono-block and a pure copper interlayer was achieved by means of HIP technology and the bonding strength was over 150 MPa. The good bonding between the pure copper interlayer and a CuCrZr cooling tube was obtained by means of HRP technology. In order to understand deeply the process of HRP, the stress distribution of the mock-up during HRP process was simulated using ANSYS code. Ultrasonic Nondestructive Testing (NDT) of the W/Cu and Cu/CuCrZr interfaces was performed, showing that excellent bonding of the W/Cu and Cu/CuCrZr interfaces. The thermal cycle fatigue testing of the mock-up has been carried out by means of an e-beam device in Southwest Institute of Physics, Chengdu (SWIP) and the mock-up withstood 1000 cycles of heat loads up to 8.4 MW/m{sup 2} with the cooling water of 2 m/s, 20 °C, 0.2 MPa.

  1. Genetic variation of pfhrp2 in Plasmodium falciparum isolates from Yemen and the performance of HRP2-based malaria rapid diagnostic test.

    Science.gov (United States)

    Atroosh, Wahib M; Al-Mekhlafi, Hesham M; Al-Jasari, Adel; Sady, Hany; Al-Delaimy, Ahmed K; Nasr, Nabil A; Dawaki, Salwa; Abdulsalam, Awatif M; Ithoi, Init; Lau, Yee Ling; Fong, Mun Yik; Surin, Johari

    2015-07-22

    The genetic variation in the Plasmodium falciparum histidine-rich protein 2 (pfhrp2) gene that may compromise the use of pfhrp2-based rapid diagnostic tests (RDTs) for the diagnosis of malaria was assessed in P. falciparum isolates from Yemen. This study was conducted in Hodeidah and Al-Mahwit governorates, Yemen. A total of 622 individuals with fever were examined for malaria by CareStart malaria HRP2-RDT and Giemsa-stained thin and thick blood films. The Pfhrp2 gene was amplified and sequenced from 180 isolates, and subjected to amino acid repeat types analysis. A total of 188 (30.2%) participants were found positive for P. falciparum by the RDT. Overall, 12 different amino acid repeat types were identified in Yemeni isolates. Six repeat types were detected in all the isolates (100%) namely types 1, 2, 6, 7, 10 and 12 while types 9 and 11 were not detected in any of the isolates. Moreover, the sensitivity and specificity of the used PfHRP2-based RDTs were high (90.5% and 96.1%, respectively). The present study provides data on the genetic variation within the pfhrp2 gene, and its potential impact on the PfHRP2-based RDTs commonly used in Yemen. CareStart Malaria HRP2-based RDT showed high sensitivity and specificity in endemic areas of Yemen.

  2. Exploring the Medical and Psychosocial Concerns of Adolescents and Young Adults With Craniofacial Microsomia: A Qualitative Study.

    Science.gov (United States)

    Hamilton, Kayla V; Ormond, Kelly E; Moscarello, Tia; Bruce, Janine S; Bereknyei Merrell, Sylvia; Chang, Kay W; Bernstein, Jonathan A

    2018-01-01

    This study explores the experiences of adolescents and young adults with craniofacial microsomia, including the impact of growing up with this craniofacial condition on daily life and sense of self. The results may guide future research on optimally supporting individuals with craniofacial microsomia during this critical life phase. Participants were recruited through a craniofacial center, online patient support groups, and social media sites. Eleven individual semistructured interviews with participants between 12 and 22 years old were conducted by a single interviewer, transcribed, iteratively coded, and thematically analyzed. Five themes were evident in the data: (1) impact on personal growth and character development, (2) negative psychosocial impact, (3) deciding to hide or reveal the condition, (4) desire to make personal surgical decisions, and (5) struggles with hearing loss. We identified both medical and psychosocial concerns prevalent among adolescents with craniofacial microsomia. Although adolescents with craniofacial microsomia exhibit considerable resilience, the challenges they face impact their sense of self and should be addressed through psychosocial support and counseling. Further research should investigate the potential benefit of the wider use of hearing aids, as well as the involvement of patients in decision-making about reconstructive ear surgery.

  3. Exploring perspectives on restraint during medical procedures in paediatric care: a qualitative interview study with nurses and physicians.

    Science.gov (United States)

    Svendsen, Edel Jannecke; Pedersen, Reidar; Moen, Anne; Bjørk, Ida Torunn

    2017-12-01

    The aim of this study was to explore nurses' and physicians' perspectives on and reasoning about the use of restraint during medical procedures on newly admitted preschoolers in somatic hospital care. We analysed qualitative data from individual interviews with a video recall session at the end with seven physicians and eight nurses. They had earlier participated in video recorded peripheral vein cannulations on preschool children. The data were collected between May 2012 and May 2013 at a paediatric hospital unit in Norway. The analysis resulted in three main themes: (1) disparate views on the concept of restraint and restraint use (2), ways to limit the use of physical restraint and its negative consequences, and (3) experience with the role of parents and their influence on restraint. Perspectives from both healthcare professions were represented in all the main themes and had many similarities. The results of this study may facilitate more informed and reflective discussions of restraint and contribute to higher awareness of restraint in clinical practice. Lack of guidance and scientific attention to restraint combined with conflicting interests and values among healthcare providers may result in insecurity, individual dogmatism, and a lack of shared discussions, language, and terminology.

  4. An ethnographic study exploring the role of ward-based Advanced Nurse Practitioners in an acute medical setting.

    Science.gov (United States)

    Williamson, Susan; Twelvetree, Timothy; Thompson, Jacqueline; Beaver, Kinta

    2012-07-01

    This article is a report of a study that aimed to examine the role of ward-based Advanced Nurse Practitioners and their impact on patient care and nursing practice. Revised doctor/nurse skill mix combined with a focus on improving quality of care while reducing costs has had an impact on healthcare delivery in the western world. Diverse advanced nursing practice roles have developed and their function has varied globally over the last decade. However, roles and expectations for ward-based Advanced Nurse Practitioners lack clarity, which may hinder effective contribution to practice. An ethnographic approach was used to explore the advanced nurse practitioner role. Participant observation and interviews of five ward-based Advanced Nurse Practitioners working in a large teaching hospital in the North West of England during 2009 were complemented by formal and informal interviews with staff and patients. Data were descriptive and broken down into themes, patterns and processes to enable interpretation and explanation. The overarching concept that ran through data analysis was that of Advanced Nurse Practitioners as a lynchpin, using their considerable expertise, networks and insider knowledge of health care not only to facilitate patient care but to develop a pivotal role facilitating nursing and medical practice. Sub-themes included enhancing communication and practice, acting as a role model, facilitating the patients' journey and pioneering the role. Ward-based Advanced Nurse Practitioners are pivotal and necessary for providing quality holistic patient care and their role can be defined as more than junior doctor substitutes. © 2012 Blackwell Publishing Ltd.

  5. Comparative Genomics Identifies a Novel Conserved Protein, HpaT, in Proteobacterial Type III Secretion Systems that Do Not Possess the Putative Translocon Protein HrpF

    Directory of Open Access Journals (Sweden)

    Céline Pesce

    2017-06-01

    Full Text Available Xanthomonas translucens is the causal agent of bacterial leaf streak, the most common bacterial disease of wheat and barley. To cause disease, most xanthomonads depend on a highly conserved type III secretion system, which translocates type III effectors into host plant cells. Mutagenesis of the conserved type III secretion gene hrcT confirmed that the X. translucens type III secretion system is required to cause disease on the host plant barley and to trigger a non-host hypersensitive response (HR in pepper leaves. Type III effectors are delivered to the host cell by a surface appendage, the Hrp pilus, and a translocon protein complex that inserts into the plant cell plasma membrane. Homologs of the Xanthomonas HrpF protein, including PopF from Ralstonia solanacearum and NolX from rhizobia, are thought to act as a translocon protein. Comparative genomics revealed that X. translucens strains harbor a noncanonical hrp gene cluster, which rather shares features with type III secretion systems from Ralstonia solanacearum, Paraburkholderia andropogonis, Collimonas fungivorans, and Uliginosibacterium gangwonense than other Xanthomonas spp. Surprisingly, none of these bacteria, except R. solanacearum, encode a homolog of the HrpF translocon. Here, we aimed at identifying a candidate translocon from X. translucens. Notably, genomes from strains that lacked hrpF/popF/nolX instead encode another gene, called hpaT, adjacent to and co-regulated with the type III secretion system gene cluster. An insertional mutant in the X. translucens hpaT gene, which is the first gene of a two-gene operon, hpaT-hpaH, was non-pathogenic on barley and did not cause the HR or programmed cell death in non-host pepper similar to the hrcT mutant. The hpaT mutant phenotypes were partially complemented by either hpaT or the downstream gene, hpaH, which has been described as a facilitator of translocation in Xanthomonas oryzae. Interestingly, the hpaT mutant was also complemented

  6. The Hudson River Plume: Exploring Human Impact on the Coastal Environment

    Science.gov (United States)

    McDonnell, Janice; Duncan, Ravit; Lichtenwalner, C. Sage; Dunbar, Laura

    2010-01-01

    The Hudson River Watershed contains a variety of geologic, topographic, climatic, and hydrologic features and a diversity of land-use patterns--making it an ideal model for studying human impact on the coastal environment. In this article, the authors present the Hudson River Plume (HRP), a problem-based online module that explores nonpoint-source…

  7. Accuracy of PfHRP2 versus Pf-pLDH antigen detection by malaria rapid diagnostic tests in hospitalized children in a seasonal hyperendemic malaria transmission area in Burkina Faso

    OpenAIRE

    Maltha, Jessica; Guiraud, Issa; Lompo, Palpouguini; Kaboré, Bérenger; Gillet, Philippe; Van Geet, Chris; Tinto, Halidou; Jacobs, Jan

    2014-01-01

    Background In most sub-Saharan African countries malaria rapid diagnostic tests (RDTs) are now used for the diagnosis of malaria. Most RDTs used detect Plasmodium falciparum histidine-rich protein-2 (PfHRP2), though P. falciparum-specific parasite lactate dehydrogenase (Pf-pLDH)-detecting RDTs may have advantages over PfHRP2-detecting RDTs. Only few data are available on the use of RDTs in severe illness and the present study compared Pf-pLDH to PfHRP2-detection. Methods Hospitalized children...

  8. Exploring example models of cross-sector, sessional employment of pharmacists to improve medication management and pharmacy support in rural hospitals.

    Science.gov (United States)

    Tan, Amy Cw; Emmerton, Lynne M; Hattingh, Laetitia; La Caze, Adam

    2015-01-01

    Many rural hospitals in Australia are not large enough to sustain employment of a full-time pharmacist, or are unable to recruit or retain a full-time pharmacist. The absence of a pharmacist may result in hospital nurses undertaking medication-related roles outside their scope of practice. A potential solution to address rural hospitals' medication management needs is contracted part-time ('sessional') employment of a local pharmacist external to the hospital ('cross-sector'). The aim of this study was to explore the roles and experiences of pharmacists in their provision of sessional services to rural hospitals with no on-site pharmacist and explore how these roles could potentially address shortfalls in medication management in rural hospitals. A qualitative study was conducted to explore models with pharmacists who had provided sessional services to a rural hospital. A semi-structured interview guide was informed by a literature review, preliminary research and stakeholder consultation. Participants were recruited via advertisement and personal contacts. Consenting pharmacists were interviewed between August 2012 and January 2013 via telephone or Skype for 40-55 minutes. Thirteen pharmacists with previous or ongoing hospital sessional contracts in rural communities across Australia and New Zealand participated. Most commonly, the pharmacists provided weekly services to rural hospitals. All believed the sessional model was a practical solution to increase hospital access to pharmacist-mediated support and to address medication management gaps. Roles perceived to promote quality use of medicines were inpatient consultation services, medicines information/education to hospital staff, assistance with accreditation matters and system reviews, and input into pharmaceutical distribution activities. This study is the first to explore the concept of sessional rural hospital employment undertaken by pharmacists in Australia and New Zealand. Insights from participants

  9. A Novel Conductive Poly(3,4-ethylenedioxythiophene-BSA Film for the Construction of a Durable HRP Biosensor Modified with NanoAu Particles

    Directory of Open Access Journals (Sweden)

    Fangcheng Xu

    2016-03-01

    Full Text Available In this study, we have investigated the contribution of bovine serum albumin (BSA to the durability of the electrochemically synthesized poly(3,4-ethylenedioxythiophene (PEDOT film on a platinum (Pt electrode. The electrode was capable to effectively adsorb the nano Au particles (AuNPs to form a uniform layout, which was then able to immobilize the horseradish peroxidase (HRP to construct a functional HRP/AuNPs/PEDOT(BSA/Pt biosensor. Cyclic voltammetry was employed to evaluate the performance of the biosensor through the measurement of hydrogen peroxide. Our results revealed a satisfied linear correlation between the cathodic current and the concentration of H2O2. Furthermore, the addition of oxidized form of nicotinamide adenine dinucleotide, or NAD+, as the electron transfer mediator in the detection solution could dramatically enhance the sensitivity of detection by about 35.5%. The main advantages of the current biosensor are its durability, sensitivity, reliability, and biocompatibility.

  10. Horseradish Peroxidase (HRP Immobilized Poly(aniline-co-m-aminophenol Film Electrodes–fabrication and Evaluation as Hydrogen Peroxide Sensor

    Directory of Open Access Journals (Sweden)

    Seong-Ho Choi

    2007-05-01

    Full Text Available Enzyme modified electrodes were fabricated with poly(aniline-co-m-aminophenol. Electrochemical polymerization of aniline and m-aminophenol wasperformed to get the film of copolymer on the surface of gold electrode. Modifiedelectrodes were fabricated by two methods, physical entrapment and covalent cross-linking.In one of the method, gold nanoparticles were loaded into the copolymer film andhorseradish peroxidase (HRP was immobilized into the Au nanoparticle loaded copolymerfilm through physical entrapment. In the other method, the amino and -OH groups in thecopolymer are utilized to form covalent functionalization with HRP via glutaric dialdehydeas cross-linker/mediator. The conducting copolymer/enzyme modified electrodes preparedby physical entrapment/covalent functionalization of enzyme were tested forelectrocatalytic activities towards sensing of H2O2. Amperometric results indicate thatenzyme modified electrode via physical entrapment possesses better electrocatalyticperformance over covalent functionalized enzyme electrode.

  11. Coping with adverse drug events in patients with heart failure : Exploring the role of medication beliefs and perceptions

    NARCIS (Netherlands)

    De Smedt, R. H.; Jaarsma, T.; Ranchor, A. V.; van der Meer, K.; Groenier, K. H.; Haaijer-Ruskamp, F. M.; Denig, P.

    2012-01-01

    This study describes coping strategies that patients with heart failure (HF) use to manage adverse drug events (ADEs). The included coping strategies were social support seeking, information seeking, non-adherence and taking alleviating medication. The role of beliefs about medication and ADE

  12. The cytoskeleton is disrupted by the bacterial effector HrpZ, but not by the bacterial PAMP flg22, in tobacco BY-2 cells.

    Science.gov (United States)

    Guan, Xin; Buchholz, Günther; Nick, Peter

    2013-04-01

    Plant innate immunity is composed of two layers. Basal immunity is triggered by pathogen-associated molecular patterns (PAMPs) such as the flagellin-peptide flg22 and is termed PAMP-triggered immunity (PTI). In addition, effector-triggered immunity (ETI) linked with programmed cell death and cytoskeletal reorganization can be induced by pathogen-derived factors, such as the Harpin proteins originating from phytopathogenic bacteria. To get insight into the link between cytoskeleton and PTI or ETI, this study followed the responses of actin filaments and microtubules to flg22 and HrpZ in vivo by spinning-disc confocal microscopy in GFP-tagged marker lines of tobacco BY-2. At a concentration that clearly impairs mitosis, flg22 can induce only subtle cytoskeletal responses. In contrast, HrpZ causes a rapid and massive bundling of actin microfilaments (completed in ~20 min, i.e. almost simultaneously with extracellular alkalinization), which is followed by progressive disintegration of actin cables and cytoplasmic microtubules, a loss of cytoplasmic structure, and vacuolar disintegration. Cytoskeletal disruption is proposed as an early event that discriminates HrpZ-triggered ETI-like defence from flg22-triggered PTI.

  13. Influencia del Estado de Oxidación del Ión Cobalto en la Estabilidad de Electrodos Modificados con Monocapas SAM-TOA-ANTA-Con+-HRP-NHis.

    Directory of Open Access Journals (Sweden)

    Pedro R. Matheus*

    Full Text Available Influence of state oxidation of cobalt ion in the stability electrodes modified with monolayers SAM-TOA-ANTA-Con+-HRP-NHis. Quartz Crystal Microbalance (QCM was used to investigate the adsorption of the HRP-NHis enzyme (horseradish peroxidase, which was modified by the addition of a tail of six histidine on its extreme N-terminal. The QCM operating at flow of 0.025 mL min-1 on a crystal whose gold electrode was modified with monolayers of SAM-TOA-ANTA-Co2+ and SAM-TOA-ANTA -Co3+. The oxidize form was obtained from the electrochemical oxidation of a monolayer of SAM-TOA-ANTA-Co2+. The results suggest that the HRP-NHis is attached to both monolayers in a similar way; on the contrary, the desortion of the attached protein is dramatically different. Thus, whereas the ligand-Co2+ bonds are reversible, which allows that the anchored protein is easily replaced by imidazol molecules. The 3+ oxidation state of the metal does not allow the interchange of protein by the imidazol molecules.

  14. Exploration and Practice of Systematic Medical Ethics Education for Medical Students%医学生的医德系统教育探究与实践

    Institute of Scientific and Technical Information of China (English)

    李雅梅

    2011-01-01

    Medical ethics education for medical students should be progressively more systematic, which involves education on medical ethics cognition, emotion, will, and conduct. Based on the system of which cognition is the foundation, emotion the driving force, will the endurance, and conduct the utmost purpose, ethics education and teaching in theory and practice have been carried out systematically in the process of implementation, focusing on cultivating medical students' ethics cognition and emotion, training their ethics will and finally promoting the formation of their good ethical conducts.%在医德教育中,医德认知是基础,医德情感是动力、医德意志是保证、医德行为是目的.医学生的医德系统教育,应着力培育医学生的医德认知、培养医学生的医德情感、磨练医学生的医德意志,最终促使医学生养成医德行为.

  15. Proceedings of the annual conference of Association of Medical Physicists of India (Northern Chapter) - exploring diverse applications of medical physics in cancer management: souvenir and conference proceedings

    International Nuclear Information System (INIS)

    2016-01-01

    The scientific programme under this theme is designed in such a way that stimulates both scientific intellect and clinical knowledge in the field of Medical Physics in Radiation Oncology, Radiology, Nuclear Medicine and Radiation Protection. Papers relevant to INIS are indexed separately

  16. Benefits of Medical Home Care Reaching Beyond Chronically Ill Teens: Exploring Parent Health-Related Quality of Life.

    Science.gov (United States)

    Chavez, Laura J; Grannis, Connor; Dolce, Millie; Chisolm, Deena J

    2018-03-15

    Caring for teens with special health care needs places physical and mental health burdens on parents, which can be exacerbated by the stresses of transitions to independence. Medical homes can improve teen transitions to greater self-management and reduce health care-related time and financial burdens for families. We examined the association between parent-reported teen medical home status and caregiver health-related quality of life (HRQOL). The study sample included parents or caregivers of teens with special health care needs aged 15 to 18 recruited from a pediatric Medicaid accountable care organization who participated in a survey (response rate, 40.5%). The primary outcome was parent HRQOL scores (0-100 points) measured using the Pediatric Quality of Life Inventory Family Impact Module. Medical home status was based on parent report of teen's health care meeting medical home criteria. Linear regression models were used to estimate HRQOL scores, adjusted for demographic characteristics, health literacy, and teen functional limitation. Among 488 parents, 27% reported their teen received care consistent with a medical home. Adjusted parent HRQOL scores were significantly higher among those whose teens had a medical home (74.40; 95% confidence interval, 71.31-77.48), relative to those whose teens did not (65.78; 95% confidence interval, 63.92-67.65). Medical home subscale analyses showed HRQOL scores had significant positive associations with family-centered care and coordinated care, but not other subscales. Teen medical home status was positively associated with caregiver HRQOL, suggesting that the medical home may benefit overall caregiver well-being. In particular, receiving care that was family centered and coordinated appeared to be the most beneficial. Copyright © 2018 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  17. Thank you for asking: Exploring patient perceptions of barcode medication administration identification practices in inpatient mental health settings.

    Science.gov (United States)

    Strudwick, Gillian; Clark, Carrie; McBride, Brittany; Sakal, Moshe; Kalia, Kamini

    2017-09-01

    Barcode medication administration systems have been implemented in a number of healthcare settings in an effort to decrease medication errors. To use the technology, nurses are required to login to an electronic health record, scan a medication and a form of patient identification to ensure that these correspond correctly with the ordered medications prior to medication administration. In acute care settings, patient wristbands have been traditionally used as a form of identification; however, past research has suggested that this method of identification may not be preferred in inpatient mental health settings. If barcode medication administration technology is to be effectively used in this context, healthcare organizations need to understand patient preferences with regards to identification methods. The purpose of this study was to elicit patient perceptions of barcode medication administration identification practices in inpatient mental health settings. Insights gathered can be used to determine patient-centered preferences of identifying patients using barcode medication administration technology. Using a qualitative descriptive approach, fifty-two (n=52) inpatient interviews were completed by a Peer Support Worker using a semi-structured interview guide over a period of two months. Interviews were conducted in a number of inpatient mental health areas including forensic, youth, geriatric, acute, and rehabilitation services. An interprofessional team, inclusive of a Peer Support Worker, completed a thematic analysis of the interview data. Six themes emerged as a result of the inductive data analysis. These included: management of information, privacy and security, stigma, relationships, safety and comfort, and negative associations with the technology. Patients also indicated that they would like a choice in the type of identification method used during barcode medication administration. As well, suggestions were made for how barcode medication

  18. [Exploring Flow and Supervision of Medical Instruments by Standing on Frontier of the Reform of Free Trade Zone].

    Science.gov (United States)

    Shen, Jianhua; Han, Meixian; Lu, Fei

    2017-11-30

    Shanghai Waigaoqiao Free Trade Zone as one of the special customs supervision areas of China (Shanghai) free trade pilot area, gathered a large number of general agent enterprises related to medical apparatus and instruments. This article analyzes the characteristics of special environment and medical equipment business in Shanghai Waigaoqiao Free Trade Zone in order to further implement the national administrative examination and approval reform. According to the latest requirement in laws and regulations of medical instruments, and trend of development in the industry of medical instruments, as well as research on the basis of practices of market supervision in countries around the world, this article also proposes measures about precision supervision, coordination of supervision, classification supervision and dynamic supervision to establish a new order of fair and standardized competition in market, and create conditions for establishment of allocation and transport hub of international medicine.

  19. Towards healthy learning climates in postgraduate medical education: exploring the role of hospital-wide education committees

    NARCIS (Netherlands)

    Silkens, Milou E. W. M.; Lombarts, Kiki M. J. M. H.; Scherpbier, Albert J. J. A.; Heineman, Maas Jan; Arah, Onyebuchi A.

    2017-01-01

    Background: Postgraduate medical education prepares residents for delivery of high quality patient care during training as well as for later practice, which makes high quality residency training programs crucial to safeguard patient care. Healthy learning climates contribute to high quality

  20. ENCAPSULATION OF HORSERADISH PEROXIDASE-GLUCOSE OXIDASE (HRP-GOx IN SILICA AQUAGEL SYNTHESIZED FROM RICE HULL ASH FOR ENZYMATIC REACTION OF GLUCOSE

    Directory of Open Access Journals (Sweden)

    Nuryono Nuryono

    2010-06-01

    Full Text Available In recent years, the sol-gel technique has attracted increasing interest as a unique approach to immobilize biomolecules for bioanalytical applications as well as biochemical and biophysical studies. In this research, encapsulation of Horseradish peroxidase-Glucose oxidase (HRP-GOx enzymes in silica aquagel from rice hull ash by sol-gel process has been carried out. In addition, the effect of several parameters (weight ratio of HRP to GOx, pH, temperature, sodium ion concentration on enzyme activity was studied, as well. Rice hull ash, which was produced by ashing at 700 °C, was extracted it's silika by NaOH solution 1 M at 100 °C for two hours to produce sodium silikate (Na2SiO3 solution. The Na2SiO3 solution with pH of 13 was added with a strong cation exchanger resin, to produce sol solution with the pH of 4. Encapsulation was emphasized by mixing sol solution and phosphate buffer pH 7 containing HRP-GOx solution at volume ratio of buffer to sol solution 1:5. The mixture was transferred into 96-microwell plate and was aged for 24 hours. Enzymatic reaction was carried out by adding chromogenic solution of phenol and 4-aminoantipyrine (4-AAP and b-D-glucose solution (as substrate into the microwell. Enzymatic activity was examined by measuring absorbance of product solution at 490 nm with ELISA reader. Result of enzymatic activity for encapsulated enzymes (SGE was compared to that for free enzymes (EB. Results showed that at the investigated condition, HRP-GOx enzymes gave high activity at weight ratio of HRP to GOx 10:1 and pH 7 for both SGE and EB. Encapsulation caused the enzymes activity decrease to 53.0±0.2 %. However, SGE was observed to be more stable on pH and temperature changes than EB. Study on the effect of sodium concentration showed that the increase of sodium concentration from 0.10 to 0.37 M decreased the enzymatic activity to 56±0.2%. Reusability test showed that the synthesized SGE was reusable with activity decrease of 60

  1. Effect of BMI and body weight on pregnancy rates with LNG as emergency contraception: analysis of four WHO HRP studies.

    Science.gov (United States)

    Festin, Mario Philip R; Peregoudov, Alexandre; Seuc, Armando; Kiarie, James; Temmerman, Marleen

    2017-01-01

    To estimate the effect of increased body weight and body mass index (BMI) on pregnancy rates with levonorgestrel (LNG) 1.5mg used as emergency contraception (EC). The study reviewed data from 6873 women in four WHO-HRP randomized trials on EC conducted between 1993 and 2010. Participants took either 1.5mg of LNG as a single dose or in two doses 12h apart, up to 120h of unprotected intercourse. Contraceptive efficacy (pregnancy rates) at different weight and BMI categories was evaluated. Overall pregnancy rate was low at 1.2%. Pregnancy rates were also low in women weighing over 80kg (0.7%) and who were obese (BMI over 30kg/m 2 ) (2.0%). The pooled analyses for pregnancy demonstrated that BMI over 30kg/m 2 decreased efficacy significantly (odds ratio 8.27, 95% confidence interval = 2.70-25.37) when compared to women in lower BMI categories, mainly influenced by pregnancies in obese women from one study site. Sensitivity analyses excluding that site showed that obesity was no longer a risk factor; however, the other studies included too few obese women in the sample to exclude a substantial decrease in efficacy. Pregnancy rates with use of LNG 1.5mg for EC were low at less than 3% across different weight and BMI categories. Pooled analyses showed an increase in pregnancy rates among obese women (BMI more than 30kg/m 2 ) compared to women with normal BMI levels, influenced by pregnancies all coming from one study site. Access to LNG as EC should still be promoted to women who need them, and not be restricted in any weight or BMI category, with additional attention for counselling and advice for obese women. Copyright © 2016. Published by Elsevier Inc.

  2. A balancing act: a phenomenological exploration of medical students' experiences of using mobile devices in the clinical setting.

    Science.gov (United States)

    Rashid-Doubell, F; Mohamed, S; Elmusharaf, K; O'Neill, C S

    2016-05-03

    The aims of this study were to describe the experiences of senior students using mobile devices in a clinical setting while learning and interacting with clinical teachers, patients and each other, and to identify challenges that facilitated or impeded the use of such devices in the hospital. Interpretative phenomenology was chosen to guide our enquiry. Semi-structured interviews were conducted to examine the experiences of five senior medical students using mobile devices in the clinical setting. Senior medical students at an international medical school in the Middle East. Three main themes emerged from the data analysis: learning; professional identity and transitioning from student to doctor. The findings showed that using mobile devices in the clinical area as a learning tool was not a formalised process. Rather, it was opportunistic learning at the bedside and on occasion a source of distraction from clinical teaching. Students needed to negotiate relationships between themselves, the clinical teacher and patients in order to ensure that they maintained an acceptable professional image. Participants experienced and negotiated the change from student to doctor making them mindful of using their devices at the bedside. Mobile devices are part of daily life for a medical student and there is a need to adapt medical education in the clinical setting, to allow the students to use their devices in a sensitive manner. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  3. Exploring the usage of a mobile phone application in transplanted patients to encourage medication compliance and education.

    Science.gov (United States)

    Zanetti-Yabur, Alana; Rizzo, Amanda; Hayde, Nicole; Watkins, Anthony C; Rocca, Juan P; Graham, Jay A

    2017-10-01

    Medication non-adherence in transplant patients is a grave problem that results in increased rejection episodes, graft loss and significant morbidity. The efficacy of users and non-users of a mobile phone application (mobile app) in promoting medication adherence was investigated. The Beliefs about Medicine Questionnaire (BMQ) and Morisky Medication Adherence Scale (MMAS-8) were used in these cohorts to assess the predilection for poor adherence. Serum tacrolimus, creatinine levels, and rejection episodes were also recorded. Lastly, the patients were tested on their recall of their immunosuppression. Overall, patients had extremely negative beliefs about medication reflected in their tendency toward higher predicted rates of non-adherence. Interestingly, though not significant, app users had higher rates of medication recollection. The high-risk nature of this population demands efforts to abrogate non-adherence. Caregivers are charged with the responsibility to offer patients a feasible option to safeguard treatment compliance. Mobile apps are a potentially powerful tool, which can be used to decrease non-adherence. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. A pilot study exploring awareness among general public toward issues related to medication safety in the state of Penang, Malaysia

    Directory of Open Access Journals (Sweden)

    Mohamed Azmi Hassali

    2012-01-01

    Full Text Available Context: A better understanding of medication safety ensures better health state among healthcare consumers. Aim: The study aims to assess general public awareness toward issues related to medication safety. Settings and Design: A cross-sectional study was conducted among general public selected conveniently in the state of Penang, Malaysia. Materials and methods: A total of 500 respondents were approached and 476 consumers participated in the survey giving a response rate of 95.2%. Statistical analysis: Data were analyzed by using SPSS version 12.0 and descriptive statistics were reported where appropriate. Results: Majority of the respondents (n=292, 61.3% stated that they were well aware of the possible side effects of their current medications. A total of 196 respondents (41.17% believed that all medicines registered in Malaysia are safe to use as these medicines have no side effects. About 40.33% (n=192 of the respondents claimed that they share their unused medicines with family and friends who are having similar illness. Majority of respondents 57.7% (n=275 were satisfied with the drug information provided by the healthcare professionals. This study also found that more than 80% of the respondents (n=409 did report that they read the labels of their medication before using. Conclusions: In this study, it was revealed that there is a moderate level of public knowledge regarding medication safety. It is evident that public underestimates the risk of their medications. There is a general lack of awareness and understanding among the public especially toward side effects.

  5. A qualitative exploration of how Canadian informal caregivers in medical tourism use experiential resources to cope with providing transnational care.

    Science.gov (United States)

    Whitmore, Rebecca; Crooks, Valorie A; Snyder, Jeremy

    2017-01-01

    Canadians travelling abroad for privately arranged surgeries paid for out-of-pocket are engaging in what has come to be known as medical tourism. They are often accompanied by friends or family members, who we call caregiver-companions. Caregiver-companions provide care in and across a variety of formal and informal settings, such as in hotels, airplanes and at home. This qualitative study examines the experiences of informal caregivers in medical tourism to learn more about the lived experiences or 'experiential resources' they draw upon to cope with providing care and avoiding caregiver burden. The care-giving literature has demonstrated that such burden can negatively impact caregivers' well-being. The unique, transnational context of care-giving in medical tourism and recent growth in popularity of this practice means that there are few supports or resources currently in place to assist informal caregivers. In this article, we report on an analysis that sought to detail how caregiver-companions draw upon their previous lived experiences to cope with providing transnational care and to minimise or avoid the onset of caregiver burden. We conducted semi-structured telephone interviews with 20 Canadians who had accompanied their friends or family members abroad for surgery between September 2013 and January 2014. Thematic analysis revealed the ways that participants had developed practical strategies to deal with the challenges they faced in medical tourism. The interviews revealed three important experiential resources drawn upon by participants: (i) previous experiences of international travel; (ii) previous experiences of informal care-giving; and (iii) dimensions of the existing relationship with the care recipient. Differences in access to and use of these experiential resources related to participants' perspectives on medical tourism and the outcomes of the trip. By identifying the experiential resources drawn upon by informal caregivers in medical tourism

  6. Exploring medical undergraduates' perceptions of the educational value of a novel ENT iBook: a qualitative study.

    Science.gov (United States)

    Al-Hussaini, Ali; Tomkinson, Alun

    2016-01-01

    Undergraduate otolaryngology exposure is limited. It may be consolidated by the use of an iBook as a self-study tool. Following invitation to participate by email, five focus groups were formed, each consisting of six medical students (18 female, 12 male, median age 23 years). The focus group transcripts were imported to the qualitative data analysis software NVivo (QSR International, UK). The iBook was found to have a clear and consistent presentation, and a focused and user-friendly style, with reasonable interactivity and a good range of well-integrated media elements. It was, overall, perceived to be a valuable educational resource by the medical students.

  7. A mixed methods exploration of family involvement in medical care for older adults with serious mental illness

    NARCIS (Netherlands)

    Aschbrenner, K.A.; Pepin, R.; Mueser, K.T.; Naslund, J.A.; Rolin, S.A.; Faber, M.J.; Bartels, S.J.

    2014-01-01

    OBJECTIVE: Many older persons with serious mental illness (SMI) suffer from high rates of comorbid medical conditions. Although families play a critical role in psychiatric illness management among adults with SMI, their contributions to improving health outcomes in this population has received

  8. Quality management of medical specialist care in the Netherlands : an explorative study of its nature and development

    NARCIS (Netherlands)

    N.S. Klazinga (Niek)

    1996-01-01

    textabstractIn January 1985, the author of this study was employed as a scientific staff member at CBO, the Dutch National Organisation for Quality Assurance in Hospitals. His main job was to support peer review committees of medical specialists in hospitals. The task proved to be challenging and

  9. Using item response theory to explore the psychometric properties of extended matching questions examination in undergraduate medical education

    Directory of Open Access Journals (Sweden)

    Lawton Gemma

    2005-03-01

    Full Text Available Abstract Background As assessment has been shown to direct learning, it is critical that the examinations developed to test clinical competence in medical undergraduates are valid and reliable. The use of extended matching questions (EMQ has been advocated to overcome some of the criticisms of using multiple-choice questions to test factual and applied knowledge. Methods We analysed the results from the Extended Matching Questions Examination taken by 4th year undergraduate medical students in the academic year 2001 to 2002. Rasch analysis was used to examine whether the set of questions used in the examination mapped on to a unidimensional scale, the degree of difficulty of questions within and between the various medical and surgical specialties and the pattern of responses within individual questions to assess the impact of the distractor options. Results Analysis of a subset of items and of the full examination demonstrated internal construct validity and the absence of bias on the majority of questions. Three main patterns of response selection were identified. Conclusion Modern psychometric methods based upon the work of Rasch provide a useful approach to the calibration and analysis of EMQ undergraduate medical assessments. The approach allows for a formal test of the unidimensionality of the questions and thus the validity of the summed score. Given the metric calibration which follows fit to the model, it also allows for the establishment of items banks to facilitate continuity and equity in exam standards.

  10. Mindfulness training for medical students in their clinical clerkships: two cross-sectional studies exploring interest and participation

    NARCIS (Netherlands)

    Dijk, I. van; Lucassen, P.L.B.J.; Speckens, A.E.M.

    2015-01-01

    BACKGROUND: So far, studies investigating Mindfulness Based Stress Reduction (MBSR) training in medical students are conducted in self-selected, pre-clinical samples, with modest response rates without collecting data on non-participants. This study first examines interest and participation rates of

  11. Exploring the evidence base for how people with dementia and their informal carers manage their medication in the community: a mixed studies review.

    Science.gov (United States)

    Aston, Lydia; Hilton, Andrea; Moutela, Tiago; Shaw, Rachel; Maidment, Ian

    2017-10-18

    Little is known about the general medicines management issues for people with dementia living in the community. This review has three aims: firstly to explore and evaluate the international literature on how people with dementia manage medication; assess understanding of medicines management from an informal carers perspective; and lastly to understand the role that healthcare professionals play in assisting this population with medicines management. A mixed studies review was conducted. Web of Knowledge, PubMed and Cochrane Library were searched post-1999 for studies that explored medicines management in people with dementia dwelling in the community, and the role healthcare professionals play in supporting medicines management in people with dementia. Following screening, nine articles were included. Data from included studies were synthesised using a convergent synthesis approach and analysed thematically to combine findings from studies using a range of methods (qualitative, quantitative and mixed methods). Four themes were generated from the synthesis: The nature of the disease and the effects this had on medicines management; the additional responsibilities informal carers have; informal caregivers' knowledge of the importance of managing medication and healthcare professionals' understanding of medicines management in people with dementia. Consequently, these were found to affect management of medication, in particular adherence to medication. This review has identified that managing medication for people with dementia dwelling in the community is a complex task with a frequently associated burden on their informal caregivers. Healthcare professionals can be unaware of this burden. The findings warrant the need for healthcare professionals to undergo further training in supporting medicines management for people with dementia in their own homes.

  12. Concept of Operations Evaluation for Mitigating Space Flight-Relevant Medical Issues in a Planetary Habitat

    Science.gov (United States)

    Barsten, Kristina; Hurst, Victor, IV; Scheuring, Richard; Baumann, David K.; Johnson-Throop, Kathy

    2010-01-01

    Introduction: Analogue environments assist the NASA Human Research Program (HRP) in developing capabilities to mitigate high risk issues to crew health and performance for space exploration. The Habitat Demonstration Unit (HDU) is an analogue habitat used to assess space-related products for planetary missions. The Exploration Medical Capability (ExMC) element at the NASA Johnson Space Center (JSC) was tasked with developing planetary-relevant medical scenarios to evaluate the concept of operations for mitigating medical issues in such an environment. Methods: Two medical scenarios were conducted within the simulated planetary habitat with the crew executing two space flight-relevant procedures: Eye Examination with a corneal injury and Skin Laceration. Remote guidance for the crew was provided by a flight surgeon (FS) stationed at a console outside of the habitat. Audio and video data were collected to capture the communication between the crew and the FS, as well as the movements of the crew executing the procedures. Questionnaire data regarding procedure content and remote guidance performance also were collected from the crew immediately after the sessions. Results: Preliminary review of the audio, video, and questionnaire data from the two scenarios conducted within the HDU indicate that remote guidance techniques from an FS on console can help crew members within a planetary habitat mitigate planetary-relevant medical issues. The content and format of the procedures were considered concise and intuitive, respectively. Discussion: Overall, the preliminary data from the evaluation suggest that use of remote guidance techniques by a FS can help HDU crew execute space exploration-relevant medical procedures within a habitat relevant to planetary missions, however further evaluations will be needed to implement this strategy into the complete concept of operations for conducting general space medicine within similar environments

  13. Exploring the use of smartphones and tablets by medical House Officers in Korle-Bu Teaching Hospital.

    Science.gov (United States)

    Barnor-Ahiaku, Edem

    2016-03-01

    Smartphones and tablets are being used widely in the Western World creating benefits in healthcare. The Ministry of Health in Ghana has an e-Health strategy, with the aim of integrating such resources into healthcare. Whilst there are numerous mHealth projects going on in Ghana, there is little evidence of doctors using such devices in their practice. A qualitative study was undertaken in Korle-Bu Teaching Hospital. Random sampling was used to identify House Officers, who engaged in semi-structured interviews. Interviews were recorded, transcribed and analysed using thematic content analysis. Consent was gained from all participants and the University of Leeds granted ethical approval. The results demonstrate that current House Officers began using smartphones and tablets at various stages during medical school. Their use has increased since qualification. Although the overall use has increased, some staff remain resistant to the use of smartphones and tablets. In the future, the integration of smartphones and tablets into medical practice can be improved by integration with the medical curriculum and accepted practice. House Officers are routinely using smartphones and tablets to assist them in their daily practice. The use is informal and is peer led. Whilst they bring many benefits, there are issues, which need to be addressed. In Korle-Bu Teaching Hospital integrating smartphone and tablet use into practice is feasible and would prove beneficial.

  14. Practice Report / Bericht aus der Praxis: An exploration of peer tutor roles and recruitment at German medical schools.

    Science.gov (United States)

    Alvarez, Simone; Schultz, Jobst-Hendrik

    2017-11-01

    Almost all medical faculties in Germany actively employ peer tutors. However, little is known about the roles these tutors play from a faculty point of view. Also, there are only few descriptions of the tutor recruitment and selection processes. 32 of the medical faculties in Germany, where tutors are used in the training of medical students, were asked to provide information on the role and recruitment of tutors by means of a partially standardized questionnaire. At the surveyed faculties (return rate 28%), tutors are mostly employed for the purpose of teaching staff support. Even though desired in individual cases, tutors rarely play an active role in curriculum- or faculty development. The way tutor recruitment is handled strongly depends on the capabilities of the individual faculties and the way tutors are utilized. In many cases this process is structured, consisting of written and oral application phases, in other cases recruitment takes place without formal application procedures. The selection criteria, however, were found to be very similar at most faculties. The role of tutors from the faculties' point of view depends strongly on the respective nature of the tutorials, which are just as diverse as the approaches to tutor recruitment. Copyright © 2017. Published by Elsevier GmbH.

  15. Exploring Summer Medical Care Within the National Collegiate Athletic Association Division I Setting: A Perspective From the Athletic Trainer.

    Science.gov (United States)

    Mazerolle, Stephanie M; Eason, Christianne M; Goodman, Ashley

    2016-02-01

    Over the last few decades, the National Collegiate Athletics Association (NCAA) has made changes related to the increase in sanctioned team activities during summer athletics. These changes may affect how athletic training services are provided. To investigate the methods by which athletic training departments of NCAA institutions manage expectations regarding athletic training services during the summer. Mixed-methods qualitative and quantitative study. The NCAA Division I. Twenty-two athletic trainers (13 men, 9 women) participated. All were employed full time within the NCAA Division I setting. Participants were 35 ± 8 years of age (range, 26-52 years), with 12 ± 7 years (range, 3-29 years) of athletic training experience. All participants completed a series of questions online that consisted of closed- (demographic and Likert-scale 5-point) and open-ended items that addressed the research questions. Descriptive statistics, frequency distributions, and phenomenologic analyses were completed with the data. Peer review and multiple-analyst triangulation established credibility. Summer athletic training services included 3 primary mechanisms: individual medical care, shared medical care, or a combination of the 2. Participants reported working 40 ± 10 hours during the summer. Likert-item analysis showed that participants were moderately satisfied with their summer medical care structure (3.3 ± 1.0) and with the flexibility of summer schedules (3.0 ± 1.2). Yet the qualitative analysis revealed that perceptions of summer medical care were more positive for shared-care participants than for individual- or combination-care participants. The perceived effect on the athletic trainer included increased workload and expectations and a negative influence on work-life balance, particularly in terms of decreased schedule flexibility and opportunities for rejuvenation. For many, the summer season mimicked the hours, workload, and expectations of the nontraditional season

  16. Exploring Summer Medical Care Within the National Collegiate Athletic Association Division I Setting: A Perspective From the Athletic Trainer

    Science.gov (United States)

    Mazerolle, Stephanie M.; Eason, Christianne M.; Goodman, Ashley

    2016-01-01

    Context:  Over the last few decades, the National Collegiate Athletics Association (NCAA) has made changes related to the increase in sanctioned team activities during summer athletics. These changes may affect how athletic training services are provided. Objective:  To investigate the methods by which athletic training departments of NCAA institutions manage expectations regarding athletic training services during the summer. Design:  Mixed-methods qualitative and quantitative study. Setting:  The NCAA Division I. Patients or Other Participants:  Twenty-two athletic trainers (13 men, 9 women) participated. All were employed full time within the NCAA Division I setting. Participants were 35 ± 8 years of age (range, 26−52 years), with 12 ± 7 years (range, 3−29 years) of athletic training experience. Data Collection and Analysis:  All participants completed a series of questions online that consisted of closed- (demographic and Likert-scale 5-point) and open-ended items that addressed the research questions. Descriptive statistics, frequency distributions, and phenomenologic analyses were completed with the data. Peer review and multiple-analyst triangulation established credibility. Results:  Summer athletic training services included 3 primary mechanisms: individual medical care, shared medical care, or a combination of the 2. Participants reported working 40 ± 10 hours during the summer. Likert-item analysis showed that participants were moderately satisfied with their summer medical care structure (3.3 ± 1.0) and with the flexibility of summer schedules (3.0 ± 1.2). Yet the qualitative analysis revealed that perceptions of summer medical care were more positive for shared-care participants than for individual- or combination-care participants. The perceived effect on the athletic trainer included increased workload and expectations and a negative influence on work-life balance, particularly in terms of decreased schedule flexibility and

  17. Mollie Lentaigne, the nurse who drew McIndoe's Guinea pigs: Exploring the role of a medical artist at the Queen Victoria Hospital, 1940-1945.

    Science.gov (United States)

    Baldwin, Alexander J

    2018-04-16

    Mollie Lentaigne was a medical artist who worked at the Queen Victoria Hospital in East Grinstead during the Second World War alongside Archibald McIndoe and his dedicated team. She drew hundreds of medical illustrations for McIndoe and his fellow surgeons during the years between 1940 and 1945. Her illustrations depict the plastic surgery that was carried out in that hospital on the badly burnt RAF servicemen injured during the war that took place in the skies over Europe, which included many aircrew injured during the Battle of Britain. This project looks at the career of Lentaigne and her role within the surgical team in East Grinstead during that era and explores a number of Lentaigne's illustrations whilst providing context as to the procedures and patients depicted. An examination of Lentaigne's story, using an interview conducted by the author with the artist offers an alternative perspective with which to observe the events that unfolded in East Grinstead during that conflict. An analysis of these images shows the ability of this artist to portray relatively complex operations with a series of simple pencil or ink diagrams whilst also skilfully engaging the observer's sense of touch. The ability of a medical artist to be selective with her illustrations allowed them to provide clearer, less cluttered images that were preferred by McIndoe when recording the specific surgical procedures for use in the patient's medical records. Copyright © 2018 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  18. Exploring the beliefs underlying attitudes to active voluntary euthanasia in a sample of Australian medical practitioners and nurses: a qualitative analysis.

    Science.gov (United States)

    White, Katherine M; Wise, Susi E; Young, Ross McD; Hyde, Melissa K

    A qualitative study explored beliefs about active voluntary euthanasia (AVE) in a sample (N = 18) of medical practitioners and nurses from Australia, where AVE is not currently legal. Four behaviors relating to AVE emerged during the interviews: requesting euthanasia for oneself, legalizing AVE, administering AVE to patients if it were legalized, and discussing AVE with patients if they request it. Using thematic analysis, interviews were analyzed for beliefs related to advantages and disadvantages of performing these AVE behaviors. Medical practitioners and nurses identified a number of similar benefits for performing the AVE-related behaviors, both for themselves personally and as health professionals. Benefits also included a consideration of the positive impact for patients, their families, and the health care system. Disadvantages across behaviors focused on the potential conflict between those parties involved in the decision making process, as well as conflict between one's own personal and professional values.

  19. Evaluating the Effects of Medical Explorers a Case Study Curriculum on Critical Thinking, Attitude Toward Life Science, and Motivational Learning Strategies in Rural High School Students

    Science.gov (United States)

    Brand, Lance G.

    2011-12-01

    The purpose of this study was three-fold: to measure the ability of the Medical Explorers case-based curriculum to improve higher order thinking skills; to evaluate the impact of the Medical Explorers case-based curriculum to help students be self directed learners; and to investigate the impact of the Medical Explorers case-based curriculum to improve student attitudes of the life sciences. The target population for this study was secondary students enrolled in advanced life science programs. The resulting sample (n = 71) consisted of 36 students in the case-based experimental group and 35 students in the control group. Furthermore, this study employed an experimental, pretest-posttest control group research design. The treatment consisted of two instructional strategies: case-based learning and teacher-guided learning. Analysis of covariance indicated no treatment effect on critical thinking ability or Motivation and Self-regulation of Learning. However, the Medical Explorers case-based curriculum did show a treatment effect on student attitudes toward the life sciences. These results seem to indicate that case-based curriculum has a positive impact on students' perspectives and attitudes about the study of life science as well as their interest in life science based careers. Such outcomes are also a good indicator that students enjoy and perceive the value to use of case studies in science, and because they see value in the work that they do they open up their minds to true learning and integration. Of additional interest was the observationthat on average eleventh graders showed consistently stronger gains in critical thinking, motivation and self-regulation of learning strategies, and attitudes toward the life sciences as compared to twelfth grade students. In fact, twelfth grade students showed a pre to post loss on the Watson-Glaser and the MSLQ scores while eleventh grade students showed positive gains on each of these instruments. This decline in twelfth

  20. Training reproductive health professionals in a post-conflict environment: exploring medical, nursing, and midwifery education in Mogadishu, Somalia.

    Science.gov (United States)

    Yalahow, Abdiasis; Hassan, Mariam; Foster, Angel M

    2017-11-01

    Following two decades of civil war, Somalia recently entered the post-conflict rebuilding phase that has resulted in the rapid proliferation of higher education institutions. Given the high maternal mortality ratio, the federal government has identified the reproductive health education of health service professionals as a priority. Yet little is known about the coverage of contraception, abortion, pregnancy, childbirth, and sexual and gender-based violence (SGBV) in medicine, nursing, or midwifery. In 2016, we conducted a multi-methods study to understand the reproductive health education and training landscape and identify avenues by which development of the next generation of health service professionals could be improved. Our study comprised two components: interviews with 20 key informants and 7 focus group discussions (FGDs) with 48 physicians, nurses, midwives, and medical students. Using the transcripts, memos, and field notes, we employed a multi-phased approach to analyse our data for content and themes. Our findings show that reproductive health education for medical and nursing students is inconsistent and significant content gaps, particularly in abortion and SGBV, exist. Students have few clinical training opportunities and the overarching challenges plaguing higher education in Somalia also impact health professions programmes in Mogadishu. There is currently a window of opportunity to develop creative strategies to improve the breadth and depth of evidence-based education and training, and multi-stakeholder engagement and the promotion of South-South exchanges appear warranted.

  1. International Space Station Medical Projects - Full Services to Mars

    Science.gov (United States)

    Pietrzyk, R. A.; Primeaux, L. L.; Wood, S. J.; Vessay, W. B.; Platts, S. H.

    2018-01-01

    The International Space Station Medical Projects (ISSMP) Element provides planning, integration, and implementation services for HRP research studies for both spaceflight and flight analog research. Through the implementation of these two efforts, ISSMP offers an innovative way of guiding research decisions to meet the unique challenges of understanding the human risks to space exploration. Flight services provided by ISSMP include leading informed consent briefings, developing and validating in-flight crew procedures, providing ISS crew and ground-controller training, real-time experiment monitoring, on-orbit experiment and hardware operations and facilitating data transfer to investigators. For analog studies at the NASA Human Exploration Research Analog (HERA), the ISSMP team provides subject recruitment and screening, science requirements integration, data collection schedules, data sharing agreements, mission scenarios and facilities to support investigators. The ISSMP also serves as the HRP interface to external analog providers including the :envihab bed rest facility (Cologne, Germany), NEK isolation chamber (Moscow, Russia) and the Antarctica research stations. Investigators working in either spaceflight or analog environments requires a coordinated effort between NASA and the investigators. The interdisciplinary nature of both flight and analog research requires investigators to be aware of concurrent research studies and take into account potential confounding factors that may impact their research objectives. Investigators must define clear research requirements, participate in Investigator Working Group meetings, obtain human use approvals, and provide study-specific training, sample and data collection and procedures all while adhering to schedule deadlines. These science requirements define the technical, functional and performance operations to meet the research objectives. The ISSMP maintains an expert team of professionals with the knowledge and

  2. A multi-institutional study exploring the impact of positive mental health on medical students' professionalism in an era of high burnout.

    Science.gov (United States)

    Dyrbye, Liselotte N; Harper, William; Moutier, Christine; Durning, Steven J; Power, David V; Massie, F Stanford; Eacker, Anne; Thomas, Matthew R; Satele, Daniel; Sloan, Jeff A; Shanafelt, Tait D

    2012-08-01

    Although burnout is associated with erosion of professionalism and serious personal consequences, whether positive mental health can enhance professionalism and how it shapes personal experience remain poorly understood. The study simultaneously explores the relationship between positive mental health and burnout with professionalism and personal experience. The authors surveyed 4,400 medical students at seven U.S. medical schools in 2009 to assess mental health (categorized as languishing, moderate, and flourishing) and burnout. Additional items explored professional behaviors, beliefs, suicidal ideation, and serious thoughts of dropping out. A total of 2,682/4,400 (61%) responded. Prevalence of suicidal ideation (55/114 [48.2%], 281/1,128 [24.9%], and 127/1,409 [9.1%]) and serious thoughts of dropping out (15/114 [13.2%], 30/1,128 [2.7%], and 14/1,409 [1.0%]) decreased as mental health improved from languishing, moderate, and flourishing, respectively (all P mental health persisted independent of burnout (all P mental health improved, the prevalence of unprofessional behaviors (i.e., cheating and dishonest behaviors) also declined, whereas students' altruistic beliefs regarding physicians' responsibility toward society improved. For example, 33/113 (29.2%), 426/1,120 (38.0%), and 718/1,391 (51.6%) of students with languishing, moderate, and flourishing mental health endorsed all five altruistic professional beliefs (P mental health persisted among students with burnout, whereas fewer relationships were found among students without burnout. Findings suggest that positive mental health attenuates some adverse consequences of burnout. Medical student wellness programs should aspire to prevent burnout and promote mental health.

  3. Giving Voice to the Medically Under-Served: A Qualitative Co-Production Approach to Explore Patient Medicine Experiences and Improve Services to Marginalized Communities.

    Science.gov (United States)

    Latif, Asam; Tariq, Sana; Abbasi, Nasa; Mandane, Baguiasri

    2018-01-27

    With an aging population, the appropriate, effective and safe use of medicines is a global health priority. However, "'medically under-served" patients continue to experience significant inequalities around access to healthcare services. This study forms part of a wider project to co-develop and evaluate a digital educational intervention for community pharmacy. The aim of this paper is to explore the medicine needs of patients from marginalized communities and suggest practical way on how services could be better tailored to their requirements. Following ethical approval, qualitative data was gathered from: (1) workshops with patients and professionals ( n = 57 attendees); and (2) qualitative semi-structured interviews (10 patients and 10 pharmacists). Our findings revealed that patients from marginalized communities reported poor management of their medical conditions and significant problems with adherence to prescribed medicines. Their experience of pharmacy services was found to be variable with many experiencing discrimination or disadvantage as a result of their status. This study highlights the plight of medically under-served communities and the need for policy makers to tailor services to an individual's needs and circumstances. Furthermore, patients and professionals can work in collaboration using a co-production approach to develop educational interventions for pharmacy service improvements.

  4. A novel sandwich-type electrochemical aptasensor based on GR-3D Au and aptamer-AuNPs-HRP for sensitive detection of oxytetracycline.

    Science.gov (United States)

    Liu, Su; Wang, Yu; Xu, Wei; Leng, Xueqi; Wang, Hongzhi; Guo, Yuna; Huang, Jiadong

    2017-02-15

    In this paper, a novel sandwich-type electrochemical aptasensor has been fabricated and applied for sensitive and selective detection of antibiotic oxytetracycline (OTC). This sensor was based on graphene-three dimensional nanostructure gold nanocomposite (GR-3D Au) and aptamer-AuNPs-horseradish peroxidase (aptamer-AuNPs-HRP) nanoprobes as signal amplification. Firstly, GR-3D Au film was modified on glassy carbon electrode only by one-step electrochemical coreduction with graphite oxide (GO) and HAuCl 4 at cathodic potentials, which enhanced the electron transfer and loading capacity of biomolecules. Then the aptamer and HRP modified Au nanoparticles provide high affinity and ultrasensitive electrochemical probe with excellent specificity for OTC. Under the optimized conditions, the peak current was linearly proportional to the concentration of OTC in the range of 5×10 -10 -2×10 -3 gL -1 , with a detection limit of 4.98×10 -10 gL -1 . Additionally, this aptasensor had the advantages in high sensitivity, superb specificity and showed good recovery in synthetic samples. Hence, the developed sandwich-type electrochemical aptasensor might provide a useful and practical tool for OTC determination and related food safety analysis and clinical diagnosis. Copyright © 2016 Elsevier B.V. All rights reserved.

  5. A sensitive, colorimetric immunosensor based on Cu-MOFs and HRP for detection of dibutyl phthalate in environmental and food samples.

    Science.gov (United States)

    Zhu, Nuanfei; Zou, Yanmin; Huang, Menglu; Dong, Shuaibing; Wu, Xiangyang; Liang, Guoxi; Han, Zhixiang; Zhang, Zhen

    2018-08-15

    A sensitive and artful colorimetric immunosensor based on horseradish peroxidase (HRP) was designed by labelling metal-organic frameworks (Cu-MOFs) on the second antibody (Cu-MOFs@Ab 2 ) as signal amplification for the detection of trace dibutyl phthalate (DBP). In this system, when Cu-MOFs@Ab 2 was captured by antigen- primary antibody (Ab 1 ) complex, tremendous Cu(II) will be released from Cu-MOFs in the presence of nitric acid (HNO 3 ), and Cu(II) will be further reduced to Cu(I) after the addition of sodium ascorbate (SA), consequently, inhibiting the HRP to catalyse the colorless 3,3',5,5'-tetramethylbenzidine (TMB) into blue oxidized TMB (ox TMB). Under the optimized conditions, the limit of detection (LOD) was 1 μg L -1 , which was almost 60 times lower than that using a conventional ELISA with the same antibody. In addition, our method showed good accuracy and reproducibility (recoveries of 87.73-103.4%; CV values of 1.46-5.95%) through a spike-recovery analysis. The proposed immunosensor indicated great potential for trace DBP determination from environmental and food samples. Copyright © 2018. Published by Elsevier B.V.

  6. Hypothalamic projections to the ventral medulla oblongata in the rat, with special reference to the nucleus raphe pallidus: a study using autoradiographic and HRP techniques

    Energy Technology Data Exchange (ETDEWEB)

    Hosoya, Yasuhiko

    1985-10-07

    Hypothalamic descending projections to the medullary ventral surface were studied autoradiographically in the rat. A small amount of (/sup 3/H)leucine was injected unilaterally into various parts of the hypothalamus by air pressure. Abundant and characteristic terminal labelings were observed bilaterally in the nucleus raphe pallidus, the ventral surface to the pyramidal tract and the nucleus interfascicularis hypoglossi, after injections into the dorsal posterior hypothalamic area caudal to the paraventricular hypothalamic nucleus. Conspicuous, but less numerous labelings were observed in the nucleus raphe obscurus and the ipsilateral raphe magnus. After an injection of (/sup 3/H)leucine into the hypothalamus and injections of horseradish peroxidase (HRP) into the spinal cord in the same animal, silver grains were densely distributed around HRP-labeled neurons in the nucleus raphe pallidus including the nucleus interfascicularis hypoglossi. The present results suggest that the dorsal posterior hypothalamic area projects directly to the spinal-projecting neurons of the nucleus raphe pallidus. 53 refs.; 9 figs.

  7. Prevalence of Depression in Medical Students at the Lebanese University and Exploring its Correlation With Facebook Relevance: A Questionnaire Study.

    Science.gov (United States)

    Naja, Wadih J; Kansoun, Alaa H; Haddad, Ramzi S

    2016-05-31

    The prevalence of major depression is particularly high in medical students, affecting around one-third of this population. Moreover, online social media, in particular Facebook, is becoming an intrinsic part in the life of a growing proportion of individuals worldwide. Our primary objective is to identify the prevalence of depression in medical students at the Lebanese University Faculty of Medicine, a unique state university in Lebanon, its correlation with the utilization of the interactive features of Facebook, and the way students may resort to these features. Students of the Lebanese University Faculty of Medicine were assessed for (1) depression and (2) Facebook activity. To screen for major depression, we used the Patient Health Questionnaire-9 (PHQ-9) scale. To test for Facebook activity, we developed the Facebook Resorting Questionnaire (FbRQ), which measures the degree to which students resort to Facebook. A total of 365 out of 480 students (76.0%) participated in the survey. A total of 25 students were excluded, hence 340 students were included in the final analysis. Current depression was reported in 117 students out of 340 (34.4%) and t tests showed female predominance. Moreover, PHQ-9 score multiple regression analysis showed that feeling depressed is explained 63.5% of the time by specific independent variables studied from the PHQ-9 and the FbRQ. Depression varied significantly among the different academic years (PFacebook had a positive and significant relationship (P=.003) and the different FbRQ categories had significant differences in resorting-to-Facebook power. The like, add friend, and check-in features students used when resorting to Facebook were significantly associated with depression. This study showed that depression was highly prevalent among students of the Faculty of Medicine at the Lebanese University. Moreover, Facebook may be a promising, helpful, psychological tool for optimizing the management of depression. Our study brought

  8. Patient information leaflets: informing or frightening? A focus group study exploring patients' emotional reactions and subsequent behavior towards package leaflets of commonly prescribed medications in family practices.

    Science.gov (United States)

    Herber, Oliver Rudolf; Gies, Verena; Schwappach, David; Thürmann, Petra; Wilm, Stefan

    2014-10-02

    The purpose of patient information leaflets (PILs) is to inform patients about the administration, precautions and potential side effects of their prescribed medication. Despite European Commission guidelines aiming at increasing readability and comprehension of PILs little is known about the potential risk information has on patients. This article explores patients' reactions and subsequent behavior towards risk information conveyed in PILs of commonly prescribed drugs by general practitioners (GPs) for the treatment of Type 2 diabetes, hypertension or hypercholesterolemia; the most frequent cause for consultations in family practices in Germany. We conducted six focus groups comprising 35 patients which were recruited in GP practices. Transcripts were read and coded for themes; categories were created by abstracting data and further refined into a coding framework. Three interrelated categories are presented: (i) The vast amount of side effects and drug interactions commonly described in PILs provoke various emotional reactions in patients which (ii) lead to specific patient behavior of which (iii) consulting the GP for assistance is among the most common. Findings show that current description of potential risk information caused feelings of fear and anxiety in the reader resulting in undesirable behavioral reactions. Future PILs need to convey potential risk information in a language that is less frightening while retaining the information content required to make informed decisions about the prescribed medication. Thus, during the production process greater emphasis needs to be placed on testing the degree of emotional arousal provoked in patients when reading risk information to allow them to undertake a benefit-risk-assessment of their medication that is based on rational rather than emotional (fearful) reactions.

  9. 'A band of brothers'-an exploration of the range of medical ethical issues faced by British senior military clinicians on deployment to Afghanistan: a qualitative study.

    Science.gov (United States)

    Bernthal, Elizabeth M; Draper, H J A; Henning, J; Kelly, J C

    2017-06-01

    To identify and explore features of ethical issues that senior clinicians faced as deployed medical directors (DMDs) to the British Field Hospital in Afghanistan as well as to determine the ethical training requirements for future deployments. A qualitative study in two phases conducted from November 2014 to June 2015. Phase 1 analysed 60 vignettes of cases that had generated ethical dilemmas for DMDs. Phase 2 included focus groups and an interview with 13 DMDs. Phase 1 identified working with limited resources, dual conflict of meeting both clinical and military obligations and consent of children as the most prevalent ethical challenges. Themes found in Phase 2 included sharing clinical responsibilities with clinicians from other countries and not knowing team members' ways of working, in addition to the themes from Phase 1. This study has drawn together examples of scenarios to form a repository that will aid future training. Recommendations included undertaking ethics training together as a team before, during and after deployment which must include all nationalities who are assigned to the same operational tour, so that different ethical views can be explored beforehand. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  10. Workplace interpersonal conflicts among the healthcare workers: Retrospective exploration from the institutional incident reporting system of a university-affiliated medical center.

    Directory of Open Access Journals (Sweden)

    Jih-Shuin Jerng

    Full Text Available There have been concerns about the workplace interpersonal conflict (WIC among healthcare workers. As healthcare organizations have applied the incident reporting system (IRS widely for safety-related incidents, we proposed that this system might provide a channel to explore the WICs.We retrospectively reviewed the reports to the IRS from July 2010 to June 2013 in a medical center. We identified the WICs and typed these conflicts according to the two foci (task content/process and interpersonal relationship and the three properties (disagreement, interference, and negative emotion, and analyzed relevant data.Of the 147 incidents with WIC, the most common related processes were patient transfer (20%, laboratory tests (17%, surgery (16% and medical imaging (16%. All of the 147 incidents with WIC focused on task content or task process, but 41 (27.9% also focused on the interpersonal relationship. We found disagreement, interference, and negative emotion in 91.2%, 88.4%, and 55.8% of the cases, respectively. Nurses (57% were most often the reporting workers, while the most common encounter was the nurse-doctor interaction (33%, and the majority (67% of the conflicts were experienced concurrently with the incidents. There was a significant difference in the distribution of worker job types between cases focused on the interpersonal relationship and those without (p = 0.0064. The doctors were more frequently as the reporter when the conflicts focused on the interpersonal relationship (34.1% than not on it (17.0%. The distributions of worker job types were similar between those with and without negative emotion (p = 0.125.The institutional IRS is a useful place to report the workplace interpersonal conflicts actively. The healthcare systems need to improve the channels to communicate, manage and resolve these conflicts.

  11. Workplace interpersonal conflicts among the healthcare workers: Retrospective exploration from the institutional incident reporting system of a university-affiliated medical center.

    Science.gov (United States)

    Jerng, Jih-Shuin; Huang, Szu-Fen; Liang, Huey-Wen; Chen, Li-Chin; Lin, Chia-Kuei; Huang, Hsiao-Fang; Hsieh, Ming-Yuan; Sun, Jui-Sheng

    2017-01-01

    There have been concerns about the workplace interpersonal conflict (WIC) among healthcare workers. As healthcare organizations have applied the incident reporting system (IRS) widely for safety-related incidents, we proposed that this system might provide a channel to explore the WICs. We retrospectively reviewed the reports to the IRS from July 2010 to June 2013 in a medical center. We identified the WICs and typed these conflicts according to the two foci (task content/process and interpersonal relationship) and the three properties (disagreement, interference, and negative emotion), and analyzed relevant data. Of the 147 incidents with WIC, the most common related processes were patient transfer (20%), laboratory tests (17%), surgery (16%) and medical imaging (16%). All of the 147 incidents with WIC focused on task content or task process, but 41 (27.9%) also focused on the interpersonal relationship. We found disagreement, interference, and negative emotion in 91.2%, 88.4%, and 55.8% of the cases, respectively. Nurses (57%) were most often the reporting workers, while the most common encounter was the nurse-doctor interaction (33%), and the majority (67%) of the conflicts were experienced concurrently with the incidents. There was a significant difference in the distribution of worker job types between cases focused on the interpersonal relationship and those without (p = 0.0064). The doctors were more frequently as the reporter when the conflicts focused on the interpersonal relationship (34.1%) than not on it (17.0%). The distributions of worker job types were similar between those with and without negative emotion (p = 0.125). The institutional IRS is a useful place to report the workplace interpersonal conflicts actively. The healthcare systems need to improve the channels to communicate, manage and resolve these conflicts.

  12. Crew Exploration Vehicle (CEV) (Orion) Occupant Protection

    Science.gov (United States)

    Currie-Gregg, Nancy J.; Gernhardt, Michael L.; Lawrence, Charles; Somers, Jeffrey T.

    2016-01-01

    Dr. Nancy J. Currie, of the NASA Engineering and Safety Center (NESC), Chief Engineer at Johnson Space Center (JSC), requested an assessment of the Crew Exploration Vehicle (CEV) occupant protection as a result of issues identified by the Constellation Program and Orion Project. The NESC, in collaboration with the Human Research Program (HRP), investigated new methods associated with occupant protection for the Crew Exploration Vehicle (CEV), known as Orion. The primary objective of this assessment was to investigate new methods associated with occupant protection for the CEV, known as Orion, that would ensure the design provided minimal risk to the crew during nominal and contingency landings in an acceptable set of environmental and spacecraft failure conditions. This documents contains the outcome of the NESC assessment. NASA/TM-2013-217380, "Application of the Brinkley Dynamic Response Criterion to Spacecraft Transient Dynamic Events." supercedes this document.

  13. Health and medical research funding agencies' promotion of public engagement within research: a qualitative interview study exploring the United Kingdom context.

    Science.gov (United States)

    van Bekkum, Jennifer E; Fergie, Gillian M; Hilton, Shona

    2016-03-24

    Public engagement (PE) has become a common feature of many liberal governmental agendas worldwide. Since the turn of this century there has been a succession of United Kingdom policy initiatives to encourage research funding agencies, universities and researchers to reconsider how they engage with citizens and communities. Although most funding agencies now explicitly promote PE within research, little empirical work has been carried out in this area. In this study, we explored why and how health and medical research funding agencies in the United Kingdom have interpreted and implemented their role to promote PE within research. Semi-structured interviews were carried out with 30 key informants from 10 agencies that fund health or medical research. Data were also gathered from agencies' websites and documentation. The analysis was based on the constant comparative method. Across agencies, we found that PE was being interpreted and operationalised in various different ways. The terminology used within funding agencies to describe PE seems to be flexibly applied. Disciplinary differences were evident both in the terminology used to describe PE and the drivers for PE highlighted by participants - with applied health science funders more aligned with participatory models of PE. Within the grant funding process PE was rarely systematically treated as a key component of research. In particular, PE was not routinely incorporated into the planning of funding calls. PE was more likely to be considered in the application and assessment phases, where it was largely appraised as a tool for enhancing science. Concerns were expressed regarding how to monitor and evaluate PE within research. This study suggests funding agencies working within specific areas of health and medicine can promote particular definitions of PE and aligned practices which determine the boundaries in which researchers working in these areas understand and practice PE. Our study also highlights how the

  14. A medical student in private practice for a 1-month clerkship: a qualitative exploration of the challenges for primary care clinical teachers.

    Science.gov (United States)

    Muller-Juge, Virginie; Pereira Miozzari, Anne Catherine; Rieder, Arabelle; Hasselgård-Rowe, Jennifer; Sommer, Johanna; Audétat, Marie-Claude

    2018-01-01

    The predicted shortage of primary care physicians emphasizes the need to increase the family medicine workforce. Therefore, Swiss universities develop clerkships in primary care physicians' private practices. The objective of this research was to explore the challenges, the stakes, and the difficulties of clinical teachers who supervised final year medical students in their primary care private practice during a 1-month pilot clerkship in Geneva. Data were collected via a focus group using a semistructured interview guide. Participants were asked about their role as a supervisor and their difficulties and positive experiences. The text of the focus group was transcribed and analyzed qualitatively, with a deductive and inductive approach. The results show the nature of pressures felt by clinical teachers. First, participants experienced the difficulty of having dual roles: the more familiar one of clinician, and the new challenging one of teacher. Second, they felt compelled to fill the gap between the academic context and the private practice context. Clinical teachers were surprised by the extent of the adaptive load, cognitive load, and even the emotional load involved when supervising a trainee in their clinical practice. The context of this rotation demonstrated its utility and its relevance, because it allowed the students to improve their knowledge about the outpatient setting and to develop their professional autonomy and their maturity by taking on more clinical responsibilities. These findings show that future training programs will have to address the needs of clinical teachers as well as bridge the gap between students' academic training and the skills needed for outpatient care. Professionalizing the role of clinical teachers should contribute to reaching these goals.

  15. Stop. Think. Delirium! A quality improvement initiative to explore utilising a validated cognitive assessment tool in the acute inpatient medical setting to detect delirium and prompt early intervention.

    Science.gov (United States)

    Malik, Angela; Harlan, Todd; Cobb, Janice

    2016-11-01

    The paper examines the ability of nursing staff to detect delirium and apply early intervention to decrease adverse events associated with delirium. To characterise nursing practices associated with staff knowledge, delirium screening utilising the Modified Richmond Assessment Sedation Score (mRASS), and multicomponent interventions in an acute inpatient medical unit. Delirium incidence rates are up to 60% in frail elderly hospitalised patients. Under-recognition and inconsistent management of delirium is an international problem. Falls, restraints, and increased hospital length of stay are linked to delirium. A descriptive study. Exploration of relationships between cause and effect among cognitive screening, knowledge assessment and interventions. Success in identifying sufficient cases of delirium was not evident; however, multicomponent interventions were applied to patients with obvious symptoms. An increase in nursing knowledge was demonstrated after additional training. Delirium screening occurred in 49-61% of the target population monthly, with challenges in compliance and documentation of screening and interventions. Technological capabilities for trending mRASS results do not exist within the current computerised patient record system. Delirium screening increases awareness of nursing staff, prompting more emphasis on early intervention in apparent symptoms. Technological support is needed to effectively document and visualise trends in screening results. The study imparts future research on the effects of cognitive screening on delirium prevention and reduction in adverse patient outcomes. Evidence-based literature reveals negative patient outcomes associated with delirium. However, delirium is highly under-recognised indicating future research is needed to address nursing awareness and recognition of delirium. Additional education and knowledge transformation from research to nursing practice are paramount in the application of innovative strategies

  16. Spinal cord projections of the rat main forelimb nerves, studied by transganglionic transport of WGA-HRP and by the disappearance of acid phosphatase.

    Science.gov (United States)

    Castro-Lopes, J M; Coimbra, A

    1991-03-01

    The spinal cord projections of the 3 main forelimb nerves-median, radial and ulnar, were studied in the rat dorsal horn with transganglionic transport of wheat germ agglutinin-horseradish peroxidase (WGA-HRP), or using the disappearance of fluoride resistant acid phosphatase (FRAP) after nerve section. The projection patterns in lamina II were similar following the two procedures. The median and the radial nerve fibers projected to the medial and the intermediate thirds, respectively, of the dorsal horn lamina II in spinal cord segments C4-C8. The ulnar nerve projected to segments C6-C8 between the areas occupied by the other two nerves. The FRAP method also showed that the lateral part of lamina II, which was not filled by radial nerve fibers, received the projections from the dorsal cutaneous branches of cervical spinal nerves. In addition, FRAP disappeared from the medial end of segment T1 after skin incisions extending from the medial brachium to the axilla, which seemed due to severance of the cutaneous branchlets of the lateral anterior thoracic nerve. The FRAP procedure is thus sensitive enough to detect fibers in lamina II arising from small peripheral nerves, and may be used as an alternative to the anterograde tracing methods whenever there are no overlapping projections.

  17. Fabrication and Optimization of ChE/ChO/HRP-AuNPs/c-MWCNTs Based Silver Electrode for Determining Total Cholesterol in Serum

    Directory of Open Access Journals (Sweden)

    Kusum Lata

    2016-01-01

    Full Text Available The developed method used three enzymes comprised of cholesterol esterase, cholesterol oxidase, and peroxidase for fabrication of amperometric biosensor in order to determine total cholesterol in serum samples. Gold nanoparticles (AuNPs and carboxylated multiwall carbon nanotubes (cMWCNTs were used to design core of working electrode, having covalently immobilized ChO, ChE, and HRP. Polyacrylamide layer was finally coated on working electrode in order to prevent enzyme leaching. Chemically synthesised Au nanoparticles were subjected to transmission electron microscopy (TEM for analysing the shape and size of the particles. Working electrode was subjected to FTIR and XRD. The combined action of AuNP and c-MWCNT showed enhancement in electrocatalytic activity at a very low potential of 0.27 V. The pH 7, temperature 40°C, and response time of 20 seconds, respectively, were observed. The biosensor shows a broad linear range from 0.5 mg/dL to 250 mg/dL (0.01 mM–5.83 mM with minimum detection limit being 0.5 mg/dL (0.01 mM. The biosensor showed reusability of more than 45 times and was stable for 60 days. The biosensor was successfully tested for determining total cholesterol in serum samples amperometrically with no significant interference by serum components.

  18. A medical student in private practice for a 1-month clerkship: a qualitative exploration of the challenges for primary care clinical teachers

    Directory of Open Access Journals (Sweden)

    Muller-Juge V

    2017-12-01

    Full Text Available Virginie Muller-Juge, Anne Catherine Pereira Miozzari, Arabelle Rieder, Jennifer Hasselgård-Rowe, Johanna Sommer, Marie-Claude Audétat Unit of Primary Care, Faculty of Medicine, University of Geneva, Geneva, Switzerland Purpose: The predicted shortage of primary care physicians emphasizes the need to increase the family medicine workforce. Therefore, Swiss universities develop clerkships in primary care physicians’ private practices. The objective of this research was to explore the challenges, the stakes, and the difficulties of clinical teachers who supervised final year medical students in their primary care private practice during a 1-month pilot clerkship in Geneva.Methods: Data were collected via a focus group using a semistructured interview guide. Participants were asked about their role as a supervisor and their difficulties and positive experiences. The text of the focus group was transcribed and analyzed qualitatively, with a deductive and inductive approach.Results: The results show the nature of pressures felt by clinical teachers. First, participants experienced the difficulty of having dual roles: the more familiar one of clinician, and the new challenging one of teacher. Second, they felt compelled to fill the gap between the academic context and the private practice context. Clinical teachers were surprised by the extent of the adaptive load, cognitive load, and even the emotional load involved when supervising a trainee in their clinical practice. The context of this rotation demonstrated its utility and its relevance, because it allowed the students to improve their knowledge about the outpatient setting and to develop their professional autonomy and their maturity by taking on more clinical responsibilities.Conclusion: These findings show that future training programs will have to address the needs of clinical teachers as well as bridge the gap between students’ academic training and the skills needed for

  19. HRP2 and pLDH-Based Rapid Diagnostic Tests, Expert Microscopy, and PCR for Detection of Malaria Infection during Pregnancy and at Delivery in Areas of Varied Transmission: A Prospective Cohort Study in Burkina Faso and Uganda.

    Directory of Open Access Journals (Sweden)

    Daniel J Kyabayinze

    Full Text Available Intermittent screening and treatment (IST of malaria during pregnancy has been proposed as an alternative to intermittent preventive treatment in pregnancy (IPTp, where IPTp is failing due to drug resistance. However, the antenatal parasitaemias are frequently very low, and the most appropriate screening test for IST has not been defined.We conducted a multi-center prospective study of 990 HIV-uninfected women attending ANC in two different malaria transmission settings at Tororo District Hospital, eastern Uganda and Colsama Health Center in western Burkina Faso. Women were enrolled in the study in the second or third trimester of pregnancy and followed to delivery, generating 2,597 blood samples for analysis. Screening tests included rapid diagnostic tests (RDTs targeting histidine-rich protein 2 (HRP2 and parasite lactate dehydrogenase (pLDH and microscopy, compared to nPCR as a reference standard. At enrolment, the proportion of pregnant women who were positive for P. falciparum by HRP2/pan pLDH RDT, Pf pLDH/pan pLDH RDT, microscopy and PCR was 38%, 29%, 36% and 44% in Uganda and 21%, 16%, 15% and 35% in Burkina Faso, respectively. All test positivity rates declined during follow-up. In comparison to PCR, the sensitivity of the HRP2/pan pLDH RDT, Pf pLDH/pan pLDH RDT and microscopy was 75.7%, 60.1% and 69.7% in Uganda, 55.8%, 42.6% and 55.8% in Burkina Faso respectively for all antenatal visits. Specificity was greater than 96% for all three tests. Comparison of accuracy using generalized estimating equation revealed that the HRP2- detecting RDT was the most accurate test in both settings.The study suggests that HRP2-based RDTs are the most appropriate point-of-care test currently available for use during pregnancy especially for symptomatic women, but will still miss some PCR-positive women. The clinical significance of these very low density infections needs to be better defined.

  20. Human Factors in Training: Space Medical Proficiency Training

    Science.gov (United States)

    Byrne, Vicky E.; Barshi, I.; Arsintescu, L.; Connell, E.

    2010-01-01

    The early Constellation space missions are expected to have medical capabilities very similar to those currently on the Space Shuttle and the International Space Station (ISS). For Crew Exploration Vehicle (CEV) missions to the ISS, medical equipment will be located on the ISS, and carried into CEV in the event of an emergency. Flight surgeons (FS) on the ground in Mission Control will be expected to direct the crew medical officer (CMO) during medical situations. If there is a loss of signal and the crew is unable to communicate with the ground, a CMO would be expected to carry out medical procedures without the aid of a FS. In these situations, performance support tools can be used to reduce errors and time to perform emergency medical tasks. The space medical training work is part of the Human Factors in Training Directed Research Project (DRP) of the Space Human Factors Engineering (SHFE) Project under the Space Human Factors and Habitability (SHFH) Element of the Human Research Program (HRP). This is a joint project consisting of human factors team from the Ames Research Center (ARC) with Immanuel Barshi as Principal Investigator and the Johnson Space Center (JSC). Human factors researchers at JSC have recently investigated medical performance support tools for CMOs on-orbit, and FSs on the ground, and researchers at the Ames Research Center performed a literature review on medical errors. Work on medical training has been conducted in collaboration with the Medical Training Group at the Johnson Space Center (JSC) and with Wyle Laboratories that provides medical training to crew members, biomedical engineers (BMEs), and to flight surgeons under the Bioastronautics contract. One area of research building on activities from FY08, involved the feasibility of just-in-time (JIT) training techniques and concepts for real-time medical procedures. A second area of research involves FS performance support tools. Information needed by the FS during the ISS mission

  1. Cost-effectiveness of Antihypertensive Medication: Exploring Race and Sex Differences Using Data From the REasons for Geographic and Racial Differences in Stroke Study.

    Science.gov (United States)

    Tajeu, Gabriel S; Mennemeyer, Stephen; Menachemi, Nir; Weech-Maldonado, Robert; Kilgore, Meredith

    2017-06-01

    Antihypertensive medication decreases risk of cardiovascular disease (CVD) events in adults with hypertension. Although black adults have higher prevalence of hypertension and worse CVD outcomes compared with whites, limited attention has been given to the cost-effectiveness of antihypertensive medication for blacks. To compare the cost-effectiveness of antihypertensive medication treatment versus no-treatment in white and black adults. We constructed a State Transition Model to assess the costs and quality-adjusted life-years (QALYs) associated with either antihypertensive medication treatment or no-treatment using data from the REasons for Geographic and Racial Differences in Stroke (REGARDS) study and published literature. CVD events and health states considered in the model included stroke, coronary heart disease, heart failure, chronic kidney disease, and end-stage renal disease. White and black adults with hypertension in the United States, 45 years of age and above. Yearly risk of CVD was determined using REGARDS data and published literature. Antihypertensive medication costs were determined using Medicare claims. Event and health state costs were estimated from published literature. All costs were adjusted to 2012 US dollars. Effectiveness was assessed using QALYs. Antihypertensive medication treatment was cost-saving and increased QALYs compared with no-treatment for white men ($7387; 1.14 QALYs), white women ($7796; 0.89 QALYs), black men ($8400; 1.66 QALYs), and black women ($10,249; 1.79 QALYs). Antihypertensive medication treatment is cost-saving and increases QALYs for all groups considered in the model, particularly among black adults.

  2. Use of HRP-2-based rapid diagnostic test for Plasmodium falciparum malaria: assessing accuracy and cost-effectiveness in the villages of Dielmo and Ndiop, Senegal

    Directory of Open Access Journals (Sweden)

    Trape Jean-François

    2010-06-01

    Full Text Available Abstract Background In 2006, the Senegalese National Malaria Control Programme (NMCP has recommended artemisinin-based combination therapy (ACT as the first-line treatment for uncomplicated malaria and, in 2007, mandated testing for all suspected cases of malaria with a Plasmodium falciparum HRP-2-based rapid diagnostic test for malaria (RDT(Paracheck®. Given the higher cost of ACT compared to earlier anti-malarials, the objectives of the present study were i to study the accuracy of Paracheck® compared to the thick blood smear (TBS in two areas with different levels of malaria endemicity and ii analyse the cost-effectiveness of the strategy of the parasitological confirmation of clinically suspected malaria cases management recommended by the NMCP. Methods A cross-sectional study was undertaken in the villages of Dielmo and Ndiop (Senegal nested in a cohort study of about 800 inhabitants. For all the individuals consulting between October 2008 and January 2009 with a clinical diagnosis of malaria, a questionnaire was filled and finger-prick blood samples were taken both for microscopic examination and RDT. The estimated costs and cost-effectiveness analysis were made considering five scenarios, the recommendations of the NMCP being the reference scenario. In addition, a sensitivity analysis was performed assuming that all the RDT-positive patients and 50% of RDT-negative patients were treated with ACT. Results A total of 189 consultations for clinically suspected malaria occurred during the study period. The sensitivity, specificity, positive and negative predictive values were respectively 100%, 98.3%, 80.0% and 100%. The estimated cost of the reference scenario was close to 700€ per 1000 episodes of illness, approximately twice as expensive as most of the other scenarios. Nevertheless, it appeared to us cost-effective while ensuring the diagnosis and the treatment of 100% of malaria attacks and an adequate management of 98.4% of episodes

  3. Use of HRP-2-based rapid diagnostic test for Plasmodium falciparum malaria: assessing accuracy and cost-effectiveness in the villages of Dielmo and Ndiop, Senegal.

    Science.gov (United States)

    Ly, Alioune Badara; Tall, Adama; Perry, Robert; Baril, Laurence; Badiane, Abdoulaye; Faye, Joseph; Rogier, Christophe; Touré, Aissatou; Sokhna, Cheikh; Trape, Jean-François; Michel, Rémy

    2010-06-04

    In 2006, the Senegalese National Malaria Control Programme (NMCP) has recommended artemisinin-based combination therapy (ACT) as the first-line treatment for uncomplicated malaria and, in 2007, mandated testing for all suspected cases of malaria with a Plasmodium falciparum HRP-2-based rapid diagnostic test for malaria (RDT(Paracheck). Given the higher cost of ACT compared to earlier anti-malarials, the objectives of the present study were i) to study the accuracy of Paracheck compared to the thick blood smear (TBS) in two areas with different levels of malaria endemicity and ii) analyse the cost-effectiveness of the strategy of the parasitological confirmation of clinically suspected malaria cases management recommended by the NMCP. A cross-sectional study was undertaken in the villages of Dielmo and Ndiop (Senegal) nested in a cohort study of about 800 inhabitants. For all the individuals consulting between October 2008 and January 2009 with a clinical diagnosis of malaria, a questionnaire was filled and finger-prick blood samples were taken both for microscopic examination and RDT. The estimated costs and cost-effectiveness analysis were made considering five scenarios, the recommendations of the NMCP being the reference scenario. In addition, a sensitivity analysis was performed assuming that all the RDT-positive patients and 50% of RDT-negative patients were treated with ACT. A total of 189 consultations for clinically suspected malaria occurred during the study period. The sensitivity, specificity, positive and negative predictive values were respectively 100%, 98.3%, 80.0% and 100%. The estimated cost of the reference scenario was close to 700 euros per 1000 episodes of illness, approximately twice as expensive as most of the other scenarios. Nevertheless, it appeared to us cost-effective while ensuring the diagnosis and the treatment of 100% of malaria attacks and an adequate management of 98.4% of episodes of illness. The present study also demonstrated

  4. Common market but divergent regulatory practices: exploring European regulation and the effect on regulatory uncertainty in the marketing authorization of medical products

    NARCIS (Netherlands)

    Chowdhury, Nupur

    2013-01-01

    The medical product sector is characterised by a regulatory patchwork of European and national laws and guidelines operating concurrently with each other. Each of these sectors are characterised by different levels of regulatory uncertainty that may undermine the effectiveness of the regulatory

  5. Exploring Learner Acceptance of the Use of Virtual Reality in Medical Education: A Case Study of Desktop and Projection-Based Display Systems

    Science.gov (United States)

    Huang, Hsiu-Mei; Liaw, Shu-Sheng; Lai, Chung-Min

    2016-01-01

    Advanced technologies have been widely applied in medical education, including human-patient simulators, immersive virtual reality Cave Automatic Virtual Environment systems, and video conferencing. Evaluating learner acceptance of such virtual reality (VR) learning environments is a critical issue for ensuring that such technologies are used to…

  6. Can you snooze your way to an 'A'? Exploring the complex relationship between sleep, autonomic activity, wellbeing and performance in medical students.

    Science.gov (United States)

    Cvejic, Erin; Huang, Shiny; Vollmer-Conna, Uté

    2018-01-01

    Medical training brings with it multiple stressors, including demanding workloads in highly competitive environments, with well-documented impact on psychiatric morbidity. This study evaluated the impact of sleep-related factors on psychological wellbeing, cognitive task performance and academic standing in medical students. A total of 59 undergraduate medical students took part in this cross-sectional study over two consecutive days. Participants responded to questionnaires about their physical and psychological health, sleep, functioning and academic performance at the initial visit. Participants then wore an ambulatory bioharness overnight (to derive heart rate variability measures), before returning to complete a computerised battery of cognitive tasks. A sleep diary was completed for the next 7 days. Poor sleep quality in the month preceding assessment correlated with psychological distress ( p sleep during the monitoring week ( p sleep timing parameters. A greater increase in heart rate variability during the transition from awake to sleep significantly predicted better spontaneous cognitive performance ( p = 0.021). Better academic standing was predicted by consistently short, less refreshing sleep (all p sleep and psychological distress are prevalent in medical students during university training and were associated with reduced nocturnal parasympathetic autonomic activity. Achieving higher academic grades was associated with high psychological wellbeing despite consistently short, unrefreshing sleep. The long-term repercussions of such sleep behaviours on later professional functioning remain unclear, warranting further research.

  7. Building New Education Model to Enhance the Comprehensive Competence of the Medical Students The exploration of PRICE Education Model in School of Medicine, Shanghai Jiao Tong University

    Institute of Scientific and Technical Information of China (English)

    Gang Huang; Bingjie Lu; Jifeng Fu; Yanping Zhang; Wenhan Mei; Yan Li; Yifei Wang

    2014-01-01

    To enhance the competence of medical students, Shanghai Jiao Tong University School of Medicine innovates the new PRICE education model, through Problem-based Learning(P) and Research-based learning(R), guides the students to give full play to the active learning; break the traditional discipline-centered teaching model by an integrated curriculum(I),combines with clinical practice-based learning(C) to solve the disjointed question between the basic theory and clinical practice in medical education, uses the comprehensive evaluation system(E) to assess the learning effect of the students and the quality of the teaching. The PRICE education model is verified by our educational practice.

  8. Self-evaluation and peer-feedback of medical students' communication skills using a web-based video annotation system. Exploring content and specificity.

    Science.gov (United States)

    Hulsman, Robert L; van der Vloodt, Jane

    2015-03-01

    Self-evaluation and peer-feedback are important strategies within the reflective practice paradigm for the development and maintenance of professional competencies like medical communication. Characteristics of the self-evaluation and peer-feedback annotations of medical students' video recorded communication skills were analyzed. Twenty-five year 4 medical students recorded history-taking consultations with a simulated patient, uploaded the video to a web-based platform, marked and annotated positive and negative events. Peers reviewed the video and self-evaluations and provided feedback. Analyzed were the number of marked positive and negative annotations and the amount of text entered. Topics and specificity of the annotations were coded and analyzed qualitatively. Students annotated on average more negative than positive events. Additional peer-feedback was more often positive. Topics most often related to structuring the consultation. Students were most critical about their biomedical topics. Negative annotations were more specific than positive annotations. Self-evaluations were more specific than peer-feedback and both show a significant correlation. Four response patterns were detected that negatively bias specificity assessment ratings. Teaching students to be more specific in their self-evaluations may be effective for receiving more specific peer-feedback. Videofragmentrating is a convenient tool to implement reflective practice activities like self-evaluation and peer-feedback to the classroom in the teaching of clinical skills. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  9. Physician Brain Drain from Sub-Saharan Africa: Exploring the Utility of an Eco-psychopolitical Validity Framework for Medical Migration Research

    Directory of Open Access Journals (Sweden)

    Benjamin Siankam

    2011-11-01

    Full Text Available In-depth understanding of any critical social issue requires investigators to use analytical tools that reflect the complexity of the social issue of interest. Toward this aim, I examine the medical brain drain from Sub-Saharan Africa to the United States through the lens of the eco-psychopolitical validity model (see, Christen and Perkins, 2008; Prilleltensky, 2008, an integrative approach that stresses the combined influences of structural factors, individual agency, and power at play in human dynamics and social systems. By adapting the eco-psychopolitical validity model to the study of medical skilled migration, I construe migration as a liberating venture articulated around the triadic process of oppression, empowerment, and wellness. If migrants yearn to breathe free, then émigré physicians are essentially in pursuit of liberation and wellbeing. However, in a world of profound health disparities, where the increasing emigration of medical doctors from resource-constrained countries ultimately leads to loss of lives in the communities left behind, migrant doctors´ individual agency and the multilevel contexts that enable or constrain them to emigrate require critical reflection. Some emerging themes and variations of an ongoing qualitative study are examined using the eco-psychopolitical validity paradigm.

  10. Crew Exploration Vehicle (CEV) (Orion) Occupant Protection. Part 1; Appendices

    Science.gov (United States)

    Currie-Gregg, Nancy J.; Gernhardt, Michael L.; Lawrence, Charles; Somers, Jeffrey T.

    2016-01-01

    Dr. Nancy J. Currie, of the NASA Engineering and Safety Center (NESC), Chief Engineer at Johnson Space Center (JSC), requested an assessment of the Crew Exploration Vehicle (CEV) occupant protection as a result of issues identified by the Constellation Program and Orion Project. The NESC, in collaboration with the Human Research Program (HRP), investigated new methods associated with occupant protection for the Crew Exploration Vehicle (CEV), known as Orion. The primary objective of this assessment was to investigate new methods associated with occupant protection for the CEV, known as Orion, that would ensure the design provided minimal risk to the crew during nominal and contingency landings in an acceptable set of environmental and spacecraft failure conditions. This documents contains the appendices to the NESC assessment report. NASA/TM-2013-217380, Application of the Brinkley Dynamic Response Criterion to Spacecraft Transient Dynamic Events supersedes this document.

  11. Medical Rituals and Media Rituals

    OpenAIRE

    Zoltán Zsinkó-Szabó

    2013-01-01

    In the present article the author examines the ritual elements of theprofessionalization during medical studies, and its interference with media content of medical significance, comparing the role of medical and media rituals on the way of becoming a doctor. It is to be explored how these medical soap operas, medical dramas, medical thrillers or crime stories do exert influence on medical identity and role expectations. Do medical students and their relatives (withmedical expertise frequently...

  12. Faculty Development for Medical School Community-Based Faculty: A Council of Academic Family Medicine Educational Research Alliance Study Exploring Institutional Requirements and Challenges.

    Science.gov (United States)

    Drowos, Joanna; Baker, Suzanne; Harrison, Suzanne Leonard; Minor, Suzanne; Chessman, Alexander W; Baker, Dennis

    2017-08-01

    Community-based faculty play a large role in training medical students nationwide and require faculty development. The authors hypothesized that positive relationships exist between clerkships paying preceptors and requiring faculty development, and between protected clerkship directors' time and delivering face-to-face preceptor training, as well as with the number or length of community-based preceptor visits. Through under standing the quantity, delivery methods, barriers, and institutional support for faculty development provided to community-based preceptors teaching in family medicine clerkships, best practices can be developed. Data from the 2015 Council of Academic Family Medicine's Educational Research Alliance survey of Family Medicine Clerkship Directors were analyzed. The cross-sectional survey of clerkship directors is distributed annually to institutional representatives of U.S. and Canadian accredited medical schools. Survey questions focused on the requirements, delivery methods, barriers, and institutional support available for providing faculty development to community-based preceptors. Paying community-based preceptors was positively correlated with requiring faculty development in family medicine clerkships. The greatest barrier to providing faculty development was community-based preceptor time availability; however, face-to-face methods remain the most common delivery strategy. Many family medicine clerkship directors perform informal or no needs assessment in developing faculty development topics for community-based faculty. Providing payment to community preceptors may allow schools to enhance faculty development program activities and effectiveness. Medical schools could benefit from constructing a formal curriculum for faculty development, including formal preceptor needs assessment and program evaluation. Clerkship directors may consider recruiting and retaining community-based faculty by employing innovative faculty development delivery

  13. Training Tomorrow's Doctors to Safeguard the Patients of Today: Using Medical Student Simulation Training to Explore Barriers to Recognition of Elder Abuse.

    Science.gov (United States)

    Fisher, James M; Rudd, Matthew P; Walker, Richard W; Stewart, Jane

    2016-01-01

    In recognition of the fact that elder abuse is a global problem that doctors underrecognize and underreport, a simulation training session for undergraduate medical students was developed. The primary objective of this qualitative study was to examine barriers to and drivers of medical students making a diagnosis of elder abuse in simulated practice, with the goal of refining teaching methods and informing future teaching sessions for other clinical teachers. Third-year medical students (Newcastle University, United Kingdom) undertook a simulation scenario with a high-fidelity mannequin representing an elder abuse victim. After the simulation scenario, students underwent a semistructured debriefing. A tripartite approach to data collection was employed that included audio recordings of the simulation, data sheets capturing students' thoughts during the scenario, and postscenario debriefing. A different researcher analyzed each data set in isolation before discussions were held to triangulate findings from the data sets. Forty-six students undertook the scenario; none declined to participate. A number of barriers to students diagnosing elder abuse were identified. Students held a low index of suspicion for elder abuse and were overly optimistic regarding the etiology of the individual's injuries. Students lacked the confidence to raise concerns about possible elder abuse, believing that certainty was required before doing so. There was widespread confusion about nomenclature. These findings provide clinical teachers with important topic areas to address in future teaching sessions. Simulation, as a method to teach about elder abuse in a reproducible and immersive fashion, is recommended to clinical teachers. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  14. Exploring the enablers and barriers to implementing the Medication Appropriateness Tool for Comorbid Health conditions during Dementia (MATCH-D) criteria in Australia: a qualitative study.

    Science.gov (United States)

    Page, Amy Theresa; Clifford, Rhonda Marise; Potter, Kathleen; Seubert, Liza; McLachlan, Andrew J; Hill, Xaysja; King, Stephanie; Clark, Vaughan; Ryan, Cristin; Parekh, Nikesh; Etherton-Beer, Christopher D

    2017-08-23

    The Medication Appropriateness Tool for Comorbid Health conditions in Dementia (MATCH-D) criteria provide expert consensus guidance about medication use for people with dementia. This study aimed to identify enablers and barriers to implementing the criteria in practice. Participants came from both rural and metropolitan communities in two Australian states. Focus groups were held with consumers, general practitioners, nurses and pharmacists. data were analysed thematically. Nine focus groups were conducted. Fifty-five participants validated the content of MATCH-D, appraising them as providing patient-centred principles of care. Participants identified potential applications (including the use of MATCH-D as a discussion aid or educational tool for consumers about medicines) and suggested supporting resources. Participants provided insights into applying MATCH-D in practice and suggested resources to be included in an accompanying toolkit. These data provide external validation of MATCH-D and an empiric basis for their translation to practice. Following resource development, we plan to evaluate the feasibility and efficacy of implementation in practice. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  15. Field evaluation of a PfHRP-2/pLDH rapid diagnostic test and light microscopy for diagnosis and screening of falciparum malaria during the peak seasonal transmission in an endemic area in Yemen.

    Science.gov (United States)

    Alareqi, Lina M Q; Mahdy, Mohammed A K; Lau, Yee-Ling; Fong, Mun-Yik; Abdul-Ghani, Rashad; Ali, Arwa A; Cheong, Fei-Wen; Tawfek, Rehab; Mahmud, Rohela

    2016-01-28

    Malaria is a public health threat in Yemen, with 149,451 cases being reported in 2013. Of these, Plasmodium falciparum represents 99%. Prompt diagnosis by light microscopy (LM) and rapid diagnostic tests (RTDs) is a key element in the national strategy of malaria control. The heterogeneous epidemiology of malaria in the country necessitates the field evaluation of the current diagnostic strategies, especially RDTs. Thus, the present study aimed to evaluate LM and an RDT, combining both P. falciparum histidine-rich protein-2 (PfHRP-2) and Plasmodium lactate dehydrogenase (pLDH), for falciparum malaria diagnosis and survey in a malaria-endemic area during the transmission season against nested polymerase chain reaction (PCR) as the reference method. A household-based, cross-sectional malaria survey was conducted in Mawza District, a malaria-endemic area in Taiz governorate. A total of 488 participants were screened using LM and PfHRP-2/pLDH RDT. Positive samples (160) and randomly selected negative samples (52) by both RDT and LM were further analysed using 18S rRNA-based nested PCR. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the RDT were 96.0% (95% confidence interval (CI): 90.9-98.3), 56.0% (95% CI: 44.7-66.8), 76.3% (95% CI: 69.0-82.3), and 90.4% (95% CI: 78.8-96.8), respectively. On the other hand, LM showed sensitivity of 37.6% (95% CI: 29.6-46.3), specificity of 97.6% (95% CI: 91.7-99.7), PPV of 95.9% (95% CI: 86.3-98.9), and NPV of 51.3% (95% CI: 43.2-59.2). The sensitivity of LM dropped to 8.5% for detecting asymptomatic malaria. Malaria prevalence was 32.8% (32.1 and 37.5% for ≥10 and <10 years, respectively) with the RDT compared with 10.7% (10.8 and 9.4% for age groups of ≥10 and <10 years, respectively) with LM. Among asymptomatic malaria individuals, LM and RDT-based prevalence rates were 1.6 and 25.6%, respectively. However, rates of 88.2 and 94.1% of infection with P. falciparum were found

  16. Exploring the importance of different items as reasons for leaving emergency medical services between fully compensated, partially compensated, and non-compensated/volunteer samples.

    Science.gov (United States)

    Blau, Gary; Chapman, Susan; Gibson, Gregory; Bentley, Melissa A

    2011-01-01

    The purpose of our study was to investigate the importance of different items as reasons for leaving the Emergency Medical Service (EMS) profession. An exit survey was returned by three distinct EMS samples: 127 full compensated, 45 partially compensated and 72 non-compensated/volunteer respondents, who rated the importance of 17 different items for affecting their decision to leave EMS. Unfortunately, there were a high percentage of "not applicable" responses for 10 items. We focused on those seven items that had a majority of useable responses across the three samples. Results showed that the desire for better pay and benefits was a more important reason for leaving EMS for the partially compensated versus fully compensated respondents. Perceived lack of advancement opportunity was a more important reason for leaving for the partially compensated and volunteer groups versus the fully compensated group. Study limitations are discussed and suggestions for future research offered.

  17. Exploring topical anti-glaucoma medication effects on the ocular surface in the context of the current understanding of dry eye.

    Science.gov (United States)

    Wong, Aaron B C; Wang, Michael T M; Liu, Kevin; Prime, Zak J; Danesh-Meyer, Helen V; Craig, Jennifer P

    2018-07-01

    To assess tear film parameters, ocular surface characteristics, and dry eye symptomology in patients receiving topical anti-glaucoma medications. Thirty-three patients with a diagnosis of open angle glaucoma or ocular hypertension, receiving unilateral topical anti-glaucoma medication for at least 6 months, were recruited in a cross-sectional, investigator-masked, paired-eye comparison study. Tear film parameters, ocular surface characteristics, and dry eye symptomology of treated and fellow eyes were evaluated and compared. The mean ± SD age of the participants was 67 ± 12 years, and the mean ± SD treatment duration was 5.3 ± 4.4 years. Treated eyes had poorer non-invasive tear film breakup time (p = 0.03), tear film osmolarity (p = 0.04), bulbar conjunctival hyperaemia (p = 0.04), eyelid margin abnormality grade (p = 0.01), tear meniscus height (p = 0.03), and anaesthetised Schirmer value (p = 0.04) than fellow eyes. There were no significant differences in dry eye symptomology, meibomian gland assessments, and ocular surface staining between treated and fellow eyes (all p > 0.05). Adverse changes in tear film stability, tear osmolarity, conjunctival hyperaemia, and eyelid margins were observed in treated eyes. This suggests that inflammatory mechanisms may be implicated in the development of dry eye in patients receiving long term topical anti-glaucoma therapy. Copyright © 2018 Elsevier Inc. All rights reserved.

  18. International students' experience of a western medical school: a mixed methods study exploring the early years in the context of cultural and social adjustment compared to students from the host country.

    Science.gov (United States)

    McGarvey, A; Brugha, R; Conroy, R M; Clarke, E; Byrne, E

    2015-07-02

    Few studies have addressed the challenges associated with international students as they adapt to studying medicine in a new host country. Higher level institutions have increasing numbers of international students commencing programmes. This paper explores the experiences of a cohort of students in the early years of medical school in Ireland, where a considerable cohort are from an international background. A mixed exploratory sequential study design was carried out with medical students in the preclinical component of a five year undergraduate programme. Data for the qualitative phase was collected through 29 semi-structured interviews using the peer interview method. Thematic analysis from this phase was incorporated to develop an online questionnaire combined with components of the Student Adaptation to College Questionnaire and Student Integration Questionnaire. First year students were anonymously surveyed online. The Mokken Scaling procedure was used to investigate the students' experiences, both positive and negative. Three main themes are identified; social adjustment, social alienation and cultural alienation. The response rate for the survey was 49% (467 Respondents). The Mokken Scaling method identified the following scales (i) Positive experience of student life; (ii) Social alienation, which comprised of negative items about feeling lonely, not fitting in, being homesick and (iii) Cultural alienation, which included the items of being uncomfortable around cultural norms of dress and contact between the sexes. With the threshold set to H = 0.4. Subscales of the positive experiences of student life scale are explored further. Overall student adjustment to a western third level college was good. Students from regions where cultural distance is greatest reported more difficulties in adjusting. Students from these regions also demonstrate very good adaptation. Some students from the host country and more similar cultural backgrounds were also

  19. Exploring the Knowledge and Perception of Generic Medicines among Final Year Undergraduate Medical, Pharmacy, and Nursing Students in Sierra Leone: A Comparative Cross-Sectional Approach

    Directory of Open Access Journals (Sweden)

    Peter Bai James

    2018-01-01

    Full Text Available Most low-income nations have national medicine policy that emphasized the use of generic medicines in the public health sector. However, the use of generics is often debatable as there are concerns over its efficacy, quality, and safety compared to their branded counterparts. This study was conducted to compare the knowledge and perception of generic medicines among final year undergraduate medical, pharmacy, and nursing students in Sierra Leone. We conducted a questionnaire-based cross-sectional study among these students at the College of Medicine and Allied Health Sciences University of Sierra Leone. Out of the 62 students, only two (2/62, 3.2% knew about the acceptable bioequivalence limit. At least half of respondents in all three groups agreed that all generics are therapeutically equivalent to their innovator brand. At least half of the medicine (21/42, 50% and nursing (6/9, 66.6% students, compared to pharmacy students (5/11, 45.5%, believed that higher safety standards are required for proprietary medicines than for generic medicines. Most of them agreed that they need more information on the safety, quality, and efficacy aspects of generics (59/62, 95.2%. All three groups of healthcare students, despite variations in their responses, demonstrated a deficiency in knowledge and misconception regarding generic medicines. Training on issues surrounding generic drugs in healthcare training institutions is highly needed among future healthcare providers in Sierra Leone.

  20. Is it all about the money? A qualitative exploration of the effects of performance-based financial incentives on Zimbabwe's voluntary male medical circumcision program.

    Directory of Open Access Journals (Sweden)

    Caryl Feldacker

    Full Text Available In 2013, Zimbabwe's voluntary medical male circumcision (VMMC program adopted performance-based financing (PBF to speed progress towards ambitious VMMC targets. The $25 USD PBF intended to encourage low-paid healthcare workers to remain in the public sector and to strengthen the public healthcare system. The majority of the incentive supports healthcare workers (HCWs who perform VMMC alongside other routine services; a small portion supports province, district, and facility levels.This qualitative study assessed the effect of the PBF on HCW motivation, satisfaction, and professional relationships. The study objectives were to: 1 Gain understanding of the advantages and disadvantages of PBF at the HCW level; 2 Gain understanding of the advantages and disadvantages of PBF at the site level; and 3 Inform scale up, modification, or discontinuation of PBF for the national VMMC program. Sixteen focus groups were conducted: eight with HCWs who received PBF for VMMC and eight with HCWs in the same clinics who did not work in VMMC and, therefore, did not receive PBF. Fourteen key informant interviews ascertained administrator opinion.Findings suggest that PBF appreciably increased motivation among VMMC teams and helped improve facilities where VMMC services are provided. However, PBF appears to contribute to antagonism at the workplace, creating divisiveness that may reach beyond VMMC. PBF may also cause distortion in the healthcare system: HCWs prioritized incentivized VMMC services over other routine duties. To reduce workplace tension and improve the VMMC program, participants suggested increasing HCW training in VMMC to expand PBF beneficiaries and strengthening integration of VMMC services into routine care.In the low-resource, short-staffed context of Zimbabwe, PBF enabled rapid VMMC scale up and achievement of ambitious targets; however, side effects make PBF less advantageous and sustainable than envisioned. Careful consideration is warranted in

  1. Exploring Factors Affecting Voluntary Adoption of Electronic Medical Records Among Physicians and Clinical Assistants of Small or Solo Private General Practice Clinics.

    Science.gov (United States)

    Or, Calvin; Tong, Ellen; Tan, Joseph; Chan, Summer

    2018-05-29

    The health care reform initiative led by the Hong Kong government's Food and Health Bureau has started the implementation of an electronic sharing platform to provide an information infrastructure that enables public hospitals and private clinics to share their electronic medical records (EMRs) for improved access to patients' health care information. However, previous attempts to convince the private clinics to adopt EMRs to document health information have faced challenges, as the EMR adoption has been voluntary. The lack of electronic data shared by private clinics carries direct impacts to the efficacy of electronic record sharing between public and private healthcare providers. To increase the likelihood of buy-in, it is essential to proactively identify the users' and organizations' needs and capabilities before large-scale implementation. As part of the reform initiative, this study examined factors affecting the adoption of EMRs in small or solo private general practice clinics, by analyzing the experiences and opinions of the physicians and clinical assistants during the pilot implementation of the technology, with the purpose to learn from it before full-scale rollout. In-depth, semistructured interviews were conducted with 23 physicians and clinical assistants from seven small or solo private general practice clinics to evaluate their experiences, expectations, and opinions regarding the deployment of EMRs. Interview transcripts were content analyzed to identify key factors. Factors affecting the adoption of EMRs to record and manage health care information were identified as follows: system interface design; system functions; stability and reliability of hardware, software, and computing networks; financial and time costs; task and outcome performance, work practice, and clinical workflow; physical space in clinics; trust in technology; users' information technology literacy; training and technical support; and social and organizational influences. The

  2. Exploration Review

    Science.gov (United States)

    Wilburn, D.R.; Stanley, K.A.

    2013-01-01

    This summary of international mineral exploration activities for 2012 draws upon information from industry sources, published literature and U.S. Geological Survey (USGS) specialists. The summary provides data on exploration budgets by region and mineral commodity, identifies significant mineral discoveries and areas of mineral exploration, discusses government programs affecting the mineral exploration industry and presents analyses of exploration activities performed by the mineral industry. Three sources of information are reported and analyzed in this annual review of international exploration for 2012: 1) budgetary statistics expressed in U.S. nominal dollars provided by SNL Metals Economics Group (MEG) of Halifax, Nova Scotia; 2) regional and site-specific exploration activities that took place in 2012 as compiled by the USGS and 3) regional events including economic, social and political conditions that affected exploration activities, which were derived from published sources and unpublished discussions with USGS and industry specialists.

  3. Exploration technology

    Energy Technology Data Exchange (ETDEWEB)

    Roennevik, H.C. [Saga Petroleum A/S, Forus (Norway)

    1996-12-31

    The paper evaluates exploration technology. Topics discussed are: Visions; the subsurface challenge; the creative tension; the exploration process; seismic; geology; organic geochemistry; seismic resolution; integration; drilling; value creation. 4 refs., 22 figs.

  4. Repository exploration

    International Nuclear Information System (INIS)

    Pentz, D.L.

    1984-01-01

    This paper discusses exploration objectives and requirements for a nuclear repository in the U.S.A. The importance of designing the exploration program to meet the system performance objectives is emphasized and some examples of the extent of exploration required before the License Application for Construction Authorization is granted are also discussed

  5. 新人文主义视野下医学生医德培养探索——医德培养档案构建初探%Exploration of Medical Ethics Education in the Perspective of New Humanism: -on medical ethics education profile building

    Institute of Scientific and Technical Information of China (English)

    陈笑笑

    2011-01-01

    医疗行为的主客体都是有意识的生命个体,这是医学生医德培养的根本出发点.然而当前我国医德培养中出现了"物化"趋势.以白璧德为代表的新人文主义思想批判过分功利性教育,旨在以人文标准来实现教育之塑造真正的人的根本目的.应充分汲取新人文主义思想中的伦理学因素-人格与道德的完善,探索构建医德培养档案的目标、形式、内容、特点和意义,为加强医学生医德伦理教育的实效性,全面提升医学专业人才的人文与科学素养,塑造医学生完善的医德人格提供有效的途径.%The fact that both the subject and the object of medical practice are conscious humanbeings is regarded as the fundamental principle in medical ethics education. However, there has been a materialization tendency in recent Chinese medical ethics education. Irving Babbitt, the representative of the New Humanism criticized the over- utilitarian education at that time in America, aiming at rebuilding humanistic standards and realizing the final goal of education - creating a truly integral man. In the perspective of New Humanism, this study explores the goal, formality, content, feature and importance of building profiles for students' medical ethics education, in order to enhance the effectiveness, promote the quality of humanity and scientific literacy, and provide effective ways for ethical personality perfection of medical students.

  6. Exploration Laboratory Analysis

    Science.gov (United States)

    Krihak, M.; Ronzano, K.; Shaw, T.

    2016-01-01

    The Exploration Laboratory Analysis (ELA) project supports the Exploration Medical Capability (ExMC) risk to minimize or reduce the risk of adverse health outcomes and decrements in performance due to in-flight medical capabilities on human exploration missions. To mitigate this risk, the availability of inflight laboratory analysis instrumentation has been identified as an essential capability for manned exploration missions. Since a single, compact space-ready laboratory analysis capability to perform all exploration clinical measurements is not commercially available, the ELA project objective is to demonstrate the feasibility of emerging operational and analytical capability as a biomedical diagnostics precursor to long duration manned exploration missions. The initial step towards ground and flight demonstrations in fiscal year (FY) 2015 was the down selection of platform technologies for demonstrations in the space environment. The technologies selected included two Small Business Innovation Research (SBIR) performers: DNA Medicine Institutes rHEALTH X and Intelligent Optical Systems later flow assays combined with Holomics smartphone analyzer. The selection of these technologies were based on their compact size, breadth of analytical capability and favorable ability to process fluids in a space environment, among several factors. These two technologies will be advanced to meet ground and flight demonstration success criteria and requirements that will be finalized in FY16. Also, the down selected performers will continue the technology development phase towards meeting prototype deliverables in either late 2016 or 2017.

  7. Medical imaging

    CERN Document Server

    Townsend, David W

    1996-01-01

    Since the introduction of the X-ray scanner into radiology almost 25 years ago, non-invasive imaging has become firmly established as an essential tool in the diagnosis of disease. Fully three-dimensional imaging of internal organs is now possible, b and for studies which explore the functional status of the body. Powerful techniques to correlate anatomy and function are available, and scanners which combine anatomical and functional imaging in a single device are under development. Such techniques have been made possible through r ecent technological and mathematical advances. This series of lectures will review both the physical basis of medical imaging techniques using X-rays, gamma and positron emitting radiosiotopes, and nuclear magnetic resonance, and the mathematical methods used to reconstruct three-dimentional distributions from projection data. The lectures will trace the development of medical imaging from simple radiographs to the present-day non-invasive measurement of in vivo biochemistry. They ...

  8. The Muddle of Medicalization

    DEFF Research Database (Denmark)

    Sholl, Jonathan

    2017-01-01

    to describe inappropriate or abusive instances of medical authority. Yet, while this standard approach claims that medicalization is a growing problem, it assumes that there is simply one “medical model” and that the expanding realm of “the medical” can be more or less clearly delineated. Moreover, while...... of medical discourse. In doing so, I will explore the distinction between medicalization and pathologization, a distinction that is often overlooked and that brings with it many conceptual and practical implications. After defining these terms, I will use some examples to show that while pathologizing...

  9. Abdominal exploration

    Science.gov (United States)

    ... help diagnose and treat many health conditions, including: Cancer of the ovary, colon, pancreas, liver Endometriosis Gallstones Hole in the intestine (intestinal perforation) Inflammation of the appendix ( acute ... practice specializing in breast cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed ...

  10. Human Research Program Integrated Research Plan. Revision A January 2009

    Science.gov (United States)

    2009-01-01

    The Integrated Research Plan (IRP) describes the portfolio of Human Research Program (HRP) research and technology tasks. The IRP is the HRP strategic and tactical plan for research necessary to meet HRP requirements. The need to produce an IRP is established in HRP-47052, Human Research Program - Program Plan, and is under configuration management control of the Human Research Program Control Board (HRPCB). Crew health and performance is critical to successful human exploration beyond low Earth orbit. The Human Research Program (HRP) is essential to enabling extended periods of space exploration because it provides knowledge and tools to mitigate risks to human health and performance. Risks include physiological and behavioral effects from radiation and hypogravity environments, as well as unique challenges in medical support, human factors, and behavioral or psychological factors. The Human Research Program (HRP) delivers human health and performance countermeasures, knowledge, technologies and tools to enable safe, reliable, and productive human space exploration. Without HRP results, NASA will face unknown and unacceptable risks for mission success and post-mission crew health. This Integrated Research Plan (IRP) describes HRP s approach and research activities that are intended to address the needs of human space exploration and serve HRP customers and how they are integrated to provide a risk mitigation tool. The scope of the IRP is limited to the activities that can be conducted with the resources available to the HRP; it does not contain activities that would be performed if additional resources were available. The timescale of human space exploration is envisioned to take many decades. The IRP illustrates the program s research plan through the timescale of early lunar missions of extended duration.

  11. Farside explorer

    DEFF Research Database (Denmark)

    Mimoun, David; Wieczorek, Mark A.; Alkalai, Leon

    2012-01-01

    the primary differentiation and evolution of the Moon, it can be continuously monitored from the Earth-Moon L2 Lagrange point, and there is a complete lack of reflected solar illumination from the Earth. Farside Explorer will exploit these properties and make the first radio-astronomy measurements from...... the most radio-quiet region of near-Earth space, determine the internal structure and thermal evolution of the Moon, from crust to core, and quantify impact hazards in near-Earth space by the measurement of flashes generated by impact events. The Farside Explorer flight system includes two identical solar......Farside Explorer is a proposed Cosmic Vision medium-size mission to the farside of the Moon consisting of two landers and an instrumented relay satellite. The farside of the Moon is a unique scientific platform in that it is shielded from terrestrial radio-frequency interference, it recorded...

  12. Uranium exploration

    International Nuclear Information System (INIS)

    De Voto, R.H.

    1984-01-01

    This paper is a review of the methodology and technology that are currently being used in varying degrees in uranium exploration activities worldwide. Since uranium is ubiquitous and occurs in trace amounts (0.2 to 5 ppm) in virtually all rocks of the crust of the earth, exploration for uranium is essentially the search of geologic environments in which geologic processes have produced unusual concentrations of uranium. Since the level of concentration of uranium of economic interest is dependent on the present and future price of uranium, it is appropriate here to review briefly the economic realities of uranium-fueled power generation. (author)

  13. Medical Data Architecture Project Status

    Science.gov (United States)

    Krihak, M.; Middour, C.; Gurram, M.; Wolfe, S.; Marker, N.; Winther, S.; Ronzano, K.; Bolles, D.; Toscano, W.; Shaw, T.

    2018-01-01

    The Medical Data Architecture (MDA) project supports the Exploration Medical Capability (ExMC) risk to minimize or reduce the risk of adverse health outcomes and decrements in performance due to in-flight medical capabilities on human exploration missions. To mitigate this risk, the ExMC MDA project addresses the technical limitations identified in ExMC Gap Med 07: We do not have the capability to comprehensively process medically-relevant information to support medical operations during exploration missions. This gap identifies that the current in-flight medical data management includes a combination of data collection and distribution methods that are minimally integrated with on-board medical devices and systems. Furthermore, there are a variety of data sources and methods of data collection. For an exploration mission, the seamless management of such data will enable a more medically autonomous crew than the current paradigm. The medical system requirements are being developed in parallel with the exploration mission architecture and vehicle design. ExMC has recognized that in order to make informed decisions about a medical data architecture framework, current methods for medical data management must not only be understood, but an architecture must also be identified that provides the crew with actionable insight to medical conditions. This medical data architecture will provide the necessary functionality to address the challenges of executing a self-contained medical system that approaches crew health care delivery without assistance from ground support. Hence, the products supported by current prototype development will directly inform exploration medical system requirements.

  14. College Explorer.

    Science.gov (United States)

    Ahl, David H.

    1985-01-01

    The "College Explorer" is a software package (for the 64K Apple II, IBM PC, TRS-80 model III and 4 microcomputers) which aids in choosing a college. The major features of this package (manufactured by The College Board) are described and evaluated. Sample input/output is included. (JN)

  15. Exploring Size.

    Science.gov (United States)

    Brand, Judith, Ed.

    1995-01-01

    "Exploring" is a magazine of science, art, and human perception that communicates ideas museum exhibits cannot demonstrate easily by using experiments and activities for the classroom. This issue concentrates on size, examining it from a variety of viewpoints. The focus allows students to investigate and discuss interconnections among…

  16. Exploration Laboratory Analysis FY13

    Science.gov (United States)

    Krihak, Michael; Perusek, Gail P.; Fung, Paul P.; Shaw, Tianna, L.

    2013-01-01

    The Exploration Laboratory Analysis (ELA) project supports the Exploration Medical Capability (ExMC) risk, which is stated as the Risk of Inability to Adequately Treat an Ill or Injured Crew Member, and ExMC Gap 4.05: Lack of minimally invasive in-flight laboratory capabilities with limited consumables required for diagnosing identified Exploration Medical Conditions. To mitigate this risk, the availability of inflight laboratory analysis instrumentation has been identified as an essential capability in future exploration missions. Mission architecture poses constraints on equipment and procedures that will be available to treat evidence-based medical conditions according to the Space Medicine Exploration Medical Conditions List (SMEMCL), and to perform human research studies on the International Space Station (ISS) that are supported by the Human Health and Countermeasures (HHC) element. Since there are significant similarities in the research and medical operational requirements, ELA hardware development has emerged as a joint effort between ExMC and HHC. In 2012, four significant accomplishments were achieved towards the development of exploration laboratory analysis for medical diagnostics. These achievements included (i) the development of high priority analytes for research and medical operations, (ii) the development of Level 1 functional requirements and concept of operations documentation, (iii) the selection and head-to-head competition of in-flight laboratory analysis instrumentation, and (iv) the phase one completion of the Small Business Innovation Research (SBIR) projects under the topic Smart Phone Driven Blood-Based Diagnostics. To utilize resources efficiently, the associated documentation and advanced technologies were integrated into a single ELA plan that encompasses ExMC and HHC development efforts. The requirements and high priority analytes was used in the selection of the four in-flight laboratory analysis performers. Based upon the

  17. Exploring digital professionalism.

    Science.gov (United States)

    Ellaway, Rachel H; Coral, Janet; Topps, David; Topps, Maureen

    2015-01-01

    The widespread use of digital media (both computing devices and the services they access) has blurred the boundaries between our personal and professional lives. Contemporary students are the last to remember a time before the widespread use of the Internet and they will be the first to practice in a largely e-health environment. This article explores concepts of digital professionalism and their place in contemporary medical education, and proposes a series of principles of digital professionalism to guide teaching, learning and practice in the healthcare professions. Despite the many risks and fears surrounding their use, digital media are not an intrinsic threat to medical professionalism. Professionals should maintain the capacity for deliberate, ethical, and accountable practice when using digital media. The authors describe a digital professionalism framework structured around concepts of proficiency, reputation, and responsibility. Digital professionalism can be integrated into medical education using strategies based on awareness, alignment, assessment, and accountability. These principles of digital professionalism provide a way for medical students and medical practitioners to embrace the positive aspects of digital media use while being mindful and deliberate in its use to avoid or minimize any negative consequences.

  18. Human Research Program 2010 Chair Standing Review Panel Meeting

    Science.gov (United States)

    Steinberg, Susan

    2011-01-01

    The 13 Human Research Program (HRP) Standing Review Panel (SRP) Chairs, and in some cases one or two additional panel members (see section XIV, roster) referred to as the Chair (+1) SRP throughout this document, met at the NASA Johnson Space Center (JSC) on December 7, 2010 to allow the HRP Elements and Projects to report on their progress over the past year, their current status, and their plans for the upcoming year based on NASA's current goals and objectives for human space exploration. A large focus of the meeting was also used to discuss integration across the HRP scientific disciplines based on a recommendation from the 2009 HRP SRP review. During the one-day meeting, each of the HRP Elements and Projects presented the changes they made to the HRP Integrated Research Plan (IRP Rev. B) over the last year, and what their top three areas of integration are between other HRP Elements/Projects. The Chair (+1) SRP spent sufficient time addressing the panel charge, either as a group or in a separate closed session, and the Chair (+1) SRP and the HRP presenters and observers, in most cases, had sufficient time to discuss during and after the presentations. The SRP made a final debriefing to the HRP Program Scientist, Dr. John B. Charles, prior to the close of the meeting on December 7, 2010. Overall, the Chair (+1) SRP concluded that most of the HRP Elements/Projects did a commendable job during the past year in addressing integration across the HRP scientific disciplines with the available resources. The Chair (+1) SRP agreed that the idea of integration between HRP Elements/Projects is noble, but believes all parties involved should have the same definition of integration, in order to be successful. The Chair (+1) SRP also believes that a key to successful integration is communication among the HRP Elements/Projects which may present a challenge. The Chair (+1) SRP recommends that the HRP have a workshop on program integration (with HRP Element

  19. Cannabinoids: Medical implications.

    Science.gov (United States)

    Schrot, Richard J; Hubbard, John R

    2016-01-01

    Herbal cannabis has been used for thousands of years for medical purposes. With elucidation of the chemical structures of tetrahydrocannabinol (THC) and cannabidiol (CBD) and with discovery of the human endocannabinoid system, the medical usefulness of cannabinoids has been more intensively explored. While more randomized clinical trials are needed for some medical conditions, other medical disorders, like chronic cancer and neuropathic pain and certain symptoms of multiple sclerosis, have substantial evidence supporting cannabinoid efficacy. While herbal cannabis has not met rigorous FDA standards for medical approval, specific well-characterized cannabinoids have met those standards. Where medical cannabis is legal, patients typically see a physician who "certifies" that a benefit may result. Physicians must consider important patient selection criteria such as failure of standard medical treatment for a debilitating medical disorder. Medical cannabis patients must be informed about potential adverse effects, such as acute impairment of memory, coordination and judgment, and possible chronic effects, such as cannabis use disorder, cognitive impairment, and chronic bronchitis. In addition, social dysfunction may result at work/school, and there is increased possibility of motor vehicle accidents. Novel ways to manipulate the endocannbinoid system are being explored to maximize benefits of cannabinoid therapy and lessen possible harmful effects.

  20. Exploring quadrangulations

    KAUST Repository

    Peng, Chi-Han; Barton, Michael; Jiang, Caigui; Wonka, Peter

    2014-01-01

    Here we presented a framework to explore quad mesh topologies. The core of our work is a systematic enumeration algorithm that can generate all possible quadrangular meshes inside a defined boundary with an upper limit of v3-v5 pairs. The algorithm is orders of magnitude more efficient than previous work. The combination of topological enumeration and shape-space exploration demonstrates that mesh topology has a powerful influence on geometry. The Fig. 18. A gallery of different quadrilateral meshes for a Shuriken. The quadrilaterals of the model were colored in a postprocess. Topological variations have distinctive, interesting patterns of mesh lines. © 2014 ACM 0730-0301/2014/01-ART3 15.00.

  1. Exploring quadrangulations

    KAUST Repository

    Peng, Chi-Han

    2014-02-04

    Here we presented a framework to explore quad mesh topologies. The core of our work is a systematic enumeration algorithm that can generate all possible quadrangular meshes inside a defined boundary with an upper limit of v3-v5 pairs. The algorithm is orders of magnitude more efficient than previous work. The combination of topological enumeration and shape-space exploration demonstrates that mesh topology has a powerful influence on geometry. The Fig. 18. A gallery of different quadrilateral meshes for a Shuriken. The quadrilaterals of the model were colored in a postprocess. Topological variations have distinctive, interesting patterns of mesh lines. © 2014 ACM 0730-0301/2014/01-ART3 15.00.

  2. Explorative Faktorenanalyse

    OpenAIRE

    Klopp, Eric

    2010-01-01

    Die explorative Faktorenanalyse (EFA) ist ein Verfahren aus der multivariaten Statistik. Mithilfe der Faktorenanalyse kann aus den Beobachtungen vieler manifester Variablen (z .B Items eines Fragebogens) auf wenige zugrunde liegende latente Variablen, die Faktoren genannt werden, geschlossen werden. Eine EFA führt zu einer Reduktion der Variablen auf wenige, den manifesten Variablen zugrunde liegende Faktoren. Der folgende Text gibt einen Überblick über die Grundlagen der EFA sowie der wichti...

  3. Exploring Science Through Polar Exploration

    Science.gov (United States)

    Pfirman, S. L.; Bell, R. E.; Zadoff, L.; Kelsey, R.

    2003-12-01

    Exploring the Poles is a First Year Seminar course taught at Barnard College, Columbia University. First Year Seminars are required of incoming students and are designed to encourage critical analysis in a small class setting with focused discussion. The class links historical polar exploration with current research in order to: introduce non-scientists to the value of environmental science through polar literature; discuss issues related to venturing into the unknown that are of relevance to any discipline: self-reliance, leadership, preparation, decisions under uncertainty; show students the human face of science; change attitudes about science and scientists; use data to engage students in exploring/understanding the environment and help them learn to draw conclusions from data; integrate research and education. These goals are met by bringing analysis of early exploration efforts together with a modern understanding of the polar environment. To date to class has followed the efforts of Nansen in the Fram, Scott and Amundsen in their race to the pole, and Shackleton's Endurance. As students read turn-of-the-century expedition journals, expedition progress is progressively revealed on an interactive map showing the environmental context. To bring the exploration process to life, students are assigned to expedition teams for specific years and the fates of the student "expeditions" are based on their own decisions. For example, in the Arctic, they navigate coastal sea ice and become frozen into the ice north of Siberia, re-creating Nansen's polar drift. Fates of the teams varied tremendously: some safely emerged at Fram Strait in 4 years, while others nearly became hopelessly lost in the Beaufort Gyre. Students thus learn about variability in the current polar environment through first hand experience, enabling them to appreciate the experiences, decisions, and, in some cases, the luck, of polar explorers. Evaluation by the Columbia Center for New Media, Teaching

  4. Space exploration

    CERN Document Server

    2009-01-01

    Space Exploration, is one book in the Britannica Illustrated Science Library Series that is correlated to the science curriculum in grades 5-8. The Britannica Illustrated Science Library is a visually compelling set that covers earth science, life science, and physical science in 16 volumes.  Created for ages 10 and up, each volume provides an overview on a subject and thoroughly explains it through detailed and powerful graphics-more than 1,000 per volume-that turn complex subjects into information that students can grasp.  Each volume contains a glossary with full definitions for vocabulary help and an index.

  5. Abortion - medical

    Science.gov (United States)

    Therapeutic medical abortion; Elective medical abortion; Induced abortion; Nonsurgical abortion ... A medical, or nonsurgical, abortion can be done within 7 weeks from the first day of the woman's last ...

  6. Motivation in medical students

    OpenAIRE

    Kusurkar, R.A.

    2012-01-01

    Introduction The importance of motivation in learning behaviour and education is well-researched and proven in general education, but much less in medical education. There is sometimes focus on increasing the quantity of motivation, but the how and why need more evidence. The aims of this thesis were to gather insights and investigate medical students’ motivation, particularly the importance of quality of motivation, factors influencing and outcomes and to explore how these can be applied to ...

  7. Geoelectrical exploration

    Directory of Open Access Journals (Sweden)

    Mostafa Said Barseem

    2015-12-01

    Full Text Available Sinai development is a goal of successive governments in Egypt. The present study is a geoelectrical exploration to find appropriate solutions of the problems affecting the land of a Research Station in Southeast Al Qantara. This research station is one of the Desert Research Center stations to facilitate the development of desert land for agriculture by introducing applied research. It suffers from some problems which can be summarized in the shortage of irrigation water and water logging. The appropriate solutions of these problems have been delineated by the results of 1D and 2D geoelectrical measurements. Electrical resistivity (ER revealed the subsurface sedimentary sequences and extension of subsurface layers in the horizontal and vertical directions, especially, the water bearing layer. Additionally it helped to choose the most suitable places to drill productive wells with a good condition.

  8. Exploration economics

    International Nuclear Information System (INIS)

    Mcgill, R.E.

    1992-01-01

    This paper deals with determining the economic viability of the play or prospect. At the outset, one point is important. Preexploration economists are important because they enable geologists to see if their assumptions will prove profitable. Their assumptions must consider the full range of possible outcomes, even if only some portion of that range may contain prospects or plays that are estimated to be profitable. Play economics are preferable to prospect economics because, being the sum of several prospects, they give a broader view of the investment opportunity. Finally, remember that play and prospect economics are always slightly optimistic. They seldom include all of the exploration and overhead changes that must ultimately be borne by the successful prospects

  9. HR Explorer

    CERN Document Server

    Möller, M

    1997-01-01

    At the European Laboratory for Particle Physics Research (CERN), Geneva Switzerland we are using OracleHR for managing our human resources since 1995. After the first year of production it became clear that there was a strong need for an easy-to-use Decision Support Tool exploring the data in OracleHR. This paper illustrates an approach which we have adopted to provide on-line management reporting, multi-dimensional analysis, drill-down and slicing & dicing of data, warehoused from OracleHR. The tool offers strong resource management and planning capabilities including career follow-up. The user management and security monitoring are implemented using the Oracle WebServer.

  10. Hydrocarbon exploration

    Energy Technology Data Exchange (ETDEWEB)

    Lerche, I. (South Carolina Univ., Columbia, SC (United States). Dept. of Geological Sciences)

    1993-01-01

    This special issue of the journal examines various aspects of the on-going search for hydrocarbons, ranging from frontier basins where little data are available, to more mature areas where considerable data are available. The incentives underlying the search for oil are roughly: the social, economic and industrial needs of a nation; the incentive of a corporation to be profitable; and the personal incentives of individuals in the oil industry and governments, which range from financial wealth to power and which are as diverse as the individuals who are involved. From a geopolitical perspective, the needs, requirements, goals, strategies, and philosophies of nations, and groups of nations, also impact on the oil exploration game. Strategies that have been employed have ranged from boycott to austerity and rationing, to physical intervention, to global ''flooding'' with oil by over-production. (author)

  11. Exploring ESASky

    Science.gov (United States)

    De Marchi, Guido; ESASky Team

    2017-06-01

    ESASky is a science-driven discovery portal for all ESA space astronomy missions. It also includes missions from international partners such as Suzaku and Chandra. The first public release of ESASky features interfaces for sky exploration and for single and multiple target searches. Using the application requires no prior-knowledge of any of the missions involved and gives users world-wide simplified access to high-level science-ready data products from space-based Astronomy missions, plus a number of ESA-produced source catalogues, including the Gaia Data Release 1 catalogue. We highlight here the latest features to be developed, including one that allows the user to project onto the sky the footprints of the JWST instruments, at any chosen position and orientation. This tool has been developed to aid JWST astronomers when they are defining observing proposals. We aim to include other missions and instruments in the near future.

  12. NASA Laboratory Analysis for Manned Exploration Missions

    Science.gov (United States)

    Krihak, Michael K.; Shaw, Tianna E.

    2014-01-01

    The Exploration Laboratory Analysis (ELA) project supports the Exploration Medical Capability Element under the NASA Human Research Program. ELA instrumentation is identified as an essential capability for future exploration missions to diagnose and treat evidence-based medical conditions. However, mission architecture limits the medical equipment, consumables, and procedures that will be available to treat medical conditions during human exploration missions. Allocated resources such as mass, power, volume, and crew time must be used efficiently to optimize the delivery of in-flight medical care. Although commercial instruments can provide the blood and urine based measurements required for exploration missions, these commercial-off-the-shelf devices are prohibitive for deployment in the space environment. The objective of the ELA project is to close the technology gap of current minimally invasive laboratory capabilities and analytical measurements in a manner that the mission architecture constraints impose on exploration missions. Besides micro gravity and radiation tolerances, other principal issues that generally fail to meet NASA requirements include excessive mass, volume, power and consumables, and nominal reagent shelf-life. Though manned exploration missions will not occur for nearly a decade, NASA has already taken strides towards meeting the development of ELA medical diagnostics by developing mission requirements and concepts of operations that are coupled with strategic investments and partnerships towards meeting these challenges. This paper focuses on the remote environment, its challenges, biomedical diagnostics requirements and candidate technologies that may lead to successful blood-urine chemistry and biomolecular measurements in future space exploration missions.

  13. OECD - HRP Summer School on Nuclear Fuel

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-07-01

    In cooperation with the OECD Nuclear Energy Agency (NEA), the Halden Reactor Project organised a Summer School on nuclear fuel in the period August 28 September 1, 2000. The summer school was primarily intended for people who wanted to become acquainted with fuel-related subjects and issues without being experts. It was especially hoped that the summer school would serve to transfer knowledge to the ''young generation'' in the field of nuclear fuel. Experts from Halden Project member organisations gave the following presentations: (1) Overview of the nuclear community, (2) Criteria for safe operation and design of nuclear fuel, (3) Fuel design and fabrication, (4) Cladding Manufacturing, (5) Overview of the Halden Reactor Project, (6) Fuel performance evaluation and modelling, (7) Fission gas release, and (8) Cladding issues. Except for the Overview, which is a written paper, the other contributions are overhead figures from spoken lectures.

  14. OECD - HRP Summer School on Nuclear Fuel

    International Nuclear Information System (INIS)

    2000-01-01

    In cooperation with the OECD Nuclear Energy Agency (NEA), the Halden Reactor Project organised a Summer School on nuclear fuel in the period August 28 September 1, 2000. The summer school was primarily intended for people who wanted to become acquainted with fuel-related subjects and issues without being experts. It was especially hoped that the summer school would serve to transfer knowledge to the ''young generation'' in the field of nuclear fuel. Experts from Halden Project member organisations gave the following presentations: (1) Overview of the nuclear community, (2) Criteria for safe operation and design of nuclear fuel, (3) Fuel design and fabrication, (4) Cladding Manufacturing, (5) Overview of the Halden Reactor Project, (6) Fuel performance evaluation and modelling, (7) Fission gas release, and (8) Cladding issues. Except for the Overview, which is a written paper, the other contributions are overhead figures from spoken lectures

  15. Medical Rituals and Media Rituals

    Directory of Open Access Journals (Sweden)

    Zoltán Zsinkó-Szabó

    2013-01-01

    Full Text Available In the present article the author examines the ritual elements of theprofessionalization during medical studies, and its interference with media content of medical significance, comparing the role of medical and media rituals on the way of becoming a doctor. It is to be explored how these medical soap operas, medical dramas, medical thrillers or crime stories do exert influence on medical identity and role expectations. Do medical students and their relatives (withmedical expertise frequently identify themselves with these roles? Is their way of reception critical or naïve? How media rituals are organizing, modulating the students’ medical perception and expectations. Is there a mediated “shadow initiation” via media or it is excluded and denied? Does it perfuse the common social experience of becoming a doctor via peer communication and peer shapingof model behavior? We search the answers in the context of a theory of media rituals.

  16. Space Exploration

    Science.gov (United States)

    Gallagher, Dennis

    2017-01-01

    New range Passage Tomb may be the first structure with known astronomical significance. It was built around 3,200 B.C. in Ireland. It's central passage allows light end-to-end for about 2 weeks around winter solstice. The Sun, Moon, Planets, and Stars held significance in early times due to the seasons, significance for food crops, and mythology. Citation: Corel Photography and Windows to the Universe The Greek may be among the first to pursue analytical interpretations of what they saw in the sky. In about 280 B.C. Aristarchus suggested Earth revolves around the Sun and estimated the distance between. Around 130 B.C. Hipparchus developed the first accurate star map. Today still seek to understand how the universe formed and how we came to be and are we alone. Understanding the causes and consequences of climate change using advanced space missions with major Earth science and applications research. center dotFire the public imagination and inspire students to pursue STEM fields. Train college and graduate students to create a U.S. technical workforce with employees that embody the values of competence, innovation, and service. center dotDrive the technical innovations that enable exploration and become the engine of National economic growth. center dotPartner domestically and internationally to leverage resources to extend the reach of research.

  17. Power and the teaching of medical ethics.

    OpenAIRE

    Nicholas, B

    1999-01-01

    This paper argues that ethics education needs to become more reflective about its social and political ethic as it participates in the construction and transmission of medical ethics. It argues for a critical approach to medical ethics and explores the political context in medical schools and some of the peculiar problems in medical ethics education.

  18. Exploring the nanoworld

    International Nuclear Information System (INIS)

    Cockayne, D.

    2002-01-01

    Full text: The nanoworld is a real world waiting to be explored and to be exploited, and the key to this world is microscopy. Modem techniques of microscopy reveal not only atoms and molecules, but also how they combine and interact. They allow us to explore not only the natural but also the synthesised nanoworld. Through this exploration, we can discover new natural forms which can act as templates for constructing novel materials of technological and scientific importance, we can obtain knowledge about the nanoworld (eg the structure of macromolecules) which gives us the means to manipulate the natural world, and we can discover how nature uses microstructure to achieve materials properties (eg strength) which we can then mimic. There are many modern forms of microscopy which are used in this exploration. They include not only a variety of microscopes (eg electron, atomic force, scanning tunnelling) but also an increasing range of sophisticated techniques such as electron tomography, image reconstruction, energy loss spectroscopy and high resolution microscopy, in which mathematical manipulation of the data is playing an increasingly important role. Meanwhile developments in aberration correctors and electron energy monochromation are taking microscopy into a new realm of resolution both in imaging and spectroscopy. Research at the nanoscale is causing a convergence between the biological and physical sciences, largely because the tools and techniques they use are becoming increasingly common to both fields. This challenges us to arrange our activities to optimise our efforts and resources. So we see significant developments in shared instrumentation and remote operation, and we see the setting up of nanotechnology institutes where researchers from across the biological, mathematical, materials and medical disciplines explore together. Copyright (2002) Australian Society for Electron Microscopy Inc

  19. Exploring Mars

    Science.gov (United States)

    Breuil, Stéphanie

    2016-04-01

    Mars is our neighbour planet and has always fascinated humans as it has been seen as a potential abode for life. Knowledge about Mars is huge and was constructed step by step through numerous missions. It could be difficult to describe these missions, the associated technology, the results, the questions they raise, that's why an activity is proposed, that directly interests students. Their production is presented in the poster. Step 1: The main Mars feature and the first Mars explorations using telescope are presented to students. It should be really interesting to present "Mars Canals" from Percival Lowell as it should also warn students against flawed interpretation. Moreover, this study has raised the big question about extra-terrestrial life on Mars for the first time. Using Google Mars is then a good way to show the huge knowledge we have on the planet and to introduce modern missions. Step 2: Students have to choose and describe one of the Mars mission from ESA and NASA. They should work in pairs. Web sites from ESA and NASA are available and the teacher makes sure the main missions will be studied. Step 3: Students have to collect different pieces of information about the mission - When? Which technology? What were the main results? What type of questions does it raise? They prepare an oral presentation in the form they want (role play, academic presentation, using a poster, PowerPoint). They also have to produce playing cards about the mission that could be put on a timeline. Step 4: As a conclusion, the different cards concerning different missions are mixed. Groups of students receive cards and they have to put them on a timeline as fast as possible. It is also possible to play the game "timeline".

  20. Medical tourism.

    Science.gov (United States)

    Leggat, Peter

    2015-01-01

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

  1. Medical Management

    Science.gov (United States)

    ... org Close Charcot-Marie-Tooth Disease (CMT) Medical Management Although there’s no cure for CMT, there are ... individualized physical therapy program. For more on medical management of CMT, see Surgery Sometimes, Bracing Often, Caution ...

  2. Medical Identity

    DEFF Research Database (Denmark)

    Musaeus, Peter

    2015-01-01

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

  3. [Medical negligence].

    Science.gov (United States)

    Zipper, St G

    2016-06-01

    Medical negligence is a matter of growing public interest. This review outlines various aspects of medical negligence: epidemiology, taxonomy, and the risks, causes, psychology, management and prevention of errors.

  4. Medical Illustration

    Science.gov (United States)

    ... as medical books, journals, magazines, pharma or biotech marketing, films, online video, exhibits, posters, wall charts, educational ... of the health career profession with strong communication skills, medical illustrators work closely with clients to interpret ...

  5. [Medical technology and medical education].

    Science.gov (United States)

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

    2010-08-01

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

  6. Exploring self-use, attitude and interest to study complementary and alternative medicine (CAM) among final year undergraduate medical, pharmacy and nursing students in Sierra Leone: a comparative study.

    Science.gov (United States)

    James, Peter Bai; Bah, Abdulai Jawo; Kondorvoh, Idrissa Momoh

    2016-04-27

    CAM inclusion into the curricula of health training institutions, a strategy for its integration into the main stream healthcare delivery system is growing globally. Future healthcare professionals knowledge and perception of CAM are key determinants to its successful integration. Thus, the main objective of this study was to compare the use, attitude and interest to study CAM among final year undergraduate medical, pharmacy and nursing students at the College of Medicine and Allied Health Sciences University of Sierra Leone (COMAHS-USL). A questionnaire based cross-sectional survey was carried out among final year medical, pharmacy and nursing students enrolled at the College of Medicine and Allied Health Sciences University of Sierra Leone (COMAHS-USL). Chi square, fisher exact two tailed test and Kruskal-wallis test were used to analyze data collected. Close to two-thirds (61 %) of all the three groups of final year students used one form of CAM or the other with pharmacy (72.7 %) and nursing (55.6 %) students being the highest and least users respectively. No significant difference was observed among the three groups. In general, final year students in all three cadres demonstrated a positive attitude toward CAM (33.80 ± 3. 2) with medical students showing more positive attitude than pharmacy (p = 0.022) and nursing student (p = 0.008). No significant difference in attitude was observed between students in pharmacy and nursing programs (p = 0.354). More than three quarter (76.6 %) of the students in all the three groups indicated their interest in studying CAM, with preference for the subject to be taught as an elective module (81.6 %). An appreciable number of final year medical, pharmacy and nursing students at COMAHS-USL have used at least one CAM modality and demonstrated an overall positive attitude towards CAM. Interest to study CAM was also observed among most of them even though they preferred it to be taught as an elective module.

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

    Science.gov (United States)

    Song, Peipei; Tang, Wei

    2017-05-23

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

  8. Exam Success at Undergraduate and Graduate-Entry Medical Schools: Is Learning Style or Learning Approach More Important? A Critical Review Exploring Links Between Academic Success, Learning Styles, and Learning Approaches Among School-Leaver Entry ("Traditional") and Graduate-Entry ("Nontraditional") Medical Students.

    Science.gov (United States)

    Feeley, Anne-Marie; Biggerstaff, Deborah L

    2015-01-01

    PHENOMENON: The literature on learning styles over many years has been replete with debate and disagreement. Researchers have yet to elucidate exactly which underlying constructs are measured by the many learning styles questionnaires available. Some academics question whether learning styles exist at all. When it comes to establishing the value of learning styles for medical students, a further issue emerges. The demographics of medical students in the United Kingdom have changed in recent years, so past studies may not be applicable to students today. We wanted to answer a very simple, practical question: what can the literature on learning styles tell us that we can use to help today's medical students succeed academically at medical school? We conducted a literature review to synthesise the available evidence on how two different aspects of learning-the way in which students like to receive information in a learning environment (termed learning "styles") and the motivations that drive their learning (termed learning "approaches")-can impact on medical students' academic achievement. Our review confirms that although learning "styles" do not correlate with exam performance, learning "approaches" do: those with "strategic" and "deep" approaches to learning (i.e., motivated to do well and motivated to learn deeply respectively) perform consistently better in medical school examinations. Changes in medical school entrant demographics in the past decade have not altered these correlations. Optimistically, our review reveals that students' learning approaches can change and more adaptive approaches may be learned. Insights: For educators wishing to help medical students succeed academically, current evidence demonstrates that helping students develop their own positive learning approach using "growth mind-set" is a more effective (and more feasible) than attempting to alter students' learning styles. This conclusion holds true for both "traditional" and graduate

  9. Bile Duct Exploration

    Science.gov (United States)

    ... Home / Health Library / Diagnostics & Testing / Bile Duct Exploration Bile Duct Exploration Common bile duct exploration is a ... Test Details Results and Follow-Up What is bile, and what is bile duct exploration? Bile is ...

  10. Professional identity in medical students: pedagogical challenges to medical education.

    Science.gov (United States)

    Wilson, Ian; Cowin, Leanne S; Johnson, Maree; Young, Helen

    2013-01-01

    Professional identity, or how a doctor thinks of himself or herself as a doctor, is considered to be as critical to medical education as the acquisition of skills and knowledge relevant to patient care. This article examines contemporary literature on the development of professional identity within medicine. Relevant theories of identity construction are explored and their application to medical education and pedagogical approaches to enhancing students' professional identity are proposed. The influence of communities of practice, role models, and narrative reflection within curricula are examined. Medical education needs to be responsive to changes in professional identity being generated from factors within medical student experiences and within contemporary society.

  11. Integrated Medical Model (IMM) Project Verification, Validation, and Credibility (VVandC)

    Science.gov (United States)

    Walton, M.; Boley, L.; Keenan, L.; Kerstman, E.; Shah, R.; Young, M.; Saile, L.; Garcia, Y.; Meyers, J.; Reyes, D.

    2015-01-01

    the IMM Project to better communicate VVC status. This has included refining original 7009 methodology with augmentation from the HRP NASA-STD-7009 Guidance Document working group and the NASA-HDBK-7009 [2]. End user requests and requirements are being satisfied as evidenced by ISS Program acceptance of IMM risk forecasts, transition to an operational model and simulation tool, and completion of service requests from a broad end user consortium including operations, science and technology planning, and exploration planning. IMM v4.0 is slated for operational release in the FY015 and current VVC assessments illustrate the expected VVC status prior to the completion of customer lead external review efforts. CONCLUSIONS: The VVC approach established by the IMM Project of incorporating Project-specific recommended practices and guidelines for implementing the 7009 requirements is comprehensive and includes the involvement of end users at every stage in IMM evolution. Methods and techniques used to quantify the VVC status of the IMM Project represented a critical communication tool in providing clear and concise suitability assessments to IMM customers. These processes have not only received approval from the local NASA community but have also garnered recognition by other federal agencies seeking to develop similar guidelines in the medical modeling community.

  12. Medical marijuana.

    OpenAIRE

    Marmor, J B

    1998-01-01

    Although many clinical studies suggest the medical utility of marijuana for some conditions, the scientific evidence is weak. Many patients in California are self-medicating with marijuana, and physicians need data to assess the risks and benefits. The only reasonable solution to this problem is to encourage research on the medical effects of marijuana. The current regulatory system should be modified to remove barriers to clinical research with marijuana. The NIH panel has identified several...

  13. The Nueva Granada pharmacy of the Company of Jesus: a laboratory for the exploration of medical practices in the province of Santafé in the irst half of the XVIIIth century.

    Directory of Open Access Journals (Sweden)

    María Eugenia Osorio Oliveros

    2013-01-01

    Full Text Available This paper is focused on the study of an inventory carried out in the pharmacy belonging to Colegio Máximo de Santafé of the Company of Jesus in 1767. This inventory is intended to recognize medical practices performed by missionaries in the province of Santafé during the irst half of the XVIIIth century. In the same way, importance is given to the exchange of healing knowledge between Jesuits and American natives, which was crucial for the colonial and local establishment of the paradigm of Humanist Galenism.

  14. Can We Trust Computational Modeling for Medical Applications?

    Science.gov (United States)

    Mulugeta, Lealem; Walton, Marlei; Nelson, Emily; Myers, Jerry

    2015-01-01

    Operations in extreme environments such as spaceflight pose human health risks that are currently not well understood and potentially unanticipated. In addition, there are limited clinical and research data to inform development and implementation of therapeutics for these unique health risks. In this light, NASA's Human Research Program (HRP) is leveraging biomedical computational models and simulations (M&S) to help inform, predict, assess and mitigate spaceflight health and performance risks, and enhance countermeasure development. To ensure that these M&S can be applied with confidence to the space environment, it is imperative to incorporate a rigorous verification, validation and credibility assessment (VV&C) processes to ensure that the computational tools are sufficiently reliable to answer questions within their intended use domain. In this presentation, we will discuss how NASA's Integrated Medical Model (IMM) and Digital Astronaut Project (DAP) have successfully adapted NASA's Standard for Models and Simulations, NASA-STD-7009 (7009) to achieve this goal. These VV&C methods are also being leveraged by organization such as the Food and Drug Administration (FDA), National Institute of Health (NIH) and the American Society of Mechanical Engineers (ASME) to establish new M&S VV&C standards and guidelines for healthcare applications. Similarly, we hope to provide some insight to the greater aerospace medicine community on how to develop and implement M&S with sufficient confidence to augment medical research and operations.

  15. Medical Data Architecture (MDA) Project Status

    Science.gov (United States)

    Krihak, M.; Middour, C.; Gurram, M.; Wolfe, S.; Marker, N.; Winther, S.; Ronzano, K.; Bolles, D.; Toscano, W.; Shaw, T.

    2018-01-01

    The Medical Data Architecture (MDA) project supports the Exploration Medical Capability (ExMC) risk to minimize or reduce the risk of adverse health outcomes and decrements in performance due to in-flight medical capabilities on human exploration missions. To mitigate this risk, the ExMC MDA project addresses the technical limitations identified in ExMC Gap Med 07: We do not have the capability to comprehensively process medically-relevant information to support medical operations during exploration missions. This gap identifies that the current in-flight medical data management includes a combination of data collection and distribution methods that are minimally integrated with on-board medical devices and systems. Furthermore, there are a variety of data sources and methods of data collection. For an exploration mission, the seamless management of such data will enable a more medically autonomous crew than the current paradigm. The medical system requirements are being developed in parallel with the exploration mission architecture and vehicle design. ExMC has recognized that in order to make informed decisions about a medical data architecture framework, current methods for medical data management must not only be understood, but an architecture must also be identified that provides the crew with actionable insight to medical conditions. This medical data architecture will provide the necessary functionality to address the challenges of executing a self-contained medical system that approaches crew health care delivery without assistance from ground support. Hence, the products supported by current prototype development will directly inform exploration medical system requirements.

  16. Medical Terminology.

    Science.gov (United States)

    Mercer County Community Coll., Trenton, NJ.

    This document is one of a series of student workbooks developed for workplace skill development courses or workshops by Mercer County Community College (New Jersey) and its partners. Designed to help employees of medical establishments learn medical terminology, this course provides information on basic word structure, body parts, suffixes and…

  17. Motivational Strategies in Medical English Classroom

    Institute of Scientific and Technical Information of China (English)

    TIAN Jun-ying

    2014-01-01

    Objective:To explore strategies to motivate students in the classroom of Medical English. Methods:The motivational strategies applied in medical English classroom including defining course goals early in the semester, appropriate teacher behavior, creating real context and giving helpful and frequent Feedback were recommended. Results & Conclusion: The motivational strategies make a positive impact on students’motivation in medical English classroom.

  18. Human-centred automation: an explorative study

    International Nuclear Information System (INIS)

    Hollnagel, Erik; Miberg, Ann Britt

    1999-05-01

    The purpose of the programme activity on human-centred automation at the HRP is to develop knowledge (in the form of models and theories) and tools (in the form of techniques and simulators) to support design of automation that ensures effective human performance and comprehension. This report presents the work done on both the analytical and experimental side of this project. The analytical work has surveyed common definitions of automation and traditional design principles. A general finding is that human-centred automation usually is defined in terms of what it is not. This is partly due to a lack of adequate models and of human-automation interaction. Another result is a clarification of the consequences of automation, in particular with regard to situation awareness and workload. The experimental work has taken place as an explorative experiment in HAMMLAB in collaboration with IPSN (France). The purpose of this experiment was to increase the understanding of how automation influences operator performance in NPP control rooms. Two different types of automation (extensive and limited) were considered in scenarios having two different degrees of complexity (high and low), and involving diagnostic and procedural tasks. Six licensed NPP crews from the NPP at Loviisa, Finland, participated in the experiment. The dependent variables applied were plant performance, operator performance, self-rated crew performance, situation awareness, workload, and operator trust in the automation. The results from the diagnostic scenarios indicated that operators' judgement of crew efficiency was related to their level of trust in the automation, and further that operators trusted automation least and rated crew performance lowest in situations where crew performance was efficient and vice versa. The results from procedural scenarios indicated that extensive automation efficiently supported operators' performance, and further that operator' judgement of crew performance efficiency

  19. Exploring the Rate and Causes of Deductions Imposed on Social Security and Health Insurance`s Bills Related to Inpatients in Two Hospitals Affiliated with Tabriz University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Hossein Rezvanjou

    2017-02-01

    Full Text Available Background and Objectives: Annually, a large amount of fees that are paid by hospitals, will not be reimbursed as deductions by health insurance which imposes irreparable financial losses on hospitals. The purpose of this study was to determine the amount of deductions imposed on social security and health insurance`s bills and its causes related to inpatients in two hospitals affiliated with Tabriz University of Medical Sciences. Material and Methods: This was a cross-sectional study conducted in Alavi and Madani hospitals affiliated with Tabriz University of Medical Sciences by using 2015 data.  Researcher-designed checklist was used for data collecting. According to population size, census method and random sampling were used in Alavi and Madani hospitals, respectively. Gathered data were analyzed through descriptive statistics assisted by Excel v.13 software. Results: In the studied hospitals, most of the deductions in the Alavi and Madani hospitals were related to charge of surgeon and angioplasty, respectively. Also, in Alavi Hospital among deductions factors, the most repeated one was extra application in contrary to determined tariffs. In both hospitals, the role of the human factor in cases of error cannot be denied. Extra applications, inaccuracy in registration costs and lack of knowledge of the approved insurance tariffs are the main important factors influential on the deduction. Conclusion: Due to high rates of preventable deductions in both hospitals and being given the multiplicity and variety of services offered at the health centers, establishing income monitoring unit in hospitals and use of experienced staff is inevitable.

  20. Medical education... meet Michel Foucault.

    Science.gov (United States)

    Hodges, Brian D; Martimianakis, Maria A; McNaughton, Nancy; Whitehead, Cynthia

    2014-06-01

    There have been repeated calls for the greater use of conceptual frameworks and of theory in medical education. Although it is familiar to few medical educators, Michel Foucault's work is a helpful theoretical and methodological source. This article explores what it means to use a 'Foucauldian approach', presents a sample of Foucault's historical-genealogical studies that are relevant to medical education, and introduces the work of four researchers currently undertaking Foucauldian-inspired medical education research. Although they are not without controversy, Foucauldian approaches are employed by an increasing number of scholars and are helpful in shedding light on what it is possible to think, say and be in medical education. Our hope in sharing this Foucauldian work and perspective is that we might stimulate a dialogue that is forward-looking and optimistic about the possibilities for change in medical education. © 2014 John Wiley & Sons Ltd.

  1. Cardiac Medications

    Science.gov (United States)

    ... cholesterol from circulating in the blood. Watch an animation of how statins work. Reason for Medication Used ... Kindle Fire Popular Articles 1 Understanding Blood Pressure Readings 2 Sodium and Salt 3 Heart Attack Symptoms ...

  2. Medication Guide

    Science.gov (United States)

    ... Size Small Text Medium Text Large Text Contrast Dark on Light Light on Dark Donate Search Menu Donate What is Glaucoma? Care ... Low Vision Resources Medication Guide Resources on the Web » See All Articles Where the Money Goes Have ...

  3. Medical Cyclotrons

    Science.gov (United States)

    Friesel, D. L.; Antaya, T. A.

    Particle accelerators were initially developed to address specific scientific research goals, yet they were used for practical applications, particularly medical applications, within a few years of their invention. The cyclotron's potential for producing beams for cancer therapy and medical radioisotope production was realized with the early Lawrence cyclotrons and has continued with their more technically advanced successors — synchrocyclotrons, sector-focused cyclotrons and superconducting cyclotrons. While a variety of other accelerator technologies were developed to achieve today's high energy particles, this article will chronicle the development of one type of accelerator — the cyclotron, and its medical applications. These medical and industrial applications eventually led to the commercial manufacture of both small and large cyclotrons and facilities specifically designed for applications other than scientific research.

  4. Medical imaging

    International Nuclear Information System (INIS)

    Loshkajian, A.

    2000-01-01

    This didactical book presents the medical imaging techniques: radiography, scanner, nuclear magnetic resonance (NMR). Examples are given for the most common pathologies in all domains of medicine. (J.S.)

  5. Medical Imaging.

    Science.gov (United States)

    Barker, M. C. J.

    1996-01-01

    Discusses four main types of medical imaging (x-ray, radionuclide, ultrasound, and magnetic resonance) and considers their relative merits. Describes important recent and possible future developments in image processing. (Author/MKR)

  6. JAXA's Space Exploration Scenario

    Science.gov (United States)

    Sato, N. S.

    2018-04-01

    Japan Aerospace Exploration Agency (JAXA) has been studying space exploration scenario, including human exploration for Japan since 2015, which encompasses goals, knowledge gap assessment, and architecture. assessment, and technology roadmap.

  7. Medical education.

    Science.gov (United States)

    Krishnan, P

    1992-01-01

    In theory, the Medical Council of India (MCI) determines the standards and qualifications of medical schools. It also sanctions curricula and ensures standards. Yet no standards exist on the mode of selection in medical schools, duration of study, course content, student stipends or period of internship. It takes 4.5 years to finish medical school. Students undergo preclinical, paraclinical, and clinical training. Most courses are in English which tends to favor the urban elite. Students cannot always communicate with patients in local languages. Textbooks often provide medical examples unrelated to India. Pedagogy consists mainly of lectures and rote learning predominates. Curricula tend not to provide courses in community health. Students pick up on the elitist attitudes of the faculty. For example, faculty do not put much emphasis on community health, individual health, equity in health care delivery, and teamwork. Further the education system is not patient oriented, but hospital or disease oriented. Faculty should train students in creating sanitation programs, knowing local nutritious foods, and in making community diagnoses. Yet they tend to be practitioners 1st then educators. Further faculty are not paid well and are not always invited to take part in improving curriculum, so morale is often low. Moreover experience in health planning and management issues is not required for administrators. In addition, medical schools are not well equipped with learning aids, libraries, or teaching staff. Tax revenues finance medical education. 75% of graduating physicians set up a private practice. Further many physicians go to urban areas. 34-57% emigrate to other countries. The problems of medical education will not be solved until the political and economic system becomes more responsive to the health needs of the people.

  8. Medical tourism

    OpenAIRE

    Abbas Ghanbari; Khadijeh Zirak Moradlu; Morteza Ramazani

    2014-01-01

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

  9. Medical Applications

    OpenAIRE

    Biscari, C.; Falbo, L.

    2016-01-01

    The use of accelerators for medical applications has evolved from initial experimentation to turn-key devices commonly operating in hospitals. New applications are continuously being developed around the world, and the hadrontherapy facilities of the newest generation are placed at the frontier between industrial production and advanced R&D. An introduction to the different medical application accelerators is followed by a description of the hadrontherapy facilities, with special emphasis on ...

  10. Medical radiation

    International Nuclear Information System (INIS)

    1992-01-01

    This leaflet in the At-a-Glance Series describes the medical use of X-rays, how X-rays help in diagnosis, radiation protection of the patient, staff protection, how radioactive materials in nuclear medicine examinations help in diagnosis and the use of radiation in radiotherapy. Magnetic resonance imaging, a diagnostic technique involving no ionizing radiation, is also briefly examined. The role of the NRPB in the medical use of radiation is outlined. (UK)

  11. Medical negligence.

    OpenAIRE

    Rosen, M.

    1992-01-01

    The progress made in diagnostic and therapeutic medicine has resulted in an increase in the number of malpractice suits brought against medical practitioners. To constitute negligence it must be shown that the conduct of the accused did not measure up to the standard of care the law required of him in the particular circumstances and that he acted with guilt and therefore can be blamed for the deed. This paper describes medical practitioner negligence and reviews relevant cases.

  12. Medical Data Architecture Project Status

    Science.gov (United States)

    Krihak, M.; Middour, C.; Lindsey, A.; Marker, N.; Wolfe, S.; Winther, S.; Ronzano, K.; Bolles, D.; Toscano, W.; Shaw, T.

    2017-01-01

    The Medical Data Architecture (MDA) project supports the Exploration Medical Capability (ExMC) risk to minimize or reduce the risk of adverse health outcomes and decrements in performance due to in-flight medical capabilities on human exploration missions. To mitigate this risk, the ExMC MDA project addresses the technical limitations identified in ExMC Gap Med 07: We do not have the capability to comprehensively process medically-relevant information to support medical operations during exploration missions. This gap identifies that the current International Space Station (ISS) medical data management includes a combination of data collection and distribution methods that are minimally integrated with on-board medical devices and systems. Furthermore, there are variety of data sources and methods of data collection. For an exploration mission, the seamless management of such data will enable an increasingly autonomous crew than the current ISS paradigm. The MDA will develop capabilities that support automated data collection, and the necessary functionality and challenges in executing a self-contained medical system that approaches crew health care delivery without assistance from ground support. To attain this goal, the first year of the MDA project focused on reducing technical risk, developing documentation and instituting iterative development processes that established the basis for the first version of MDA software (or Test Bed 1). Test Bed 1 is based on a nominal operations scenario authored by the ExMC Element Scientist. This narrative was decomposed into a Concept of Operations that formed the basis for Test Bed 1 requirements. These requirements were successfully vetted through the MDA Test Bed 1 System Requirements Review, which permitted the MDA project to begin software code development and component integration. This paper highlights the MDA objectives, development processes, and accomplishments, and identifies the fiscal year 2017 milestones and

  13. Virtue in Medical Practice: An Exploratory Study.

    Science.gov (United States)

    Kotzee, Ben; Ignatowicz, Agnieszka; Thomas, Hywel

    2017-03-01

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

  14. Medical tourism

    Directory of Open Access Journals (Sweden)

    Abbas Ghanbari

    2014-08-01

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

  15. Reform of the Method for Evaluating the Teaching of Medical Linguistics to Medical Students

    Science.gov (United States)

    Zhang, Hongkui; Wang, Bo; Zhang, Longlu

    2014-01-01

    Explorating reform of the teaching evaluation method for vocational competency-based education (CBE) curricula for medical students is a very important process in following international medical education standards, intensify ing education and teaching reforms, enhancing teaching management, and improving the quality of medical education. This…

  16. Medical Applications

    CERN Document Server

    Biscari, C.

    2014-12-19

    The use of accelerators for medical applications has evolved from initial experimentation to turn-key devices commonly operating in hospitals. New applications are continuously being developed around the world, and the hadrontherapy facilities of the newest generation are placed at the frontier between industrial production and advanced R&D. An introduction to the different medical application accelerators is followed by a description of the hadrontherapy facilities, with special emphasis on CNAO, and the report closes with a brief outlook on the future of this field.

  17. Medical Applications

    International Nuclear Information System (INIS)

    Biscari, C; Falbo, L

    2014-01-01

    The use of accelerators for medical applications has evolved from initial experimentation to turn-key devices commonly operating in hospitals. New applications are continuously being developed around the world, and the hadrontherapy facilities of the newest generation are placed at the frontier between industrial production and advanced R&D. An introduction to the different medical application accelerators is followed by a description of the hadrontherapy facilities, with special emphasis on CNAO, and the report closes with a brief outlook on the future of this field

  18. Medical emplotment

    DEFF Research Database (Denmark)

    Mønsted, Troels Sune

    ’. Theoretically the project departs from Computer Supported Cooperative Work and Participatory Design and is informed by Medical Informatics, Design Research and Science and Technology Studies. Methodically the project is founded on collaborative prototyping, ethnographic studies, and design interventions...... philosophy and building on theory on narrative reasoning, the dissertation offers the notions of emplotment and re-emplotment to describe how physicians marshal information from various sources, including the medical record, the patient and coSummary to form a narrative, when making sense of patients...

  19. Medical negligence

    African Journals Online (AJOL)

    Enrique

    19. SA JOURNAL OF RADIOLOGY • August 2004. Abstract. The progress made in diagnostic and therapeutic medicine has resulted in an increase in the number of malprac- tice suits brought against medical practitioners. To constitute negligence it must be shown that the conduct of the accused did not measure up to the.

  20. Medical Devices

    NARCIS (Netherlands)

    Verkerke, Gijsbertus Jacob; Mahieu, H.F.; Geertsema, A.A.; Hermann, I.F.; van Horn, J.R.; Hummel, J. Marjan; van Loon, J.P.; Mihaylov, D.; van der Plaats, A.; Schraffordt Koops, H.; Schutte, H.K.; Veth, R.P.H.; de Vries, M.P.; Rakhorst, G.; Shi, Donglu

    2004-01-01

    The development of new medical devices is a very time-consuming and costly process. Besides the time between the initial idea and the time that manufacturing and testing of prototypes takes place, the time needed for the development of production facilities, production of test series, marketing,

  1. Medical Malpractice

    DEFF Research Database (Denmark)

    Grembi, Veronica

    2014-01-01

    MM first came to the attention of policy makers primarily in the USA where, from the 1970s, healthcare providers denounced problems in getting insurance for medical liability, pointing out to a crisis in the MM insurance market (Sage WM (2003) Understanding the first malpractice crisis of the 21th...

  2. Medical marijuana

    Science.gov (United States)

    ... different amounts of cannabinoids. This sometimes makes the effects of medical marijuana hard to predict or control. The effects also ... wasting syndrome) Severe muscle spasms Multiple sclerosis Side Effects ... physical symptoms from using marijuana include: A fast or irregular heartbeat Dizziness Slow ...

  3. [Medical geography].

    Science.gov (United States)

    Hauri, D

    2007-10-17

    Hippocrates already noted that geographical factors such as climate, relief, geology but also settlement patterns had influenced the distribution of diseases. The task of medical geography is to investigate the associations between geographical factors and diseases. Thereby, geographic techniques and concepts are applied on health problems. Of particular importance is the mapping of diseases whose causes are environmental-related. In addition, epidemiological, ecological but also social scientific studies play an important part in the investigation of the associations between geographical factors and diseases. In order to understand the associations between the spatial distribution of diseases and environmental exposures, geographic information systems as well as statistical analyses have recently become more important. Some authors regard medical geography merely as supporting discipline of medicine. Nevertheless, as men and environment future and as they play an important part in the diffusion of diseases being regarded as defeated, medical geography will play an important part concerning medical questions. Especially travel medicine will rely on geographic knowledge, if a patient has to be consulted who plans to travel to an unknown country of which knowledge on the geographical distribution and ecology of diseases will be necessary.

  4. Geophysical Exploration. New site exploration method

    Energy Technology Data Exchange (ETDEWEB)

    Imai, Tsuneo; Otomo, Hideo; Sakayama, Toshihiko

    1988-07-25

    Geophysical exploration is used for geologic survey to serve purposes in civil engineering. New methods are being developed inside and outside Japan and are used to serve various purposes. This paper discusses recently developed techniques based on the measurement of seismic waves and electric potential. It also explains seismic tomography, radar tomography, and resistivity tomography which are included in the category of geotomography. At present, effort is being made to apply geophysical exploration technology to problems which were considered to be unsuitable for conventional exploration techniques. When such effort proceeds successfully, it is necessary to develop technology for presenting results quickly and exploration equipment which can work in various conditions. (10 figs, 15 refs)

  5. Influence of the medication environment on the unsafe medication behavior of nurses: A path analysis.

    Science.gov (United States)

    Yu, Xi; Li, Ce; Gao, Xueqin; Liu, Furong; Lin, Ping

    2018-04-20

    To explore the relationship between the medication environment and the unsafe medication behavior of nurses and to analyze its influence path. Unsafe medication behavior is the direct cause of medication error. The organizational environment is the foundation of and plays a guiding role in work behavior. Whether the medication environment correlates with the unsafe medication behavior of nurses remains unclear. This study used a correlative design with self-administered questionnaires, and the SHEL model, an acronym of its elements of software, hardware, environment, and liveware, was used as the framework for the medication environment. A survey was conducted among 1012 clinical nurses from five tertiary hospitals in China using the nurse unsafe medication behavior scale (NUMBS) and the nurses' perceptions of the medication environment scale (NPMES). Data were collected from January to February 2017. Path analyses were used to examine the hypothesized model. The medication environment correlated negatively with unsafe medication behavior (r=-0.48, pbehavior. Software, hardware and the environment indirectly influenced unsafe medication behavior, and nurses' personal factors played a mediating role in the relationships of unsafe medication behavior with software, hardware, and the environment. The unsafe medication behavior of nurses should be further improved. The medication environment was a predictor of unsafe medication behavior. Care managers should actively improve the medication environment to reduce the incidence of unsafe medication behaviors. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  6. Using the MMPI 168 with Medical Inpatients

    Science.gov (United States)

    Erickson, Richard C.; Freeman, Charles

    1976-01-01

    Explores the potential utility of the MMPI 168 with two inpatient medical populations. Correlations and clinically relevant comparisons suggest that the MMPI 168 predicted the standard MMPI with a high degree accuracy. (Editor/RK)

  7. Medical students' agenda-setting abilities during medical interviews.

    Science.gov (United States)

    Roh, HyeRin; Park, Kyung Hye; Jeon, Young-Jee; Park, Seung Guk; Lee, Jungsun

    2015-06-01

    Identifying patients' agendas is important; however, the extent of Korean medical students' agenda-setting abilities is unknown. The study aim was to investigate the patterns of Korean medical students' agenda solicitation. A total of 94 third-year medical students participated. One scenario involving a female patient with abdominal pain was created. Students were video-recorded as they interviewed the patient. To analyze whether students identify patients' reasons for visiting, a checklist was developed based on a modified version of the Calgary-Cambridge Guide to the Medical Interview: Communication Process checklist. The duration of the patient's initial statement of concerns was measured in seconds. The total number of patient concerns expressed before interruption and the types of interruption effected by the medical students were determined. The medical students did not explore the patients' concerns and did not negotiate an agenda. Interruption of the patient's opening statement occurred in 4.62±2.20 seconds. The most common type of initial interruption was a recompleter (79.8%). Closed-ended questions were the most common question type in the second and third interruptions. Agenda setting should be emphasized in the communication skills curriculum of medical students. The Korean Clinical Skills Exam must assess medical students' ability to set an agenda.

  8. Medical imaging

    International Nuclear Information System (INIS)

    Elliott, Alex

    2005-01-01

    Diagnostic medical imaging is a fundamental part of the practice of modern medicine and is responsible for the expenditure of considerable amounts of capital and revenue monies in healthcare systems around the world. Much research and development work is carried out, both by commercial companies and the academic community. This paper reviews briefly each of the major diagnostic medical imaging techniques-X-ray (planar and CT), ultrasound, nuclear medicine (planar, SPECT and PET) and magnetic resonance. The technical challenges facing each are highlighted, with some of the most recent developments. In terms of the future, interventional/peri-operative imaging, the advancement of molecular medicine and gene therapy are identified as potential areas of expansion

  9. Medication Errors - A Review

    OpenAIRE

    Vinay BC; Nikhitha MK; Patel Sunil B

    2015-01-01

    In this present review article, regarding medication errors its definition, medication error problem, types of medication errors, common causes of medication errors, monitoring medication errors, consequences of medication errors, prevention of medication error and managing medication errors have been explained neatly and legibly with proper tables which is easy to understand.

  10. Exploration and Mining Roadmap

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2002-09-01

    This Exploration and Mining Technology Roadmap represents the third roadmap for the Mining Industry of the Future. It is based upon the results of the Exploration and Mining Roadmap Workshop held May 10 ñ 11, 2001.

  11. Exploring the relationship between demographic factors ...

    African Journals Online (AJOL)

    The significant, albeit moderate, positive correlation between fortitude and academic performance highlights the need for further exploration of wellbeing and holistic development of medical students. Support programmes are recommended to bridge the gap related to gender and educational background. Low and fair ...

  12. Asteroid exploration and utilization: The Hawking explorer

    Science.gov (United States)

    Carlson, Alan; Date, Medha; Duarte, Manny; Erian, Neil; Gafka, George; Kappler, Peter; Patano, Scott; Perez, Martin; Ponce, Edgar; Radovich, Brian

    1991-01-01

    The Earth is nearing depletion of its natural resources at a time when human beings are rapidly expanding the frontiers of space. The resources which may exist on asteroids could have enormous potential for aiding and enhancing human space exploration as well as life on Earth. With the possibly limitless opportunities that exist, it is clear that asteroids are the next step for human existence in space. This report comprises the efforts of NEW WORLDS, Inc. to develop a comprehensive design for an asteroid exploration/sample return mission. This mission is a precursor to proof-of-concept missions that will investigate the validity of mining and materials processing on an asteroid. Project STONER (Systematic Transfer of Near Earth Resources) is based on two utilization scenarios: (1) moving an asteroid to an advantageous location for use by Earth; and (2) mining an asteroids and transporting raw materials back to Earth. The asteroid explorer/sample return mission is designed in the context of both scenarios and is the first phase of a long range plane for humans to utilize asteroid resources. The report concentrates specifically on the selection of the most promising asteroids for exploration and the development of an exploration scenario. Future utilization as well as subsystem requirements of an asteroid sample return probe are also addressed.

  13. Intelligent distributed medical image management

    Science.gov (United States)

    Garcia, Hong-Mei C.; Yun, David Y.

    1995-05-01

    The rapid advancements in high performance global communication have accelerated cooperative image-based medical services to a new frontier. Traditional image-based medical services such as radiology and diagnostic consultation can now fully utilize multimedia technologies in order to provide novel services, including remote cooperative medical triage, distributed virtual simulation of operations, as well as cross-country collaborative medical research and training. Fast (efficient) and easy (flexible) retrieval of relevant images remains a critical requirement for the provision of remote medical services. This paper describes the database system requirements, identifies technological building blocks for meeting the requirements, and presents a system architecture for our target image database system, MISSION-DBS, which has been designed to fulfill the goals of Project MISSION (medical imaging support via satellite integrated optical network) -- an experimental high performance gigabit satellite communication network with access to remote supercomputing power, medical image databases, and 3D visualization capabilities in addition to medical expertise anywhere and anytime around the country. The MISSION-DBS design employs a synergistic fusion of techniques in distributed databases (DDB) and artificial intelligence (AI) for storing, migrating, accessing, and exploring images. The efficient storage and retrieval of voluminous image information is achieved by integrating DDB modeling and AI techniques for image processing while the flexible retrieval mechanisms are accomplished by combining attribute- based and content-based retrievals.

  14. Barriers to medical error reporting

    Directory of Open Access Journals (Sweden)

    Jalal Poorolajal

    2015-01-01

    Full Text Available Background: This study was conducted to explore the prevalence of medical error underreporting and associated barriers. Methods: This cross-sectional study was performed from September to December 2012. Five hospitals, affiliated with Hamadan University of Medical Sciences, in Hamedan,Iran were investigated. A self-administered questionnaire was used for data collection. Participants consisted of physicians, nurses, midwives, residents, interns, and staffs of radiology and laboratory departments. Results: Overall, 50.26% of subjects had committed but not reported medical errors. The main reasons mentioned for underreporting were lack of effective medical error reporting system (60.0%, lack of proper reporting form (51.8%, lack of peer supporting a person who has committed an error (56.0%, and lack of personal attention to the importance of medical errors (62.9%. The rate of committing medical errors was higher in men (71.4%, age of 50-40 years (67.6%, less-experienced personnel (58.7%, educational level of MSc (87.5%, and staff of radiology department (88.9%. Conclusions: This study outlined the main barriers to reporting medical errors and associated factors that may be helpful for healthcare organizations in improving medical error reporting as an essential component for patient safety enhancement.

  15. Becoming 'ward smart' medical students.

    Science.gov (United States)

    Walker, Beth; Wallace, Deirdre; Mangera, Zaheer; Gill, Deborah

    2017-10-01

    A small number of medical students elect to work as health care assistants (HCAs) during or prior to their undergraduate training. There is a significant body of evidence in the literature regarding the impact of HCA experience on student nurses; however, little research has examined the effects of such experience on medical students. All fourth-year medical students with self-declared experience as HCAs from a single UK medical school were invited to participate in focus groups to explore their experiences and perceptions. Ten students from the year group took part. Participants felt that their experience as HCAs enhanced their learning in the workplace through becoming 'ward smart', helping them to become socialised into the world of health care, providing early meaningful and humanised patient interaction, and increasing their understanding of multidisciplinary team (MDT) members' roles. Little research has examined the effects of [HCA] experience on medical students DISCUSSION: Becoming 'ward smart' and developing a sense of belonging are central to maximising learning in, from and through work on the ward. Experience as a HCA provides a range of learning and social opportunities for medical students, and legitimises their participation within clinical communities. HCA experience also seems to benefit in the 'hard to reach' dimensions of medical training: empathy; humanisation of patient care; professional socialisation; and providing a sense of belonging within health care environments. © 2016 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

  16. Personalized Information Service for Clinicians: Users Like It. A Review of: Jerome, Rebecca N., Nunzia Bettinsoli Giuse, S. Trent Rosenbloom, and Patrick G. Arbogast. “Exploring Clinician Adoption of a Novel Evidence Request Feature in an Electronic Medical Record System.” Journal of the Medical Library Association 96.1 (Jan. 2008: 34-41, with online appendices.

    Directory of Open Access Journals (Sweden)

    Gale G. Hannigan

    2008-09-01

    Full Text Available Objective – To examine physician use of an Evidence-Based Medicine (EBM literature request service available to clinicians through the institution’s electronic medical record system (EMR. Specifically, the authors posed the following questions: 1 Did newly implemented marketing and communication strategies increase physicians’ use of the service? 2 How did clinicians rate the relevance of the information provided? 3 How was the information provided used and shared? Design – Ten-month, prospective, observational study employing a questionnaire, statistics, a focus group, and a “before and after marketing intervention” analysis.Setting – Adult primary care outpatient clinic in an academic medical centre.Subjects – Forty-eight attending and 89 resident physicians.Methods – In 2003, a new service was introduced that allowed physicians in the Adult Primary Care Center clinic to request evidence summaries from the library regarding complex clinical questions. Contact with the library was through the secure messaging feature of the institution’s electronic medical record (EMR. From March through July 2005, the librarian employed “standard” publicity methods (email, flyers, posters, demonstrations to promote the service. A focus group in July 2005 provided feedback about the service as well as recommendations about communicating its availability and utility. New communication methods were implemented, including a monthly electronic “current awareness” newsletter, more frequent visits by the librarian during resident clinic hours, and collaborations between the librarian and residents preparing for morning report presentations. At the end of the study period, a 25-item Web-based questionnaire was sent to the 137 physicians with access to the service. Main Results – During the 10-month study period, 23 unique users submitted a total of 45 questions to the EBM Literature RequestService. More questions were from attending

  17. Modelling oil exploration

    International Nuclear Information System (INIS)

    Padilla, V.R.

    1992-01-01

    The analysis of oil exploration models in this paper is developed in four parts. The way in which exploration has been dealt with in oil supply models is first described. Five recent models are then looked at, paying particular attention to the explanatory variables used when modelling exploration activities. This is followed by a discussion of the factors which have been shown by several empirical studies to determine exploration in less developed countries. Finally, the interdependence between institutional factors, oil prices and exploration effort is analysed with a view to drawing conclusions for modelling in the future. (UK)

  18. Marine Mineral Exploration

    DEFF Research Database (Denmark)

    in EEZ areas are fairly unknown; many areas need detailed mapping and mineral exploration, and the majority of coastal or island states with large EEZ areas have little experience in exploration for marine hard minerals. This book describes the systematic steps in marine mineral exploration....... Such exploration requires knowledge of mineral deposits and models of their formation, of geophysical and geochemical exploration methods, and of data evaluation and interpretation methods. These topics are described in detail by an international group of authors. A short description is also given of marine...

  19. CRC Handbook of Medical Physics, vol. 3

    International Nuclear Information System (INIS)

    Waggener, R.G.; Kereiakes, J.G.; Shalek, R.J.

    1984-01-01

    In this work, the care and testing of measurement and diagnostic instruments are described in detail. Difficulties encountered with therapeutic and diagnostic calibrations are explored and solutions are suggested. VOLUME III Physics Teaching for Radiologic Technologists, Physics Teaching for Diagnostic Radiology Residents, Physics Teaching for Nuclear Medicine Residents, Physics Teaching for Radiotherapy Residents, Degree Programs in Medical Physics, Radiobiology Teaching, Non-Degree Medical Physics Training and American Board of Radiology Certifications, Radioactivity and Production of Medical Isotopes, Practical Medical Physics Consulting, Radiologic Terminology, Nuclear Medicine Imaging Techniques, Description of Radiotherapy Procedures, Medical Applications of Ultrasonography and Thermography, Glossary of Medical and Anatomical Terms Used in Medical Physics, Equipment List for Medical Physics and Acquisition Priority. Bibliography of Reference Materials. Index

  20. Preceptor engagement in distributed medical school campuses

    Directory of Open Access Journals (Sweden)

    Thomas Piggott

    2015-12-01

    Conclusions: Barriers to engagement in teaching primarily focused on differences in job structure in the community, administrative barriers both at the hospital and through the medical school, and lack of knowledge on how to teach.  As medical schools look to expand the capacity of distributed campuses, misperceptions should be addressed and opportunities to improve engagement should be further explored.

  1. Exploring the use of smartphones and tablets by medical House ...

    African Journals Online (AJOL)

    Method: A qualitative study was undertaken in Korle-Bu Teaching Hospital. ... was used to identify House Officers, who engaged in semi-structured interviews. ... Consent was gained from all participants and the University of Leeds granted ...

  2. Biosensors for Exploration Medical System (PI=Winther)

    Data.gov (United States)

    National Aeronautics and Space Administration — The following items are critical topics for this task. Most of the work has been a continuation from last year; however, the scope of the hardware need has changed....

  3. Exploration of the medical periodic table: towards new targets.

    Science.gov (United States)

    Barry, Nicolas P E; Sadler, Peter J

    2013-06-07

    Metallodrugs offer potential for unique mechanisms of drug action based on the choice of the metal, its oxidation state, the types and number of coordinated ligands and the coordination geometry. We discuss recent progress in identifying new target sites and elucidating the mechanisms of action of anti-cancer, anti-bacterial, anti-viral, anti-parasitic, anti-inflammatory, and anti-neurodegenerative agents, as well as in the design of metal-based diagnostic agents. Progress in identifying and defining target sites has been accelerated recently by advances in proteomics, genomics and metal speciation analysis. Examples of metal compounds and chelating agents (enzyme inhibitors) currently in clinical use, clinical trials or preclinical development are highlighted.

  4. Medical robotics

    CERN Document Server

    Troccaz, Jocelyne

    2013-01-01

    In this book, we present medical robotics, its evolution over the last 30 years in terms of architecture, design and control, and the main scientific and clinical contributions to the field. For more than two decades, robots have been part of hospitals and have progressively become a common tool for the clinician. Because this domain has now reached a certain level of maturity it seems important and useful to provide a state of the scientific, technological and clinical achievements and still open issues. This book describes the short history of the domain, its specificity and constraints, and

  5. Applications of VLSI circuits to medical imaging

    International Nuclear Information System (INIS)

    O'Donnell, M.

    1988-01-01

    In this paper the application of advanced VLSI circuits to medical imaging is explored. The relationship of both general purpose signal processing chips and custom devices to medical imaging is discussed using examples of fabricated chips. In addition, advanced CAD tools for silicon compilation are presented. Devices built with these tools represent a possible alternative to custom devices and general purpose signal processors for the next generation of medical imaging systems

  6. [The globalization of medical education].

    Science.gov (United States)

    Stevens, Fred C J

    2013-01-01

    With reference to a recently published research article on the applicability and effectiveness of problem-based learning (PBL) in non-Western medical schools, this commentary explores the assumption that a set of shared values is the common denominator of the globalisation of medical education. The use and effectiveness of PBL are not isolated from the cultural and social structural context in which it is applied; critical differences in values and in views on education underlie what educators and students perceive to be effective locally. The globalisation of medical education is more than the import of instructional designs, and includes Western models of social organisation that require deep reflection and adaptation for success; hence, instead of spreading models for medical education across the globe, more effort should be put into the support of 'home-grown' equivalents and alternatives.

  7. The effects of medical tourism: Thailand's experience.

    Science.gov (United States)

    NaRanong, Anchana; NaRanong, Viroj

    2011-05-01

    To explore the positive and negative effects of medical tourism on the economy, health staff and medical costs in Thailand. The financial repercussions of medical tourism were estimated from commerce ministry data, with modifications and extrapolations. Survey data on 4755 foreign and Thai outpatients in two private hospitals were used to explore how medical tourism affects human resources. Trends in the relative prices of caesarean section, appendectomy, hernia repair, cholecystectomy and knee replacement in five private hospitals were examined. Focus groups and in-depth interviews with hospital managers and key informants from the public and private sectors were conducted to better understand stakeholders' motivations and practices in connection with these procedures and learn more about medical tourism. Medical tourism generates the equivalent of 0.4% of Thailand's gross domestic product but has exacerbated the shortage of medical staff by luring more workers away from the private and public sectors towards hospitals catering to foreigners. This has raised costs in private hospitals substantially and is likely to raise them in public hospitals and in the universal health-care insurance covering most Thais as well. The "brain drain" may also undermine medical training in future. Medical tourism in Thailand, despite some benefits, has negative effects that could be mitigated by lifting the restrictions on the importation of qualified foreign physicians and by taxing tourists who visit the country solely for the purpose of seeking medical treatment. The revenue thus generated could then be used to train physicians and retain medical school professors.

  8. Bullying among medical students in a Saudi medical school

    Directory of Open Access Journals (Sweden)

    Alzahrani Hasan

    2012-07-01

    Full Text Available Abstract Background Bullying and sexual harassment of medical students by their teachers appears to be widespread phenomenon. However, nothing is published about its prevalence in conservative countries such as Saudi Arabia. This survey aims to ascertain the extent of these mistreatments among students in a Saudi medical school. Findings A cross-sectional questionnaire survey was conducted on a group of 542 clinical years’ medical students in a Saudi medical school to explore students' perceptions of their educational environment including exposure to different kinds of bullying. Bullying was defined as “a “persistent behaviour against a medical student that is intimidating, degrading, offensive or malicious and undermines the confidence and self- esteem of the recipient”. Results revealed that more than one quarter (28.0% of the surveyed students reported exposure to some sort of bullying during their clinical. Ninety percent of the reported insults were verbal, 6% sexual and 4% physical. Males were more exposed but difference was not statistically significant. Conclusions Bullying among Saudi medical students is an existing problem. A policy against bullying and harassment should be adopted in all of medical colleges to monitor this phenomenon and support students who have been bullied.

  9. Medical student fitness to practise committees at UK medical schools

    Directory of Open Access Journals (Sweden)

    Aldridge Jocelyne

    2009-06-01

    Full Text Available Abstract Background The aim was to explore the structures for managing student fitness to practise hearings in medical schools in the UK. We surveyed by email the named fitness to practise leads of all full members of the UK Medical Schools Council with a medical undergraduate programme. We asked whether student fitness to practise cases were considered by a committee/panel dedicated to medicine, or by one which also considered other undergraduate health and social care students. Findings All 31 medical schools responded. 19 medical schools had a fitness to practise committee dealing with medical students only. Three had a committee that dealt with students of medicine and dentistry. One had a committee that dealt with students of medicine and veterinary medicine. Eight had a committee that dealt with students of medicine and two or more other programmes, such as dentistry, nursing, midwifery, physiotherapy, dietetics, social work, pharmacy, psychology, audiology, speech therapy, operating department practice, veterinary medicine and education. Conclusion All 31 UK medical schools with undergraduate programmes have a fitness to practise committee to deal with students whose behaviour has given rise to concern about their fitness to practise. The variation in governance structures for student fitness to practise committees/panels can in part be explained by variations in University structures and the extent to which Universities co-manage undergraduate medicine with other courses.

  10. Medical robotics.

    Science.gov (United States)

    Ferrigno, Giancarlo; Baroni, Guido; Casolo, Federico; De Momi, Elena; Gini, Giuseppina; Matteucci, Matteo; Pedrocchi, Alessandra

    2011-01-01

    Information and communication technology (ICT) and mechatronics play a basic role in medical robotics and computer-aided therapy. In the last three decades, in fact, ICT technology has strongly entered the health-care field, bringing in new techniques to support therapy and rehabilitation. In this frame, medical robotics is an expansion of the service and professional robotics as well as other technologies, as surgical navigation has been introduced especially in minimally invasive surgery. Localization systems also provide treatments in radiotherapy and radiosurgery with high precision. Virtual or augmented reality plays a role for both surgical training and planning and for safe rehabilitation in the first stage of the recovery from neurological diseases. Also, in the chronic phase of motor diseases, robotics helps with special assistive devices and prostheses. Although, in the past, the actual need and advantage of navigation, localization, and robotics in surgery and therapy has been in doubt, today, the availability of better hardware (e.g., microrobots) and more sophisticated algorithms(e.g., machine learning and other cognitive approaches)has largely increased the field of applications of these technologies,making it more likely that, in the near future, their presence will be dramatically increased, taking advantage of the generational change of the end users and the increasing request of quality in health-care delivery and management.

  11. International exploration by independent

    International Nuclear Information System (INIS)

    Bertragne, R.G.

    1992-01-01

    Recent industry trends indicate that the smaller U.S. independents are looking at foreign exploration opportunities as one of the alternatives for growth in the new age of exploration. Foreign finding costs per barrel usually are accepted to be substantially lower than domestic costs because of the large reserve potential of international plays. To get involved in overseas exploration, however, requires the explorationist to adapt to different cultural, financial, legal, operational, and political conditions. Generally, foreign exploration proceeds at a slower pace than domestic exploration because concessions are granted by a country's government, or are explored in partnership with a national oil company. First, the explorationist must prepare a mid- to long-term strategy, tailored to the goals and the financial capabilities of the company; next, is an ongoing evaluation of quality prospects in various sedimentary basins, and careful planning and conduct of the operations. To successfully explore overseas also requires the presence of a minimum number of explorationists and engineers thoroughly familiar with the various exploratory and operational aspects of foreign work. Ideally, these team members will have had a considerable amount of on-site experience in various countries and climates. Independents best suited for foreign expansion are those who have been financially successful in domestic exploration. When properly approached, foreign exploration is well within the reach of smaller U.S. independents, and presents essentially no greater risk than domestic exploration; however, the reward can be much larger and can catapult the company into the 'big leagues.'

  12. Medical informatics in morocco.

    Science.gov (United States)

    Bouhaddou, O; Bennani Othmani, M; Diouny, S

    2013-01-01

    Informatics is an essential tool for helping to transform healthcare from a paper-based to a digital sector. This article explores the state-of-the-art of health informatics in Morocco. Specifically, it aims to give a general overview of the Moroccan healthcare system, the challenges it is facing, and the efforts undertaken by the informatics community and Moroccan government in terms of education, research and practice to reform the country's health sector. Through the experience of establishing Medical Informatics as a medical specialty in 2008, creating a Moroccan Medical Informatics Association in 2010 and holding a first national congress took place in April 2012, the authors present their assessment of some important priorities for health informatics in Morocco. These Moroccan initiatives are facilitating collaboration in education, research, and implementation of clinical information systems. In particular, the stakeholders have recognized the need for a national coordinator office and the development of a national framework for standards and interoperability. For developing countries like Morocco, new health IT approaches like mobile health and trans-media health advertising could help optimize scarce resources, improve access to rural areas and focus on the most prevalent health problems, optimizing health care access, quality, and cost for Morocco population.

  13. Medical revolution in Argentina.

    Science.gov (United States)

    Ballarin, V L; Isoardi, R A

    2010-01-01

    The paper discusses the major Argentineans contributors, medical physicists and scientists, in medical imaging and the development of medical imaging in Argentina. The following are presented: history of medical imaging in Argentina: the pioneers; medical imaging and medical revolution; nuclear medicine imaging; ultrasound imaging; and mathematics, physics, and electronics in medical image research: a multidisciplinary endeavor.

  14. Coordination of International Risk-Reduction Investigations by the Multilateral Human Research Panel for Exploration

    Science.gov (United States)

    Charles, John B.; Bogomolov, Valery V.

    2015-01-01

    Effective use of the unique capabilities of the International Space Station (ISS) for risk reduction on future deep space missions involves preliminary work in analog environments to identify and evaluate the most promising techniques, interventions and treatments. This entails a consolidated multinational approach to biomedical research both on ISS and in ground analogs. The Multilateral Human Research Panel for Exploration (MHRPE) was chartered by the five ISS partners to recommend the best combination of partner investigations on ISS for risk reduction in the relatively short time available for ISS utilization. MHRPE will also make recommendations to funding agencies for appropriate preparatory analog work. In 2011, NASA's Human Research Program (HRP) and the Institute of Biomedical Problems (IBMP) of the Russian Academy of Science, acting for MHRPE, developed a joint US-Russian biomedical program for the 2015 one-year ISS mission (1YM) of American and Russian crewmembers. This was to evaluate the possibilities for multilateral research on ISS. An overlapping list of 16 HRP, 9 IBMP, 3 Japanese, 3 European and 1 Canadian investigations were selected to address risk-reduction goals in 7 categories: Functional Performance, Behavioral Health, Visual Impairment, Metabolism, Physical Capacity, Microbial and Human Factors. MHRPE intends to build on this bilateral foundation to recommend more fully-integrated multilateral investigations on future ISS missions commencing after the 1YM. MHRPE has also endorsed an on-going program of coordinated research on 6-month, one-year and 6-week missions ISS expeditions that is now under consideration by ISS managers. Preparatory work for these missions will require coordinated and collaborative campaigns especially in the psychological and psychosocial areas using analog isolation facilities in Houston, Köln and Moscow, and possibly elsewhere. The multilateral Human Analogs research working group (HANA) is the focal point of those

  15. Web-Based Medical Service: Technology Attractiveness, Medical Creditability, Information Source, and Behavior Intention.

    Science.gov (United States)

    Wang, Shan Huei

    2017-08-02

    Web-based medical service (WBMS), a cooperative relationship between medical service and Internet technology, has been called one of the most innovative services of the 21st century. However, its business promotion and implementation in the medical industry have neither been expected nor executed. Few studies have explored this phenomenon from the viewpoint of inexperienced patients. The primary goal of this study was to explore whether technology attractiveness, medical creditability, and diversified medical information sources could increase users' behavior intention. This study explored the effectiveness of web-based medical service by using three situations to manipulate sources of medical information. A total of 150 questionnaires were collected from people who had never used WBMS before. Hierarchical regression was used to examine the mediation and moderated-mediation effects. Perceived ease of use (P=.002) and perceived usefulness (P=.001) significantly enhance behavior intentions. Medical credibility is a mediator (P=.03), but the relationship does not significantly differ under diverse manipulative information channels (P=.39). Medical credibility could explain the extra variation between technology attractiveness and behavior intention, but not significant under different moderating effect of medical information sources. ©Shan Huei Wang. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 02.08.2017.

  16. Chat reference service in medical libraries: part 2--Trends in medical school libraries.

    Science.gov (United States)

    Dee, Cheryl R

    2003-01-01

    An increasing number of medical school libraries offer chat service to provide immediate, high quality information at the time and point of need to students, faculty, staff, and health care professionals. Part 2 of Chat Reference Service in Medical Libraries presents a snapshot of the current trends in chat reference service in medical school libraries. In late 2002, 25 (21%) medical school libraries provided chat reference. Trends in chat reference services in medical school libraries were compiled from an exploration of medical school library Web sites and informal correspondence from medical school library personnel. Many medical libraries are actively investigating and planning new chat reference services, while others have decided not to pursue chat reference at this time. Anecdotal comments from medical school library staff provide insights into chat reference service.

  17. Medical Optimization Network for Space Telemedicine Resources

    Science.gov (United States)

    Shah, R. V.; Mulcahy, R.; Rubin, D.; Antonsen, E. L.; Kerstman, E. L.; Reyes, D.

    2017-01-01

    INTRODUCTION: Long-duration missions beyond low Earth orbit introduce new constraints to the space medical system such as the inability to evacuate to Earth, communication delays, and limitations in clinical skillsets. NASA recognizes the need to improve capabilities for autonomous care on such missions. As the medical system is developed, it is important to have an ability to evaluate the trade space of what resources will be most important. The Medical Optimization Network for Space Telemedicine Resources was developed for this reason, and is now a system to gauge the relative importance of medical resources in addressing medical conditions. METHODS: A list of medical conditions of potential concern for an exploration mission was referenced from the Integrated Medical Model, a probabilistic model designed to quantify in-flight medical risk. The diagnostic and treatment modalities required to address best and worst-case scenarios of each medical condition, at the terrestrial standard of care, were entered into a database. This list included tangible assets (e.g. medications) and intangible assets (e.g. clinical skills to perform a procedure). A team of physicians working within the Exploration Medical Capability Element of NASA's Human Research Program ranked each of the items listed according to its criticality. Data was then obtained from the IMM for the probability of occurrence of the medical conditions, including a breakdown of best case and worst case, during a Mars reference mission. The probability of occurrence information and criticality for each resource were taken into account during analytics performed using Tableau software. RESULTS: A database and weighting system to evaluate all the diagnostic and treatment modalities was created by combining the probability of condition occurrence data with the criticalities assigned by the physician team. DISCUSSION: Exploration Medical Capabilities research at NASA is focused on providing a medical system to

  18. Pediatric Nurses' Perceptions of Medication Safety and Medication Error: A Mixed Methods Study.

    Science.gov (United States)

    Alomari, Albara; Wilson, Val; Solman, Annette; Bajorek, Beata; Tinsley, Patricia

    2017-05-30

    This study aims to outline the current workplace culture of medication practice in a pediatric medical ward. The objective is to explore the perceptions of nurses in a pediatric clinical setting as to why medication administration errors occur. As nurses have a central role in the medication process, it is essential to explore nurses' perceptions of the factors influencing the medication process. Without this understanding, it is difficult to develop effective prevention strategies aimed at reducing medication administration errors. Previous studies were limited to exploring a single and specific aspect of medication safety. The methods used in these studies were limited to survey designs which may lead to incomplete or inadequate information being provided. This study is phase 1 on an action research project. Data collection included a direct observation of nurses during medication preparation and administration, audit based on the medication policy, and guidelines and focus groups with nursing staff. A thematic analysis was undertaken by each author independently to analyze the observation notes and focus group transcripts. Simple descriptive statistics were used to analyze the audit data. The study was conducted in a specialized pediatric medical ward. Four key themes were identified from the combined quantitative and qualitative data: (1) understanding medication errors, (2) the busy-ness of nurses, (3) the physical environment, and (4) compliance with medication policy and practice guidelines. Workload, frequent interruptions to process, poor physical environment design, lack of preparation space, and impractical medication policies are identified as barriers to safe medication practice. Overcoming these barriers requires organizations to review medication process policies and engage nurses more in medication safety research and in designing clinical guidelines for their own practice.

  19. Geochemical exploration for uranium

    International Nuclear Information System (INIS)

    1988-01-01

    This Technical Report is designed mainly to introduce the methods and techniques of uranium geochemical exploration to exploration geologists who may not have had experience with geochemical exploration methods in their uranium programmes. The methods presented have been widely used in the uranium exploration industry for more than two decades. The intention has not been to produce an exhaustive, detailed manual, although detailed instructions are given for a field and laboratory data recording scheme and a satisfactory analytical method for the geochemical determination of uranium. Rather, the intention has been to introduce the concepts and methods of uranium exploration geochemistry in sufficient detail to guide the user in their effective use. Readers are advised to consult general references on geochemical exploration to increase their understanding of geochemical techniques for uranium

  20. Medications (for IBS)

    Medline Plus

    Full Text Available ... July 2017 Print Jump to Topic Medications for IBS Laxatives Anticholinergic/Antispasmodic Agents Antidiarrheal Agents Antidepressant Medications Newer IBS Medications Probiotics and Antibiotics Pharmacologic, ...

  1. Smoking cessation medications

    Science.gov (United States)

    Smoking cessation - medications; Smokeless tobacco - medications; Medications for stopping tobacco ... Smoking cessation medicines can: Help with the craving for tobacco. Help you with withdrawal symptoms. Keep you ...

  2. Medication adherence among transgender women living with HIV

    OpenAIRE

    Baguso, Glenda N.; Gay, Caryl L.; Lee, Kathryn A.

    2016-01-01

    Medication adherence is linked to health outcomes among adults with HIV infection. Transgender women living with HIV (TWLWH) in the U.S. report suboptimal adherence to medications and are found to have difficulty integrating HIV medication into their daily routine, but few studies explore factors associated with medication adherence among transgender women. Thus, the purpose of this paper is to examine demographic and clinical factors related to self-reported medication adherence among transg...

  3. Medical humanities in the undergraduate medical curriculum.

    Science.gov (United States)

    Supe, Avinash

    2012-01-01

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

  4. Visual explorer facilitator's guide

    CERN Document Server

    Palus, Charles J

    2010-01-01

    Grounded in research and practice, the Visual Explorer™ Facilitator's Guide provides a method for supporting collaborative, creative conversations about complex issues through the power of images. The guide is available as a component in the Visual Explorer Facilitator's Letter-sized Set, Visual Explorer Facilitator's Post card-sized Set, Visual Explorer Playing Card-sized Set, and is also available as a stand-alone title for purchase to assist multiple tool users in an organization.

  5. [Virtual reality in medical education].

    Science.gov (United States)

    Edvardsen, O; Steensrud, T

    1998-02-28

    Virtual reality technology has found new applications in industry over the last few years. Medical literature has for several years predicted a break-through in this technology for medical education. Although there is a great potential for this technology in medical education, there seems to be a wide gap between expectations and actual possibilities at present. State of the technology was explored by participation at the conference "Medicine meets virtual reality V" (San Diego Jan. 22-25 1997) and a visit to one of the leading laboratories on virtual reality in medical education. In this paper we introduce some of the basic terminology and technology, review some of the topics covered by the conference, and describe projects running in one of the leading laboratories on virtual reality technology for medical education. With this information in mind, we discuss potential applications of the current technology in medical education. Current virtual reality systems are judged to be too costly and their usefulness in education too limited for routine use in medical education.

  6. Depression in medical students: current insights

    Directory of Open Access Journals (Sweden)

    Moir F

    2018-05-01

    Full Text Available Fiona Moir,1 Jill Yielder,2 Jasmine Sanson,3 Yan Chen4 1Department of General Practice and Primary Health Care, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand; 2Medical Programme Directorate, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand; 3Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand; 4Centre for Medical and Health Sciences Education, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand Abstract: Medical students are exposed to multiple factors during their academic and clinical study that have been shown to contribute to high levels of depression, anxiety, and stress. The purpose of this article was to explore the issue of depression in the medical student population, including prevalence, causes, and key issues, along with suggestions for early identification and support from one medical school in New Zealand. After establishing that the prevalence of depression is higher for medical students than the general population, the key issues explored include assessment used in the program, characteristics of the student population (such as Type A personality and perfectionism, resilience, selection procedures, students’ motivation, and the nature of the clinical environment. This review includes several recommendations to improve students’ psychological health such as positioning well-being within an overarching comprehensive workplace wellness model and integrating peer and faculty-led support into the day-to-day running of the institution. It also highlights the advantages of the addition of a well-being curriculum, as skills to prevent and manage distress and depression are relevant in supporting the competencies required by medical practitioners. It concludes that medical schools need wide-ranging strategies to address the complexities associated with the particular student

  7. Medical telesensors

    Science.gov (United States)

    Ferrell, Trinidad L.; Crilly, P. B.; Smith, S. F.; Wintenberg, Alan L.; Britton, Charles L., Jr.; Morrison, Gilbert W.; Ericson, M. N.; Hedden, D.; Bouldin, Donald W.; Passian, A.; Downey, Todd R.; Wig, A. G.; Meriaudeau, Fabrice

    1998-05-01

    Medical telesensors are self-contained integrated circuits for measuring and transmitting vital signs over a distance of approximately 1-2 meters. The circuits are unhoused and contain a sensor, signal processing and modulation electronics, a spread-spectrum transmitter, an antenna and a thin-film battery. We report on a body-temperature telesensor, which is sufficiently small to be placed on a tympanic membrane in a child's ear. We also report on a pulse-oximeter telesensor and a micropack receiver/long- range transmitter unit, which receives form a telesensor array and analyzes and re-transmits the vital signs over a longer range. Signal analytics are presented for the pulse oximeter, which is currently in the form of a finger ring. A multichip module is presented as the basic signal-analysis component. The module contains a microprocessor, a field=programmable gate array, memory elements and other components necessary for determining trauma and reporting signals.

  8. [MEDICAL CANNABIS].

    Science.gov (United States)

    Naftali, Timna

    2016-02-01

    The cannabis plant has been known to humanity for centuries as a remedy for pain, diarrhea and inflammation. Current research is inspecting the use of cannabis for many diseases, including multiple sclerosis, epilepsy, dystonia, and chronic pain. In inflammatory conditions cannabinoids improve pain in rheumatoid arthritis and:pain and diarrhea in Crohn's disease. Despite their therapeutic potential, cannabinoids are not free of side effects including psychosis, anxiety, paranoia, dependence and abuse. Controlled clinical studies investigating the therapeutic potential of cannabis are few and small, whereas pressure for expanding cannabis use is increasing. Currently, as long as cannabis is classified as an illicit drug and until further controlled studies are performed, the use of medical cannabis should be limited to patients who failed conventional better established treatment.

  9. Medical foods for Alzheimer's disease.

    Science.gov (United States)

    Shah, Raj C

    2011-06-01

    Alzheimer's disease (AD) is a neurodegenerative condition associated with cognitive loss, behavioural changes, functional ability decline and caregiver burden. Given the worldwide public health impact of AD, novel interventions to reduce suffering experienced by AD patients need to be developed. Foods may offer a mechanism for intervention complementary to drugs, devices, biologicals and vaccines. Apart from foods with health claims (including dietary supplements), medical foods are also being explored as an intervention option. The purpose of this article is to describe how medical foods may complement other interventions for AD patients by: (i) defining what a medical food is; (ii) discussing whether AD is a condition amenable to medical food intervention; (iii) reviewing current clinical trial data on medical foods used in participants with AD; and (iv) highlighting steps needed to establish a more comprehensive framework for developing medical foods for AD. While medical foods may be defined differently in other countries, the US Orphan Drug Act of 1998 defined a medical food as a food formulated for enteral intake, taken under physician supervision, and intended to meet the distinctive nutritional requirements identified for a disease or condition. For AD to be amenable to medical food intervention, it must: (i) result in limited or impaired capacity to ingest, digest, absorb or metabolize ordinary foodstuff or certain nutrients; or (ii) have unique, medically determined nutrient requirements; and (iii) require dietary management that cannot be achieved by modification of the normal diet alone. While these criteria are most likely met in advanced AD, identifying unique nutritional requirements in early AD that cannot be met by normal diet modification requires a better understanding of AD pathophysiology. A PubMed search using the terms 'medical food' and 'Alzheimer', limited to clinical trials published in English with human participants with AD aged >65

  10. "Mindless Medicals".

    Science.gov (United States)

    Michell, Karen Elizabeth; Rispel, Laetitia C

    2017-03-01

    This article explores stakeholders' perceptions of the quality of occupational health service (OHS) delivery in South Africa. Using a purposive sampling technique, 11 focus group discussions (FGDs) were conducted in three provinces. Focus group participants ( n = 69) were recruited through professional organizations of occupational physicians and occupational health nurses as well as employer representatives of major industries in South Africa. Transcriptions of FGDs were analyzed using thematic content analysis. South Africa has diverse models of OHS delivery with varying quality. Focus group participants criticized the outsourced model of service delivery and the excessive focus on physical examinations to achieve legal compliance. These problems are exacerbated by a perceived lack of employer emphasis on occupational health, insufficient human and financial resources, and lack of specific quality of care standards for occupational health. Improvement in the quality of OHS delivery is essential to realize South Africa's quest for universal health coverage.

  11. Medications (for IBS)

    Medline Plus

    Full Text Available ... Agents Antidepressant Medications Newer IBS Medications Probiotics and Antibiotics Pharmacologic, or drug, therapy is best used in ... Agents Antidepressant Medications Newer IBS Medications Probiotics and ... Treatments Understanding Stress Cognitive Behavioral Therapy Relaxation ...

  12. Medications (for IBS)

    Medline Plus

    Full Text Available ... Agents Antidiarrheal Agents Antidepressant Medications Newer IBS Medications Probiotics and Antibiotics Pharmacologic, or drug, therapy is best ... Agents Antidiarrheal Agents Antidepressant Medications Newer IBS Medications ... Psychological Treatments Understanding Stress Cognitive Behavioral ...

  13. The Medical Home

    Science.gov (United States)

    ... Videos for Educators Search English Español The Medical Home KidsHealth / For Parents / The Medical Home What's in ... for your child. What Does the Term "Medical Home" Mean? A medical home isn't a place ...

  14. Medications (for IBS)

    Medline Plus

    Full Text Available ... Agents Antidepressant Medications Newer IBS Medications Probiotics and Antibiotics Pharmacologic, or drug, therapy is best used in ... Agents Antidepressant Medications Newer IBS Medications Probiotics and Antibiotics Psychological Treatments Understanding Stress Cognitive Behavioral Therapy Relaxation ...

  15. Benefits for Health; NASA

    Science.gov (United States)

    Perchonok, Michele

    2014-01-01

    The goal of HRP is to provide human health and performance countermeasures, knowledge, technologies, and tools to enable safe, reliable, and productive human space exploration. Presentation discusses (1) Bone Health: Vitamin D, Fish Consumption and Exercise (2) Medical Support in Remote Areas (3) ISS Ultrasound 4) Dry electrode EKG System (5) Environmental Factors and Psychological Health.

  16. Uranium exploration in Ecuador

    International Nuclear Information System (INIS)

    Severne, B.; Penaherrera, P.F.; Fiallos, V.S.

    1981-01-01

    The 600-km segment of the Andean Cordillera in Ecuador includes zones that can be correlated, geologically, with uranium districts elsewhere in the Andes. It is believed that these essentially unexplored zones have the potential for economic uranium mineralization. Exploration activity to date has been limited, although it has involved both geochemical and radiometric techniques to evaluate geological concepts. Minor uranium occurrences (with chemical analyses up to 100 ppm) have been encountered, which provide further incentive to commence large-scale systematic exploration. It is recognized that a very large exploration budget and considerable technical expertise will be required to ensure exploration success. Consequently, participation by groups of proven capability from other countries will be sought for Ecuador's national exploration programme. (author)

  17. Exploring nature's secrets

    Indian Academy of Sciences (India)

    Lawrence

    tablished techniques useful in Biomedical research – genetics, tis- sue culture and ... microscopy, we were aware of the human aspect of our work. Life science and the ... Memorial Centre's medical ethics committee. I worked for 17 years.

  18. Medical muddle.

    Science.gov (United States)

    Gartrell, Nanette

    2014-01-01

    Nanette Gartrell, MD, is a psychiatrist and researcher whose investigations have documented the mental health and psychological well-being of lesbian, gay, bisexual, and transgender (LGBT) people over the past four decades. Nanette is the principal investigator of an ongoing longitudinal study of lesbian families in which the children were conceived by donor insemination. Now in its 27th year, this project has been cited internationally in the debates over equality in marriage, foster care, and adoption. Previously on the faculty at Harvard Medical School and the University of California, San Francisco, Nanette is currently a Visiting Distinguished Scholar at the Williams Institute, UCLA School of Law. In 2013, Nanette received the Association of Women Psychiatrists Presidential Commendation Award for "selfless and enduring vision, leadership, wisdom, and mentorship in the fields of women's mental health, ethics, and gender research." At the age of 63, Nanette experienced a 3 ½ month period of intractable, incapacitating dizziness for which there was never a clear diagnosis.

  19. MEDICAL PROFESSIONALISH

    Directory of Open Access Journals (Sweden)

    Jože Drinovec

    2002-12-01

    Full Text Available Background. Due to restrictions imposed on a clinical freedom, interest for professionalism in healthcare has been getting bigger not only in medicine literature and various mass media but also in teaching and organisation of healthcare. Professionalism stands not only for a medicine’s contract with society, recognition of a physician status, privilege and monopoly but also for a genuine physician’s commitment to professional responsibilities.Analysis. In 2002 European and American associations approved a document on medical professionalism in the new millenium, so-called Physician Charter. This document includes fundamental principles of professionalism such as altruism, patient autonomy and social justice. In particular, it analyses a physician’s professional competency, honesty with patients, patient confidentiality, appropriate relations with patients, improvements regarding a healthcare quality, healthcare access, just distribution of finite funds, commitment to scientific knowledge, trust maintenance by managing conflicts of interest and a professional responsibility.Conclusions. Physician’s professionalism means philosophycal and sociological analysis of his/her profession and its position in a society. It includes a concern for improvements of his/ her own scientific knowledge, skills, a genuine ethic interest for an individual patient bearing in mind principles of equality and justice in society. Whether performing an organisational and public work or participating in professional health organizations, physician’s interest for a patient must prevail.

  20. Library school education for medical librarianship.

    Science.gov (United States)

    Roper, F W

    1979-10-01

    This paper reviews the current situation in library school education for medical librarianship in the United States and Canada based on information from a questionnaire sent to teachers of courses in medical librarianship in accredited library schools. Since 1939, when the first course devoted entirely to medical librarianship was offered at Columbia University, courses have been introduced into the curricula of at least forty-seven of the ALA-accredited library schools. In 1978 there were seventy courses available through forty-seven library schools. Possibilities for specialization in medical librarianship are examined. Course content is reviewed. Implications of the MLA certification examination for library school courses are explored.

  1. Patient safety and technology-driven medication

    DEFF Research Database (Denmark)

    Orbæk, Janne; Gaard, Mette; Keinicke Fabricius, Pia

    2015-01-01

    ways of educating nursing students in today's medication administration. AIM: To explore nursing students' experiences and competences with the technology-driven medication administration process. METHODS: 16 pre-graduate nursing students were included in two focus group interviews which were recorded...... for the technology-driven medication process, nursing students face difficulties in identifying and adopting best practices. The impact of using technology on the frequency, type and severity of medication errors; the technologies implications on nursing professionalism and the nurses ability to secure patient...

  2. Library School Education for Medical Librarianship *

    Science.gov (United States)

    Roper, Fred W.

    1979-01-01

    This paper reviews the current situation in library school education for medical librarianship in the United States and Canada based on information from a questionnaire sent to teachers of courses in medical librarianship in accredited library schools. Since 1939, when the first course devoted entirely to medical librarianship was offered at Columbia University, courses have been introduced into the curricula of at least forty-seven of the ALA-accredited library schools. In 1978 there were seventy courses available through forty-seven library schools. Possibilities for specialization in medical librarianship are examined. Course content is reviewed. Implications of the MLA certification examination for library school courses are explored. PMID:385086

  3. International exploration by independents

    International Nuclear Information System (INIS)

    Bertagne, R.G.

    1991-01-01

    Recent industry trends indicate that the smaller US independents are looking at foreign exploration opportunities as one of the alternatives for growth in the new age of exploration. It is usually accepted that foreign finding costs per barrel are substantially lower than domestic because of the large reserve potential of international plays. To get involved overseas requires, however, an adaptation to different cultural, financial, legal, operational, and political conditions. Generally foreign exploration proceeds at a slower pace than domestic because concessions are granted by the government, or are explored in partnership with the national oil company. First, a mid- to long-term strategy, tailored to the goals and the financial capabilities of the company, must be prepared; it must be followed by an ongoing evaluation of quality prospects in various sedimentary basins, and a careful planning and conduct of the operations. To successfully explore overseas also requires the presence on the team of a minimum number of explorationists and engineers thoroughly familiar with the various exploratory and operational aspects of foreign work, having had a considerable amount of onsite experience in various geographical and climatic environments. Independents that are best suited for foreign expansion are those that have been financially successful domestically, and have a good discovery track record. When properly approached foreign exploration is well within the reach of smaller US independents and presents essentially no greater risk than domestic exploration; the reward, however, can be much larger and can catapult the company into the big leagues

  4. Admirable dishonesty in medical practice.

    Science.gov (United States)

    McCabe, Matthew

    2013-01-01

    Historically, the ethics of dishonesty within the physician-patient relationship has been analyzed largely from the deontological and consequentialist viewpoints. In this essay I offer a new exploration of dishonesty from the recently developed Virtue Ethics of Care perspective. First, I will explain and justify a general prescription for honest conduct within the relationship. Next, I will explore the conditions under which the Virtue Ethics of Care would find acts of dishonesty in medical practice to be admirable. Here, the moral distinction between lying and deception will be discussed. Then, two special contexts in medical practice, paternalistic dishonesty and patient dishonesty, will be analyzed. I will close with a discussion of the role of trust in the relationship and how it acts to prevent the Virtue Ethics of Care from sliding down the path toward objectionable acts of dishonesty.

  5. Exploration: A misunderstood business

    International Nuclear Information System (INIS)

    Lohrenz, J.

    1991-01-01

    The business of exploration is persistently misunderstand. Why? Misunderstandings persist and even pervade educated, sophisticated, and obviously capable business practitioners and savants of an array of disciplines - finance, economics, and the management sciences. Routine and appropriate assumptions that apply for most businesses invoke nonsense applied to exploration, a unique business. The uniqueness of exploration, unrecognized, sustains the misunderstandings. The authors will not here obliterate these obdurate misunderstandings with some revelation. They show, however, how the misunderstandings naturally arise among those who certainly are not used to being naive

  6. Arts of urban exploration

    DEFF Research Database (Denmark)

    Pinder, David

    2005-01-01

    to the city’ and ‘writing the city’. Through addressing recent cases of psychogeographical experimentation in terms of these themes, the paper raises broad questions about artistic practices and urban exploration to introduce this theme issue on ‘Arts of urban exploration’ and to lead into the specific......This paper addresses ways in which artists and cultural practitioners have recently been using forms of urban exploration as a means of engaging with, and intervening in, cities. It takes its cues from recent events on the streets of New York that involved exploring urban spaces through artistic...

  7. MBN Explorer Users' Guide

    DEFF Research Database (Denmark)

    Solov'yov, Ilia A.; Sushko, Gennady; Solov'yov, Andrey V.

    The MBN Explorer Users' Guide describes how to install and to run MBN Explorer, the software package for advanced multiscale simulations of complex molecular structure and dynamics. This guide includes the description of the main features and the algorithms of the program, the manual how to use...... simulations of structure and dynamics of a broad range of systems with the sizes from the atomic up to the mesoscopic scales. MBN Explorer is being developed and distributed by MBN Research Center, www.mbnresearch.com, which organises hands-on tutorials for the software, user's workshops and conferences....

  8. Eco-medical tourism: can it be sustainable?

    Science.gov (United States)

    Robert S. Bristow

    2009-01-01

    Medical tourism has gained popularity over the past few years. While its roots may be found in the Neolithic and Bronze Ages with visits to mineral springs around the Mediterranean, current medical tourism is more likely to be driven by patients seeking less expensive medical procedures in eastern Europe, southeast Asia, and Latin America. This paper explores the role...

  9. Widening Participation in Medical Education: Challenging Elitism and Exclusion

    Science.gov (United States)

    Boursicot, Kathy; Roberts, Trudie

    2009-01-01

    In this paper, we examine issues relating to the enduring nature of elitism and exclusion in medical education by exploring the changes in social and policy influences on the admission and inclusion of women and disabled people to undergraduate medical courses and the medical profession. The widening participation imperative in the United Kingdom…

  10. Mobile medical image retrieval

    Science.gov (United States)

    Duc, Samuel; Depeursinge, Adrien; Eggel, Ivan; Müller, Henning

    2011-03-01

    Images are an integral part of medical practice for diagnosis, treatment planning and teaching. Image retrieval has gained in importance mainly as a research domain over the past 20 years. Both textual and visual retrieval of images are essential. In the process of mobile devices becoming reliable and having a functionality equaling that of formerly desktop clients, mobile computing has gained ground and many applications have been explored. This creates a new field of mobile information search & access and in this context images can play an important role as they often allow understanding complex scenarios much quicker and easier than free text. Mobile information retrieval in general has skyrocketed over the past year with many new applications and tools being developed and all sorts of interfaces being adapted to mobile clients. This article describes constraints of an information retrieval system including visual and textual information retrieval from the medical literature of BioMedCentral and of the RSNA journals Radiology and Radiographics. Solutions for mobile data access with an example on an iPhone in a web-based environment are presented as iPhones are frequently used and the operating system is bound to become the most frequent smartphone operating system in 2011. A web-based scenario was chosen to allow for a use by other smart phone platforms such as Android as well. Constraints of small screens and navigation with touch screens are taken into account in the development of the application. A hybrid choice had to be taken to allow for taking pictures with the cell phone camera and upload them for visual similarity search as most producers of smart phones block this functionality to web applications. Mobile information access and in particular access to images can be surprisingly efficient and effective on smaller screens. Images can be read on screen much faster and relevance of documents can be identified quickly through the use of images contained in

  11. Avionics Architecture for Exploration

    Data.gov (United States)

    National Aeronautics and Space Administration — The goal of the AES Avionics Architectures for Exploration (AAE) project is to develop a reference architecture that is based on standards and that can be scaled and...

  12. Titanic: A Statistical Exploration.

    Science.gov (United States)

    Takis, Sandra L.

    1999-01-01

    Uses the available data about the Titanic's passengers to interest students in exploring categorical data and the chi-square distribution. Describes activities incorporated into a statistics class and gives additional resources for collecting information about the Titanic. (ASK)

  13. Exploration Augmentation Module Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The Exploration Augmentation Module (EAM) project goal is to design and deliver a flight module that is to be deployed to Earth-Lunar Distant Retrograde Orbit (DRO)....

  14. Foreign Aid Explorer)

    Data.gov (United States)

    US Agency for International Development — The Foreign Aid Explorer shows the multi-dimensional picture of U.S. foreign assistance through a highly visual and interactive website. The website makes it easy...

  15. Brazilian uranium exploration program

    International Nuclear Information System (INIS)

    Marques, J.P.M.

    1981-01-01

    General information on Brazilian Uranium Exploration Program, are presented. The mineralization processes of uranium depoits are described and the economic power of Brazil uranium reserves is evaluated. (M.C.K.) [pt

  16. Redefining "Medical Care."

    Science.gov (United States)

    Roth, Lauren R

    for fruits and vegetables may be covered for those in the lower income brackets who could not otherwise afford these items and would not choose to spend scarce resources on them if they could. This all assumes that the government takes funds previously used to subsidize the purchase of health insurance under the ACA (or allocates new funds) and puts the funds in individual accounts so the poor or near poor have money to pay for these expenses. Section I of this Article will explore the current definition of medical care, which excludes the social determinants of health from "healthcare" spending. I then address how precision medicine has changed the types of services and treatments that it makes sense to reimburse for each individual. If efficacy can vary from person to person based on genetic code, then it also can vary depending on environment. There is an opportunity to not only vary the types of "medical care" that can be reimbursed or deducted within the traditional range of services and drugs, but also outside of that range. Section II addresses the historical shift towards health financing through individual accounts, and specifically through HSAs. If this is the only avenue for health reform in the next few years, I advocate using it to engage in the type of experiments that are typically only possible under the cover of tax expenditures. My proposal for precision healthcare accounts moves the government to experiment with individual social spending that can lead to improved overall health outcomes. Finally, in Section III, I address two dichotomies that affect any healthcare proposal: (1) entitlement programs v. grants-in-aid, and (2) pooled insurance v. consumer-driven health plans (CDHPs). In the end, I argue that an entitlement method of funding precision HSAs along with pooled insurance subsidized by the government is the most realistic resolution to these dichotomies. Only a broad-based entitlement to funding for all healthcare expenses (medical and

  17. Exploring Vietnam's oil potential

    International Nuclear Information System (INIS)

    Anon.

    1993-01-01

    A brief review is given of the oil production potential in Vietnam. Since Since 1987, the country has been open to foreign investment in offshore exploration but has suffered from a US embargo on trade and economic ties. Nevertheless some exploration has occurred and twenty production sharing contracts with international oil companies has been signed. To date most of the finds have been non-commercial but optimism remains high. (U.K.)

  18. Developing the MD Explorer

    Science.gov (United States)

    Howie, Philip V.

    1993-04-01

    The MD Explorer is an eight-seat twin-turbine engine helicopter which is being developed using integrated product definition (IPD) team methodology. New techniques include NOTAR antitorque system for directional control, a composite fuselage, an all-composite bearingless main rotor, and digital cockpit displays. Three-dimensional CAD models are the basis of the entire Explorer design. Solid models provide vendor with design clarification, removing much of the normal drawing interpretation errors.

  19. Differences of smoking knowledge, attitudes, and behaviors between medical and non-medical students.

    Science.gov (United States)

    Han, Min-Yan; Chen, Wei-Qing; Wen, Xiao-Zhong; Liang, Cai-Hua; Ling, Wen-Hua

    2012-03-01

    Previous studies in the world reported inconsistent results about the relationship of medical professional education with medical students' smoking behaviors, and no similar research had been published in China. This paper aims to explore whether the differences of smoking-related knowledge, attitudes, and behaviors existed between medical and non-medical undergraduate students. Eight thousand one hundred thirty-eight undergraduate students sampled from a university in Guangzhou were investigated with a self-administered structured questionnaire about their smoking-related knowledge, attitude and behaviors, and other relevant factors. General linear model and multinomial logistic regression were conducted to test the differences in smoking-related knowledge, attitude, and behaviors between medical and non-medical students while controlling for potential confounding variables. There was no difference in smoking-related knowledge scores between medical and non-medical freshmen, but medical sophomores and juniors had higher scores of smoking-related knowledge than their non-medical counterparts. The medical sophomores had higher mean score of attitudes towards smoking than non-medical ones. Before entering university, the difference in the prevalence of experimental and regular smoking between medical and non-medical college students was not significant. After entering university, in contrast, the overall prevalence of regular smoking was significantly higher among male non-medical college students than among male medical students. Stratified by current academic year, this difference was significant only among male sophomores. Medical students have higher smoking-related knowledge, stronger anti-smoking attitude, and lower prevalence of regular smoking than non-medical college students of similar age, which may be associated with medical professional education.

  20. International exploration by independents

    International Nuclear Information System (INIS)

    Bertagne, R.G.

    1992-01-01

    Recent industry trends indicate that the smaller U.S. independents are looking at foreign exploration opportunities as one of the alternatives for growth in the new age of exploration. The problems of communications and logistics caused by different cultures and by geographic distances must be carefully evaluated. A mid-term to long-term strategy tailored to the goals and the financial capabilities of the company should be prepared and followed by a careful planning of the operations. This paper addresses some aspects of foreign exploration that should be considered before an independent venture into the foreign field. It also provides some guidelines for conducting successful overseas operations. When properly assessed, foreign exploration is well within the reach of smaller U.S. independents and presents no greater risk than domestic exploration; the rewards, however, can be much larger. Furthermore, the Oil and Gas Journal surveys of the 300 largest U.S. petroleum companies show that companies with a consistent foreign exploration policy have fared better financially during difficult times

  1. Psychodynamics in medically ill patients.

    Science.gov (United States)

    Nash, Sara Siris; Kent, Laura K; Muskin, Philip R

    2009-01-01

    This article explores the role of psychodynamics as it applies to the understanding and treatment of medically ill patients in the consultation-liaison psychiatry setting. It provides historical background that spans the eras from Antiquity (Hippocrates and Galen) to nineteenth-century studies of hysteria (Charcot, Janet, and Freud) and into the twentieth century (Flanders Dunbar, Alexander, Engle, and the DSM). The article then discusses the effects of personality on medical illness, treatment, and patients' ability to cope by reviewing the works of Bibring, Kahana, and others. The important contribution of attachment theory is reviewed as it pertains the patient-physician relationship and the health behavior of physically ill patients. A discussion of conversion disorder is offered as an example of psychodynamics in action. This article highlights the important impact of countertransference, especially in terms of how it relates to patients who are extremely difficult and "hateful," and explores the dynamics surrounding the topic of physician-assisted suicide, as it pertains to the understanding of a patient's request to die. Some attention is also given to the challenges surrounding the unique experience of residents learning how to treat medically ill patients on the consultation-liaison service. Ultimately, this article concludes that the use and understanding of psychodynamics and psychodynamic theory allows consultation-liaison psychiatrists the opportunity to interpret the life narratives of medically ill patients in a meaningful way that contributes importantly to treatment.

  2. Cognitive Medical Multiagent Systems

    OpenAIRE

    Barna Iantovics

    2010-01-01

    The development of efficient and flexible agent-based medical diagnosis systems represents a recent research direction. Medical multiagent systems may improve the efficiency of traditionally developed medical computational systems, like the medical expert systems. In our previous researches, a novel cooperative medical diagnosis multiagent system called CMDS (Contract Net Based Medical Diagnosis System) was proposed. CMDS system can solve flexibly a large variety of medical diagnosis problems...

  3. Medical anthropology and the physician assistant profession.

    Science.gov (United States)

    Henry, Lisa R

    2015-01-01

    Medical anthropology is a subfield of anthropology that investigates how culture influences people's ideas and behaviors regarding health and illness. Medical anthropology contributes to the understanding of how and why health systems operate the way they do, how different people understand and interact with these systems and cultural practices, and what assets people use and challenges they may encounter when constructing perceptions of their own health conditions. The goal of this article is to highlight the methodological tools and analytical insights that medical anthropology offers to the study of physician assistants (PAs). The article discusses the field of medical anthropology; the advantages of ethnographic and qualitative research; and how medical anthropology can explain how PAs fit into improved health delivery services by exploring three studies of PAs by medical anthropologists.

  4. Explorations in Personal Health.

    Science.gov (United States)

    Haro, Michael S.; And Others

    This text, designed for college students, is oriented toward the social, emotional, and behavioral aspects of health. Eight health-related topics of major concern for college students were selected for inclusion: (1) interpersonal relationships; (2) coping strategies; (3) sexuality; (4) nutrition; (5) medical care and services; (6) health…

  5. Dealing with exploration uncertainties

    International Nuclear Information System (INIS)

    Capen, E.

    1992-01-01

    Exploration for oil and gas should fulfill the most adventurous in their quest for excitement and surprise. This paper tries to cover that tall order. The authors will touch on the magnitude of the uncertainty (which is far greater than in most other businesses), the effects of not knowing target sizes very well, how to build uncertainty into analyses naturally, how to tie reserves and chance estimates to economics, and how to look at the portfolio effect of an exploration program. With no apologies, the authors will be using a different language for some readers - the language of uncertainty, which means probability and statistics. These tools allow one to combine largely subjective exploration information with the more analytical data from the engineering and economic side

  6. Exploring ambiguous realms

    DEFF Research Database (Denmark)

    Clemensen, Nana

    2016-01-01

    In Hang'ombe Village in rural Zambia, the relative lack of physical boundaries between the activities of family members allow children to observe the actions and discussions of adults on close hand, exposing them to the ambiguities of daily life. Children explore these ambiguities in their intera...... in their interactions, testing social roles and conventions. This article explores the vigilance and creative agency displayed by Hang'ombe children, in an environment spurring their acquisition of distinct social and discursive skills.......In Hang'ombe Village in rural Zambia, the relative lack of physical boundaries between the activities of family members allow children to observe the actions and discussions of adults on close hand, exposing them to the ambiguities of daily life. Children explore these ambiguities...

  7. Trailblazing Medicine Sustaining Explorers During Interplanetary Missions

    CERN Document Server

    Seedhouse, Erik

    2011-01-01

    To prepare for the day when astronauts leave low-Earth orbit for long-duration exploration missions, space medicine experts must develop a thorough understanding of the effects of microgravity on the human body, as well as ways of mitigating them. To gain a complete understanding of the effects of space on the human body and to create tools and technologies required for successful exploration, space medicince will become an increasingly collaborative discipline incorporating the skills of physicians, biomedical scientists, engineers, and mission planners. Trailblazing Medicine examines the future of space medicine in relation to human space exploration; describes what is necessary to keep a crew alive in space, including the use of surgical robots, surface-based telemedicine, and remote emergency care; discusses bioethical problems such as euthanasia, sex, and precautionary surgery; investigates the medical challenges faced by interplanetary astronauts; details the process of human hibernation.

  8. Exploring the solar system

    CERN Document Server

    Bond, Peter

    2012-01-01

    The exploration of our solar system is one of humanity's greatest scientific achievements. The last fifty years in particular have seen huge steps forward in our understanding of the planets, the sun, and other objects in the solar system. Whilst planetary science is now a mature discipline - involving geoscientists, astronomers, physicists, and others - many profound mysteries remain, and there is indeed still the tantalizing possibility that we may find evidence of life on another planet in our system.Drawing upon the latest results from the second golden age of Solar System exploration, aut

  9. Optimal exploration target zones

    CSIR Research Space (South Africa)

    Debba, Pravesh

    2008-09-01

    Full Text Available -of-evidence (WofE) method logistic regression canonical favorability analysis neural networks evidential belief functions Optimal Exploration Target Zones Debba, Carranza, Stein, van der Meer Introduction to Remote Sensing Background and Objective of the study... for the following equation: n∑ i=r ( n i ) pi(1− p)n−i = 0.95 . (1) Optimal Exploration Target Zones Debba, Carranza, Stein, van der Meer Introduction to Remote Sensing Background and Objective of the study Methodology Results METHODS (cont. . . ): FITNESS FUNCTION...

  10. Implantable Medical Devices

    Science.gov (United States)

    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More Implantable Medical Devices Updated:Sep 16,2016 For Rhythm Control ... a Heart Attack Introduction Medications Surgical Procedures Implantable Medical Devices • Life After a Heart Attack • Heart Attack ...

  11. Medical alert bracelet (image)

    Science.gov (United States)

    People with diabetes should always wear a medical alert bracelet or necklace that emergency medical workers will be able to find. Medical identification products can help ensure proper treatment in an ...

  12. Asthma Medications and Pregnancy

    Science.gov (United States)

    ... Asthma Associated Conditions Asthma & Pregnancy Asthma & Pregnancy: Medications Asthma & Pregnancy: Medications Make an Appointment Refer a Patient ... make sure you are using it correctly. Other Asthma Related Medication Treatment Annual influenza vaccine (flu shot) ...

  13. Medications (for IBS)

    Medline Plus

    Full Text Available ... Agents Antidiarrheal Agents Antidepressant Medications Newer IBS Medications Probiotics and Antibiotics Pharmacologic, or drug, therapy is best ... Agents Antidiarrheal Agents Antidepressant Medications Newer IBS ... Antibiotics Psychological Treatments Understanding Stress Cognitive Behavioral ...

  14. Medication/Drug Allergy

    Science.gov (United States)

    ... Training Home Conditions Medication/Drug Allergy Medication/Drug Allergy Make an Appointment Find a Doctor Ask a ... risk for adverse reactions to medications. Facts about Allergies The tendency to develop allergies may be inherited. ...

  15. Seeking health care through international medical tourism.

    Science.gov (United States)

    Eissler, Lee Ann; Casken, John

    2013-06-01

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

  16. Leadership and power in medical imaging

    Energy Technology Data Exchange (ETDEWEB)

    Yielder, Jill [School of Health and Community Studies, Unitec New Zealand, Private Bag 92 025, Mt Albert, Auckland (New Zealand)]. E-mail: jyielder@unitec.ac.nz

    2006-11-15

    This article examines the concept of professional leadership in medical imaging. It explores the context of power issues in which such leadership is located, the differences between leadership and management, the qualities needed for effective leadership and how an individual's psychology may affect it. The article concludes that in the current climate of change and development, the medical imaging profession needs strong and appropriate leadership to profile the profession effectively and to lead it through to a more autonomous future.

  17. Leadership and power in medical imaging

    International Nuclear Information System (INIS)

    Yielder, Jill

    2006-01-01

    This article examines the concept of professional leadership in medical imaging. It explores the context of power issues in which such leadership is located, the differences between leadership and management, the qualities needed for effective leadership and how an individual's psychology may affect it. The article concludes that in the current climate of change and development, the medical imaging profession needs strong and appropriate leadership to profile the profession effectively and to lead it through to a more autonomous future

  18. Medical applications for biomaterials in Bolivia

    CERN Document Server

    Arias, Susan

    2015-01-01

    This book investigates the potential medical benefits natural biomaterials can offer in developing countries by analyzing the case of Bolivia. The book explores the medical and health related applications of Bolivian commodities: quinoa, barley, sugarcane, corn, sorghum and sunflower seeds. This book helps readers better understand some of the key health concerns facing countries like Bolivia and how naturally derived biomaterials and therapeutics could help substantially alleviate many of their problems.

  19. Good information cuts medical risk of travel

    International Nuclear Information System (INIS)

    Clyde, J.D.

    1996-01-01

    Today the oil industry is seeking exploration, production, and business opportunities around the globe. A result is that its employees are traveling more and visiting distant and remote locations. This travel significantly increases the level of their exposure to illness and accident. This paper discusses the information needs for oil company personnel which will be visiting foreign countries. It describes the medical preparation, immunizations, sanitary conditions, medical facilities, auto accidents, and other hazards which should be known about

  20. Medications (for IBS)

    Medline Plus

    Full Text Available ... Antidepressant Medications Newer IBS Medications Probiotics and Antibiotics Psychological Treatments Understanding Stress Cognitive Behavioral Therapy Relaxation Techniques for IBS Take Part in Online ...

  1. Medications (for IBS)

    Medline Plus

    Full Text Available ... Agents Antidepressant Medications Newer IBS Medications Probiotics and Antibiotics Psychological Treatments Understanding Stress Cognitive Behavioral Therapy Relaxation Techniques for ...

  2. Cognitive Medical Multiagent Systems

    Directory of Open Access Journals (Sweden)

    Barna Iantovics

    2010-01-01

    Full Text Available The development of efficient and flexible agent-based medical diagnosis systems represents a recent research direction. Medical multiagent systems may improve the efficiency of traditionally developed medical computational systems, like the medical expert systems. In our previous researches, a novel cooperative medical diagnosis multiagent system called CMDS (Contract Net Based Medical Diagnosis System was proposed. CMDS system can solve flexibly a large variety of medical diagnosis problems. This paper analyses the increased intelligence of the CMDS system, which motivates its use for different medical problem’s solving.

  3. Medications (for IBS)

    Medline Plus

    Full Text Available ... Anthony J. Lembo, MD, Instructor of Medicine, Harvard Medical School; Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, MA. Last modified on February 23, ...

  4. Exploring Racism through Photography

    Science.gov (United States)

    Fey, Cass; Shin, Ryan; Cinquemani, Shana; Marino, Catherine

    2010-01-01

    Photography is a powerful medium with which to explore social issues and concerns through the intersection of artistic form and concept. Through the discussions of images and suggested activities, students will understand various ways photographers have documented and addressed racism and discrimination. This Instructional Resource presents a…

  5. Exploring pedestrian movement patterns

    NARCIS (Netherlands)

    Orellana, D.A.

    2012-01-01

    The main objective of this thesis is to develop an approach for exploring, analysing and interpreting movement patterns of pedestrians interacting with the environment. This objective is broken down in sub-objectives related to four research questions. A case study of the movement of visitors in a

  6. Exploring Sound with Insects

    Science.gov (United States)

    Robertson, Laura; Meyer, John R.

    2010-01-01

    Differences in insect morphology and movement during singing provide a fascinating opportunity for students to investigate insects while learning about the characteristics of sound. In the activities described here, students use a free online computer software program to explore the songs of the major singing insects and experiment with making…

  7. Geophysics in uranium exploration

    International Nuclear Information System (INIS)

    Darnley, A.G.

    1975-01-01

    There are no revolutionary new methods of uranium exploration on the horizon. Continuing improvements in existing methods and types of instrumentation are to be expected, but the main scope of improvement will hinge upon using the best of the available methods more meticulously and systematically, and paying more attention to the analysis of data. (author)

  8. Exploring heroin consumption

    NARCIS (Netherlands)

    Trautmann, Franz; Frijns, Tom

    2013-01-01

    In this report we explore some aspects of heroin consumption, using the data we collected through the face-to-face interviews and comparing our findings with data from other research and monitoring sources. We focus on Italy, the Netherlands and England, the three sample Member States where we have

  9. Antarctica: Discovery & Exploration.

    Science.gov (United States)

    Gascoigne, Toss; Collett, Peter

    An examination of Antarctica, from the first sightings to the heroic explorations of the late 18th and early 19th centuries to modern-day research, is presented in this book. Twelve chapters are as follows: (1) The search begins; (2) Whalers and sealers: bites and nibbles; (3) The new continent: first sight; (4) Wintering: the first party; (5)…

  10. Exploring Project Management Education

    NARCIS (Netherlands)

    Steven Nijhuis

    2017-01-01

    From the article: "The object of this paper is to explore the actual practice in project management education in the Netherlands and compare it to reference institutions and recent literature. A little over 40% of the Higher Education institutions in the Netherlands mentions PM education in

  11. Exploring processes and deviations

    NARCIS (Netherlands)

    Leemans, S.J.J.; Fahland, D.; Aalst, van der W.M.P.; Fournier, F.; Mendling, J.

    2015-01-01

    In process mining, one of the main challenges is to discover a process model, while balancing several quality criteria. This often requires repeatedly setting parameters, discovering a map and evaluating it, which we refer to as process exploration. Commercial process mining tools like Disco,

  12. Beyond frontier exploration

    NARCIS (Netherlands)

    Visser, A.; Ji, X.; van Ittersum, M.; González Jaime, L.A.; Stancu, L.A.

    2008-01-01

    This article investigates the prerequisites for a global exploration strategy in an unknown environment on a virtual disaster site. Assume that a robot equipped with a laser range scanner can build a detailed map of a previous unknown environment. The remaining question is how to use this

  13. Domestic uranium exploration activities

    International Nuclear Information System (INIS)

    Chenoweth, W.L.

    1980-01-01

    Uranium exploration in the United States reached its alltime high in 1978 when the chief exploration indicator, surface drilling, totaled 47 million feet. In 1979, however, total drilling declined to 41 million feet, and during the first 8 months of 1980 the trend continued, as surface drilling was 27% less than for the same period in 1979. The total drilling for 1980 now is expected to be below 30 million feet, far less than the 39.4 million feet planned by industry at the beginning of the year. Falling uranium prices, the uncertainties of future uranium demand, rising costs, and the possibility of stiff foreign competition are the prime causes for the current reduction in domestic uranium exploration. Uranium exploration in the United States continues to be concentrated in the vicinity of major producing areas such as the San Juan Basin, Wyoming Basins, Texas Coastal Plain, Paradox Basin, and northeastern Washington, and in areas of recent discoveries including the Henry Mountains, Utah, the McDermitt caldera in Nevada and Oregon, and central Colorado. The distributions, by location, of total surface drilling for 1979 and the first half of 1980 are presented

  14. Uranium exploration in Australia

    International Nuclear Information System (INIS)

    Battey, G.C.; Hawkins, B.W.

    1977-01-01

    As a result of exploration which recommenced in 1966 Australia's uranium reserves increased from 6,200 tonnes in 1967 to 227,000 tonnes uranium by June 1976. Most discoveries in the early 1950's were made by prospectors. The increase in reserves during the past decade is the result of exploration by companies utilising improved technology in areas selected as geologically favourable. These reserves were established at relatively low cost. In the Alligator Rivers Uranium Province the ''vein'' type deposits at Jabiluka, Ranger, Koongarra and Nabarlek contain 17% of the world's reserves. Most of these discoveries resulted from the investigation of airborne radiometric anomalies but cover over the prospective host rocks will necessitate the future use of costlier and more indirect exploration techniques. There was exploration for sandstone type uranium deposits in most of Australia's sedimentary basins. The greatest success was achieved in the Lake Frome Basin in South Australia. Other deposits were found in the Ngalia and Amadeus Basins in Central Australia and in the Westmoreland area, N.W. Queensland. A major uranium deposit was found in an unusual environment at Yeelirrie, Western Australia where carnotite occurs in a caliche and clay host which fills a shallow, ancient drainage channel. Although caliche occurrences are relatively widespread on the Precambrian shield no other economic deposit has been found. Recent discoveries in the Georgetown area of Queensland indicate the presence of another uranium province but it is too early to assess its potential. The ore occurs in clastic sediments at the base of a volcanic sequence overlying a Precambrian basement. Several companies which have established large uranium reserves have a number of additional attractive prospects. Exploration activity in Australia in 1975 was at a lower level than in previous years, but the potential for discovering further deposits is considered to be high

  15. Exploring primary care activities in ACT teams.

    Science.gov (United States)

    Vanderlip, Erik R; Williams, Nancy A; Fiedorowicz, Jess G; Katon, Wayne

    2014-05-01

    People with serious mental illness often receive inadequate primary and preventive care services. Federal healthcare reform endorses team-based care that provides high quality primary and preventive care to at risk populations. Assertive community treatment (ACT) teams offer a proven, standardized treatment approach effective in improving mental health outcomes for the seriously mentally ill. Much is known about the effectiveness of ACT teams in improving mental health outcomes, but the degree to which medical care needs are addressed is not established. The purpose of this study was to explore the extent to which ACT teams address the physical health of the population they serve. ACT team leaders were invited to complete an anonymous, web-based survey to explore attitudes and activities involving the primary care needs of their clients. Information was collected regarding the use of health screening tools, physical health assessments, provision of medical care and collaboration with primary care systems. Data was analyzed from 127 team leaders across the country, of which 55 completed the entire survey. Nearly every ACT team leader believed ACT teams have a role in identifying and managing the medical co-morbidities of their clientele. ACT teams report participation in many primary care activities. ACT teams are providing a substantial amount of primary and preventive services to their population. The survey suggests standardization of physical health identification, management or referral processes within ACT teams may result in improved quality of medical care. ACT teams are in a unique position to improve physical health care by virtue of having medically trained staff and frequent, close contact with their clients.

  16. Virtual Exploration of Earth's Evolution

    Science.gov (United States)

    Anbar, A. D.; Bruce, G.; Semken, S. C.; Summons, R. E.; Buxner, S.; Horodyskyj, L.; Kotrc, B.; Swann, J.; Klug Boonstra, S. L.; Oliver, C.

    2014-12-01

    Traditional introductory STEM courses often reinforce misconceptions because the large scale of many classes forces a structured, lecture-centric model of teaching that emphasizes delivery of facts rather than exploration, inquiry, and scientific reasoning. This problem is especially acute in teaching about the co-evolution of Earth and life, where classroom learning and textbook teaching are far removed from the immersive and affective aspects of field-based science, and where the challenges of taking large numbers of students into the field make it difficult to expose them to the complex context of the geologic record. We are exploring the potential of digital technologies and online delivery to address this challenge, using immersive and engaging virtual environments that are more like games than like lectures, grounded in active learning, and deliverable at scale via the internet. The goal is to invert the traditional lecture-centric paradigm by placing lectures at the periphery and inquiry-driven, integrative virtual investigations at the center, and to do so at scale. To this end, we are applying a technology platform we devised, supported by NASA and the NSF, that integrates a variety of digital media in a format that we call an immersive virtual field trip (iVFT). In iVFTs, students engage directly with virtual representations of real field sites, with which they interact non-linearly at a variety of scales via game-like exploration while guided by an adaptive tutoring system. This platform has already been used to develop pilot iVFTs useful in teaching anthropology, archeology, ecology, and geoscience. With support the Howard Hughes Medical Institute, we are now developing and evaluating a coherent suite of ~ 12 iVFTs that span the sweep of life's history on Earth, from the 3.8 Ga metasediments of West Greenland to ancient hominid sites in East Africa. These iVFTs will teach fundamental principles of geology and practices of scientific inquiry, and expose

  17. Exploring Urban Screens

    Directory of Open Access Journals (Sweden)

    Zlatan Krajina

    2009-12-01

    Full Text Available There is a tautological tendency in the widespread claims that urban space is 'me-diated'. Never before has the citizen, it is argued, been confronted with such an unprecedented array of signage. I depart from the rhetoric of 'biggest-ever-saturation' as not necessarily untrue, but as insufficient in exploring the diverse spatial operations of urban screens. I examine some contemporary cases of ani-mated architectural surfaces, informational panels, and advertising billboards, with reference to much longer standing cultural practices of spatial management in modern cities, such as illumination, to suggest that the contemporary display media do not mediate the city anew but re-invent urban space as a field of ubiqui-tous mediation. From that standpoint I suggest exploring urban screens as a both singular visual agents and indivisible items in plural structural assemblages, b complementary forces of public illumination, and c complex perceptual platforms in visual play of scale and distance.

  18. Exploring rationality in schizophrenia

    DEFF Research Database (Denmark)

    Revsbech, Rasmus; Mortensen, Erik Lykke; Owen, Gareth

    2015-01-01

    Background Empirical studies of rationality (syllogisms) in patients with schizophrenia have obtained different results. One study found that patients reason more logically if the syllogism is presented through an unusual content. Aims To explore syllogism-based rationality in schizophrenia. Meth...... differences became non-significant. Conclusions When taking intelligence and neuropsychological performance into account, patients with schizophrenia and controls perform similarly on syllogism tests of rationality.......Background Empirical studies of rationality (syllogisms) in patients with schizophrenia have obtained different results. One study found that patients reason more logically if the syllogism is presented through an unusual content. Aims To explore syllogism-based rationality in schizophrenia. Method...... Thirty-eight first-admitted patients with schizophrenia and 38 healthy controls solved 29 syllogisms that varied in presentation content (ordinary v. unusual) and validity (valid v. invalid). Statistical tests were made of unadjusted and adjusted group differences in models adjusting for intelligence...

  19. Exploring textual data

    CERN Document Server

    Lebart, Ludovic; Berry, Lisette

    1998-01-01

    Researchers in a number of disciplines deal with large text sets requiring both text management and text analysis. Faced with a large amount of textual data collected in marketing surveys, literary investigations, historical archives and documentary data bases, these researchers require assistance with organizing, describing and comparing texts. Exploring Textual Data demonstrates how exploratory multivariate statistical methods such as correspondence analysis and cluster analysis can be used to help investigate, assimilate and evaluate textual data. The main text does not contain any strictly mathematical demonstrations, making it accessible to a large audience. This book is very user-friendly with proofs abstracted in the appendices. Full definitions of concepts, implementations of procedures and rules for reading and interpreting results are fully explored. A succession of examples is intended to allow the reader to appreciate the variety of actual and potential applications and the complementary processin...

  20. Exploring improvisation in nursing.

    Science.gov (United States)

    Hanley, Mary Anne; Fenton, Mary V

    2007-06-01

    Improvisation has long been considered a function of music, dance, and the theatre arts. An exploration of the definitions and characteristics of this concept in relation to the art and practice of nursing provide an opportunity to illuminate related qualities within the field of nursing. Nursing has always demonstrated improvisation because it is often required to meet the needs of patients in a rapidly changing environment. However, little has been done to identify improvisation in the practice of nursing or to teach improvisation as a nursing knowledge-based skill. This article strives to explore the concept of improvisation in nursing, to describe the characteristics of improvisation as applied to nursing, and to utilize case studies to illustrate various manifestations of improvisation in nursing practice.