WorldWideScience

Sample records for international medical reviews

  1. An international review of tobacco smoking among medical students

    Directory of Open Access Journals (Sweden)

    Smith D

    2007-01-01

    Full Text Available We conducted a systematic international review of tobacco smoking habits among medical students. Particular attention was paid to countries where smoking rates have been historically well-documented in local journals, but were less often included in larger international review articles. The methodology involved a search of relevant medical subject headings, after which the reference lists of journal papers were also examined to find additional publications. A total of 66 manuscripts met the inclusion criteria. The most common countries previously studied included India, the United States, Australia, Japan, Pakistan, Turkey and the United Kingdom. Overall, our review suggests that the prevalence of smoking among medical students varies widely amongst different countries and also between male and female students within the same areas. Consistently low smoking rates were found in Australia and the United States, while generally high rates were reported in Spain and Turkey. Given their important future role as exemplars, more effective measures to help reduce tobacco smoking among medical students are clearly needed worldwide.

  2. International medical migration: a critical conceptual review of the global movements of doctors and nurses.

    Science.gov (United States)

    Bradby, Hannah

    2014-11-01

    This paper critically appraises the discourse around international medical migration at the turn of the 21st century. A critical narrative review of a range of English-language sources, including grey literature, books and research reports, traces the development and spread of specific causative models. The attribution of causative relations between the movement of skilled medical workers, the provision of health care and population health outcomes illustrates how the global reach of biomedicine has to be understood in the context of local conditions. The need to understand migration as an aspect of uneven global development, rather than a delimited issue of manpower services management, is illustrated with reference to debates about 'brain drain' of Africa's health-care professionals, task-shifting and the crisis in health-care human resources. The widespread presumed cause of shortages of skilled health-care staff in sub-Saharan Africa was overdetermined by a compelling narrative of rich countries stealing poor countries' trained health-care professionals. This narrative promotes medical professional interests and ignores historical patterns of underinvestment in health-care systems and structures. Sociological theories of medicalization suggest that the international marketization of medical recruitment is a key site where the uneven global development of capital is at work. A radical reconfiguration of medical staffing along the lines of 'task-shifting' in rich and poor countries' health-care systems alike offers one means of thinking about global equity in access to quality care.

  3. Dealing with foreign cultural paradigms: A systematic review on intercultural challenges of international medical graduates.

    Science.gov (United States)

    Michalski, Kerstin; Farhan, Nabeel; Motschall, Edith; Vach, Werner; Boeker, Martin

    2017-01-01

    An increasing number of International Medical Graduates (IMG), who are defined to be physicians working in a country other than their country of origin and training, immigrate to Western countries. In order to ensure safe and high-quality patient care, they have to take medical and language tests. This systematic review aims to (1) collect all empiric research on intercultural communication of IMGs in medical settings, (2) identify and categorize all text passages mentioning intercultural issues in the included studies, and (3) describe the most commonly reported intercultural areas of communication of IMGs. This review was based on the PRISMA-Guidelines for systematic reviews. We conducted a broad and systematic electronic literature search for empiric research in the following databases: MEDLINE, BIOSIS Citation Index, BIOSIS Previews, KCI-Korean Journal Database and SciELO Citation Index. The search results were synthesized and analyzed with the aid of coding systems. These coding systems were based on textual analysis and derived from the themes and topics of the results and discussion sections from the included studies. A quality assessment was performed, comparing the studies with their corresponding checklist (COREQ or STROBE). Textual results of the studies were extracted and categorized. Among 10,630 search results, 47 studies were identified for analysis. 31 studies were qualitative, 12 quantitative and 4 studies used mixed methods. The quality assessment revealed a low level of quality of the studies in general. The following intercultural problems were identified: IMGs were not familiar with shared decision-making and lower hierarchies in the health care system in general. They had difficulties with patient-centered care, the subtleties of the foreign language and with the organizational structures of the new health care system. In addition, they described the medical education in their home countries as science-oriented, without focusing on

  4. Substantial agreement of referee recommendations at a general medical journal--a peer review evaluation at Deutsches Arzteblatt International.

    Directory of Open Access Journals (Sweden)

    Christopher Baethge

    Full Text Available BACKGROUND: Peer review is the mainstay of editorial decision making for medical journals. There is a dearth of evaluations of journal peer review with regard to reliability and validity, particularly in the light of the wide variety of medical journals. Studies carried out so far indicate low agreement among reviewers. We present an analysis of the peer review process at a general medical journal, Deutsches Ärzteblatt International. METHODOLOGY/PRINCIPAL FINDINGS: 554 reviewer recommendations on 206 manuscripts submitted between 7/2008 and 12/2009 were analyzed: 7% recommended acceptance, 74% revision and 19% rejection. Concerning acceptance (with or without revision versus rejection, there was a substantial agreement among reviewers (74.3% of pairs of recommendations that was not reflected by Fleiss' or Cohen's kappa (<0.2. The agreement rate amounted to 84% for acceptance, but was only 31% for rejection. An alternative kappa-statistic, however, Gwet's kappa (AC1, indicated substantial agreement (0.63. Concordance between reviewer recommendation and editorial decision was almost perfect when reviewer recommendations were unanimous. The correlation of reviewer recommendations and citations as counted by Web of Science was low (partial correlation adjusted for year of publication: -0.03, n.s.. CONCLUSIONS/SIGNIFICANCE: Although our figures are similar to those reported in the literature our conclusion differs from the widely held view that reviewer agreement is low: Based on overall agreement we consider the concordance among reviewers sufficient for the purposes of editorial decision making. We believe that various measures, such as positive and negative agreement or alternative Kappa values are superior to the application of Cohen's or Fleiss' Kappa in the analysis of nominal or ordinal level data regarding reviewer agreement. Also, reviewer recommendations seem to be a poor proxy for citations because, for example, manuscripts will be

  5. Medications and International Travel

    Centers for Disease Control (CDC) Podcasts

    2011-04-12

    This podcast answers a listener's question about her medications and an international trip she's planning.  Created: 4/12/2011 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 4/12/2011.

  6. 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.

  7. 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.

  8. Effects of international health electives on medical student learning and career choice: results of a systematic literature review.

    Science.gov (United States)

    Jeffrey, Jessica; Dumont, Rebecca A; Kim, Gloria Y; Kuo, Tony

    2011-01-01

    The present study reviewed the published literature to examine the effects of international health electives (IHEs) on medical student learning and career choice. A systematic literature review was conducted to identify key English-language articles on IHEs, using PubMed journal databases for the period 1990--2009. Article inclusion for this review was vetted by a rigorous evaluation of each article's study methods, content, and data quality. Pooled or aggregate information from 11 key articles, including information on type and duration of IHE, study and comparison group characteristics, and measured outcomes such as self-reported changes in cultural competency, clinical skills, and specialty choice, were extracted and summarized. Findings suggest that having IHE experiences contributed to a more well-rounded training for medical students; students reported being more culturally competent and were more likely to choose a primary care specialty and/or a public service career. Although IHE experiences appear to have educational benefits, the quality and availability of these electives vary by institution. Barriers to ensuring that students attain a safe and rich experience include the lack of consistent categorical funding, safety concerns when traveling, and limited faculty experience and resources to support and guide students during their rotations abroad.

  9. Reflections on international medical law.

    Science.gov (United States)

    Wattad, Mohammed S; Hrevtsova, Radmyla Yu

    2011-12-01

    Does international medical law exist, in the first place, as an independent area of study? If so, is it urgently required in an era of comparative studies? Namely, to what extent, if at all, international studies differ from comparative ones? Besides, what are the particular characteristics of such international discipline? Namely, what are the particular features of this field that elaborate on our legal and scientific understanding in sketching possible definition for this notion of "international medical law?" In addition, how does international medical law correlate with health, ethics and health policies in our globalized world? And finally, what are the challenges that might face the international community, once the concept of "international medical law" is acknowledged? This papers aims at establishing the conceptual grounds for these questions, thus calling for the acknowledgment of a new field of study described as "international medical law".

  10. Substantial agreement of referee recommendations at a general medical journal--a peer review evaluation at Deutsches Ärzteblatt International.

    Science.gov (United States)

    Baethge, Christopher; Franklin, Jeremy; Mertens, Stephan

    2013-01-01

    Peer review is the mainstay of editorial decision making for medical journals. There is a dearth of evaluations of journal peer review with regard to reliability and validity, particularly in the light of the wide variety of medical journals. Studies carried out so far indicate low agreement among reviewers. We present an analysis of the peer review process at a general medical journal, Deutsches Ärzteblatt International. 554 reviewer recommendations on 206 manuscripts submitted between 7/2008 and 12/2009 were analyzed: 7% recommended acceptance, 74% revision and 19% rejection. Concerning acceptance (with or without revision) versus rejection, there was a substantial agreement among reviewers (74.3% of pairs of recommendations) that was not reflected by Fleiss' or Cohen's kappa (<0.2). The agreement rate amounted to 84% for acceptance, but was only 31% for rejection. An alternative kappa-statistic, however, Gwet's kappa (AC1), indicated substantial agreement (0.63). Concordance between reviewer recommendation and editorial decision was almost perfect when reviewer recommendations were unanimous. The correlation of reviewer recommendations and citations as counted by Web of Science was low (partial correlation adjusted for year of publication: -0.03, n.s.). Although our figures are similar to those reported in the literature our conclusion differs from the widely held view that reviewer agreement is low: Based on overall agreement we consider the concordance among reviewers sufficient for the purposes of editorial decision making. We believe that various measures, such as positive and negative agreement or alternative Kappa values are superior to the application of Cohen's or Fleiss' Kappa in the analysis of nominal or ordinal level data regarding reviewer agreement. Also, reviewer recommendations seem to be a poor proxy for citations because, for example, manuscripts will be changed considerably during the revision process.

  11. 'Natural' and 'Unnatural' medical deaths and coronial law: A UK and international review of the medical literature on natural and unnatural death and how it applies to medical death certification and reporting deaths to coroners: Natural/Unnatural death: A Scientific Review.

    Science.gov (United States)

    Harris, Andrew

    2017-07-01

    In the United Kingdom, when people die, either a doctor writes an acceptable natural cause of death medical certificate, or a coroner (fiscal in Scotland) investigates the case, usually with an autopsy. An inquest may or may not follow. The concept of 'natural or unnatural cause' death is not internationally standardized. This article reviews scientific evidence as to what is a natural death or unnatural death and how that relates to the international classification of deaths. Whilst there is some consensus on the definition, its application in considering whether to report to the coroner is more difficult. Depictions of deaths in terminal care, medical emergencies and post-operative care highlight these difficulties. It secondly reviews to what extent natural and unnatural are criteria for notification of deaths in England and Wales and internationally. It concludes with consideration of how medical concepts of unnatural death relate in England and Wales to coroners' legal concepts of what is unnatural. Deaths that appear natural to clinicians and pathologists may be legally unnatural and vice versa. It is argued that the natural/unnatural dichotomy is not a good criterion for reporting deaths under medical care to coroners, but the notification of a medical cause of death, using the International Classification of Disease Codes and the medical professional view as to whether it is scientifically natural, is of great value to the coroner in deciding whether it is legally unnatural.

  12. International medical leadership, collaboration and communication

    OpenAIRE

    Arbel, Yael; Zadik, Yehuda; Nakdimon, Idan; Ran, Yuval; Mendelovich, Jacob; Bader, Tarif; Frenkel, Hagay

    2016-01-01

    Background International social networking is eminent in medical practice, mainly in sharing knowledge and mutual inspiring and in social and professional bonding. Since 2006, the International Medical Course is taking place in Commander Branch at the Military Medicine Academy of the Medical Corps, Israeli Defense Forces; in which medical officers from other military forces are participating along with Israeli officers. One of the course?s objectives is international networking. The purpose o...

  13. Book reviews in medical journals.

    Science.gov (United States)

    Kroenke, K

    1986-01-01

    In a study of book reviews published in four general medical journals over a six-month period, 480 reviews were analyzed. Twenty-five features that reviewers address when evaluating a text were identified, and the frequency of commentary for each feature was determined. The mean number of features addressed per review was 9.0. Reviews averaged 389 words, but review length did not correlate with the length or scope of the book, with the number of features addressed, nor with the reviewer's assessment of the text. Extraneous commentary by the reviewer occurred in 16% of the reviews. This editorializing appeared in lengthier reviews that addressed fewer features. Favorable reviews were far more common than unfavorable ones (88.5% vs. 11.5%). Consequently, for the fifty-five books reviewed in more than one journal, agreement regarding rating of the text was high (86%). Results of this study may provide useful guidelines for reviewers of medical texts.

  14. TOPICAL REVIEW: Trend report on international and Japanese standardization activities for bioceramics and tissue engineered medical products

    Science.gov (United States)

    Tsutsumi, Sadami

    2010-02-01

    Since porous and injectable bioceramics have recently been utilized often as scaffolds for bone regenerative medicine, the need for their standardization has increased. One of the standard proposals in ISO/TC150 and JIS has been a draft for characterization of the porous bioceramic scaffolds in both micro- and macro-scopic aspects. ISO/TC150/SC7 (Tissue engineered medical products) has been co-chaired by Professor J E Lemons, Department of Surgery, University of Alabama at Birmingham and Dr R Nakaoka, Division of Medical Devices, National Institute of Health Sciences, Japan. The scope of SC7 has been specified as 'Standardization for the general requirements and performance of tissue engineered medical products with the exclusion of gene therapy, transplantation and transfusion'.

  15. Fostering international undergraduate medical education

    Directory of Open Access Journals (Sweden)

    James D Smith

    2016-01-01

    Full Text Available The severe lack of human resources in the health care field in many countries has resulted in avid interest in global undergraduate medical education. Christian medical missionaries have, thus, a unique opportunity to contribute to transformative, holistic development through the training of future physicians for resource-limited settings. Starting a new medical school is, however, a complex process which requires significant resources and intellectual investment. This paper outlines some of the challenges encountered in faith-based individuals’ engagement in undergraduate medical education, as well as suggesting some practical solutions and recommendations.

  16. [International progress of unique device identification for medical devices].

    Science.gov (United States)

    Yang, Wanjuan; Li, Jun; Li, Jingli

    2014-09-01

    Unique Device Identification (UDI) is a hot spot research area in the medical device administration. It comes a breakthrough from International Medical Device Regulators Forum (IMDRF) and government implementation recently. The article reviewed the advancement of IMDRF UDI program, discussed the framework for UDI system, analyzed the implementation of UDI in other countries, put forward some suggestions on the development of medical device coding system in our country.

  17. 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.

  18. Initiatives for Medical Education Research at the International Medical University

    Directory of Open Access Journals (Sweden)

    Ramesh Chandra Jutti

    2008-12-01

    Full Text Available Medical Education research is a relativelynew field but one that is progressing rapidly worldwide.This article is an attempt to take stock of the currentstatus of Medical Education research in InternationalMedical University and to explore the various factorsthat have influenced its direction. It also shares some ofthe initiatives that have been instituted or intended tobe instituted at our university.

  19. International medical cooperation project for State of Libya using international medical tourism system in Thailand

    OpenAIRE

    奥寺, 敬; 坂本, 美重

    2013-01-01

    International medical cooperation project for State of Libya is reported. The concept of this project is to treat Libyan injured people using international medical tourism system in Thailand. Management of patient, including evaluation, domestic and international transportation arrangement of hospital, is supported by Normeca International Co., Ltd, (Pattaya, Thailand). Treatment of Libyan patient in two international hospitals (Bangpakok 9 Hospital and Navamin 9 Hopsital) in Bangkok was succ...

  20. International collaboration in medical radiation science.

    Science.gov (United States)

    Denham, Gary; Allen, Carla; Platt, Jane

    2016-06-01

    International collaboration is recognised for enhancing the ability to approach complex problems from a variety of perspectives, increasing development of a wider range of research skills and techniques and improving publication and acceptance rates. The aim of this paper is to describe the current status of international collaboration in medical radiation science and compare this to other allied health occupations. This study utilised a content analysis approach where co-authorship of a journal article was used as a proxy for research collaboration and the papers were assigned to countries based on the corporate address given in the by-line of the publication. A convenience sample method was employed and articles published in the professional medical radiation science journals in the countries represented within our research team - Australia, the United Kingdom (UK) and the United States of America (USA) were sampled. Physiotherapy, speech pathology, occupational therapy and nursing were chosen for comparison. Rates of international collaboration in medical radiation science journals from Australia, the UK and the USA have steadily increased over the 3-year period sampled. Medical radiation science demonstrated lower average rates of international collaboration than the other allied health occupations sampled. The average rate of international collaboration in nursing was far below that of the allied health occupations sampled. Overall, the UK had the highest average rate of international collaboration, followed by Australia and the USA, the lowest. Overall, medical radiation science is lagging in international collaboration in comparison to other allied health fields.

  1. INTERNATIONAL ECONOMIC REVIEW

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    Some Thoughts on Renminbi Internationalization The objectives of RMB internationalization include less need for China to hold US dollar assets so as to avoid risking capital losses, the elimination of exchange-rate risks for Chinese firms, greater funding efficiency for Chinese financial institutions and the promotion of Shanghai as an international financial center. However, the progress in China' s RMB internationalization so far has failed to achieve the above-mentioned objectives.

  2. An Approach to Establishing International Quality Standards for Medical Travel

    Directory of Open Access Journals (Sweden)

    Ondřej eKácha

    2016-03-01

    Full Text Available Traveling abroad to receive a non-elective treatment is expanding each year. Such rising popularity of medical travel and the absence of clear minimum quality requirements in this area urgently calls for setting international standards to ensure good practice and patient safety. The aim of this study is to identify the key domains in medical travel where such quality standards should be established. Drawing from the evidence-based OECD framework and an extensive literature review, this study proposes three critical areas for international quality standards in medical travel: minimum standards of health care facilities and third-party agencies, financial responsibility and patient-centeredness. Several cultural challenges are subsequently introduced that may pose a barrier to the development of the guidelines and should be additionally taken into consideration. Establishing international quality standards in medical travel enhances the benefits to patients and providers, which is urgently needed given the rapid growth in this industry.

  3. Medication discrepancies at discharge from an internal medicine service.

    Science.gov (United States)

    Herrero-Herrero, José-Ignacio; García-Aparicio, Judit

    2011-02-01

    Medication errors most commonly occur at the time of medication prescribing and particularly at the moment of the transitions of care. The objectives of this study were to identify and characterize the discrepancies between the physicians' discharge medication orders and the medication lists at admission obtained by an internal medicine specialist physician in a general internal medicine service. This descriptive, retrospective, study was carried out at a tertiary care university teaching hospital in Spain. It was based on the review of non selected, consecutive, hospital discharge reports. Discrepancies were identified, categorized and characterized through the analysis of the information (medication lists, laboratory tests results, diagnosis, and clinical evolution) contained in them. We analyzed 954 discharge reports. In the medication reconciliation process, we find discrepancies in 832 (87.2%) of them. Justified discrepancies were found in 828 (86.8%) reports and unjustified discrepancies in 52 (5.4%). Omission of a medication was the most frequent medication error detected in 86.4% of cases, followed by incomplete prescription (9.6%). The number of diagnosis, the length of hospital stay and the number of permanent medications at admission were the characteristics of cases associated with medication discrepancies in multivariate linear regression (Premarkable the low number of medication errors detected in our study. Appropriate routines to ensure an accurate medication history collection and a methodical elaboration of the medication list at discharge, when performed by trained internists, are important for an adequate medication reconciliation process. Copyright © 2010 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  4. Safety of Acupuncture and Pharmacopuncture in 80,523 Musculoskeletal Disorder Patients: A Retrospective Review of Internal Safety Inspection and Electronic Medical Records.

    Science.gov (United States)

    Kim, Me-Riong; Shin, Joon-Shik; Lee, Jinho; Lee, Yoon Jae; Ahn, Yong-Jun; Park, Ki Byung; Lee, Hwa Dong; Lee, Yoonmi; Kim, Sung Geun; Ha, In-Hyuk

    2016-05-01

    We investigated the range and frequency of significant adverse events (AEs) in use of pharmacopuncture and acupuncture using large-scale, single-center safety data as evidence supporting safety of acupuncture with pharmacopuncture, used extensively in Asia, is scarce. Status reports (nurse records in ambulatory and inpatient care units, and administrative event records) as a part of an internal audit at a Korean Medicine hospital specializing in the treatment of musculoskeletal disorders, patient complaints filed through the hospital website, and medical records of patients visiting from December, 2010 (inception of internal audit) to October, 2014 were retrospectively reviewed. A total 80,523 patients (5966 inpatients and 74,557 outpatients) visited during this period. Inpatients received an average 31.9 ± 20.7 acupuncture, 23.0 ± 15.6 pharmacopuncture, and 15.4 ± 11.3 bee venom pharmacopuncture sessions, and outpatients were administered 8.2 ± 12.2 acupuncture, 7.8 ± 11.5 pharmacopuncture, and 10.0 ± 12.3 bee venom sessions, respectively. AEs associated with acupuncture/pharmacopuncture were forgotten needle (n = 47), hypersensitivity to bee venom (n = 37), presyncopic episode (n = 4), pneumothorax (n = 4), and infection (n = 2). Most cases were mild requiring little or no additional intervention and leaving no sequelae. Although serious AEs including infection (n = 2) and anaphylaxis associated with bee venom treatment (n = 3) were also reported, incidence was rare at 0.002% in infection and 0.019% in anaphylaxis. Incidence of AEs associated with acupuncture/pharmacopuncture treatment was low, and most cases were not serious. Still, however rare, avoidable AEs can and should be prevented through education and corrective action. Further prospective studies on the effect of error reduction strategies on incidence of adverse effects are warranted.

  5. Bibliographic reviews in Cuban medical journals.

    Directory of Open Access Journals (Sweden)

    Lucitere Rodríguez González

    2008-04-01

    Full Text Available Background: Bibliographic reviews acquire great importance in the specific context of medical publications; however, some editorial facts can affect their scientific value. Objective: To characterize the bibliographic reviews published by some Cuban medical journals. Methods: The most recent reviews (10 were analyzed by means of an exploratory, retrospective and descriptive study. Selected from 5 electronic medical journals, summing up 50 articles. The following variables were studied: article's length, statement of objective and characteristics of bibliographic references. Results: In 20 reviews the objective was not stated, only in 23 (46% the objective was correctly declared. More than 50% of the article had between 4 and 9 screens; 16 structural variables were found with a predominance of blocks and block plus discussion. Only 20 (40% gathered between 25 and 50 references and 24 had more than 50% of their references not updated. Conclusion: There is a misapprehension regarding the review article among Cuban medical journals, which could somehow affect its pertinence and scientific rigor to the eyes of the international scientific community.

  6. Medical leadership and management: An international revolution

    Directory of Open Access Journals (Sweden)

    Alex Till

    2015-01-01

    Full Text Available Medical leadership and management are increasingly receiving widespread attention internationally. Significant focus has been paid as to the style of leadership within healthcare and how to develop both leadership and management skills and competencies (the two are inseparable yet distinct throughout the careers of all healthcare professionals. This article discusses how leadership and management development is being considered internationally, both at an organisational and personal level, helpful models and frameworks and challenges and opportunities.

  7. International travel as medical research: architecture and the modern hospital.

    Science.gov (United States)

    Logan, Cameron; Willis, Julie

    2010-01-01

    The design and development of the modern hospital in Australia had a profound impact on medical practice and research at a variety of levels. Between the late 1920s and the 1950s hospital architects, administrators, and politicians travelled widely in order to review the latest international developments in the hospital field They were motivated by Australia's geographic isolation and a growing concern with how to govern the population at the level of physical health. While not 'medical research' in the conventional sense of the term, this travel was a powerful generator of medical thinking in Australia and has left a rich archival legacy. This paper draws on that archive to demonstrate the ways in which architectural research and international networks of hospital specialists profoundly shaped the provision of medical infrastructure in Australia.

  8. Are Asian international medical students just rote learners?

    Science.gov (United States)

    Tavakol, Mohsen; Dennick, Reg

    2010-08-01

    A wide variety of countries are seeking to attract international medical students. This could be due to the fact that their universities not only receive the economic benefit from these students, but also because they recognise the issues of cultural diversity and pedagogical practice. This review paper draws on literature to understand more fully the learning process of Asian international students. Whereas views on learning are different across cultures, medical school teachers must understand how Asian international students learn based on their culture. Two general themes emerged from the literature review: firstly culture's influence on learning and secondly memorisation versus understanding, both of which relate to the learning process of Asian international students. This study shows that Asian international students have a different approach to learning, which is not just about rote learning. Changes in attitudes towards Asian international students may stimulate the internationalisation of a more culturally sensitive form of medical education. The paper suggests further work on the area of appreciative thinking in order to identify the epistemological and ontological dimensions for a flexible approach to learning.

  9. Medical hyperspectral imaging: a review

    Science.gov (United States)

    Lu, Guolan; Fei, Baowei

    2014-01-01

    Abstract. Hyperspectral imaging (HSI) is an emerging imaging modality for medical applications, especially in disease diagnosis and image-guided surgery. HSI acquires a three-dimensional dataset called hypercube, with two spatial dimensions and one spectral dimension. Spatially resolved spectral imaging obtained by HSI provides diagnostic information about the tissue physiology, morphology, and composition. This review paper presents an overview of the literature on medical hyperspectral imaging technology and its applications. The aim of the survey is threefold: an introduction for those new to the field, an overview for those working in the field, and a reference for those searching for literature on a specific application. PMID:24441941

  10. Medical hyperspectral imaging: a review.

    Science.gov (United States)

    Lu, Guolan; Fei, Baowei

    2014-01-01

    Hyperspectral imaging (HSI) is an emerging imaging modality for medical applications, especially in disease diagnosis and image-guided surgery. HSI acquires a three-dimensional dataset called hypercube, with two spatial dimensions and one spectral dimension. Spatially resolved spectral imaging obtained by HSI provides diagnostic information about the tissue physiology, morphology, and composition. This review paper presents an overview of the literature on medical hyperspectral imaging technology and its applications. The aim of the survey is threefold: an introduction for those new to the field, an overview for those working in the field, and a reference for those searching for literature on a specific application.

  11. An Approach to Establishing International Quality Standards for Medical Travel.

    Science.gov (United States)

    Kácha, Ondřej; Kovács, Beáta E; McCarthy, Cormac; Schuurmans, Angela A T; Dobyns, Christopher; Haller, Elisa; Hinrichs, Saba; Ruggeri, Kai

    2016-01-01

    The number of individuals traveling abroad is increasing annually. The rising popularity of medical travel and the absence of clear minimum quality requirements in this area urgently call for the development of international standards to ensure good practice and patient safety. The aim of this study is to identify the key domains in medical travel where quality standards should be established. Drawing from the evidence-based OECD framework and an extensive literature review, this study proposes three critical areas for consideration: minimum standards of health-care facilities and third-party agencies, financial responsibility, and patient centeredness. Several cultural challenges have been introduced that may pose a barrier to development of the guidelines and should be taken into consideration. Establishing international quality standards in medical travel enhances benefits to patients and providers, which is an urgent necessity given the rapid growth in this industry.

  12. International Medical Collaboration: Lessons from Cuba

    Directory of Open Access Journals (Sweden)

    Mauro Castelló González

    2016-10-01

    Full Text Available Over 50,000 Cuban health professionals are currently working overseas in 67 different countries. They work in conjunction with local health professionals. The majority work in primary care in deprived areas. The aim is to reduce morbidity and mortality but also improve health in the long term by training local health professionals, and building both institutions and a structure to deliver health care alongside educating the local population. Cuba is a small, middle-income country. It has, however, made a significant international contribution in relation to medical collaboration. Cuba’s international collaboration is based on the principles of social justice and equity for all. It has set an example for other countries to emulate.

  13. International Medical Collaboration: Lessons from Cuba

    Science.gov (United States)

    Castelló González, Mauro; Pons Vásquez, Reinaldo; Rodriguez Bencomo, David; Choonara, Imti

    2016-01-01

    Over 50,000 Cuban health professionals are currently working overseas in 67 different countries. They work in conjunction with local health professionals. The majority work in primary care in deprived areas. The aim is to reduce morbidity and mortality but also improve health in the long term by training local health professionals, and building both institutions and a structure to deliver health care alongside educating the local population. Cuba is a small, middle-income country. It has, however, made a significant international contribution in relation to medical collaboration. Cuba’s international collaboration is based on the principles of social justice and equity for all. It has set an example for other countries to emulate. PMID:27763571

  14. Medication review practices in European countries

    NARCIS (Netherlands)

    Bulajeva, A; Labberton, L; Leikola, S; Pohjanoksa-Mäntylä, M; Geurts, M M E; de Gier, J J; Airaksinen, M

    2014-01-01

    BACKGROUND: Medication review procedures have been developed in many countries to improve rational and safe medication use. The similarities, comprehensiveness, and effectiveness of these procedures has not been assessed, or compared. OBJECTIVE: The aim of this study was to explore medication review

  15. THE CHINA MEDICAL ABSTRACTS (Internal Medicine English Edition)

    Institute of Scientific and Technical Information of China (English)

    2004-01-01

    The purpose of the China Medical Abstracts (Internal Medicine) is to promote international exchange of works done by the Chinese medical profession in the field of internal medicine. The papers selected from journals represent the newest and most important advances and progress in various specialities in internal medicine.

  16. THE CHINA MEDICAL ABSTRACTS(Internal Medicine English Edition)

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    The purpose of the China Medical Abstracts (Internal Medicine) is to promote international exchange of works done by the Chinese medical profession in the field of internal medicine. The papers selected from journals represent the newest and most important advances and progress in various specialities in internal medicine.

  17. THE CHINA MEDICAL ABSTRACTS(Internal Medicine English Edition)

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    The purpose of the China Medical Abstracts (Internal Medicine) is to promote international exchange of works done by the Chinese medical profession in the field of internal medicine. The papers selected from journals represent the newest and most important advances and progress in various specialities in internal medicine.

  18. THE CHINA MEDICAL ABSTRACTS(Internal Medicine English Edition)

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    The purpose of the China Medical Abstracts (Internal Medicine) is to promote international exchange of works done by the Chinese medical profession in the field of internal medicine. The papers selected from journals represent the newest and most important advances and progress in various specialities in internal medicine.

  19. THE CHINA MEDICAL ABSTRACTS(Internal Medicine English Edition)

    Institute of Scientific and Technical Information of China (English)

    2004-01-01

    The purpose of the China Medical Abstracts (Internal Medicine) is to promote international exchange of works done by the Chinese medical profession in the field of internal medicine. The papers selected from journals represent the newest and most important advances and progress in various specialities in internal medicine.

  20. Medical nanobiosensors: A tutorial review

    Directory of Open Access Journals (Sweden)

    Hamideh Razavi

    2015-04-01

    Full Text Available A sensitive monitoring of biological analytes, such as biomolecules (protein, lipid, DNA and RNA, and biological cells (blood cell, virus and bacteria, is essential to assess and avoid risks for human health. Nanobiosensors, analytical devices that combine a biologically sensitive element with a nanostructured transducer, are being widely used for molecular detection of biomarkers associated with diagnosis of disease and detection of infectious organisms. Nanobiosensors show certain advantages over laboratory and many field methods due to their inherent specificity, simplicity and quick response. In this review, recent progress in the development of nanobiosensors in medicine is illuminated. In addition, this article reviews different kinds of bio-receptors and transducers employed in nanobiosensors. In the last section, overview of the development and application of various nanomaterials and nanostructures in biosensing has been provided. Considering all of these aspects, it can be stated that nanobiosensors offer the possibility of diagnostic tools with increased sensitivity, specificity, and reliability for medical applications.  

  1. [The relevance of the International Committee of Medical Journal Editors (ICMJE) for medical publishing and research].

    Science.gov (United States)

    Reyes, Humberto B

    2014-01-01

    The International Committee of Medical Journal Editors is a leading independent institution providing guidance for the report of biomedical research and health related topics in medical journals. Established in 1978, it is currently constituted by editors of fourteen general medical journals from different countries, plus one representative for the US National Library of Medicine and one representative for the World Association of Biomedical Journal Editors. Since 1978 the Committee provides a document, originally named "Uniform Requirements…", "to help authors, editors, and others involved in peer review and biomedical publishing create and distribute accurate, clear, unbiased medical journal articles". This document has been updated several times and the last version was released in August 2013, now renamed "Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals", available in www.icmje.org and citable as "ICMJE Recommendations". A vast proportion of medical journals, worldwide, have adopted these recommendations as rules. The ICMJE discusses and provides guidance on several relevant aspects including criteria on authorship, peer review, scientific misconduct, conflicts of interest, clinical trials registration, good editorial practices, the relations between editors and journal owners, the protection of individuals subject to medical research, the solvency of electronic publications, among others. The 2013 ICMJE Annual Meeting took place in Santiago, Chile, in November 4 and 5. The photograph shows attendants to the final session.

  2. Fourth-Year Medical School Course Load and Success as a Medical Intern.

    Science.gov (United States)

    Richards, Christopher J; Mukamal, Kenneth J; DeMelo, Nikki; Smith, C Christopher

    2017-02-01

    The fourth year of medical school has come under recent scrutiny for its lack of structure, cost- and time-effectiveness, and quality of education it provides. Some have advocated for increasing clinical burden in the fourth year, while others have suggested it be abolished. To assess the relationship between fourth-year course load and success during internship. We reviewed transcripts of 78 internal medicine interns from 2011-2013 and compared the number of intensive courses (defined as subinternships, intensive care, surgical clerkships, and emergency medicine rotations) with multi-source performance evaluations from the internship. We assessed relative risk (RR) and 95% confidence interval (CI) of achieving excellent scores according to the number of intensive courses taken, using generalized estimating equations, adjusting for demographics, US Medical Licensing Examination (USMLE) Step 1 board scores, and other measures of medical school performance. For each additional intensive course taken, the RR of obtaining an excellent score per intensive course was 1.05 (95% CI 1.03-1.07, P interns, increased exposure to intensive course work during the fourth year of medical school was associated with better clinical evaluations during internship.

  3. International Symposium on Biomedical Engineering and Medical Physics

    CERN Document Server

    Katashev, Alexei; Lancere, Linda

    2013-01-01

    This volume presents the proceedings of the International Symposium on Biomedical Engineering and Medical Physics and is dedicated to the 150 anniversary of the Riga Technical University, Latvia. The content includes various hot topics in biomedical engineering and medical physics.

  4. 1st International Conference on Advancements of Medical Electronics

    CERN Document Server

    Bag, Sandip; Ganguly, Karabi; Sarkar, Indranath; Biswas, Papun

    2015-01-01

    The book is a collection of peer-reviewed scientific papers submitted by active researchers in the 1st International Conference on Advancements of Medical Electronics (ICAME2015). The conference is organized jointly by the Department of Biomedical Engineering and Electronics and Communication Engineering, JIS College of Engineering, West Bengal, India. The primary objective of the conference is to strengthen interdisciplinary research and its applications for the welfare of humanity. A galaxy of academicians, professionals, scientists, statesman and researchers from different parts of the country and abroad got together and shared their knowledge. The book presents research articles of medical image processing & analysis, biomedical instrumentation & measurements, DSP & clinical applications, embedded systems & its applications in healthcare. The book can be referred as a tool for further research.

  5. Undergraduate pharmacology curriculum at an international medical college in India.

    Science.gov (United States)

    Devi, Vasudha; Bhat, Vishal; Shenoy, Ganesh K

    2016-10-01

    Pharmacology is an important aspect of rational therapeutics. There has been a long-standing need for a change in the undergraduate medical curriculum of pharmacology. A review of literature throws up different approaches to improve the curriculum and to provide more importance to conceptualization and relevance to clinical practice. This article describes the undergraduate pharmacology curriculum which is revised to meet the needs of our unique status as an international medical college in India. We highlight how our curriculum prepares the students for future clinical practice by inculcating higher cognitive skills and soft skills. This article also provides a model for program evaluation and also challenges faced by our department while executing the planned curriculum.

  6. Undergraduate pharmacology curriculum at an international medical college in India

    Science.gov (United States)

    Devi, Vasudha; Bhat, Vishal; Shenoy, Ganesh K.

    2016-01-01

    Pharmacology is an important aspect of rational therapeutics. There has been a long-standing need for a change in the undergraduate medical curriculum of pharmacology. A review of literature throws up different approaches to improve the curriculum and to provide more importance to conceptualization and relevance to clinical practice. This article describes the undergraduate pharmacology curriculum which is revised to meet the needs of our unique status as an international medical college in India. We highlight how our curriculum prepares the students for future clinical practice by inculcating higher cognitive skills and soft skills. This article also provides a model for program evaluation and also challenges faced by our department while executing the planned curriculum. PMID:28031601

  7. [A preliminary exploration into medical genetics teaching to international students].

    Science.gov (United States)

    Chen, Cao-Yi; Zhao, Xiang-Qiang; Xie, Xiao-Ling; Tan, Xiang-Ling

    2008-12-01

    Medical education to international students has become an important part of higher education in China. Medical genetics is an essential and required course for international medical students. However, the internationalization of higher education in China has challenged the traditional teaching style of medical genetics. In this article, we discussed current situation and challenges in medical genetics teaching to international students, summarized special features and problems we encountered in teaching Indian students, and proposed some practical strategies to address these challenges and to improve the teaching.

  8. Israeli medical education: international perspectives, and reflections on challenges and changes.

    Science.gov (United States)

    Katz, David R

    2016-01-01

    Medical education is a dynamic and continually evolving process, some of which is style, and some of which is linked to changing perspectives in medical practice. A paper by Reis et al., taken in conjunction with the recent paper from an ad hoc International Review Committee (Schoenbaum et al.), provides a reflective view of where Israeli medical education stood in 2014 and places it in an international perspective. Reis at al also take this further, showing that in Israel change is occurring as a result of this review and comment on a number of important issues where further reflection, discussion, and work is required.

  9. Politics and Graduate Medical Education in Internal Medicine: A Dynamic Landscape.

    Science.gov (United States)

    Wardrop, Richard M; Berkowitz, Lee R

    2017-02-01

    The promotion of change and growth within medical education is oftentimes the result of a complex mix of societal, cultural and economic forces. Graduate medical education in internal medicine is not immune to these forces. Several entities and organizations can be identified as having a major influence on internal medicine training and graduate medical education as a whole. We have reviewed how this is effectively accomplished through these entities and organizations. The result is a constantly changing and dynamic landscape for internal medicine training. Copyright © 2017 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

  10. Qualitative methods used in medical informatics research: a 12-year review.

    Science.gov (United States)

    Li, Jingyi; Finkelstein, Joseph

    2008-11-06

    Qualitative methodology is gaining popularity in medical informatics research. We performed a systematic review of published studies, between 1994 and 2005, in two major medical informatics journals: JAMIA and International Journal of Medical Informatics (IJMI). The goal is to describe the emerging trends of using qualitative methodology in medical informatics research and to access the methodological quality of these qualitative studies.

  11. Medical audible alarms: a review

    Science.gov (United States)

    Edworthy, Judy

    2013-01-01

    Objectives This paper summarizes much of the research that is applicable to the design of auditory alarms in a medical context. It also summarizes research that demonstrates that false alarm rates are unacceptably high, meaning that the proper application of auditory alarm design principles are compromised. Target audience Designers, users, and manufacturers of medical information and monitoring systems that indicate when medical or other parameters are exceeded and that are indicated by an auditory signal or signals. Scope The emergence of alarms as a ‘hot topic’; an outline of the issues and design principles, including IEC 60601-1-8; the high incidence of false alarms and its impact on alarm design and alarm fatigue; approaches to reducing alarm fatigue; alarm philosophy explained; urgency in audible alarms; different classes of sound as alarms; heterogeneity in alarm set design; problems with IEC 60601-1-8 and ways of approaching this design problem. PMID:23100127

  12. Burnout in medical residents : a review

    NARCIS (Netherlands)

    Prins, J.T.; Gazendam-Donofrio, S.M.; Tubben, B.J.; van der Heijden, F.M.M.A.; De Wiel, H.B.M.V.; Hoekstra-Weebers, J.E.H.M.

    2007-01-01

    OBJECTIVES This study aimed to review current knowledge on burnout in medical residents, including reported prevalence rates, and to establish which risk and resistance factors contribute to or prevent burnout in medical residents. METHODS We conducted a comprehensive search of the literature publis

  13. International Medical Geology Association (IMGA) formed

    Institute of Scientific and Technical Information of China (English)

    Olle Selinus; Jose Centeno; Robert Finkelman

    2006-01-01

    @@ "Medical Geology" is defined as the science dealing with the relationship between natural geological factors and health problems in man and animals and understanding the influence of ordinary environmental factors on the geographical distribution of such health problems. Medical Geology is therefore a broad and complicated subject and if the problems to be addressed are to be understood, mitigated, or resolved, it will require interdisciplinary contributions from different scientific fields (involving geo-scientists,medical scientists, health professionals, veterinarians, and biologists, etc.). Medical Geology involves the whole geo-sphere and can be considered as dealing with ecosystem health.

  14. Irish medical students’ understanding of the intern year

    LENUS (Irish Health Repository)

    Gouda, P,

    2016-03-01

    Upon completion of medical school in Ireland, graduates must make the transition to becoming interns. The transition into the intern year may be described as challenging as graduates assume clinical responsibilities. Historically, a survey of interns in 1996 found that 91% felt unprepared for their role. However, recent surveys in 2012 have demonstrated that this is changing with preparedness rates reaching 52%. This can be partially explained by multiple initiatives at the local and national level. Our study aimed evaluate medical student understanding of the intern year and associated factors. An online, cross-sectional survey was sent out to all Irish medical students in 2013 and included questions regarding their understanding of the intern year. Two thousand, two hundred and forty-eight students responded, with 1224 (55.4%) of students agreeing or strongly agreeing that they had a good understanding of what the intern year entails. This rose to 485 (73.7%) among senior medical students. Of junior medical students, 260 (42.8%) indicated they understood what the intern year, compared to 479 (48.7%) of intermediate medical students. Initiatives to continue improving preparedness for the intern year are essential in ensuring a smooth and less stressful transition into the medical workforce

  15. Irish Medical Students Understanding of the Intern Year.

    Science.gov (United States)

    Gouda, P; Kitt, K; Evans, D S; Goggin, D; McGrath, D; Last, J; Hennessy, M; Arnett, R; O'Flynn, S; Dunne, F; O'Donovan, D

    2016-04-11

    Upon completion of medical school in Ireland, graduates must make the transition to becoming interns. The transition into the intern year may be described as challenging as graduates assume clinical responsibilities. Historically, a survey of interns in 1996 found that 91% felt unprepared for their role. However, recent surveys in 2012 have demonstrated that this is changing with preparedness rates reaching 52%. This can be partially explained by multiple initiatives at the local and national level. Our study aimed evaluate medical student understanding of the intern year and associated factors. An online, cross-sectional survey was sent out to all Irish medical students in 2013 and included questions regarding their understanding of the intern year. Two thousand, two hundred and forty-eight students responded, with 1,224 (55.4%) of students agreeing or strongly agreeing that they had a good understanding of what the intern year entails. This rose to 485 (73.7%) among senior medical students. Of junior medical students, 260 (42.8%) indicated they understood what the intern year, compared to 479 (48.7%) of intermediate medical students. Initiatives to continue improving preparedness for the intern year are essential in ensuring a smooth and less stressful transition into the medical workforce.

  16. Problems faced by editors of peer reviewed medical journals.

    Science.gov (United States)

    Jawaid, Shaukat A

    2004-01-01

    Forty-six medical and dental journals are published from Pakistan of which only 29 are currently recognized by the Pakistan Medical and Dental Council. Only a few are peer reviewed. Six are indexed in Medline while EMBASE Excerpta Medica and World Health Organization Index Medicus for Eastern Mediterranean Region cover others. Editors of the peer reviewed medical journals are faced with numerous problems, which relate to the authors. Some of these are: shortage of quality of manuscripts, poor quality of reviewers, problems with indexation in international indexing services particularly Medline, duplicate submission and authorship and lastly, financial problems. Patronage from the Pharma industry is the major source of revenue which itself has serious implications. Editing a medical journal is a very stressful job and the editors have to work under too many pressures. A lot of useful data is presented at medical conferences, but a vast majority of it remains unpublished for various reasons, which adversely affects the citation rate from scientists from the developing third world countries in the world of medical literature. A few lectures on medical writing and research methodology to final year medical students will expose them to the art of medical writing. Specialty organizations can be persuaded to have a session on medical writing at their conferences, which will be extremely helpful not only to the potential new authors but also others, thereby improving the quality of their manuscripts. In addition to regular seminars, workshops for authors, reviewers and training courses for editors, subscribing to local medical journals by healthcare professionals and libraries are some of the measures that will help improve the situation to a great extent.

  17. Teaching Medical Ethics in Graduate and Undergraduate Medical Education: A Systematic Review of Effectiveness.

    Science.gov (United States)

    de la Garza, Santiago; Phuoc, Vania; Throneberry, Steven; Blumenthal-Barby, Jennifer; McCullough, Laurence; Coverdale, John

    2017-08-01

    One objective was to identify and review studies on teaching medical ethics to psychiatry residents. In order to gain insights from other disciplines that have published research in this area, a second objective was to identify and review studies on teaching medical ethics to residents across all other specialties of training and on teaching medical students. PubMed, EMBASE, and PsycINFO were searched for controlled trials on teaching medical ethics with quantitative outcomes. Search terms included ethics, bioethics, medical ethics, medical students, residents/registrars, teaching, education, outcomes, and controlled trials. Nine studies were found that met inclusion criteria, including five randomized controlled trails and four controlled non-randomized trials. Subjects included medical students (5 studies), surgical residents (2 studies), internal medicine house officers (1 study), and family medicine preceptors and their medical students (1 study). Teaching methods, course content, and outcome measures varied considerably across studies. Common methodological issues included a lack of concealment of allocation, a lack of blinding, and generally low numbers of subjects as learners. One randomized controlled trial which taught surgical residents using a standardized patient was judged to be especially methodologically rigorous. None of the trials incorporated psychiatry residents. Ethics educators should undertake additional rigorously controlled trials in order to secure a strong evidence base for the design of medical ethics curricula. Psychiatry ethics educators can also benefit from the findings of trials in other disciplines and in undergraduate medical education.

  18. Nurse Participation in Medical Peer Review

    Science.gov (United States)

    Orme, June Y.; Lindbeck, Rosemary S.

    1974-01-01

    The Utah Professional Review Organization (UPRO) enables nurse-coordinators to conduct an ongoing evaluation of the quality of patient care, to upgrade care through physician-sponsored continuing education programs, and to limit care cost, in a medical peer review program. (DS)

  19. Medical record review for clinical pertinence.

    Science.gov (United States)

    Lewis, K S

    1991-08-01

    This clinical pertinence review process described was in effect for seven months, after which the author terminated affiliation with the hospital. Despite resistance by many physicians, this monthly review process focused the medical staff's attention on good documentation practices. To the author's knowledge, the plan is still in use.

  20. Complicating common ideas about medical tourism: gender, class, and globality in Yemenis' international medical travel.

    Science.gov (United States)

    Kangas, Beth

    2011-01-01

    Three cases of international medical travelers from Yemen, a capital‐poor country in the southwest corner of the Arabian Peninsula, help to counter misconceptions within discussions of medical tourism. These misconceptions include the suggestion of leisure in medical tourism, the role of gender and class, and the ease with which we dismiss the health concerns of wealthy individuals. Instead, this article proposes, we should uncover commonalities and differences within international medical travel while avoiding slipping into generalities and stereotypical portrayals.

  1. Internal hernias: a brief review.

    Science.gov (United States)

    Salar, O; El-Sharkawy, A M; Singh, R; Speake, W

    2013-06-01

    Hernias are very familiar to a core surgical trainee in the setting of clinics and the surgical assessment unit. By definition, a hernia is an abnormal protrusion of a viscus from one compartment to another. In clinic, they are visible lumps, exhibiting a cough reflex often with a well definable history making them readily identifiable. In the acute setting, they are the third commonest cause of small bowel obstruction in the developed world. Ventral and inguinal hernias account for the majority of these with only a small proportion due to internal hernias. This article aims to educate the core surgical trainee on the anatomy and distinguishing clinical features of these rare but important types of internal abdominal hernias.

  2. Changes in intern attitudes toward medical error and disclosure.

    Science.gov (United States)

    Varjavand, Nielufar; Bachegowda, Lohith S; Gracely, Edward; Novack, Dennis H

    2012-07-01

    The 2000 Institute of Medicine report, 'To Err is Human: Building a Safer Health System', focused the medical community on medical error. This focus led to educational initiatives and legislation designed to minimise errors and increase their disclosure. This study aimed to investigate whether increased general awareness about medical error has affected interns' attitudes toward medical error and disclosure by comparing responses to surveys of interns carried out at either end of the last decade. Two cohorts of interns for the academic years 1999, 2000 and 2001 (n = 304) and 2008 and 2009 (n = 206) at a university hospital were presented with two hypothetical scenarios involving errors that resulted in, respectively, no permanent harm and an adverse outcome. The interns were questioned regarding their likely responses to error and disclosure. We collected 510 surveys (100% response rate). For both scenarios, the percentage of interns who would be willing to fully disclose their mistakes increased substantially from 1999-2001 to 2008-2009 ('no permanent harm': 38% and 71%, respectively [p interns in both scenarios believed 'the patient's right to full information' to be the primary reason for their disclosure. Fear of litigation in response to error disclosure decreased (70% and 52%, respectively), the percentage of interns who felt that 'medical mistakes are preventable if doctors know enough' decreased (49% and 31%, respectively), belief that competent doctors keep emotions and uncertainties to themselves decreased (51% and 14%, respectively), and agreement with leaving medicine if one (as an intern) caused harm or death decreased (50% and 3%, respectively). Prior training about medical mistakes increased more than four-fold between the cohorts. This comparison of intern responses to a survey administered at either end of the last decade reveals that there may have been some important changes in interns' intended disclosure practices and attitudes toward medical

  3. Nursing student medication errors: a retrospective review.

    Science.gov (United States)

    Harding, Lorill; Petrick, Teresa

    2008-01-01

    This article presents the findings of a retrospective review of medication errors made and reported by nursing students in a 4-year baccalaureate program. Data were examined in relation to the semester of the program, kind of error according to the rights of medication administration, and contributing factors. Three categories of contributing factors were identified: rights violations, system factors, and knowledge and understanding. It became apparent that system factors, or the context in which medication administration takes place, are not fully considered when students are taught about medication administration. Teaching strategies need to account for the dynamic complexity of this process and incorporate experiential knowledge. This review raised several important questions about how this information guides our practice as educators in the clinical and classroom settings and how we can work collaboratively with practice partners to influence change and increase patient safety.

  4. International medical education and future directions: a global perspective.

    Science.gov (United States)

    Harden, Ronald M

    2006-12-01

    Internationalization, one of the most important forces in higher education today, presents a powerful challenge and an opportunity for medical schools. Factors encouraging internationalization include (1) globalization of health care delivery, (2) governmental pressures, (3) improved communication channels, (4) development of a common vocabulary, (5) outcome-based education and standards, (6) staff development initiatives, and (7) competitiveness and commercialization. A three-dimensional model--based on the student (local or international), the teacher (local or international), and the curriculum (local, imported, or international)-offers a range of perspectives for international medical education. In the traditional approach to teaching and learning medicine, local students and local teachers use a local curriculum. In the international medical graduate or overseas student model, students from one country pursue in another country a curriculum taught and developed by teachers in the latter. In the branch-campus model, students, usually local, have an imported curriculum taught jointly by international and local teachers. The future of medical education, facilitated by the new learning technologies and pedagogies, lies in a move from such international interconnected approaches, which emphasize the mobility of students, teachers, and curriculum across the boundaries of two countries, to a transnational approach in which internationalization is integrated and embedded within a curriculum and involves collaboration between a number of schools in different countries. In this approach, the study of medicine is exemplified in the global context rather than the context of a single country. The International Virtual Medical School serves as an example in this regard.

  5. Organization, Management and Function of International Space Station (ISS) Multilateral Medical Operations

    Science.gov (United States)

    Duncan, James M.; Bogomolov, V. V.; Castrucci, F.; Koike, Y.; Comtois, J. M.; Sargsyan, A. E.

    2007-01-01

    Long duration crews have inhabited the ISS since November of 2000. The favorable medical outcomes of its missions can be largely attributed to sustained collective efforts of all ISS Partners medical organizations. In-flight medical monitoring and support, although crucial, is just a component of the ISS system of Joint Medical Operations. The goal of this work is to review the principles, design, and function of the multilateral medical support of the ISS Program. The governing documents, which describe the relationships among all ISS partner medical organizations, were evaluated, followed by analysis of the roles, responsibilities, and decision-making processes of the ISS medical boards, panels, and working groups. The degree of integration of the medical support system was evaluated by reviewing the multiple levels of the status reviews and mission assurance activities carried out throughout the last six years. The Integrated Medical Group, consisting of physicians and other essential personnel in the mission control centers represents the front-line medical support of the ISS. Data from their day-to-day activities are presented weekly at the Space Medicine Operations Team (SMOT), where known or potential concerns are addressed by an international group of physicians. A broader status review is conducted monthly to project the state of crew health and medical support for the following month, and to determine measures to return to nominal state. Finally, a comprehensive readiness review is conducted during preparations for each ISS mission. The Multilateral Medical Policy Board (MMPB) issues medical policy decisions and oversees all health and medical matters. The Multilateral Space Medicine Board (MSMB) certifies crewmembers and visitors for training and space flight to the Station, and physicians to practice space medicine for the ISS. The Multilateral Medical Operations Panel (MMOP) develops medical requirements, defines and supervises implementation of

  6. Internal Medicine Residents Do Not Accurately Assess Their Medical Knowledge

    Science.gov (United States)

    Jones, Roger; Panda, Mukta; Desbiens, Norman

    2008-01-01

    Background: Medical knowledge is essential for appropriate patient care; however, the accuracy of internal medicine (IM) residents' assessment of their medical knowledge is unknown. Methods: IM residents predicted their overall percentile performance 1 week (on average) before and after taking the in-training exam (ITE), an objective and well…

  7. [Medication-induced dysphagia : A review].

    Science.gov (United States)

    Schwemmle, C; Jungheim, M; Miller, S; Kühn, D; Ptok, M

    2015-07-01

    As a highly differentiated physiological process, swallowing may be affected by a variety of confounding factors. Primarily described are swallowing disorders caused by mechanical anatomic changes (e. g., alteration of the cervical spine, goiter), surgery for head and neck tumors, thyroid abnormalities, and neuromuscular disorders. Age-related cerebral neurological and blood vessel-associated changes can also cause dysphagia (so-called presbyphagia) or worsen the condition.Medication-associated dysphagia is recognized far less frequently, not paid due attention, or accepted in silence; particularly in older patients. Furthermore, pharmacological interference of different medications is frequently inadequately considered, particularly in the case of polypharmacy.Initial treatment of medication-induced dysphagia includes a critical review of medication status, with the aim of reducing/discontinuing the causative medication by giving precise instructions regarding its administration; as well as antacid medication, diet, and professional oral stimulation or swallowing training.To date, medication-induced dysphagia has not occupied the focus of physicians and therapists. This is despite the fact that many active agents can have a negative effect on swallowing and medication-induced dysphagia caused by polypharmacy is not uncommon, particularly in old age. This article presents an overview of the different classes of drugs in terms of their direct or indirect negative effects on the swallowing function.

  8. Morphological Techniques for Medical Images: A Review

    Directory of Open Access Journals (Sweden)

    Isma Irum

    2012-08-01

    Full Text Available Image processing is playing a very important role in medical imaging with its versatile applications and features towards the development of computer aided diagnostic systems, automatic detections of abnormalities and enhancement in ultrasonic, computed tomography, magnetic resonance images and lots more applications. Medical images morphology is a field of study where the medical images are observed and processed on basis of geometrical and changing structures. Medical images morphological techniques has been reviewed in this study underlying the some human organ images, the associated diseases and processing techniques to address some anatomical problem detection. Images of Human brain, bone, heart, carotid, iris, lesion, liver and lung have been discussed in this study.

  9. International Journal of Development and Management Review

    African Journals Online (AJOL)

    PROMOTING ACCESS TO AFRICAN RESEARCH ... International Journal of Development and Management Review ... Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives. Journal Homepage Image. The journal aims to be proactive in initiating and sustaining quality academic debates in ...

  10. Developing medical geology in Uruguay: a review.

    Science.gov (United States)

    Mañay, Nelly

    2010-05-01

    Several disciplines like Environmental Toxicology, Epidemiology, Public Health and Geology have been the basis of the development of Medical Geology in Uruguay during the last decade. The knowledge and performance in environmental and health issues have been improved by joining similar aims research teams and experts from different institutions to face environmental problems dealing with the population's exposure to metals and metalloids and their health impacts. Some of the Uruguayan Medical Geology examples are reviewed focusing on their multidisciplinary approach: Lead pollution and exposed children, selenium in critically ill patients, copper deficiency in cattle and arsenic risk assessment in ground water. Future actions are also presented.

  11. Scoping medical tourism and international hospital accreditation growth.

    Science.gov (United States)

    Woodhead, Anthony

    2013-01-01

    Uwe Reinhardt stated that medical tourism can do to the US healthcare system what the Japanese automotive industry did to American carmakers after Japanese products developed a value for money and reliability reputation. Unlike cars, however, healthcare can seldom be test-driven. Quality is difficult to assess after an intervention (posteriori), therefore, it is frequently evaluated via accreditation before an intervention (a priori). This article aims to scope the growth in international accreditation and its relationship to medical tourism markets. Using self-reported data from Accreditation Canada, Joint Commission International (JCI) and Australian Council on Healthcare Standards (ACHS), this article examines how quickly international accreditation is increasing, where it is occurring and what providers have been accredited. Since January 2000, over 350 international hospitals have been accredited; the JCI's total nearly tripling between 2007-2011. Joint Commission International staff have conducted most international accreditation (over 90 per cent). Analysing which countries and regions where the most international accreditation has occurred indicates where the most active medical tourism markets are. However, providers will not solely be providing care for medical tourists. Accreditation will not mean that mistakes will never happen, but that accredited providers are more willing to learn from them, to varying degrees. If a provider has been accredited by a large international accreditor then patients should gain some reassurance that the care they receive is likely to be a good standard. The author questions whether commercializing international accreditation will improve quality, arguing that research is necessary to assess the accreditation of these growing markets.

  12. Patient adherence to medical treatment. A review of reviews.

    NARCIS (Netherlands)

    Dulmen, S. van; Sluijs, E.; Dijk, L. van; Ridder, D. de; Heerdink, R.; Bensing, J.

    2007-01-01

    BACKGROUND: Patients' non-adherence to medical treatment remains a persistent problem. Many interventions to improve patient adherence are unsuccessful and sound theoretical foundations are lacking. Innovations in theory and practice are badly needed. A new and promising way could be to review the

  13. Patient adherence to medical treatment. A review of reviews.

    NARCIS (Netherlands)

    Dulmen, S. van; Sluijs, E.; Dijk, L. van; Ridder, D. de; Heerdink, R.; Bensing, J.

    2007-01-01

    BACKGROUND: Patients' non-adherence to medical treatment remains a persistent problem. Many interventions to improve patient adherence are unsuccessful and sound theoretical foundations are lacking. Innovations in theory and practice are badly needed. A new and promising way could be to review the e

  14. Interns as teachers of medical students: a pilot programme.

    LENUS (Irish Health Repository)

    Dunne, B

    2012-01-31

    BACKGROUND: In recent years, rising numbers of medical students and an increasingly demanding clinical workload has put pressures on the educational systems for medical students in the hospital. Bedside teaching remains central to education, but tutorial delivery by registrars, tutors and consultants has proven to be increasingly difficult with the greater numbers of students now in the undergraduate system. AIMS: We have performed a pilot study to determine the feasibility of developing a Junior Tutor Programme, to assist in the delivery of tutorials to undergraduate medical students. METHODS: This was designed and delivered by interns under the supervision of the academic staff in the Departments of Medicine and Surgery in Connolly Hospital. The programme was evaluated by a questionnaire filled in by the students anonymously. RESULTS: A supervised programme of tutorials delivered by interns is a potentially useful way to ensure delivery of clinical teaching to undergraduate medical students.

  15. Review on emergency medical response against terrorist attack.

    Science.gov (United States)

    Wang, De-Wen; Liu, Yao; Jiang, Ming-Min

    2014-01-01

    Terrorism is a global issue and a constant international threat. As a result, anti-terrorism and emergency response strategies are tasks of critical importance that have a direct impact on the national security of every country in the world. This paper reviews new characteristics of international anti-terrorism measures and offers an in-depth reflection on emergency medical response countermeasures; additionally, this paper presents the goals of related research, which include: 1) to present a model of a highly efficient medical response command; 2) to introduce the pre-planning phases of the emergency medical response; 3) to establish a response system capable of handling various types of terror attacks; 4) to promote anti-terrorism awareness to the general public and emphasize its prevention; and 5) to continue basic investigations into emergency medical responses for various types of terrorist attacks (for example, the classifications and characteristics of new injuries, pathophysiology, prevention and treatment of the resultant stress disorders, improved high-efficiency medical response measures and equipment, etc.).

  16. Medical imaging technology reviews and computational applications

    CERN Document Server

    Dewi, Dyah

    2015-01-01

    This book presents the latest research findings and reviews in the field of medical imaging technology, covering ultrasound diagnostics approaches for detecting osteoarthritis, breast carcinoma and cardiovascular conditions, image guided biopsy and segmentation techniques for detecting lung cancer, image fusion, and simulating fluid flows for cardiovascular applications. It offers a useful guide for students, lecturers and professional researchers in the fields of biomedical engineering and image processing.

  17. A systematic review of medical practice variation in OECD countries.

    Science.gov (United States)

    Corallo, Ashley N; Croxford, Ruth; Goodman, David C; Bryan, Elisabeth L; Srivastava, Divya; Stukel, Therese A

    2014-01-01

    Major variations in medical practice have been documented internationally. Variations raise questions about the quality, equity, and efficiency of resource allocation and use, and have important implications for health care and health policy. To perform a systematic review of the peer-reviewed literature on medical practice variations in OECD countries. We searched MEDLINE to find publications on medical practice variations in OECD countries published between 2000 and 2011. We present an overview of the characteristics of published studies as well as the magnitude of variations for select high impact conditions. A total of 836 studies were included. Consistent with the gray literature, there were large variations across regions, hospitals and physician practices for almost every condition and procedure studied. Many studies focused on high-impact conditions, but very few looked at the causes or outcomes of medical practice variations. While there were an overwhelming number of publications on medical practice variations the coverage was broad and not often based on a theoretical construct. Future studies should focus on conditions and procedures that are clinically important, policy relevant, resource intensive, and have high levels of public awareness. Further study of the causes and consequences of variations is important. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  18. You, too, can be an international medical traveler: Reading medical travel guidebooks

    NARCIS (Netherlands)

    Ormond, M.E.; Sothern, M.

    2012-01-01

    Drawing on literature on self-help and travel guide writing, this paper interrogates five international medical travel guidebooks aimed at encouraging American and British audiences to travel abroad to purchase medical care. These guidebooks articulate a three-step self-help “program” to produce a

  19. You, too, can be an international medical traveler: Reading medical travel guidebooks

    NARCIS (Netherlands)

    Ormond, M.E.; Sothern, M.

    2012-01-01

    Drawing on literature on self-help and travel guide writing, this paper interrogates five international medical travel guidebooks aimed at encouraging American and British audiences to travel abroad to purchase medical care. These guidebooks articulate a three-step self-help “program” to produce a “

  20. You, too, can be an international medical traveler: Reading medical travel guidebooks

    NARCIS (Netherlands)

    Ormond, M.E.; Sothern, M.

    2012-01-01

    Drawing on literature on self-help and travel guide writing, this paper interrogates five international medical travel guidebooks aimed at encouraging American and British audiences to travel abroad to purchase medical care. These guidebooks articulate a three-step self-help “program” to produce a “

  1. Current trends in medical English education and the Japan College of Rheumatology International School.

    Science.gov (United States)

    Jego, Eric Hajime; Amengual, Olga

    2017-04-11

    In light of the present revolution happening in medical education in Japan as medical schools implement new curricula to conform to global standards, there is a growing demand for more internationalization and higher quality practical medical English education. In response, many institutions including governmental organizations, universities and academic associations are moving ahead with new initiatives to adapt to these changing demands. This paper reviews the current trends and innovations in medical English education in Japan. This paper also describes one initiative by the Japan College of Rheumatology (JCR) known as the JCR International School held yearly in Karuizawa. By examining recent trends and innovations in medical English education in Japan, the most relevant and applicable can be elucidated to illuminate a path forward for improved medical English education within the JCR.

  2. [Medical indications for acupuncture: Systematic review].

    Science.gov (United States)

    Muñoz-Ortego, Juan; Solans-Domènech, Maite; Carrion, Carme

    2016-09-16

    Acupuncture is a medical procedure with a very wide range of indications according to the WHO. However the indications require robust scientific evidence to support them. We have conducted a systematic review (2010-2015) in order to define in which pathologies acupuncture can be an effective strategy, STRICTA criteria that aim to set up acupuncture clinical trials standard criteria were defined in 2010. Only systematic reviews and meta-analyses of good or very good methodological quality according to SIGN criteria were selected. Its main objective was to evaluate the effectiveness of acupuncture in the management of any disease. Most of the final 31 selected reviews focus on chronic pain-related diseases, mainly in the disciplines of Neurology, Orthopaedics and Rheumatology. Current evidence supports the use of acupuncture in the treatment of headaches, migraines, back pain, cervical pain and osteoarthritis. The remaining pathologies still require further good quality studies.

  3. International students in United States' medical schools: does the medical community know they exist?

    Science.gov (United States)

    Datta, Jashodeep; Miller, Bonnie M

    2012-01-01

    Matriculation of international students to United States' (US) medical schools has not mirrored the remarkable influx of these students to other US institutions of higher education. While these students' numbers are on the rise, the visibility for their unique issues remains largely ignored in the medical literature. These students are disadvantaged in the medical school admissions process due to financial and immigration-related concerns, and academic standards for admittance also continue to be significantly higher compared with their US-citizen peers. Furthermore, it is simply beyond the mission of many medical schools - both public and private - to support international students' education, especially since federal, state-allocated or institutional funds are limited and these institutions have a commitment to fulfill the healthcare education needs of qualified domestic candidates. In spite of these obstacles, a select group of international students do gain admission to US medical schools and, upon graduation, are credentialed equally as their US-citizen counterparts by the Accreditation Council for Graduate Medical Education (ACGME). However, owing to their foreign citizenship, these students have visa requirements for post-graduate training that may adversely impact their candidacy for residency placement. By raising such issues, this article aims to increase the awareness of considerations pertinent to this unique population of medical students. The argument is also made to support continued recruitment of international students to US medical schools in spite of these impediments. In our experience, these students are not only qualified to tackle the rigors of a US medical education, but also enrich the cultural diversity of the medical student body. Moreover, these graduates could effectively complement the efforts to augment US physician workforce diversity while contributing to healthcare disparity eradication, minority health issues, and service in

  4. International students in United States’ medical schools: does the medical community know they exist?

    Directory of Open Access Journals (Sweden)

    Jashodeep Datta

    2012-06-01

    Full Text Available Background: Matriculation of international students to United States’ (US medical schools has not mirrored the remarkable influx of these students to other US institutions of higher education. Methods: While these students’ numbers are on the rise, the visibility for their unique issues remains largely ignored in the medical literature. Results: These students are disadvantaged in the medical school admissions process due to financial and immigration-related concerns, and academic standards for admittance also continue to be significantly higher compared with their US-citizen peers. Furthermore, it is simply beyond the mission of many medical schools – both public and private – to support international students’ education, especially since federal, state-allocated or institutional funds are limited and these institutions have a commitment to fulfill the healthcare education needs of qualified domestic candidates. In spite of these obstacles, a select group of international students do gain admission to US medical schools and, upon graduation, are credentialed equally as their US-citizen counterparts by the Accreditation Council for Graduate Medical Education (ACGME. However, owing to their foreign citizenship, these students have visa requirements for post-graduate training that may adversely impact their candidacy for residency placement. Conclusion: By raising such issues, this article aims to increase the awareness of considerations pertinent to this unique population of medical students. The argument is also made to support continued recruitment of international students to US medical schools in spite of these impediments. In our experience, these students are not only qualified to tackle the rigors of a US medical education, but also enrich the cultural diversity of the medical student body. Moreover, these graduates could effectively complement the efforts to augment US physician workforce diversity while contributing to

  5. Neoliberal governance and International medical travel in Malaysia

    NARCIS (Netherlands)

    Ormond, M.E.

    2013-01-01

    International medical travel (IMT), people crossing national borders in the pursuit of healthcare, has become a growing phenomenon. With many of the countries currently being promoted as IMT destinations located in the ‘developing’ world, IMT poses a significant challenge to popular assumptions

  6. EUROPEAN AND INTERNATIONAL STANDARDS ON MEDICAL DEVICES FOR DENTISTRY.

    Directory of Open Access Journals (Sweden)

    Jordan Deliversky

    2015-02-01

    Full Text Available Standards are produced for many different products and services, and may be created for company, national, regional or global application. In Europe there are three different categories of standard: International standard – a standard adopted by an international standardization organization; European standard – a standard adopted by a European standardization body; National standard – a standard adopted by a national standardization body and made available to the public. Harmonized standards play a special role in the EU. A harmonised standard is a European standard elaborated on the basis of a request from the European Commission to a recognised European Standards Organisation to develop a European standard that provides solutions for compliance with a legal provision. Most standards for dental materials have been harmonized through a so-called cumulative standard (EN 1641:2009 - Dentistry - Medical devices for dentistry - Materials. This European Standard specifies general requirements for materials used in the practice of dentistry for the restoration of the form and function of the dentition and which are medical devices. A multiplicity of laws, standards, and recommendations regulate the marketing of medical devices. The medical doctor and the dentist should be informed about the European and international standards concerning medical devices and use only those for which appropriate information is available. The manufacturer/importer is responsible for its products and is potentially liable for damages.

  7. Balancing the act: The international migration of medical graduates.

    Science.gov (United States)

    Zubaran, Carlos

    2011-03-01

    In this article I examine the phenomenon of international migration of medical graduates. The debate involving the ethical aspects of medical migration as well as the obstacles faced by doctors to practice unreservedly in their host countries are addressed. The situation of Australia in this context is also scrutinised. Finally, I propose a series of strategies aimed at minimising the unfavourable consequences of the international migration of doctors. This commentary favours a reform in the way institutions and society respond to the process of medical migration and to the needs of migrant doctors. Continued research on this health care topic is required in order to identify the major factors that play a role in this process.

  8. Review article: eplerenone: an underused medication?

    Science.gov (United States)

    Abuannadi, Mohammad; O'Keefe, James H

    2010-12-01

    In this article, we review the evidence supporting the use of eplerenone for improving cardiovascular prognosis. Activation of the renin-angiotensin-aldosterone system plays a major role in the pathogenesis of heart disease, and blockage of this system has been shown to improve prognosis in several cardiovascular conditions. The 2 marketed aldosterone antagonists, spironolactone and eplerenone, improve prognosis in patients with left ventricular (LV) dysfunction and are effective antihypertensive medications. In addition, a potential role for aldosterone antagonists in the treatment of patients with heart failure and preserved LV function has been suggested and is currently being evaluated in clinical trials. In patients with myocardial infarction having LV dysfunction and evidence of heart failure, eplerenone improves cardiovascular outcomes and attenuates myocardial remodeling. In addition, eplerenone is effective for the treatment of hypertension, where it regresses both LV hypertrophy and proteinuria (2 powerful markers of increased cardiovascular risk). In contrast to spironolactone, eplerenone essentially lacks the sexual side effects that sometimes limit the use of spironolactone. Hyperkalemia is the main potential side effect of eplerenone, especially when used in combination with other medications that can cause hyperkalemia. Adequate patient selection and monitoring are therefore of utmost importance when using this medication. In conclusion, eplerenone is a medication that offers the cardiovascular therapeutic and prognostic benefits of aldosterone antagonism but with fewer side effects compared to spironolactone.

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

    Directory of Open Access Journals (Sweden)

    Majra Jai

    2009-01-01

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

  10. Equal, global, local: discourses in Taiwan's international medical graduate debate.

    Science.gov (United States)

    Ho, Ming-Jung; Shaw, Kevin; Liu, Tzu-Hung; Norris, Jessie; Chiu, Yu-Ting

    2015-01-01

    With the globalisation of medicine, the role of international medical graduates (IMGs) has expanded. Nonetheless, the experiences of native-born IMGs remain under-researched. In Taiwan, public controversy has unfolded around IMGs educated in Poland, calling into question the meaning(s) of equality in policy and medicine. In focusing on the return of IMGs to their countries of origin, this study adds to the growing literature concerning equality and globalisation in medical education. The primary research aim was to analyse how stakeholders in the IMG debate use equality in their arguments. The authors set out to frame the dispute within the recent history of Taiwanese medical governance. An overarching objective was to contribute a critical, historical view of how discourses of globalisation and equality construct different policy approaches to international medical education. The authors performed a critical discourse analysis of a public policy dispute in Taiwan, assembling an archive from online interactions, government reports and news articles. Coding focused on stakeholders' uses of equality to generate broader discourses. International and domestic Taiwanese students conceived of equality differently, referencing both 'equality of opportunity' and 'equality of outcome' within localisation and globalisation frameworks, respectively. The dominance of localisation discourse is reflected in hostile online rhetoric towards Poland-educated IMGs. Rhetorical disagreements over equality in medical education trace shifting state policies, from earlier attempts to remove barriers for IMGs to the present-day push to regulate IMGs for acculturation and quality assurance. The global Internet had a double-sided influence, facilitating both democratic political mobilization and the spread of hate speech. The policy debate in Taiwan mirrors discourses in Canada, where IMGs are likewise conceived either as globally competent physicians or as lacking in merit and technical

  11. Critical review: medical students' motivation after failure.

    Science.gov (United States)

    Holland, Chris

    2016-08-01

    About 10 % of students in each years' entrants to medical school will encounter academic failure at some stage in their programme. The usual approach to supporting these students is to offer them short term remedial study programmes that often enhance approaches to study that are orientated towards avoiding failure. In this critical review I will summarise the current theories about student motivation that are most relevant to this group of students and describe how they are enhanced or not by various contextual factors that medical students experience during their programme. I will conclude by suggesting ways in which support programmes for students who have encountered academic failure might be better designed and researched in the future.

  12. Medication reconciliation is a prerequisite for obtaining a valid medication review

    DEFF Research Database (Denmark)

    Bjeldbak-Olesen, Mette; Danielsen, Anja Gadsbølle; Tomsen, Dorthe Vilstrup

    2013-01-01

    The objective of this study was to compare medication reconciliation and medication review based on number, type and severity of discrepancies and drug-related problems (DRPs), denoted errors.......The objective of this study was to compare medication reconciliation and medication review based on number, type and severity of discrepancies and drug-related problems (DRPs), denoted errors....

  13. Performance of International Medical Students In psychosocial medicine.

    Science.gov (United States)

    Huhn, D; Lauter, J; Roesch Ely, D; Koch, E; Möltner, A; Herzog, W; Resch, F; Herpertz, S C; Nikendei, C

    2017-07-10

    Particularly at the beginning of their studies, international medical students face a number of language-related, social and intercultural challenges. Thus, they perform poorer than their local counterparts in written and oral examinations as well as in Objective Structured Clinical Examinations (OSCEs) in the fields of internal medicine and surgery. It is still unknown how international students perform in an OSCE in the field of psychosocial medicine compared to their local fellow students. All students (N = 1033) taking the OSCE in the field of psychosocial medicine and an accompanying written examination in their eighth or ninth semester between 2012 and 2015 were included in the analysis. The OSCE consisted of four different stations, in which students had to perform and manage a patient encounter with simulated patients suffering from 1) post-traumatic stress disorder, 2) schizophrenia, 3) borderline personality disorder and 4) either suicidal tendency or dementia. Students were evaluated by trained lecturers using global checklists assessing specific professional domains, namely building a relationship with the patient, conversational skills, anamnesis, as well as psychopathological findings and decision-making. International medical students scored significantly poorer than their local peers (p International students showed poorer results in clinical-practical exams in the field of psychosocial medicine, with conversational skills yielding the poorest scores. However, regarding factual and practical knowledge examined via a multiple-choice test, no differences emerged between international and local students. These findings have decisive implications for relationship building in the doctor-patient relationship.

  14. International Workshop and Summer School on Medical and Service Robotics

    CERN Document Server

    Bouri, Mohamed; Mondada, Francesco; Pisla, Doina; Rodic, Aleksandar; Helmer, Patrick

    2016-01-01

    Medical and Service Robotics integrate the most recent achievements in mechanics, mechatronics, computer science, haptic and teleoperation devices together with adaptive control algorithms. The book  includes topics such as surgery robotics, assist devices, rehabilitation technology, surgical instrumentation and Brain-Machine Interface (BMI) as examples for medical robotics. Autonomous cleaning, tending, logistics, surveying and rescue robots, and elderly and healthcare robots are typical examples of topics from service robotics. This is the Proceedings of the Third International Workshop on Medical and Service Robots, held in Lausanne, Switzerland in 2014. It presents an overview of current research directions and fields of interest. It is divided into three sections, namely 1) assistive and rehabilitation devices; 2) surgical robotics; and 3) educational and service robotics. Most contributions are strongly anchored on collaborations between technical and medical actors, engineers, surgeons and clinicians....

  15. 临床实习生医德教育的伦理审视及教育对策%Ethical review and strategies of enhancing the medical ethics education for intern

    Institute of Scientific and Technical Information of China (English)

    汤莉莉

    2014-01-01

    临床实习阶段是医德教育的关键时期,在分析医学生临床实习阶段加强医德教育重要性基础上,进一步探讨临床实习阶段医德教育的现状及存在的主要问题,提出在临床实习阶段应通过多种途径加强临床实习生医德教育,从而培养德才兼备的医学高级人才。%The clinical practice is the critical stage of medical ethics education. In this article, it is argued on the signiifcance, current status, the main problems of medical ethics education for intern. In order to foster advanced medicine professionals with moral integrity and professional competence, medical ethics education for intern should be strengthened in multiple ways summarized in this article.

  16. A literature review of medical record keeping by foreign medical teams in sudden onset disasters.

    Science.gov (United States)

    Jafar, Anisa J N; Norton, Ian; Lecky, Fiona; Redmond, Anthony D

    2015-04-01

    Medical records are a tenet of good medical practice and provide one method of communicating individual follow-up arrangements, informing research data, and documenting medical intervention. The objective of this review was to look at one source (the published literature) of medical records used by foreign medical teams (FMTs) in sudden onset disasters (SODs). The published literature was searched systematically for evidence of what medical records have been used by FMTs in SODs. Findings The style and content of medical records kept by FMTs in SODs varied widely according to the published literature. Similarly, there was great variability in practice as to what happens to the record and/or the data from the record following its use during a patient encounter. However, there was a paucity of published work comprehensively detailing the exact content of records used. Interpretation Without standardization of the content of medical records kept by FMTs in SODs, it is difficult to ensure robust follow-up arrangements are documented. This may hinder communication between different FMTs and local medical teams (LMTs)/other FMTs who may then need to provide follow-up care for an individual. Furthermore, without a standard method of reporting data, there is an inaccurate picture of the work carried out. Therefore, there is not a solid evidence base for improving the quality of future response to SODs. Further research targeting FMTs and LMTs directly is essential to inform any development of an internationally agreed minimum data set (MDS), for both recording and reporting, in order that FMTs can reach the World Health Organization (WHO) standards for FMT practice.

  17. Medication-overuse headache: a review

    Directory of Open Access Journals (Sweden)

    Kristoffersen ES

    2014-06-01

    Full Text Available Espen Saxhaug Kristoffersen,1–3 Christofer Lundqvist1,2,41Research Centre, Akershus University Hospital, Lørenskog, 2Department of Neurology, Akershus University Hospital, Nordbyhagen, 3Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, 4Institute of Clinical Medicine, Campus Akershus University Hospital, University of Oslo, Nordbyhagen, NorwayAbstract: Medication-overuse headache (MOH is a worldwide health problem with a prevalence of 1%–2%. It is a severe form of headache where the patients often have a long history of headache and of unsuccessful treatments. MOH is characterized by chronic headache and overuse of different headache medications. Through the years, withdrawal of the overused medication has been recognized as the treatment of choice. However, currently, there is no clear consensus regarding the optimal strategy for management of MOH. Treatment approaches are based on expert opinion rather than scientific evidence. This review focuses on aspects of epidemiology, diagnosis, pathogenesis, prevention, and treatment of MOH. We suggest that information and education about the risk of MOH is important since the condition is preventable. Most patients experience reduction of headache days and intensity after successful treatment. The first step in the treatment of MOH should be carried out in primary care and focus primarily on withdrawal, leaving prophylactic medication to those who do not manage primary detoxification. For most patients, a general practitioner can perform the follow-up after detoxification. More complicated cases should be referred to neurologists and headache clinics. Patients suffering with MOH have much to gain by an earlier treatment-focused approach, since the condition is both preventable and treatable.Keywords: medication-overuse headache, migraine, chronic headache, dependence

  18. 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.

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

    Science.gov (United States)

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

    2013-01-01

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

  20. Human rights and the requirement for international medical aid.

    Science.gov (United States)

    Tolchin, Benjamin

    2008-08-01

    Every year approximately 18 million people die prematurely from treatable medical conditions including infectious diseases and nutritional deficiencies. The deaths occur primarily amongst the poorest citizens of poor developing nations. Various groups and individuals have advanced plans for major international medical aid to avert many of these unnecessary deaths. For example, the World Health Organization's Commission on Macroeconomics and Health estimated that eight million premature deaths could be prevented annually by interventions costing roughly US$57 bn per year. This essay advances an argument that human rights require high-income nations to provide such aid. The essay briefly examines John Rawls' obligations of justice and the reasons that their applicability to cases of international medical aid remains controversial. Regardless, the essay argues that purely humanitarian obligations bind the governments and citizens of high-income liberal democracies at a minimum to provide major medical aid to avert premature deaths in poor nations. In refusing to undertake such medical relief efforts, developed nations fail to adequately protect a fundamental human right to life.

  1. 78 FR 68853 - International Medical Device Regulators Forum; Medical Device Single Audit Program International...

    Science.gov (United States)

    2013-11-15

    ... management systems and other specific regulatory requirements of the regulatory authorities participating in... Dockets Management (HFA-305), Food and Drug Administration, 5630 Fishers Lane, Rm. 1061, Rockville, MD... Ministry of Health, Labour and Welfare and Pharmaceuticals and Medical Devices Agency, are...

  2. CIOMS stellt "International Guidelines for Ethical Review of Epidemiological Studies" zur Diskussion

    OpenAIRE

    Müller,W.

    2005-01-01

    Das Council for International Organisations of Medical Sciences (CIOMS) bei der WHO - in dem Deutschland durch die AWMF vertreten ist - erstellt derzeit eine Überarbeitung der erstmals 1991 verabschiedeten International Guidelines for Ethical Review of Epidemiological Studies. Alle interessierten Wissenschaftler aus dem Gesamtbereich der Medizin sind gebeten, ihre Anregungen bis Ende Oktober 2005 einzubringen.

  3. Patient safety education for undergraduate medical students: a systematic review

    Directory of Open Access Journals (Sweden)

    Zhang Mingming

    2011-06-01

    Full Text Available Abstract Background To reduce harm caused by health care is a global priority. Medical students should be able to recognize unsafe conditions, systematically report errors and near misses, investigate and improve such systems with a thorough understanding of human fallibility, and disclose errors to patients. Incorporating the knowledge of how to do this into the medical student curriculum is an urgent necessity. This paper aims to systematically review the literature about patient safety education for undergraduate medical students in terms of its content, teaching strategies, faculty availability and resources provided so as to identify evidence on how to promote patient safety in the curriculum for medical schools. This paper includes a perspective from the faculty of a medical school, a major hospital and an Evidence Based Medicine Centre in Sichuan Province, China. Methods We searched MEDLINE, ERIC, Academic Source Premier(ASP, EMBASE and three Chinese Databases (Chinese Biomedical Literature Database, CBM; China National Knowledge Infrastructure, CNKI; Wangfang Data from 1980 to Dec. 2009. The pre-specified form of inclusion and exclusion criteria were developed for literature screening. The quality of included studies was assessed using Darcy Reed and Gemma Flores-Mateo criteria. Two reviewers selected the studies, undertook quality assessment, and data extraction independently. Differing opinions were resolved by consensus or with help from the third person. Results This was a descriptive study of a total of seven studies that met the selection criteria. There were no relevant Chinese studies to be included. Only one study included patient safety education in the medical curriculum and the remaining studies integrated patient safety into clinical rotations or medical clerkships. Seven studies were of a pre and post study design, of which there was only one controlled study. There was considerable variation in relation to contents

  4. Cutaneous metastasis from internal carcinomas: a review of 45 years*

    Science.gov (United States)

    Sittart, Jose Alexandre de Souza; Senise, Monica

    2013-01-01

    BACKGROUND cutaneous metastases are not so frequent and in the medical literature there are several communications of isolated cases, thereby we decided to continue our study initiated in 1981 (45 years). OBJECTIVE our objective is to present the research and review of cutaneous metastases of 45 years through our archives at Hospital do Servidor Publico Estadual de Sao Paulo. METHODS the data were collected from clinical cases registered in our archives at anatomopathology department. RESULTS since 1963 we have registered 209 patients with cutaneous metastases being the anterior thorax region the most affected area and in second place the abdominal region. Breast cancer was responsible for most of the cases in women and the lung in men. CONCLUSION this study represents a signioficant number of cases in medical practice because skin metastases of internal carcinomas rarely are observed and the great predominance, mainly due of his origin were represented by adenocarcinomas. PMID:24068124

  5. Cutaneous metastasis from internal carcinomas: a review of 45 years.

    Science.gov (United States)

    Sittart, Jose Alexandre de Souza; Senise, Monica

    2013-01-01

    cutaneous metastases are not so frequent and in the medical literature there are several communications of isolated cases, thereby we decided to continue our study initiated in 1981 (45 years). our objective is to present the research and review of cutaneous metastases of 45 years through our archives at Hospital do Servidor Publico Estadual de Sao Paulo. the data were collected from clinical cases registered in our archives at anatomopathology department. since 1963 we have registered 209 patients with cutaneous metastases being the anterior thorax region the most affected area and in second place the abdominal region. Breast cancer was responsible for most of the cases in women and the lung in men. this study represents a significant number of cases in medical practice because skin metastases of internal carcinomas rarely are observed and the great predominance, mainly due of his origin were represented by adenocarcinomas.

  6. Patient adherence to medical treatment: a review of reviews

    Directory of Open Access Journals (Sweden)

    Heerdink Rob

    2007-04-01

    Full Text Available Abstract Background Patients' non-adherence to medical treatment remains a persistent problem. Many interventions to improve patient adherence are unsuccessful and sound theoretical foundations are lacking. Innovations in theory and practice are badly needed. A new and promising way could be to review the existing reviews of adherence to interventions and identify the underlying theories for effective interventions. That is the aim of our study. Methods The study is a review of 38 systematic reviews of the effectiveness of adherence interventions published between 1990 and 2005. Electronic literature searches were conducted in Medline, Psychinfo, Embase and the Cochrane Library. Explicit inclusion and exclusion criteria were applied. The scope of the study is patient adherence to medical treatment in the cure and care sector. Results Significant differences in the effectiveness of adherence interventions were found in 23 of the 38 systematic reviews. Effective interventions were found in each of four theoretical approaches to adherence interventions: technical, behavioural, educational and multi-faceted or complex interventions. Technical solutions, such as a simplification of the regimen, were often found to be effective, although that does not count for every therapeutic regimen. Overall, our results show that, firstly, there are effective adherence interventions without an explicit theoretical explanation of the operating mechanisms, for example technical solutions. Secondly, there are effective adherence interventions, which clearly stem from the behavioural theories, for example incentives and reminders. Thirdly, there are other theoretical models that seem plausible for explaining non-adherence, but not very effective in improving adherence behaviour. Fourthly, effective components within promising theories could not be identified because of the complexity of many adherence interventions and the lack of studies that explicitly compare

  7. Medical humanities in healthcare education in Italy: a literature review

    Directory of Open Access Journals (Sweden)

    Laura Fieschi

    2013-03-01

    Full Text Available OBJECTIVE. The introduction of medical humanities (MH in undergraduate medical education in Italy has been an issue of debate since the 90's and few years later it was extended to other healthcare degrees. The aims of this Italian literature review, after considering the international scene, are: to evaluate the extent to which the interest in this subject has gradually developed throughout the country; which professional groups have contributed to the debate; to identify which theoretical constructs led to the introduction of MH in undergraduate medical education; to identify whether a clear and shared definition of MH exists in Italian literature; to verify what kinds of MH experiences have been accomplished in Italy. MATERIALS AND METHODS. A comprehensive literature search was conducted, including electronic databases, bibliographies, manual sorting of articles in paper format, congress proceedings. RESULTS. The analysis of the chosen articles underlines that, however limited, Italian literature does not present a very different picture from the international scene. It emerges that teaching MH is believed to be an important feature in undergraduate education of healthcare professionals who intend to propose a bio-psychological-social approach to care, in spite of the difficulty to measure its short and long term effectiveness. The lack of a multidisciplinary, multi-professional approach is also evident. CONCLUSION. Further research aiming to implement the quantity and quality of MH studies in the curricula of undergraduate healthcare education is desirable.

  8. Microhistory and Chinese Medical History: A Review.

    Science.gov (United States)

    Yu, Xinzhong; Wang, Yumeng

    2015-08-01

    With a reflection on the grand quantitative analysis in previous historical investigations, microhistory came into being in Italy in the 1960s and the 70s. Microhistory is, in principle, the intensive historical investigation of a relatively well defined smaller object. Notwithstanding, it still has the ambition to draw a larger picture of the history. Microhistory is also characterized by its preference to the exceptional individuals or phenomena, its "narrative" style and the delicate way it deals with historical sources. Essentially, microhistory endeavors to bring the individual's role, the concrete life as well as the diversity and complexity of history to the historical writing. At first, microhistory did not have intersection with the medical history. Nevertheless, the history of medicine echoes microhistory in bringing the concrete and vivid life beings to history. Mainly due to this similarity, historical surveys on medicine from the perspective of microhistory are increasing and gradually develop into a remarkable trend in the international historical academy from the 1980s onwards. As the microhistory is rising and its influence is expanding, the microhistorical approach has been practiced to a certain extent in the historical writings on medicine in China. Concentrating on an individual person, a single event, a particular drug or a specific concept, there already have some studies conduct intensive historical investigation on a small scale. A small part of these researches, for example, those of Chang Che-Chia, Li Shang-jen and etc. could be regarded as perfect examples of microhistory. However, no relevant research is carried out explicitly under the heading of microhistory, instead, they are the offspring of the "new history". Besides, most of these researches could not be regarded as real microhistories, strictly speaking. They do not practice microhistory consciously and they have a long way to go to improve the delicacy of the analysis, to

  9. PRESENT AND FUTURE PERSPECTIVES IN INTERNATIONAL MEDICAL ASSISTANCE

    Directory of Open Access Journals (Sweden)

    Carmen Stadoleanu

    2012-12-01

    Full Text Available Paneuropean development of patients’ rights represent a relatively recent concern, the legislative norms of which aim at granting to patients real-time access to all sorts of medical services. To this end, the European Union implemented a unitary normative professional and juridical background: Directive 2011/24/U.E. on the rights of patients to international treatments. Consequently, the patients are free to choose themselves the suppliers of medical services which do not include hospitalization, without a previous authorisation (country, doctor and medical institution while, in the case of long-term treatments, a principial authorisation will be necessary. In both cases, the carrier of the therapeutic service receives the payment for his actions at the level of those established at national level, the difference being usually payed by the patient.

  10. 42 CFR 405.2113 - Medical review board.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Medical review board. 405.2113 Section 405.2113... PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Conditions for Coverage of Suppliers of End-Stage Renal Disease (ESRD) Services § 405.2113 Medical review board. (a) General. The medical...

  11. Medication review in hospitalised patients to reduce morbidity and mortality

    DEFF Research Database (Denmark)

    Christensen, Mikkel; Lundh, Andreas

    2013-01-01

    accepted definition of medication review exists, it can be defined as a systematic assessment of the pharmacotherapy of an individual patient that aims to evaluate and optimise patient medication by a change (or not) in prescription, either by a recommendation or by a direct change. Medication review...

  12. Adherence to international recommendations for gastric lavage in medical drug poisonings in Denmark 2007-2010

    DEFF Research Database (Denmark)

    Westergaard, Bo; Høgberg, Lotte Christine Groth; Groenlykke, Thor Buch

    2012-01-01

    Recent reviews strongly discourage the routine use of gastric lavage in oral poisonings, but the authors suspected that gastric lavage might still be in widespread use in Denmark. We wished to estimate the extent to which gastric lavage in cases of medical drug poisoning, reported in inquiries...... to the Danish Poison Information Centre (DPIC) from 2007 to 2010, was performed according to international recommendations and whether adherence to recommendations improved over the period....

  13. [Quality of German medical services: a review].

    Science.gov (United States)

    Braun, J; Robbers, J; Lakomek, H-J

    2016-02-01

    In the current draft of the law on the reform of the support structures of hospital provision (German Hospital Structure Law) the future quality of provision is highly significant. Quality assurance measures are mandatory for hospitals. The Federal General Committee was legally charged with developing the relevant quality indicators for structural, procedural and outcome quality that are designed to form the criteria and the basis for planning decisions in the federal states. This involves a paradigm shift in quality assurance measures in hospitals. In the future, subject to the verified quality, this should have an influence on hospital planning, and the funding or regulation of hospital departments should also adhere to this prescribed quality. This review reveals the course of quality or quality assurance measures in medical services in Germany. The status of the institutions responsible for the quality of care in hospitals and the significance of quality indicators are explained.

  14. A systematic review of publications studies on medical tourism.

    Science.gov (United States)

    Masoud, Ferdosi; Alireza, Jabbari; Mahmoud, Keyvanara; Zahra, Agharahimi

    2013-01-01

    Medical tourism for any study area is complex. Using full articles from other databases, Institute for Scientific Information (ISI), Science Direct, Emerald, Oxford, Magiran, and Scientific Information Database (SID), to examine systematically published articles about medical tourism in the interval 2000-2011 paid. Articles were obtained using descriptive statistics and content analysis categories were analyzed. Among the 28 articles reviewed, 11 cases were a kind of research articles, three cases were case studies in Mexico, India, Hungary, Germany, and Iran, and 14 were case studies, review documents and data were passed. The main topics of study included the definition of medical tourism, medical tourists' motivation and development of medical tourism, ethical issues in medical tourism, and impact on health and medical tourism marketing. The findings indicate the definition of medical tourism in various articles, and medical tourists are motivated. However, most studies indicate the benefits of medical tourism in developing countries and more developed countries reflect the consequences of medical tourism.

  15. Review of medical reports on pedophilia.

    Science.gov (United States)

    Hughes, John R

    2007-10-01

    The present report is a review of all 554 papers published on Medline on pedophilia. The first discussion is the history of the disorder from ancient Greece to the present time, especially the influence of the liberal country of the Netherlands, the North American Man-Boy Love Association, and the sexual crisis in the Catholic Church. One important question is the relationship between homosexual pedophilia and adult homosexuality. Evidence for and against this relationship is presented. Next discussed are the characteristics of the victim and the long lasting serious effects of sexual abuse. Laboratory correlations are included, especially phallometric tests in order to objectively measure the physical responses to sexual stimuli. Electrophysiological and radiographic tests are also mentioned, including electroencephalography, computed tomography, magnetic resonance imaging, and positron emission tomography scans. An important section is the characterization of pedophiles with emphasis on their frequent previous sexual abuse, their past, their present, and their anticipated future. The final topic is treatment of this disorder with surgery, medication, behavioral therapy and the combination of medication and behavioral therapy.

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

    Science.gov (United States)

    2011-01-01

    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 student performances in multiple choice questions, short answer questions and objective structured clinical examinations (70.3%, 49.7% & 61.7% respectively), indicating existence of communication issues. 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. PMID:21702988

  17. Factors associated with dropping out of medical school: a literature review

    DEFF Research Database (Denmark)

    O’Neill, Lotte Dyhrberg

    2010-01-01

    of Aarhus; Jan Hartvigsen, PhD, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark.   Title: Factors associated with dropping out of medical school: a literature review.      Background: Considerable resources are spent on medical school selection and the competition...... for places is usually fierce. Dropping out must therefore be the worst possible performance outcome in medical education. What do we know about factors associated with dropping out of medical school? Summary of work: A systematic critical literature review of the international peer-reviewed research...... literature on medical education is ongoing. Inclusion criteria are: Study population=medical students, outcome=dropout, follow up period=minimum 1 year, study designs=cohort/case-control/experimental. An experienced research librarian performed a primary search of the databases PubMed, ERIC, Psyc...

  18. Parochialism or Self-Consciousness? Internationality in Medical History Journals 1997–2006

    Science.gov (United States)

    Steinke, Hubert; Lang, Yves

    2011-01-01

    Research councils, universities and funding agencies are increasingly asking for tools to measure the quality of research in the humanities. One of their preferred methods is a ranking of journals according to their supposed level of internationality. Our quantitative survey of seventeen major journals of medical history reveals the futility of such an approach. Most journals have a strong national character with a dominance of native language, authors and topics. The most common case is a paper written by a local author in his own language on a national subject regarding the nineteenth or twentieth century. American and British journals are taken notice of internationally but they only rarely mention articles from other history of medicine journals. Continental European journals show a more international review of literature, but are in their turn not noticed globally. Increasing specialisation and fragmentation has changed the role of general medical history journals. They run the risk of losing their function as international platforms of discourse on general and theoretical issues and major trends in historiography, to international collections of papers. Journal editors should therefore force their authors to write a more international report, and authors should be encouraged to submit papers of international interest and from a more general, transnational and methodological point of view. PMID:22028500

  19. Parochialism or self-consciousness? Internationality in medical history journals 1997-2006.

    Science.gov (United States)

    Steinke, Hubert; Lang, Yves

    2011-10-01

    Research councils, universities and funding agencies are increasingly asking for tools to measure the quality of research in the humanities. One of their preferred methods is a ranking of journals according to their supposed level of internationality. Our quantitative survey of seventeen major journals of medical history reveals the futility of such an approach. Most journals have a strong national character with a dominance of native language, authors and topics. The most common case is a paper written by a local author in his own language on a national subject regarding the nineteenth or twentieth century. American and British journals are taken notice of internationally but they only rarely mention articles from other history of medicine journals. Continental European journals show a more international review of literature, but are in their turn not noticed globally. Increasing specialisation and fragmentation has changed the role of general medical history journals. They run the risk of losing their function as international platforms of discourse on general and theoretical issues and major trends in historiography, to international collections of papers. Journal editors should therefore force their authors to write a more international report, and authors should be encouraged to submit papers of international interest and from a more general, transnational and methodological point of view.

  20. Educational challenges faced by international medical graduates in the UK

    Directory of Open Access Journals (Sweden)

    Hashim A

    2017-06-01

    Full Text Available Ahmed Hashim Gastroenterology Department, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK Introduction: International medical graduates (IMGs in the UK constitute approximately one-quarter of the total number of doctors registered in the General Medical Council (GMC. The transition of IMGs into the health care system in the UK is accompanied by significant sociocultural and educational challenges. This study aims to explore the views of IMGs in medical training on the educational challenges they face.Methods: This study was conducted in the Kent, Surrey and Sussex region in 2015. All IMGs who work in medical (physicianly training programs were included. Data were collected through a questionnaire and semi-structured interviews. Thematic approach was used to analyze the qualitative data.Results: Of the total 61 IMGs included, 17 responded to the survey and 3 were interviewed. The common educational barriers faced by IMGs were related to lack of appreciation of the values and structure of the National Health Service (NHS, ethical and medicolegal issues, receiving feedback from colleagues and the different learning strategies in the UK. IMGs suggested introduction of a mandatory dedicated induction program in the form of formal teaching sessions. They also believed that a supervised shadowing period prior in the first job in the UK would be beneficial. Further assessment areas should be incorporated into the prequalifying examinations to address specific educational needs such as NHS structure and hospital policies. Other measures such as buddying schemes with senior IMGs and educating NHS staff on different needs of IMGs should also be considered.Conclusion: This study highlighted important educational challenges faced by IMGs and generated relevant solutions. However, the opinions of the supervisors and other health care professionals need to be explored. Keywords: international medical graduates, IMG, educational barriers

  1. International medical students – a survey of perceived challenges and established support services at medical faculties

    Science.gov (United States)

    Huhn, D.; Junne, F.; Zipfel, S.; Duelli, R.; Resch, F.; Herzog, W.; Nikendei, C.

    2015-01-01

    Introduction: Medical students with a non-German background face several challenges during their studies. Besides support given by foreign student offices further specific projects for international students have been developed and are offered by medical faculties. However, so far, neither a systematic survey of the faculties’ perceived problems nor of the offered support exists. Method: All study deaneries of medical faculties in Germany were contacted between April and October 2013 and asked for their participation in a telephone interview. Interview partners were asked about 1.) The percentage of non-German students at the medical faculty; 2.) The perceived difficulties and problems of foreign students; 3.) The offers for non-German students; and 4.) The specification of further possibilities of support. Given information was noted, frequencies counted and results interpreted via frequency analysis. Results: Only 39% of the medical faculties could give detailed information about the percentage of non-German students. They reported an average share of 3.9% of students with an EU migration background and 4.9% with a non-EU background. Most frequently cited offers are student conducted tutorials, language courses and tandem-programs. The most frequently reported problem by far is the perceived lack of language skills of foreign students at the beginning of their studies. Suggested solutions are mainly the development of tutorials and the improvement of German medical terminology. Discussion: Offers of support provided by medical faculties for foreign students vary greatly in type and extent. Support offered is seen to be insufficient in coping with the needs of the international students in many cases. Hence, a better coverage of international students as well as further research efforts to the specific needs and the effectiveness of applied interventions seem to be essential. PMID:25699112

  2. International medical students – a survey of perceived challenges and established support services at medical faculties

    Directory of Open Access Journals (Sweden)

    Huhn, D.

    2015-02-01

    Full Text Available Introduction: Medical students with a non-German background face several challenges during their studies. Besides support given by foreign student offices further specific projects for international students have been developed and are offered by medical faculties. However, so far, neither a systematic survey of the faculties’ perceived problems nor of the offered support exists.Method: All study deaneries of medical faculties in Germany were contacted between April and October 2013 and asked for their participation in a telephone interview. Interview partners were asked about 1. The percentage of non-German students at the medical faculty; 2. The perceived difficulties and problems of foreign students; 3. The offers for non-German students; and 4. The specification of further possibilities of support. Given information was noted, frequencies counted and results interpreted via frequency analysis.Results: Only 39% of the medical faculties could give detailed information about the percentage of non-German students. They reported an average share of 3.9% of students with an EU migration background and 4.9% with a non-EU background. Most frequently cited offers are student conducted tutorials, language courses and tandem-programs. The most frequently reported problem by far is the perceived lack of language skills of foreign students at the beginning of their studies. Suggested solutions are mainly the development of tutorials and the improvement of German medical terminology.Discussion: Offers of support provided by medical faculties for foreign students vary greatly in type and extent. Support offered is seen to be insufficient in coping with the needs of the international students in many cases. Hence, a better coverage of international students as well as further research efforts to the specific needs and the effectiveness of applied interventions seem to be essential.

  3. Medical students-as-teachers: a systematic review of peer-assisted teaching during medical school

    Science.gov (United States)

    Yu, Tzu-Chieh; Wilson, Nichola C; Singh, Primal P; Lemanu, Daniel P; Hawken, Susan J; Hill, Andrew G

    2011-01-01

    Introduction International interest in peer-teaching and peer-assisted learning (PAL) during undergraduate medical programs has grown in recent years, reflected both in literature and in practice. There, remains however, a distinct lack of objective clarity and consensus on the true effectiveness of peer-teaching and its short- and long-term impacts on learning outcomes and clinical practice. Objective To summarize and critically appraise evidence presented on peer-teaching effectiveness and its impact on objective learning outcomes of medical students. Method A literature search was conducted in four electronic databases. Titles and abstracts were screened and selection was based on strict eligibility criteria after examining full-texts. Two reviewers used a standard review and analysis framework to independently extract data from each study. Discrepancies in opinions were resolved by discussion in consultation with other reviewers. Adapted models of “Kirkpatrick’s Levels of Learning” were used to grade the impact size of study outcomes. Results From 127 potential titles, 41 were obtained as full-texts, and 19 selected after close examination and group deliberation. Fifteen studies focused on student-learner outcomes and four on student-teacher learning outcomes. Ten studies utilized randomized allocation and the majority of study participants were self-selected volunteers. Written examinations and observed clinical evaluations were common study outcome assessments. Eleven studies provided student-teachers with formal teacher training. Overall, results suggest that peer-teaching, in highly selective contexts, achieves short-term learner outcomes that are comparable with those produced by faculty-based teaching. Furthermore, peer-teaching has beneficial effects on student-teacher learning outcomes. Conclusions Peer-teaching in undergraduate medical programs is comparable to conventional teaching when utilized in selected contexts. There is evidence to suggest

  4. A Review of Medical Education and Medical Informatics.

    Science.gov (United States)

    Haynes, R. Brian; And Others

    1989-01-01

    Information technology may help physicians to manage information more effectively through more accessible clinical indexes, databases of diagnostic test characteristics, computerized audits of clinical activities, on-line access to medical literature, etc. Medical informatics, a new discipline dedicated to the solution of information problems in…

  5. Solidarity by demand? Exit and voice in international medical travel - the case of Indonesia.

    Science.gov (United States)

    Ormond, Meghann

    2015-01-01

    Globally, more patients are intentionally travelling abroad as consumers for medical care. However, while scholars have begun to examine international medical travel's (IMT) impacts on the people and places that receive medical travellers, study of its impacts on medical travellers' home contexts has been negligible and largely speculative. While proponents praise IMT's potential to make home health systems more responsive to the needs of market-savvy healthcare consumers, critics identify it as a way to further de-politicise the satisfaction of healthcare needs. This article draws from work on political consumerism, health advocacy and social movements to argue for a reframing of IMT not as a 'one-off' statement about or an event external to struggles over access, rights and recognition within medical travellers' home health systems but rather as one of a range of critical forms of on-going engagement embedded within these struggles. To do this, the limited extant empirical work addressing domestic impacts of IMT is reviewed and a case study of Indonesian medical travel to Malaysia is presented. The case study material draws from 85 interviews undertaken in 2007-08 and 2012 with Indonesian and Malaysian respondents involved in IMT as care recipients, formal and informal care-providers, intermediaries, promoters and policy-makers. Evidence from the review and case study suggests that IMT may effect political and social change within medical travellers' home contexts at micro and macro levels by altering the perspectives, habits, expectations and accountability of, and complicity among, medical travellers, their families, communities, formal and informal intermediaries, and medical providers both within and beyond the container of the nation-state. Impacts are conditioned by the ideological foundations underpinning home political and social systems, the status of a medical traveller's ailment or therapy, and the existence of organised support for recognition and

  6. Evaluating the Medical Kit System for the International Space Station(ISS) - A Paradigm Revisited

    Science.gov (United States)

    Hailey, Melinda J.; Urbina, Michelle C.; Hughlett, Jessica L.; Gilmore, Stevan; Locke, James; Reyna, Baraquiel; Smith, Gwyn E.

    2010-01-01

    Medical capabilities aboard the International Space Station (ISS) have been packaged to help astronaut crew medical officers (CMO) mitigate both urgent and non-urgent medical issues during their 6-month expeditions. Two ISS crewmembers are designated as CMOs for each 3-crewmember mission and are typically not physicians. In addition, the ISS may have communication gaps of up to 45 minutes during each orbit, necessitating medical equipment that can be reliably operated autonomously during flight. The retirement of the space shuttle combined with ten years of manned ISS expeditions led the Space Medicine Division at the NASA Johnson Space Center to reassess the current ISS Medical Kit System. This reassessment led to the system being streamlined to meet future logistical considerations with current Russian space vehicles and future NASA/commercial space vehicle systems. Methods The JSC Space Medicine Division coordinated the development of requirements, fabrication of prototypes, and conducted usability testing for the new ISS Medical Kit System in concert with implementing updated versions of the ISS Medical Check List and associated in-flight software applications. The teams constructed a medical kit system with the flexibility for use on the ISS, and resupply on the Russian Progress space vehicle and future NASA/commercial space vehicles. Results Prototype systems were developed, reviewed, and tested for implementation. Completion of Preliminary and Critical Design Reviews resulted in a streamlined ISS Medical Kit System that is being used for training by ISS crews starting with Expedition 27 (June 2011). Conclusions The team will present the process for designing, developing, , implementing, and training with this new ISS Medical Kit System.

  7. 8 CFR 287.10 - Expedited internal review process.

    Science.gov (United States)

    2010-01-01

    ... to employees of the former INS, persons may contact the Office of Internal Audit, Bureau of... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Expedited internal review process. 287.10... OFFICERS; POWERS AND DUTIES § 287.10 Expedited internal review process. (a) Violations of standards...

  8. Microbiology and Crew Medical Events on the International Space Station

    Science.gov (United States)

    Oubre, Cherie; Charvat, Jacqueline M.; Kadwa, Biniafer; Taiym, Wafa; Ott, C. Mark; Pierson, Duane; Baalen, Mary Van

    2014-01-01

    The closed environment of the International Space Station (ISS) creates an ideal environment for microbial growth. Previous studies have identified the ubiquitous nature of microorganisms throughout the space station environment. To ensure safety of the crew, microbial monitoring of air and surface within ISS began in December 2000 and continues to be monitored on a quarterly basis. Water monitoring began in 2009 when the potable water dispenser was installed on ISS. However, it is unknown if high microbial counts are associated with inflight medical events. The microbial counts are determined for the air, surface, and water samples collected during flight operations and samples are returned to the Microbiology laboratory at the Johnson Space Center for identification. Instances of microbial counts above the established microbial limit requirements were noted and compared inflight medical events (any non-injury event such as illness, rashes, etc.) that were reported during the same calendar-quarter. Data were analyzed using repeated measures logistic regression for the forty-one US astronauts flew on ISS between 2000 and 2012. In that time frame, instances of microbial counts being above established limits were found for 10 times for air samples, 22 times for surface samples and twice for water. Seventy-eight inflight medical events were reported among the astronauts. A three times greater risk of a medical event was found when microbial samples were found to be high (OR = 3.01; p =.007). Engineering controls, crew training, and strict microbial limits have been established to mitigate the crew medical events and environmental risks. Due to the timing issues of sampling and the samples return to earth, identification of particular microorganisms causing a particular inflight medical event is difficult. Further analyses are underway.

  9. Enhancing international medical graduates' communication: the contribution of applied linguistics.

    Science.gov (United States)

    Dahm, Maria R; Yates, Lynda; Ogden, Kathryn; Rooney, Kim; Sheldon, Brooke

    2015-08-01

    International medical graduates (IMGs) make up one-third of the Australian medical workforce. Those from non-English-language backgrounds can face cultural and communication barriers, yet linguistic support is variable and medical educators are often required to provide feedback on both medical and communication issues. However, some communication difficulties may be very specific to the experiences of IMGs as second language users. This interdisciplinary study combines perspectives from applied linguistics experts and clinical educators to address IMGs' difficulties from multiple dimensions and to enhance feedback quality. Five video-recorded patient encounters with five IMGs were collected at Launceston General Hospital. Three clinical educators gave quantitative and qualitative feedback using the Rating Instrument for Clinical Consulting Skills, and two applied linguistics experts analysed the data for language, pragmatic and communication difficulties. The comparison of the educators' language-related feedback with linguistic analyses of the same interactions facilitated the exploration of differences in the difficulties identified by the two expert groups. Although the clinical educators were able to use their tacit intuitive understanding of communication issues to identify IMG difficulties, they less frequently addressed the underlying issues or suggested specific remedies in their feedback. This pilot study illustrates the effectiveness of interdisciplinary collaboration in highlighting the specific discourse features contributing to IMG communication difficulties and thus assists educators in deconstructing their intuitive knowledge. The authors suggest that linguistic insights can therefore improve communications training by assisting educators to provide more targeted feedback. © 2015 John Wiley & Sons Ltd.

  10. Medical Complications of Tattoos: A Comprehensive Review.

    Science.gov (United States)

    Islam, Parvez S; Chang, Christopher; Selmi, Carlo; Generali, Elena; Huntley, Arthur; Teuber, Suzanne S; Gershwin, M Eric

    2016-04-01

    Tattoos are defined as the introduction of exogenous pigments into the dermis in order to produce a permanent design. This process may occur unintentional or may be deliberately administered for cosmetic or medical reasons. Tattoos have been around for over 5000 years and over time have evolved to represent a common cosmetic practice worldwide. Currently, adverse reactions are relatively rare and generally unpredictable and predominantly include immune-mediated reactions and skin infections. Along with better healthcare standards and more stringent public health mandates such as the provision of disposable needles, major infectious complications related to hepatitis and human retroviral infections have decreased significantly. When they do occur, skin infections are most frequently associated with Staphylococcus aureus or Streptococcus pyogenes. The aim of this study is to review the types and rates of medical complications of permanent tattoos. PubMed search and search dates were open ended. Acute local inflammation is the most common complication, but infections, allergic contact dermatitis, and other inflammatory or immune responses that are not well-characterized may occur. As many patients with immune reactions to tattoos do not react on skin or patch testing, it is postulated that the antigens contained in dyes or pigments are such small molecules that they need to be haptenized in order to become immunogenic. Red ink is associated more frequently with long-term reactions, including granulomatous and pseudolymphomatous phenomena or morphea-like lesions and vasculitis. Exacerbation of preexisting psoriasis, atopic dermatitis, and pyoderma gangrenosum may occur after tattooing. There is no well-defined association between cancer and tattoos. The treatment of tattoo-related complications may include local destructive measures (cryotherapy, electro-surgery, dermabrasion, chemical destruction, ablative laser destruction), surgical excision, and thermolysis of the

  11. [Ethic review on clinical experiments of medical devices in medical institutions].

    Science.gov (United States)

    Shuai, Wanjun; Chao, Yong; Wang, Ning; Xu, Shining

    2011-07-01

    Clinical experiments are always used to evaluate the safety and validity of medical devices. The experiments have two types of clinical trying and testing. Ethic review must be done by the ethics committee of the medical department with the qualification of clinical research, and the approval must be made before the experiments. In order to ensure the safety and validity of clinical experiments of medical devices in medical institutions, the contents, process and approval criterions of the ethic review were analyzed and discussed.

  12. Accidental exposure to blood in medical interns of Tehran University of Medical Sciences.

    Science.gov (United States)

    Shariati, Batoul; Shahidzadeh-Mahani, Ali; Oveysi, Turadj; Akhlaghi, Hengameh

    2007-07-01

    Healthcare workers and medical students are at risk of exposure to blood-borne viruses such as HBV, HCV HIV, etc. Here we report the results of a survey of the frequency and causes of cutaneous blood exposure accidents (CBEA) among medical students. Anonymous questionnaires were randomly distributed to 200 interns in their second year of internship in hospitals affiliated to Tehran University of Medical Sciences. A definite exposure was defined as injury by a sharp object causing obvious bleeding, whereas a possible exposure was defined as subtle or superficial injury due to contact with a contaminated instrument or needle but without bleeding, or contamination of an existing wound with blood or other body fluids. One hundred eighty-four subjects (92% of the original sample) responded to the questionnaire. We recorded 121 definite exposures and 259 possible exposures over a mean time interval of 14 months. Needles were the most common objects (41% of exposure episodes) causing CBEAs, while phlebotomy and suturing were the hospital procedures that accounted for the highest percentage of exposure episodes (30 and 28 percent, respectively). Only a minority of students regularly observed basic safety measures (wearing gloves, not recapping used needles and proper disposal of sharp objects). Considering the high incidence of blood exposure in medical interns at Tehran University of Medical Sciences and the ensuing risk of blood-borne infections, the subjects are likely to develop such infections during their internship period.

  13. Six decades of the chair of Internal Medicine at the Medical Faculty in Skopje.

    Science.gov (United States)

    Chakalaroski, K

    2013-01-01

    , rheumathology, endocriniology and toxicology); 4) Publishing activities in the national journals (Macedonian Medical Review, Journal of Macedonian Medical Science, Acta Physiologica, Medicus); 5) Decision-making: the Head of CIM regularly collaborates with the subspecialities of internal medicine by means of a coordinated body for all questions related to educational purposes in clinical investigation and internal medicine.

  14. Reflections: Evolution of PBL in the International Medical University

    Directory of Open Access Journals (Sweden)

    Hla-Yee-Yee

    2012-07-01

    Full Text Available This paper traces the evolution of PBL inthe International Medical University over a periodof twenty years; since its inception in 1992 till 2012.It is a record of the reasons for the evolution, the peopleinvolved and the strategies adopted. The PBL in IMUhas metamorphosed over the years from a paper-basedcomplete case history into its present form of staggeredrelease of information, paper-based or otherwise (videos,web-based, newspaper cuttings, debates. Strategies toimprove student and facilitator buy-in, strengtheningof facilitator training, adoption of PBL templates,innovations to improve student participation arediscussed.

  15. 42 CFR 412.44 - Medical review requirements: Admissions and quality review.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Medical review requirements: Admissions and quality... Capital-Related Costs § 412.44 Medical review requirements: Admissions and quality review. Beginning on... completeness, adequacy, and quality of the services furnished in the hospital. (e) Other medical or other...

  16. Manual for Internal Audits and Management Review Energy Care; Handreiking Interne Audits en Management Review Energiezorg

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2008-09-15

    This document offers practical support for two important aspects of energy care: establishing an internal audit and a management review. Both are logical next steps following planned and implemented energy saving measures. They will help test if measures have (had) the desired effect or if they need to be adjusted and to establish if any follow-up measures are needed. (mk) [Dutch] Deze handreiking biedt praktische ondersteuning bij twee belangrijke onderdelen van Energiezorg: het opzetten van een interne audit en een management review. Beide onderdelen zijn een logisch vervolg op geplande en al genomen energiebesparende maatregelen. Het is een toetsing of de maatregelen effect hebben (gehad), of ze bijgesteld moeten worden en of er eventuele vervolgmaatregelen nodig zijn.

  17. Medical students-as-teachers: a systematic review of peer-assisted teaching during medical school

    Directory of Open Access Journals (Sweden)

    Yu TC

    2011-06-01

    Full Text Available Tzu-Chieh Yu¹, Nichola C Wilson², Primal P Singh¹, Daniel P Lemanu¹, Susan J Hawken³, Andrew G Hill¹¹South Auckland Clinical School, University of Auckland, Auckland, New Zealand; ²Department of Surgery, University of Auckland, Auckland, New Zealand; ³Department of Psychological Medicine, University of Auckland, Auckland, New ZealandIntroduction: International interest in peer-teaching and peer-assisted learning (PAL during undergraduate medical programs has grown in recent years, reflected both in literature and in practice. There, remains however, a distinct lack of objective clarity and consensus on the true effectiveness of peer-teaching and its short- and long-term impacts on learning outcomes and clinical practice.Objective: To summarize and critically appraise evidence presented on peer-teaching effectiveness and its impact on objective learning outcomes of medical students.Method: A literature search was conducted in four electronic databases. Titles and abstracts were screened and selection was based on strict eligibility criteria after examining full-texts. Two reviewers used a standard review and analysis framework to independently extract data from each study. Discrepancies in opinions were resolved by discussion in consultation with other reviewers. Adapted models of “Kirkpatrick’s Levels of Learning” were used to grade the impact size of study outcomes.Results: From 127 potential titles, 41 were obtained as full-texts, and 19 selected after close examination and group deliberation. Fifteen studies focused on student-learner outcomes and four on student-teacher learning outcomes. Ten studies utilized randomized allocation and the majority of study participants were self-selected volunteers. Written examinations and observed clinical evaluations were common study outcome assessments. Eleven studies provided student-teachers with formal teacher training. Overall, results suggest that peer-teaching, in highly selective

  18. What do we know about Canadian involvement in medical tourism? A scoping review

    Science.gov (United States)

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

    2011-01-01

    Background Medical tourism, the intentional pursuit of elective medical treatments in foreign countries, is a rapidly growing global industry. Canadians are among those crossing international borders to seek out privately purchased medical care. Given Canada’s universally accessible, single-payer domestic health care system, important implications emerge from Canadians’ private engagement in medical tourism. Methods A scoping review was conducted of the popular, academic, and business literature to synthesize what is currently known about Canadian involvement in medical tourism. Of the 348 sources that were reviewed either partly or in full, 113 were ultimately included in the review. Results The review demonstrates that there is an extreme paucity of academic, empirical literature examining medical tourism in general or the Canadian context more specifically. Canadians are engaged with the medical tourism industry not just as patients but also as investors and business people. There have been a limited number of instances of Canadians having their medical tourism expenses reimbursed by the public medicare system. Wait times are by far the most heavily cited driver of Canadians’ involvement in medical tourism. However, despite its treatment as fact, there is no empirical research to support or contradict this point. Discussion Although medical tourism is often discussed in the Canadian context, a paucity of data on this practice complicates our understanding of its scope and impact. PMID:22046228

  19. What do we know about Canadian involvement in medical tourism?: a scoping review.

    Science.gov (United States)

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

    2011-01-01

    Medical tourism, the intentional pursuit of elective medical treatments in foreign countries, is a rapidly growing global industry. Canadians are among those crossing international borders to seek out privately purchased medical care. Given Canada's universally accessible, single-payer domestic health care system, important implications emerge from Canadians' private engagement in medical tourism. A scoping review was conducted of the popular, academic, and business literature to synthesize what is currently known about Canadian involvement in medical tourism. Of the 348 sources that were reviewed either partly or in full, 113 were ultimately included in the review. The review demonstrates that there is an extreme paucity of academic, empirical literature examining medical tourism in general or the Canadian context more specifically. Canadians are engaged with the medical tourism industry not just as patients but also as investors and business people. There have been a limited number of instances of Canadians having their medical tourism expenses reimbursed by the public medicare system. Wait times are by far the most heavily cited driver of Canadians' involvement in medical tourism. However, despite its treatment as fact, there is no empirical research to support or contradict this point. Although medical tourism is often discussed in the Canadian context, a paucity of data on this practice complicates our understanding of its scope and impact.

  20. External Peer Review Report on the Missile Defense Agency Office of Internal Review

    Science.gov (United States)

    2015-05-14

    No. DODIG-2015-123 M A Y 1 4 , 2 0 1 5 External Peer Review Report on the Missile Defense Agency Office of Internal Review Report Documentation...3. DATES COVERED 00-00-2015 to 00-00-2015 4. TITLE AND SUBTITLE External Peer Review Report on the Missile Defense Agency Office of Internal... REVIEW SUBJECT: External Peer Review Report on the Missile Defense Agency Office of Internal Review (Report No. DODIG-2015-123) Attached is the

  1. Hacking medical devices a review - biomed 2013.

    Science.gov (United States)

    Frenger, Paul

    2013-01-01

    Programmable, implantable and external biomedical devices (such as pacemakers, defibrillators, insulin pumps, pain management pumps, vagus nerve stimulators and others) may be vulnerable to unauthorized access, commonly referred to as “hacking”. This intrusion may lead to compromise of confidential patient data or loss of control of the device itself, which may be deadly. Risks to health from unauthorized access is in addition to hazards from faulty (“buggy”) software or circuitry. Historically, this aspect of medical device design has been underemphasized by both manufacturers and regulatory bodies until recently. However, an insulin pump was employed as a murder weapon in 2001 and successful hacking of an implantable defibrillator was demonstrated in 2008. To remedy these problems, professional groups have announced a variety of design standards and the governmental agencies of several countries have enacted device regulations. In turn, manufacturers have developed new software products and hardware circuits to assist biomedical engineering firms to improve their commercial offerings. In this paper the author discusses these issues, reviewing known problems and zero-day threats, with potential solutions. He outlines his approach to secure software and hardware challenges using the Forth language. A plausible scenario is described in which hacking of an implantable defibrillator by terrorists results in a severe national security threat to the United States.

  2. Factors associated with dropping out of medical school: a literature review

    DEFF Research Database (Denmark)

    O'Neill, Lotte Dyhrberg

    2010-01-01

    of Aarhus; Jan Hartvigsen, PhD, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark.   Title: Factors associated with dropping out of medical school: a literature review.      Background: Considerable resources are spent on medical school selection and the competition...... for places is usually fierce. Dropping out must therefore be the worst possible performance outcome in medical education. What do we know about factors associated with dropping out of medical school? Summary of work: A systematic critical literature review of the international peer-reviewed research......  Presenter: Lotte D. O'Neill, MMedEd, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark. Co-authors: Birgitta Wallstedt, MSc, Unit for Educational Development, University of Southern Denmark; Berit Eika, MD, MHPE, MI, PhD, Unit for Medical Education, University...

  3. International medical graduates' perceptions of entering the profession in Norway.

    Science.gov (United States)

    Skjeggestad, Erik; Sandal, Gro Mjeldheim; Gulbrandsen, Pål

    2015-06-30

    There is little knowledge available about how it feels for an international medical graduate arriving in Norway. We have investigated how the initial period as an employee of the Norwegian health services is perceived. We conducted semi-structured interviews with 16 international medical graduates who had foreign training and citizenship. They had worked as doctors in Norway for less than two years. Transcriptions of the interviews were analysed using the Systematic Text Condensation method. Their background for working in Norway varied. Some had an affiliation to the country and a social network, which appeared to be a support during the initial period. Many perceived the authorisation process as bureaucratic and as throwing suspicion on them. The doctors felt that they could cope with most of their work assignments, but reported having faced challenges in terms of language, a lack of insight into systems and uncertainty regarding what was expected of the doctor's role in a Norwegian context. There was also uncertainty associated with a perceived absence of collegial support. Because of the availability of jobs, some had adjusted their career plans towards psychiatry, geriatrics or general practice. It appears that preparatory measures such as training courses, tests and the authorisation process fail to provide the practice-related experience and local knowledge that many doctors feel that they need in their new job situation. Measures such as language training and introduction to systems would be likely to improve their general well-being as well as integration.

  4. Updating systematic reviews: an international survey.

    Directory of Open Access Journals (Sweden)

    Chantelle Garritty

    Full Text Available BACKGROUND: Systematic reviews (SRs should be up to date to maintain their importance in informing healthcare policy and practice. However, little guidance is available about when and how to update SRs. Moreover, the updating policies and practices of organizations that commission or produce SRs are unclear. METHODOLOGY/PRINCIPAL FINDINGS: The objective was to describe the updating practices and policies of agencies that sponsor or conduct SRs. An Internet-based survey was administered to a purposive non-random sample of 195 healthcare organizations within the international SR community. Survey results were analyzed using descriptive statistics. The completed response rate was 58% (n = 114 from across 26 countries with 70% (75/107 of participants identified as producers of SRs. Among responders, 79% (84/107 characterized the importance of updating as high or very-high and 57% (60/106 of organizations reported to have a formal policy for updating. However, only 29% (35/106 of organizations made reference to a written policy document. Several groups (62/105; 59% reported updating practices as irregular, and over half (53/103 of organizational respondents estimated that more than 50% of their respective SRs were likely out of date. Authors of the original SR (42/106; 40% were most often deemed responsible for ensuring SRs were current. Barriers to updating included resource constraints, reviewer motivation, lack of academic credit, and limited publishing formats. Most respondents (70/100; 70% indicated that they supported centralization of updating efforts across institutions or agencies. Furthermore, 84% (83/99 of respondents indicated they favoured the development of a central registry of SRs, analogous to efforts within the clinical trials community. CONCLUSIONS/SIGNIFICANCE: Most organizations that sponsor and/or carry out SRs consider updating important. Despite this recognition, updating practices are not regular, and many organizations lack

  5. The future of medical diagnostics: review paper

    LENUS (Irish Health Repository)

    Jerjes, Waseem K

    2011-08-23

    Abstract While histopathology of excised tissue remains the gold standard for diagnosis, several new, non-invasive diagnostic techniques are being developed. They rely on physical and biochemical changes that precede and mirror malignant change within tissue. The basic principle involves simple optical techniques of tissue interrogation. Their accuracy, expressed as sensitivity and specificity, are reported in a number of studies suggests that they have a potential for cost effective, real-time, in situ diagnosis. We review the Third Scientific Meeting of the Head and Neck Optical Diagnostics Society held in Congress Innsbruck, Innsbruck, Austria on the 11th May 2011. For the first time the HNODS Annual Scientific Meeting was held in association with the International Photodynamic Association (IPA) and the European Platform for Photodynamic Medicine (EPPM). The aim was to enhance the interdisciplinary aspects of optical diagnostics and other photodynamic applications. The meeting included 2 sections: oral communication sessions running in parallel to the IPA programme and poster presentation sessions combined with the IPA and EPPM posters sessions.

  6. Satisfaction amid professional challenges: International medical graduates in rural Tasmania

    Directory of Open Access Journals (Sweden)

    Daniel R Terry

    2015-01-01

    Full Text Available Background At the time of recruitment, migration, and placement, international medical graduates (IMGs encounter professional challenges. These challenges may include a loss of status and professional identity, professional isolation in rural practice, restrictions on medical practice, and social isolation. Understanding the nature of these challenges may facilitate the recruitment, placement, and success of international medical graduates within rural Tasmania. Aims The aim of this study was to investigate the experiences, challenges,and barriers that IMGs encounter as they work and live in rural Tasmania. Methods The study used a mixed-methods design where data were collected using a questionnaire and semi-structured interviews across the south, north, and northwest of Tasmania. IMGs were recruited through purposive snowball and convenience sampling. Results A total of 105 questionnaires were returned (response rate 30.0per cent and 23semi-structured interviews were conducted with IMGs across Tasmania. Questionnaire participants indicated that the majority of IMGs are satisfied in their current employment; however, interview participants indicated there were a number of barriers to practising medicine in Tasmania as well as factors that would influence ongoing employment in the state. Despite these challenges, professional support was recognised as a key contributor to professional satisfaction, particularly among IMGs who had just arrived. Conclusion The study contributes to the current knowledge and understanding of IMGs who live and work in rural areas. The study shows that there are high levels of satisfaction among IMGs with their current position; however, the research also provides insight into the complexities and factors that impact IMGs as they work and live within rural areas such as Tasmania. This study offers an understanding for policy to improve greater retention of IMGs across rural areas.

  7. Patient participation in medication reviews is desirable but not evidence-based: a systematic literature review.

    NARCIS (Netherlands)

    Willeboordse, F.; Hugtenburg, J.G.; Schellevis, F.G.; Elders, P.J.M.

    2014-01-01

    Aim: The aim of this systematic literature review is to investigate which types of patient participation in medication reviews have been practiced and what is known about the effects of patient participation within the medication review process. Methods: A systematic literature review was performed

  8. Patient participation in medication reviews is desirable but not evidence-based: a systematic literature review.

    NARCIS (Netherlands)

    Willeboordse, F.; Hugtenburg, J.G.; Schellevis, F.G.; Elders, P.J.M.

    2014-01-01

    Aim: The aim of this systematic literature review is to investigate which types of patient participation in medication reviews have been practiced and what is known about the effects of patient participation within the medication review process. Methods: A systematic literature review was performed

  9. Causes of academic failure of medical and medical sciences students in Iran: a systematic review.

    Science.gov (United States)

    Azari, Sheida; Baradaran, Hamid Reza; Fata, Ladan

    2015-01-01

    Academic failure of medical and medical sciences students is one of the major problems of higher education centers in many countries. This study aims to collect and compare relevant researches in this field in Iran. The appropriate keywords were searched in the national and international databases, and the findings were categorized into related and non-related articles accordingly. Only 22 articles were included in this systematic review. In terms of content analysis, gender, living in a dorm, employment, marital status, age, special rights in the entrance exams, the time lag between diploma and university, diploma average, learning style, being nonnative students, being a transferred student, psychological problems, occupation of the mother, salary level, diploma type, field of study, self-esteem, exam anxiety and interest on the field of study were considered as the influential factors for academic failure of the students. This systematic review shows that there is no definite academic failure criterion. It is also suggested Iranian researchers should pay more attention on the documentation of the higher educational strategies that have been implemented to prevent avoidable academic failure and contain physiological academic failure.

  10. Critical Considerations on the Internal Medicine Syllabus implemented since 2010 in Undergraduate Medical Degrees

    Directory of Open Access Journals (Sweden)

    Víctor René Navarro Machado

    2013-12-01

    Full Text Available For the medical university to fulfill its social role, changing conditions of society, medical education and medical practice together with periodic review of their training plans should be considered. This article aims at analyzing the current syllabus (2010 for teaching Internal Medicine in undergraduate medical degrees and justifying the proposed changes. In the context of the medical university of Cienfuegos, the eight aspects that constitute the syllabus were analyzed by document review and key informant interviews. Changes in the objectives, thematic plan, and contents for each topic were proposed; methodological orientations, evaluation system and literature were suggested. A central module for elective time was proposed as well as a new evaluation card for practice activities. Proposed changes respond to transformations in the clinical practice, the development of the educational process and social needs, not only those of Cuba. Academic activities will be properly developed provided that changes contribute to the quality of the educational process and forecasts consider present and future changes in the health- disease process.

  11. Factors Influencing Successful Prescribing by Intern Doctors: A Qualitative Systematic Review

    Directory of Open Access Journals (Sweden)

    Christina R. Hansen

    2016-08-01

    Full Text Available As the majority of prescribing in hospital is undertaken by intern doctors, the aims of this systematic review were to compile the evidence of the qualitative literature on the views and experiences of intern doctors and to examine the role of the pharmacist in assisting in prescribing by interns. A systematic review of the qualitative literature was done according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA Statement. The findings were synthesized using thematic analysis. Seven publications were included. Factors influencing prescribing behaviour were related to the environment; collaboration in medical teams; hierarchical structures; and patient and individual factors. This review confirmed that interns’ prescribing behaviour is influenced by multiple factors, and further highlighted the need for an educational intervention that supports the intern completing the prescribing task in a complex environment, and not just addresses the presumed knowledge gap(s.

  12. Assessing empathy development in medical education: a systematic review.

    Science.gov (United States)

    Sulzer, Sandra H; Feinstein, Noah W; Wendland, Claire L

    2016-03-01

    Empathy in doctor-patient relationships is a familiar topic for medical scholars and a crucial goal for medical educators. Nonetheless, there are persistent disagreements in the research literature concerning how best to evaluate empathy among physicians, and whether empathy declines or increases across medical education. Some researchers have argued that the instruments used to study 'empathy' may not measure anything meaningful to clinical practice or patient satisfaction. We performed a systematic review to learn how empathy is conceptualised in medical education research. We examined how researchers define the central construct of empathy and what they choose to measure, and investigated how well definitions and operationalisations match. Among the 109 studies that met our search criteria, 20% failed to define the central construct of empathy at all and only 13% used an operationalisation that was well matched to the definition provided. The majority of studies were characterised by internal inconsistencies and vagueness in both the conceptualisation and operationalisation of empathy, constraining the validity and usefulness of the research. The methods most commonly used to measure empathy relied heavily on self-report and cognition divorced from action, and may therefore have limited power to predict the presence or absence of empathy in clinical settings. Finally, the large majority of studies treated empathy itself as a 'black box', using global construct measurements that are unable to shed light on the underlying processes that produce an empathic response. We suggest that future research should follow the lead of basic scientific research that conceptualises empathy as relational - an engagement between a subject and an object - rather than as a personal quality that may be modified wholesale through appropriate training. © 2016 John Wiley & Sons Ltd.

  13. Medication reconciliation interventions in ambulatory care: A scoping review.

    Science.gov (United States)

    McCarthy, Lisa; Su, Xinru Wendy; Crown, Natalie; Turple, Jennifer; Brown, Thomas E R; Walsh, Kate; John, Jessica; Rochon, Paula

    2016-11-15

    The published literature on medication reconciliation (MR) interventions, outcomes, and facilitators in ambulatory care settings is reviewed. A scoping review was conducted to characterize ambulatory care-based MR research in terms of study design, elements of interventions, and outcomes examined. English-language articles on comparative studies of MR programs targeting adults in ambulatory care settings were identified using data sources including MEDLINE, PreMEDLINE, EMBASE, and International Pharmaceutical Abstracts. For each study, steps undertaken in the MR process were extracted. The Cochrane Effective Practice and Organisation of Care (EPOC) taxonomy was used to classify types of interventions; taxonomies for reported outcomes and factors facilitating implementation of MR initiatives were developed by the authors. From among 2062 publications screened, 15 were included in the review. In 13 studies, multiple data sources were used to compile a "best possible medication history" (BPMH); however, the BPMH was shared with external healthcare providers in only 4 studies and with patients in only 5 studies. Most reported MR interventions were classified into two EPOC domains: professional (predominantly educational outreach visits and patient reminders) and organizational (predominantly provider-oriented interventions). Process outcomes were reported in 12 studies, with correct performance of MR being the most commonly evaluated process outcome, and 9 studies identified factors that facilitated MR implementation. Few studies have examined clinical outcomes of MR in ambulatory care settings, with the majority of pertinent reports focusing instead on process outcomes. Facilitators of successful MR interventions have been identified at the patient, staff, and clinic setting levels. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  14. International Conference on Medical and Biological Engineering 2017

    CERN Document Server

    2017-01-01

    This volume presents the proceedings of the International Conference on Medical and Biological Engineering held from 16 to 18 March 2017 in Sarajevo, Bosnia and Herzegovina. Focusing on the theme of ‘Pursuing innovation. Shaping the future’, it highlights the latest advancements in Biomedical Engineering and also presents the latest findings, innovative solutions and emerging challenges in this field. Topics include: - Biomedical Signal Processing - Biomedical Imaging and Image Processing - Biosensors and Bioinstrumentation - Bio-Micro/Nano Technologies - Biomaterials - Biomechanics, Robotics and Minimally Invasive Surgery - Cardiovascular, Respiratory and Endocrine Systems Engineering - Neural and Rehabilitation Engineering - Molecular, Cellular and Tissue Engineering - Bioinformatics and Computational Biology - Clinical Engineering and Health Technology Assessment - Health Informatics, E-Health and Telemedicine - Biomedical Engineering Education - Pharmaceutical Engineering.

  15. The effect of early in‐hospital medication review on health outcomes: a systematic review

    National Research Council Canada - National Science Library

    Hohl, Corinne M; Wickham, Maeve E; Sobolev, Boris; Perry, Jeff J; Sivilotti, Marco L. A; Garrison, Scott; Lang, Eddy; Brasher, Penny; Doyle‐Waters, Mary M; Brar, Baljeet; Rowe, Brian H; Lexchin, Joel; Holland, Richard

    2015-01-01

    ... while minimizing their potential for harm is a public health priority . Medication review, a structured and critical examination of an individual patient's medications by a qualified healthcare provider aims to accomplish exactly these goals . Medication review is performed by a qualified healthcare provider, usually a pharmacist, and includes e...

  16. 75 Years of the International Labour Review: A Retrospective.

    Science.gov (United States)

    Thomas, Albert; And Others

    1996-01-01

    Contains 18 articles published in International Labour Review from 1921-1975 that discuss the International Labour Organisation, international labor movement and law, economics and the labor market, family security, full employment, population growth, industrial welfare, trade policy and employment growth, and income expectations and rural-urban…

  17. Review of international standards for dosemeters.

    Science.gov (United States)

    Behrens, R; Ambrosi, P

    2008-01-01

    International standards for radiation protection dosemeters are published by the International Electrotechnical Commission and the International Organization for Standardization. Several standards exist side by side, although they treat the same measuring task, and specify different requirements, so that dosemeters of different quality result. In this paper, the quality of dosemeters is compared by calculating the uncertainty of dose measurements for dosemeters, which just basely fulfil the respective standard. The results are related to general yardsticks on uncertainty laid down by international organisations. Furthermore, technical differences are standards and addressed and a method to make them conform is presented.

  18. PRIME Partnerships in International Medical Education - Restoring a Christian ethos to medical education worldwide

    Directory of Open Access Journals (Sweden)

    Huw Morgan

    2016-01-01

    Full Text Available Modern medicine has developed from an essentially Christian world-view and in Western countries has been greatly influenced by the Christian tradition of hospitality and caring for the sick. However, during the 20th century, medical education became increasingly secularised and focussed on the bio-physical model of disease, losing sight of a holistic view of the person that includes awareness of a spiritual dimension. Former Communist countries in particular have little recent tradition of caring, and medical education there tends to be characterised by poor role-models and out-dated didactic teaching. In the resource poor countries of the global South there are many Christian hospitals and clinics but often a lack of experienced medical teachers. Partnerships in International Medical Education (PRIME’s vision and mission is to support health-care education worldwide to restore a Christian-based holistic approach to patients, and act as a resource where needed, tailoring medical educational programmes to meet the needs of overseas partners (or colleagues in the NHS. Using interactive leaner-centred and problem-based educational methods, PRIME tutors (all experienced and qualified Christian medical educators seek to model patient-centred care by using learner-centred teaching, valuing each person as a bearer of the image of God. Most of PRIME’s teaching involves the doctor-patient relationship, communication skills, compassion, ethics and professionalism, often based around particular clinical scenarios to suit the learners. Small teams of voluntary tutors visiting partner institutions and colleagues for a few weeks a year can have a surprisingly large impact, as those grasping the vision become advocates for positive change in their own situations. Training of trainers and teachers in learner-centred, androgogic methodology to build capacity and sustainability is also a major part of the work.

  19. Bedside teaching in medical education: a literature review.

    Science.gov (United States)

    Peters, Max; Ten Cate, Olle

    2014-04-01

    Bedside teaching is seen as one of the most important modalities in teaching a variety of skills important for the medical profession, but its use is declining. A literature review was conducted to reveal its strengths, the causes of its decline and future perspectives, the evidence with regard to learning clinical skills and patient/student/teacher satisfaction. PubMed, Embase and the Cochrane library were systematically searched with regard to terms related to bedside teaching. Articles regarding the above-mentioned subjects were included. Bedside teaching has shown to improve certain clinical diagnostic skills in medical students and residents. Patients, students/residents and teachers all seem to favour bedside teaching, for varying reasons. Despite this, the practice of bedside teaching is declining. Reasons to explain this decline include the increased patient turnover in hospitals, the assumed violation of patients' privacy and an increased reliance on technology in the diagnostic process. Solutions vary from increasingly using residents and interns as bedside teachers to actively educating staff members regarding the importance of bedside teaching and providing them with practical essentials. Impediments to bedside teaching need to be overcome if this teaching modality is to remain a valuable educational method for durable clinical skills.

  20. Medical journal peer review: process and bias.

    Science.gov (United States)

    Manchikanti, Laxmaiah; Kaye, Alan D; Boswell, Mark V; Hirsch, Joshua A

    2015-01-01

    Scientific peer review is pivotal in health care research in that it facilitates the evaluation of findings for competence, significance, and originality by qualified experts. While the origins of peer review can be traced to the societies of the eighteenth century, it became an institutionalized part of the scholarly process in the latter half of the twentieth century. This was a response to the growth of research and greater subject specialization. With the current increase in the number of specialty journals, the peer review process continues to evolve to meet the needs of patients, clinicians, and policy makers. The peer review process itself faces challenges. Unblinded peer review might suffer from positive or negative bias towards certain authors, specialties, and institutions. Peer review can also suffer when editors and/or reviewers might be unable to understand the contents of the submitted manuscript. This can result in an inability to detect major flaws, or revelations of major flaws after acceptance of publication by the editors. Other concerns include potentially long delays in publication and challenges uncovering plagiarism, duplication, corruption and scientific misconduct. Conversely, a multitude of these challenges have led to claims of scientific misconduct and an erosion of faith. These challenges have invited criticism of the peer review process itself. However, despite its imperfections, the peer review process enjoys widespread support in the scientific community. Peer review bias is one of the major focuses of today's scientific assessment of the literature. Various types of peer review bias include content-based bias, confirmation bias, bias due to conservatism, bias against interdisciplinary research, publication bias, and the bias of conflicts of interest. Consequently, peer review would benefit from various changes and improvements with appropriate training of reviewers to provide quality reviews to maintain the quality and integrity of

  1. The anatomy of medical research: US and international comparisons.

    Science.gov (United States)

    Moses, Hamilton; Matheson, David H M; Cairns-Smith, Sarah; George, Benjamin P; Palisch, Chase; Dorsey, E Ray

    2015-01-13

    Medical research is a prerequisite of clinical advances, while health service research supports improved delivery, access, and cost. Few previous analyses have compared the United States with other developed countries. To quantify total public and private investment and personnel (economic inputs) and to evaluate resulting patents, publications, drug and device approvals, and value created (economic outputs). Publicly available data from 1994 to 2012 were compiled showing trends in US and international research funding, productivity, and disease burden by source and industry type. Patents and publications (1981-2011) were evaluated using citation rates and impact factors. (1) Reduced science investment: Total US funding increased 6% per year (1994-2004), but rate of growth declined to 0.8% per year (2004-2012), reaching $117 billion (4.5%) of total health care expenditures. Private sources increased from 46% (1994) to 58% (2012). Industry reduced early-stage research, favoring medical devices, bioengineered drugs, and late-stage clinical trials, particularly for cancer and rare diseases. National Insitutes of Health allocations correlate imperfectly with disease burden, with cancer and HIV/AIDS receiving disproportionate support. (2) Underfunding of service innovation: Health services research receives $5.0 billion (0.3% of total health care expenditures) or only 1/20th of science funding. Private insurers ranked last (0.04% of revenue) and health systems 19th (0.1% of revenue) among 22 industries in their investment in innovation. An increment of $8 billion to $15 billion yearly would occur if service firms were to reach median research and development funding. (3) Globalization: US government research funding declined from 57% (2004) to 50% (2012) of the global total, as did that of US companies (50% to 41%), with the total US (public plus private) share of global research funding declining from 57% to 44%. Asia, particularly China, tripled investment from $2

  2. Using an International Medical Advisory Board to guide clinical governance in a corporate refractive surgery model.

    Science.gov (United States)

    Vukich, John A

    2009-07-01

    To describe the role played by the International Medical Advisory Board (IMAB) in clinical and corporate governance at Optical Express, a corporate provider of refractive surgery. A review of goals, objectives, and actions of the IMAB. The IMAB has contributed to study design, data analysis, and selection of instruments and procedures. Through interactions with Optical Express corporate and clinical staff, the IMAB has supported management's effort to craft a corporate culture focused on continuous improvement in the safety and visual outcomes of refractive surgery. The IMAB has fashioned significant changes in corporate policies and procedures and has had an impact on corporate culture at Optical Express.

  3. Relationship between admissions committee review and student performance in medical school and internship.

    Science.gov (United States)

    Gilliland, William R; Dong, Ting; Artino, Anthony R; Waechter, Donna M; Cruess, David F; DeZee, Kent J; McManigle, John E; Durning, Steven J

    2012-09-01

    To investigate the association between tertiary reviewer (admissions committee member) comments and medical students' performance during medical school and into internship. We collected data from seven year-groups (1993-1999) and coded tertiary reviewer comments into 14 themes. We then conducted an exploratory factor analysis to reduce the dimensions of the themes (excluding the Overall impression theme). Subsequently, we performed Pearson correlation analyses and multiple linear regression analysis to examine the relationship between the factors and seven outcome measures: medical school preclinical grade point average (GPA), medical school clinical GPA, cumulative medical school GPA, U.S. Medical Licensing Examination Step 1 and 2 scores, and scores on a program director's evaluation measuring intern professionalism and expertise. We extracted seven factors from the 13 themes and found small-to-moderate, significant correlations between the factors, the Overall impression theme, and the outcome measures. In particular, positive comments on Test and Maturity were associated with higher U.S. Medical Licensing Examination Step 1 and 2 scores. Negative comments on Interview and Recommendations were associated with lower ratings of professionalism during internship. Comments on Overall impression were significantly associated with all the outcome measures. Tertiary reviewer comments were weakly associated with performance in medical school and internship. Compared with positive comments, negative comments had stronger associations with medical school and internship performance measures.

  4. Predictors of dietary supplement usage among medical interns of Tehran university of medical sciences.

    Science.gov (United States)

    Sotoudeh, Gity; Kabiri, Sanaz; Yeganeh, Haleh Sadrzadeh; Koohdani, Fariba; Khajehnasiri, Farahnaz; Khosravi, Shahla

    2015-03-01

    This study aimed to determine the prevalence of dietary supplement-use and its relationship with demographics and lifestyle of medical interns. The study sample comprised 356 interns aged 23 to 25 years. Participants completed a questionnaire on dietary supplement-use during the month preceding the study, information on demographic characteristics and lifestyle was also obtained. Univariable and multivariable logistic regression were employed to assess the correlates of dietary supplement-use. The prevalence of dietary supplement-use was about 33% (males 20.4% and females 43.2%, pnutritional status (39.3%) and reducing hair loss (23.4%). The decision to use dietary supplement was mostly driven by the interns themselves (56% in males, 61% in females). In the univariable analysis, men who exercised once or twice a week were less likely to use supplements compared to those who reported doing exercise more than twice weekly (OR=0.35, 95% CI 0.12-0.98). Females who reported their health status to be 'excellent' were more likely to use supplements compared to those who described their health status as 'moderate/poor/very poor' (OR=2.53, 95% CI 1.15-5.56) as were women who mentioned their breakfast consumption status as 'always' (OR=2.69, 95% CI 1.47-4.92). In the multivariable analysis, only breakfast consumption was significantly related with dietary supplement-use in females (OR=2.20, 95% CI 1.11-4.38). In conclusion, dietary supplement-use among medical interns, especially among females, was relatively very common. Dietary supplement-use was related to a healthier lifestyle.

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

    Science.gov (United States)

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

    2017-02-01

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

  6. International marine environmental governance: A review.

    Science.gov (United States)

    Grip, Kjell

    2017-05-01

    Impressive numbers of global and regional governmental and non-governmental organizations are working in the field of the marine environment and its resources. Many of these organizations operate within international legal frameworks ranging from comprehensive global conventions, such as the United Nations Convention on the Law of the Sea to regional agreements aiming at protection and development of regional seas. Characteristic for the management of these seas, both at the national and international level, is that sectoral approaches predominate. Over time, several initiatives have been taken to improve cooperation, coordination and integration to achieve greater coherence of policies and strategies between different organizations dealing with marine and maritime management, within and outside the United Nation system. However, the success has been limited. The weaknesses of international organizations depend fundamentally on problems at the national level. The international organizations are no stronger than their Contracting Parties allow them to be.

  7. A systematic review of publications studies on medical tourism

    Science.gov (United States)

    Masoud, Ferdosi; Alireza, Jabbari; Mahmoud, Keyvanara; Zahra, Agharahimi

    2013-01-01

    Introduction: Medical tourism for any study area is complex. Materials and Methods: Using full articles from other databases, Institute for Scientific Information (ISI), Science Direct, Emerald, Oxford, Magiran, and Scientific Information Database (SID), to examine systematically published articles about medical tourism in the interval 2000-2011 paid. Articles were obtained using descriptive statistics and content analysis categories were analyzed. Results: Among the 28 articles reviewed, 11 cases were a kind of research articles, three cases were case studies in Mexico, India, Hungary, Germany, and Iran, and 14 were case studies, review documents and data were passed. The main topics of study included the definition of medical tourism, medical tourists’ motivation and development of medical tourism, ethical issues in medical tourism, and impact on health and medical tourism marketing. Conclusion: The findings indicate the definition of medical tourism in various articles, and medical tourists are motivated. However, most studies indicate the benefits of medical tourism in developing countries and more developed countries reflect the consequences of medical tourism. PMID:24251287

  8. Solidarity by demand? Exit and voice in international medical travel - The case of Indonesia

    NARCIS (Netherlands)

    Ormond, M.E.

    2015-01-01

    Globally, more patients are intentionally travelling abroad as consumers for medical care. However, while scholars have begun to examine international medical travel's (IMT) impacts on the people and places that receive medical travellers, study of its impacts on medical travellers' home contexts ha

  9. Solidarity by demand? Exit and voice in international medical travel - The case of Indonesia

    NARCIS (Netherlands)

    Ormond, M.E.

    2015-01-01

    Globally, more patients are intentionally travelling abroad as consumers for medical care. However, while scholars have begun to examine international medical travel's (IMT) impacts on the people and places that receive medical travellers, study of its impacts on medical travellers' home contexts ha

  10. Solidarity by demand? Exit and voice in international medical travel - The case of Indonesia

    NARCIS (Netherlands)

    Ormond, M.E.

    2015-01-01

    Globally, more patients are intentionally travelling abroad as consumers for medical care. However, while scholars have begun to examine international medical travel's (IMT) impacts on the people and places that receive medical travellers, study of its impacts on medical travellers' home contexts

  11. En route: Transport and embodiment in international medical travel journeys between Indonesia and Malaysia

    NARCIS (Netherlands)

    Ormond, M.E.

    2015-01-01

    International medical travel is increasingly big business. Using Indonesian patient-consumers’transport experiences in the pursuit of private medical care in Malaysia, this paper explores howtransport operators and infrastructure are responding and adjusting to the embodied specificities of the

  12. An index to medical book reviews: a computer experiment.

    Science.gov (United States)

    Atwood, R

    1967-01-01

    The experimental production of an index to book reviews of medical publications is described. Details of compilation and preparation of data for processing by an IBM 1440 computer are outlined. Results of a survey testing the response to the index in its present form by medical libraries are presented.

  13. Review on the administration and effectiveness of team-based learning in medical education.

    Science.gov (United States)

    Hur, Yera; Cho, A Ra; Kim, Sun

    2013-12-01

    Team-based learning (TBL) is an active learning approach. In recent years, medical educators have been increasingly using TBL in their classes. We reviewed the concepts of TBL and discuss examples of international cases. Two types of TBL are administered: classic TBL and adapted TBL. Combining TBL and problem-based learning (PBL) might be a useful strategy for medical schools. TBL is an attainable and efficient educational approach in preparing large classes with regard to PBL. TBL improves student performance, team communication skills, leadership skills, problem solving skills, and cognitive conceptual structures and increases student engagement and satisfaction. This study suggests recommendations for administering TBL effectively in medical education.

  14. Research trends in studies of medical students’ characteristics: a scoping review

    Science.gov (United States)

    2017-01-01

    The purpose of this study is to investigate domestic and international research trends in studies of medical students’ characteristics by using the scoping review methods. This study adopted the scoping review to assess papers on the characteristics of medical students. The procedure of research was carried out according to the five steps of the scoping review. The full texts of 100 papers are obtained and are read closely, after which suitable 88 papers are extracted by us for this research. The review is mapped by the year of the study, source, location, author, research design, research subject, objective, and key results. The frequency is analyzed by using Microsoft Excel and SPSS. We found 70 papers (79.5%) on a single medical school, 15 (17.0%) on multiple medical schools, and three (3.4%) on mixed schools, including medical and nonmedical schools. Sixty-nine (79.5%) were cross-sectional studies and 18 (20.5%) were longitudinal studies. Eighty-two papers (93.2%) adopted questionnaire surveys. We summarized research trends of studies on medical students in Korea and overseas by topic, and mapped them into physical health, mental health, psychological characteristics, cognitive characteristics, social characteristics, and career. This study provides insights into the future directions of research for the characteristics of medical students. PMID:28870017

  15. Research trends in studies of medical students' characteristics: a scoping review.

    Science.gov (United States)

    Jung, Sung Soo; Park, Kwi Hwa; Roh, HyeRin; Yune, So Jung; Lee, Geon Ho; Chun, Kyunghee

    2017-09-01

    The purpose of this study is to investigate domestic and international research trends in studies of medical students' characteristics by using the scoping review methods. This study adopted the scoping review to assess papers on the characteristics of medical students. The procedure of research was carried out according to the five steps of the scoping review. The full texts of 100 papers are obtained and are read closely, after which suitable 88 papers are extracted by us for this research. The review is mapped by the year of the study, source, location, author, research design, research subject, objective, and key results. The frequency is analyzed by using Microsoft Excel and SPSS. We found 70 papers (79.5%) on a single medical school, 15 (17.0%) on multiple medical schools, and three (3.4%) on mixed schools, including medical and nonmedical schools. Sixty-nine (79.5%) were cross-sectional studies and 18 (20.5%) were longitudinal studies. Eighty-two papers (93.2%) adopted questionnaire surveys. We summarized research trends of studies on medical students in Korea and overseas by topic, and mapped them into physical health, mental health, psychological characteristics, cognitive characteristics, social characteristics, and career. This study provides insights into the future directions of research for the characteristics of medical students.

  16. International student exchange and the medical curriculum: evaluation of a medical sciences translational physiology course in Brazil.

    Science.gov (United States)

    Morris, Mariana; Jones, T David; Rocha, Maria Jose Alves; Fazan, Rubens; Chapleau, Mark W; Salgado, Helio C; Johnson, Alan Kim; Irigoyen, Maria Claudia; Michelini, Lisete C; Goldstein, David L

    2006-09-01

    The objective of the present study was to conduct a short-term international course on translational physiology for medical students from Wright State University and the University of Iowa. The goals were to 1) provide students with an exposure to the academic, cultural, and medical environments in Brazil; 2) promote awareness of the global medical community; and 3) provide an academic course focused on translational physiology. An evaluation of the students was conducted to determine whether such a short-term course might be useful in the medical curriculum. The 2-wk course was held in the summer of 2005 at the University of São Paulo School of Medicine in Ribeirão Preto, Brazil, for 23 American students. The program included presentations of basic and clinical topics, meetings with medical students, and clinical presentations. The program finished with student attendance at a scientific meeting sponsored by the Brazilian Society of Hypertension. Student surveys evaluated issues related to perceived treatment, Brazilian medical school environment, culture and personal attributes, and career aspirations. The international Medical Sciences Translational Physiology course for medical students provided a brief, but intense, experience. It gave students a picture of the medical environment in Brazil and an appreciation for the differences and similarities in cultures. Most students reported that it was a positive experience that would be beneficial to their careers. In conclusion, a short-term international course provides an efficient means for medical students to experience aspects of global medical science.

  17. The Integrated Medical Model: Outcomes from Independent Review

    Science.gov (United States)

    Myers, J.; Garcia, Y.; Griffin, D.; Arellano, J.; Boley, L.; Goodenow, D. A.; Kerstman, E.; Reyes, D.; Saile, L.; Walton, M.; hide

    2017-01-01

    In 2016, the Integrated Medical Model (IMM) v4.0 underwent an extensive external review in preparation for transition to an operational status. In order to insure impartiality of the review process, the Exploration Medical Capabilities Element of NASA's Human Research Program convened the review through the Systems Review Office at NASA Goddard Space Flight Center (GSFC). The review board convened by GSFC consisted of persons from both NASA and academia with expertise in the fields of statistics, epidemiology, modeling, software development, aerospace medicine, and project management (see Figure 1). The board reviewed software and code standards, as well as evidence pedigree associated with both the input and outcomes information. The board also assesses the models verification, validation, sensitivity to parameters and ability to answer operational questions. This talk will discuss the processes for designing the review, how the review progressed and the findings from the board, as well as summarize the IMM project responses to those findings. Overall, the board found that the IMM is scientifically sound, represents a necessary, comprehensive approach to identifying medical and environmental risks facing astronauts in long duration missions and is an excellent tool for communication between engineers and physicians. The board also found IMM and its customer(s) should convene an additional review of the IMM data sources and to develop a sustainable approach to augment, peer review, and maintain the information utilized in the IMM. The board found this is critically important because medical knowledge continues to evolve. Delivery of IMM v4.0 to the Crew Health and Safety (CHS) Program will occur in the 2017. Once delivered for operational decision support, IMM v4.0 will provide CHS with additional quantitative capability in to assess astronaut medical risks and required medical capabilities to help drive down overall mission risks.

  18. Nonadherence to Medication Therapy in Haemodialysis Patients: A Systematic Review.

    Directory of Open Access Journals (Sweden)

    Saurav Ghimire

    Full Text Available End-stage kidney disease (ESKD patients are often prescribed multiple medications. Together with a demanding weekly schedule of dialysis sessions, increased number of medicines and associated regimen complexity pre-dispose them at high risk of medication nonadherence. This review summarizes existing literature on nonadherence and identifies factors associated with nonadherence to medication therapy in patients undergoing haemodialysis.A comprehensive search of PubMed, Embase, CINAHL, PsycInfo, and Cochrane Database of Systematic Reviews covering the period from 1970 through November 2014 was performed following a predefined inclusion and exclusion criteria. Reference lists from relevant materials were reviewed. Data on study characteristics, measures of nonadherence, prevalence rates and factors associated with nonadherence were collected. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA guidelines was followed in conducting this systematic review.Of 920 relevant publications, 44 were included. The prevalence of medication nonadherence varied from 12.5% to 98.6%, with widespread heterogeneity in measures and definitions employed. Most common patient-related factors significantly associated with nonadherence were younger age, non-Caucasian ethnicity, illness interfering family life, being a smoker, and living single and being divorced or widowed. Similarly, disease-related factors include longevity of haemodialysis, recurrent hospitalization, depressive symptoms and having concomitant illness like diabetes and hypertension. Medication-related factors such as daily tablet count, total pill burden, number of phosphate binders prescribed and complexity of medication regimen were also associated with poor adherence.A number of patient-, disease-, and medication-related factors are associated with medication nonadherence in haemodialysis patients. Clinicians should be aware of such factors so that adherence to medications

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

    Science.gov (United States)

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

    2016-01-28

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

  20. Simulation in Medical School Education: Review for Emergency Medicine

    Directory of Open Access Journals (Sweden)

    Shahram Lotfipour

    2011-05-01

    Full Text Available Medical education is rapidly evolving. With the paradigm shift to small-group didactic sessions and focus on clinically oriented case-based scenarios, simulation training has provided educators a novel way to deliver medical education in the 21st century. The field continues to expand in scope and practice and is being incorporated into medical school clerkship education, and specifically in emergency medicine (EM. The use of medical simulation in graduate medical education is well documented. Our aim in this article is to perform a retrospective review of the current literature, studying simulation use in EM medical student clerkships. Studies have demonstrated the effectiveness of simulation in teaching basic science, clinical knowledge, procedural skills, teamwork, and communication skills. As simulation becomes increasingly prevalent in medical school curricula, more studies are needed to assess whether simulation training improves patient-related outcomes.

  1. Simulation in medical school education: review for emergency medicine.

    Science.gov (United States)

    Chakravarthy, Bharath; Ter Haar, Elizabeth; Bhat, Srinidhi Subraya; McCoy, Christopher Eric; Denmark, T Kent; Lotfipour, Shahram

    2011-11-01

    Medical education is rapidly evolving. With the paradigm shift to small-group didactic sessions and focus on clinically oriented case-based scenarios, simulation training has provided educators a novel way to deliver medical education in the 21st century. The field continues to expand in scope and practice and is being incorporated into medical school clerkship education, and specifically in emergency medicine (EM). The use of medical simulation in graduate medical education is well documented. Our aim in this article is to perform a retrospective review of the current literature, studying simulation use in EM medical student clerkships. Studies have demonstrated the effectiveness of simulation in teaching basic science, clinical knowledge, procedural skills, teamwork, and communication skills. As simulation becomes increasingly prevalent in medical school curricula, more studies are needed to assess whether simulation training improves patient-related outcomes.

  2. Comparison of medication reconciliation and medication review: errors and clinical importance

    DEFF Research Database (Denmark)

    Bjeldbak-Olesen, Mette; Danielsen, Anja Gadsbølle; Tomsen, Dorthe Vilstrup

    2013-01-01

    Introduction: The objective of this study was to compare medication reconciliation and medication review based on number, type and severity of discrepancies and drug-re­lated problems (DRPs), denoted errors. Material and methods: This was a retrospective study conducted at the Department...... of Cardiology, Hillerød Hos­pital. Medication reconciliation compared the prescriptions in patient records, an electronic medication system (EMS) and in discharge summaries (DS). The medication review was based on the EMS. The two methods were performed on the same data material. To assess the clinical...... importance of the errors, a four-point scale was applied. Results: A total of 75 patient records were included. In all, 198 discrepancies were identified by medication reconcili­ation, 2.6 per patient. The most frequent discrepancies were omission of a drug in the DS and discrepancy between the drugs noted...

  3. 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…

  4. Challenging the premises of international policy review

    DEFF Research Database (Denmark)

    Feinstein, Noah Weeth; Læssøe, Jeppe; Blum, Nicole

    2013-01-01

    In 2009, a think tank called the International Alliance of Leading Education Institutes (IALEI) announced the results of a study entitled Climate Change and Sustainable Development: The Response from Education. Intended for a policy audience, the study offered a glimpse into the status of Education...

  5. MEDICAL vs. MEDICAL AND SURGICAL TREATMENT FOR BRUCELLA ENDOCARDITIS: A REVIEW OF THE LITERATURE

    OpenAIRE

    Keshtkar-Jahromi, Maryam; Razavi, Seyed-Mostafa; Gholamin, Sharareh; Keshtkar-Jahromi, Marzieh; Hossain, Mian; Sajadi, Mohammad

    2012-01-01

    This review was undertaken to determine the role of surgery in the treatment of brucella endocarditis. All English and French articles reporting brucella endocarditis (1966–2011) in Pubmed, Google and Scopus were reviewed. 308 cases were identified and Linear and Logistic regression was performed. Surgery improved outcomes by decreasing mortality from 32.7% in the medical treatment only group to 6.7% in the combined surgical and medical treatment group (p

  6. International free and open source software law review

    National Research Council Canada - National Science Library

    2009-01-01

    "The International Free and Open Source Software Law Review (IFOSS L. Rev.) is a collaborative legal publication aiming to increase knowledge and understanding among lawyers about Free and Open Source Software issues...

  7. Pharmacist-led medication review in an acute admissions unit

    DEFF Research Database (Denmark)

    Hansen, Trine Graabæk; Bonnerup, Dorthe Krogsgaard; Kjeldsen, Lene Juel

    2015-01-01

    Objectives Over the last decades, several papers have evaluated clinical pharmacy interventions in hospital settings with conflicting findings as results. Medication reviews are frequently a central component of these interventions. However, the term ‘medication review’ covers a plethora.......Methods A procedure was developed based on clinical experience and inspiration from previous studies and literature on medication review models. The procedure was developed to fit the busy workflow in acute admissions units.Results The procedure consists of five steps: (1) collection of clinical patient data, (2...... of principles and methodologies, and the practical procedure is seldom described in detail, which makes reproducing study findings difficult. The objective of this paper is to provide a detailed description of a procedure developed and used for pharmacist-led medication review in acute admissions units...

  8. A review of teaching skills development programmes for medical students.

    Science.gov (United States)

    Marton, Gregory E; McCullough, Brendan; Ramnanan, Christopher J

    2015-02-01

    The CanMEDS role of Scholar requires that medical trainees develop their skills as medical educators. The development of teaching skills in undergraduate medical students is therefore desirable, especially in view of the teaching obligations in residency programmes. The goal of this review was to identify the characteristics and outcomes of programmes designed to develop the teaching skills of undergraduate medical students. The authors searched medical literature databases using combinations of the search terms 'medical student', 'teacher', 'teaching skills', 'peer teaching', 'near-peer teaching' and 'student as teacher'. Twenty papers fit the predetermined search criteria, which included original characterisations of specific programmes involving undergraduate medical students. Three types of initiative were identified in the reviewed articles: peer teaching programmes; teaching workshops, and community outreach programmes. The majority of study participants were students in Years 3 and 4. Subjective self-evaluation by participants using Likert scale-based surveys was by far the most commonly used method of measuring project outcomes. Objective, quantitative teaching-related outcomes were rarely noted in the reports reviewed. Self-perceived improvements in teaching skills were noted by participants in most of the reports. Other perceived benefits included increases in organisational skills, knowledge and confidence in giving feedback. Although several types of programmes have been shown to subjectively improve the teaching skills of undergraduate medical students, characterisation of the objective outcomes of these initiatives is lacking and requires further study. © 2015 John Wiley & Sons Ltd.

  9. Medication Review and Patient Outcomes in an Orthopedic Department

    DEFF Research Database (Denmark)

    Lisby, Marianne; Bonnerup, Dorthe Krogsgaard; Brock, Birgitte

    2015-01-01

    OBJECTIVE: We investigated the health-related effect of systematic medication review performed by a clinical pharmacist and a clinical pharmacologist on nonelective elderly orthopedic patients. METHODS: This is a nonblinded randomized controlled study of 108 patients 65 years or older treated...... with at least 4 drugs. For the intervention, the clinical pharmacist reviewed the participants' medication after completion of the usual medication routine. Information was collected from medical charts, interviews with participants, and database registrations of drug purchase. Results were conferred...... with the clinical pharmacologist, and recommendations were delivered directly to the ward physicians. The control was usual medication routine, that is, physicians prescribing admitting orders. The primary outcome was time to the first unplanned contact to a physician after discharge (i.e., general practitioner...

  10. 78 FR 23940 - Use of International Standard ISO-10993, “Biological Evaluation of Medical Devices Part 1...

    Science.gov (United States)

    2013-04-23

    ... HUMAN SERVICES Food and Drug Administration Use of International Standard ISO-10993, ``Biological... International Standard ISO-10993, `Biological Evaluation of Medical Devices Part 1: Evaluation and Testing... entitled ``Use of International Standard ISO-10993, `Biological Evaluation of Medical Devices Part...

  11. The redesign of the medical intern assignment mechanism in Israel

    National Research Council Canada - National Science Library

    Roth, Alvin E; Shorrer, Ran I

    2015-01-01

    A collaboration of medical professionals with economists and computer scientists involved in "market design" had led to the redesign of the clearinghouse assigning medical students to internships in Israel...

  12. International travel and acquisition of multidrugresistant Enterobacteriaceae: A systematic review

    NARCIS (Netherlands)

    R.J. Hassing (Robert); J. Alsma (Jelmer); M.S. Arcilla (Maris); P.J. van Genderen (P.); B.H. Stricker; A. Verbon (Annelies)

    2015-01-01

    textabstractInternational travel is considered to be an important risk factor for acquisition of multidrug-resistant Enterobacteriaceae (MRE). The aim of this systematic review was to determine the effect of international travel on the risk of post-travel faecal carriage of MRE. Secondary outcomes w

  13. International Service Learning: Analytical Review of Published Research Literature

    Science.gov (United States)

    Dixon, Brett

    2015-01-01

    International service learning (ISL) is an emerging area of international education. This paper summarizes academic journal articles on ISL programs and organizes the relevant publications by academic disciplines, service learning project areas, and other topics. The basis for this review is relevant literature from full-text scholarly peer…

  14. Review: ICCS International Civics and Citizenship Study

    Directory of Open Access Journals (Sweden)

    Anu Toots

    2010-11-01

    Full Text Available In November 2010 the largest international study ever conducted on civic education in secondary schools has been released in Brussels. The study was performed under the auspices of the International Association for the Evaluation of Educational Achievement (IEA, an independent consortium that brings together educational researchers and policy makers in 62 countries around the world. The IEA is probably more widely known in connection of large-scale comparative studies on educational assessment in math and science (TIMSS and in reading (PIRLS. Yet, the association has longstanding and impressive expertise also in civic education. The first study in this area has been carried out already in 1971 (Torney et al., 1975, the second – so called CIVED in 1999 (Torney-Purta et al., 2001 and now, ten years later, 38 counties around the world participated in the third study – the IEA International Civic and Citizenship Education Study (ICCS. The study tested in 2008–2009 over 140,000 lower secondary students, over 62,000 teachers and headmasters from 5,300 schools in order to analyse how young people are prepared to undertake their roles as citizens.

  15. Culture and International Management: A Review.

    Science.gov (United States)

    Miroshnik, Victoria

    2002-01-01

    A literature review explored the effectiveness of cross-cultural managements of multinational companies. The effect of national culture on organizational culture was analyzed and ways in which multinational companies can adopt the national differences were suggested. (Contains 42 references.) (JOW)

  16. Medication errors in elderly acute care--a systematic review.

    Science.gov (United States)

    Metsälä, Eija; Vaherkoski, Ulla

    2014-03-01

    Medication safety is a part of quality of care and patient safety. Old age brings many challenges for safe use of medication. In order to improve the prerequisites of medication safety in acute care of the elderly, we systematically reviewed studies to find out what kind of medication errors happen in elderly acute care. Cinahl, Medline, Cochrane, JBI Connect+ databases and Finnish healthcare databases Medic and Ohtanen were used in the search. The search was performed using both MeSH terms and keywords by the option 'search all text'. The original keywords were pharmacy or drugs, medical error or deviation and their Finnish synonyms. These keywords were united to the terms elderly, nursing or acute care or intensive care. Studies published between 2001 and 2011 were chosen. Medication errors mentioned in the studies were associated with (i) nursing competence, (ii) prescription- and patient-related factors, (iii) medication work organisation and nursing process and (iv) safety culture. This paper presents several practical implications for improving medication safety in the acute care of the elderly. The grey literature was not included because the authors wanted to limit to the best-quality research. In some studies, elderly acute care was not their exact context or the elderly formed only a part of study population. This may have undermined some types of medication errors typical to elderly acute care. To improve the prerequisites of medication, safety in acute care of the elderly management of the medication process should be improved. Also, cooperation within the medical team in making the medical care plans and checking out the medication of the elderly people should be improved. This is an important topic of lifelong education for nurses and other healthcare staff as well. © 2013 Nordic College of Caring Science. Published by Blackwell Publishing Ltd.

  17. Effectiveness of medication review: a systematic review and meta-analysis of randomized controlled trials

    NARCIS (Netherlands)

    Huiskes, V.J.B.; Burger, D.M.; Ende, C.H.M. van den; Bemt, B.J.F van den

    2017-01-01

    BACKGROUND: Medication review is often recommended to optimize medication use. In clinical practice it is mostly operationalized as an intervention without co-interventions during a short term intervention period. However, most systematic reviews also included co-interventions and prolonged

  18. Mobile Learning in Medical Education: Review.

    Science.gov (United States)

    Walsh, Kieran

    2015-10-01

    In the past several years, mobile learning made rapid inroads into the provision of medical education. There are significant advantages associated with mobile learning. These include high access, low cost, more situated and contextual learning, convenience for the learner, continuous communication and interaction between learner and tutor and between learner and other learners, and the ability to self-assess themselves while learning. Like any other form of medical pedagogy, mobile learning has its downsides. Disadvantages of mobile learning include: inadequate technology, a risk of distraction from learning by using a device that can be used for multiple purposes, and the potential for breakdown in barriers between personal usage of the mobile device and professional or educational use. Despite these caveats, there is no question but that mobile learning offers much potential. In the future, it is likely that the strategy of mobile first, whereby providers of e-learning think of the user experience on a mobile first, will result in learners who increasingly expect that all e-learning provision will work seamlessly on a mobile device.

  19. Self-Medication Practice with Nonprescription Medication among University Students: a review of the literature

    Directory of Open Access Journals (Sweden)

    Dedy Almasdy

    2011-09-01

    Full Text Available Objective: To review the literature relating to self-medicationpractice with nonprescription medication among universitystudents.Methods: A narrative review of studies on self-medicationpractice with nonprescription medication among universitystudent was performed. An extensive literature search wasundertaken using indexing services available at UniversitiSains Malaysia (USM library. The following keywords wereused for the search: self-care, self-medication, over-thecountermedicine, nonprescription medicine, minor illnesses,minor ailment, university population and communitypharmacy. Electronic databases searched were Science Direct,Medline, ISI Web of Knowledge, Inside Web, JSTOR, SpringerLink, Proquest, Ebsco Host and Google Scholar. Theseelectronic databases were searched for full text paperspublished in English.Results: Eleven studies were identified. In general, the reviewhas shown that self-medication practice with nonprescriptionmedication highly prevalence among university students. Thereasons for self-medication are vary among this populationand the main symptoms leading to self-medication areheadache or minor pain; fever, flu, cough, or cold; anddiarrhoea.The common medication is analgesic, antipyreticproducts, cough and cold remedies, anti allergy andvitamins or minerals. The sources of the medicines arepharmacy, home medicine cabinet, supermarket/shopand other person such as family, friend, neighbours andclassmates. The sources of drug information are familymember, previous experience, pharmacy salesman,doctor or nurse, advertisement and others. The reviewalso has shown that the self-medication practice couldhave many problems.Conclusions: The review provides insights about theself-medication practices among the university students.These practices were highly prevalence among universitystudents. The symptoms leading to self-medication arevary, thus the medication used and the medicationsources. It needs an adequate drug information

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

    Science.gov (United States)

    Heist, Brian S; Torok, Haruka Matsubara

    2017-08-25

    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.

  1. Improving written and verbal communication skills for international medical graduates: a linguistic and medical approach.

    Science.gov (United States)

    Cross, Duncan; Smalldridge, Ann

    2011-01-01

    Adapting to UK communication styles can be difficult for International Medical Graduates (IMGs). Reache Northwest provides education, training and support for internationally trained refugee and asylum seeking health professionals who are looking to return to work in the UK. A Safe and Effective Communication Skills course was designed by a team of language teachers and clinicians to provide IMGs with an understanding of the written, verbal and summarisation skills required in the UK work environment. A series of language exercises adapted to clinical situations was developed. These increased in complexity to the practical application of language skills in clinical settings using simulated patients. The combination of language and clinical tutors meant that feedback could be given from a language teacher's perspective, the clinical perspective and the cultural context. The combination of language and clinical tutors meant that analysis of communication difficulties could be made from different perspectives and detailed, specific feedback could be given to each student in these areas. Using a combined linguistic and clinical approach can provide solutions to clinical communication problems that may otherwise be missed. This strategy could be extended to cover communication areas in other contexts.

  2. Sexual abuse of children in residential care : an international review

    NARCIS (Netherlands)

    Timmerman, Margaretha; Schreuder, Pauline

    2014-01-01

    This paper reports the results of an international review of academic literature on sexual abuse in residential child and youth care, 1945-2011. The review focusses on questions related to the nature and scope of sexual abuse, on personal and institutional factors providing either protection or risk

  3. Sexual abuse of children in residential care : an international review

    NARCIS (Netherlands)

    Timmerman, Margaretha; Schreuder, Pauline

    2014-01-01

    This paper reports the results of an international review of academic literature on sexual abuse in residential child and youth care, 1945-2011. The review focusses on questions related to the nature and scope of sexual abuse, on personal and institutional factors providing either protection or

  4. Sexual abuse of children in residential care : an international review

    NARCIS (Netherlands)

    Timmerman, Margaretha; Schreuder, Pauline

    2014-01-01

    This paper reports the results of an international review of academic literature on sexual abuse in residential child and youth care, 1945-2011. The review focusses on questions related to the nature and scope of sexual abuse, on personal and institutional factors providing either protection or risk

  5. Concept maps in medical education: an analytical literature review.

    Science.gov (United States)

    Daley, Barbara J; Torre, Dario M

    2010-05-01

    OBJECTIVES As the medical profession continues to change, so do the educational methods by which medical students are taught. Various authors have acknowledged the need for alternative teaching and learning strategies that will enable medical students to retain vast amounts of information, integrate critical thinking skills and solve a range of complex clinical problems. Previous research has indicated that concept maps may be one such teaching and learning strategy. This article aims to: (i) review the current research on concept maps as a potential pedagogical approach to medical student learning, and (ii) discuss implications for medical student teaching and learning, as well as directions for future research. METHODS The literature included in this review was obtained by searching library databases including ACADEMIC SEARCH, ERIC, EBSCOHost, PsychINFO, PsychARTICLES, PubMed/MEDLINE, CINAHL and EMBASE. This literature review is a summary of both conceptual and empirically published literature on the uses of concept mapping in medical education. RESULTS The 35 studies reviewed here indicate that concept maps function in four main ways: (i) by promoting meaningful learning; (ii) by providing an additional resource for learning; (iii) by enabling instructors to provide feedback to students, and (iv) by conducting assessment of learning and performance. CONCLUSIONS This review provides ideas for medical school faculty staff on the use of concept maps in teaching and learning. Strategies such as fostering critical thinking and clinical reasoning, incorporating concept mapping within problem-based learning, and using concept mapping in group and collaborative learning are identified. New developments in medical education include the use of serial concept maps, concept maps as a methodology to assist learners with lower cognitive competence, and the combination of group concept maps with structured feedback.

  6. Standardised assessment of patients' capacity to manage medications: a systematic review of published instruments

    Directory of Open Access Journals (Sweden)

    Elliott Rohan A

    2009-07-01

    Full Text Available Abstract Background Older people are commonly prescribed complex multi-drug regimens while also experiencing declines in the cognitive and physical abilities required for medication management, leading to increased risk of medication errors and need for assisted living. The purpose of this study was to review published instruments designed to assess patients' capacity to self-administer medications. Methods Searches of Medline, EMBASE, CINAHL, PsycINFO, International Pharmaceutical Abstracts, Health and Psychosocial Instruments, Google, and reference lists of identified publications were conducted to identify English-language articles describing development and validation of instruments designed to assess patients' capacity to self-administer medications. Methodological quality of validation studies was rated independently against published criteria by two reviewers and reliability and validity data were reviewed. Results Thirty-two instruments were identified, of which 14 met pre-defined inclusion criteria. Instruments fell into two categories: those that used patients' own medications as the basis for assessment and those that used a simulated medication regimen. The quality of validation studies was generally low to moderate and few instruments were subjected to reliability testing. Most instruments had some evidence of construct validity, through associations with tests of cognitive function, health literacy, activities of daily living or measures of medication management or adherence. Only one instrument had sensitivity and specificity data with respect to prediction of medication-related outcomes such as adherence to therapy. Only three instruments had validity data from more than one independent research group. Conclusion A number of performance-based instruments exist to assess patients' capacity to manage their own medications. These may be useful for identifying physical and cognitive barriers to successful medication management, but

  7. Divergent Fates of the Medical Humanities in Psychiatry and Internal Medicine: Should Psychiatry Be Rehumanized?

    Science.gov (United States)

    Rutherford, Bret R.; Hellerstein, David J.

    2008-01-01

    Objective: To determine the degree to which the medical humanities have been integrated into the fields of internal medicine and psychiatry, the authors assessed the presence of medical humanities articles in selected psychiatry and internal medicine journals from 1950 to 2000. Methods: The journals searched were the three highest-ranking…

  8. Review on Design and Performance of International Medical Savings Accounts Plan%国际医疗储蓄账户计划设计结构及效果述评

    Institute of Scientific and Technical Information of China (English)

    赵斌; 文裕慧

    2012-01-01

    Since the theory of medical savings accounts appears in the 1970s, there are four countries (China, Singapore, South Africa and United States) turning theory into practice, establishing two kinds of medical savings accounts. One is voluntary medical savings accounts, and the other is mandatory medical savings accounts. The paper tracked the history of medical savings accounts in each country first, and then made a compassion study among those countries. It is found that the basic frameworks of medical savings account are similar, with some detail designs in difference. Moreover, there is a controversy between theory and practice; the effect of medical savings accounts on health expenditure containment and efficiencies promotion as well as effect on equity are still unclear.%自20世纪70年代医疗储蓄账户思路产生,已有美国、中国、南非和新加坡4个国家建立自愿参加和强制参加的两大类医疗储蓄账户计划.文章对比了这4个国家的医疗储蓄账户制度设计要点,并随后对除我国外的其余3个国制度运行情况进行文献综述.研究发现,4国医疗储蓄账户除参加原则和一些细节设计上,基本设计方面相仿,但其他国家在制度细节方面的设计更为完善.对南非、新加坡和美国医疗储蓄账户计划实施效果的讨论发现理论和实践存在差距.医疗储蓄账户能否控制医疗费用增长、促进效率和影响公平方面都存在争论.

  9. Risks to emergency medical responders at terrorist incidents: a narrative review of the medical literature.

    Science.gov (United States)

    Thompson, Julian; Rehn, Marius; Lossius, Hans Morten; Lockey, David

    2014-09-24

    As the threat of international terrorism rises, there is an increasing requirement to provide evidence-based information and training for the emergency personnel who will respond to terrorist incidents. Current major incident training advises that emergency responders prioritize their own personal safety above that of the 'scene and survivors'. However, there is limited information available on the nature of these threats and how they may be accurately evaluated. This study reviews the published medical literature to identify the hazards experienced by emergency responders who have attended previous terrorist incidents. A PubMed literature search identified 10,894 articles on the subject of 'terrorism', and there was a dramatic increase in publications after the 9/11 attacks in 2001. There is heterogeneity in the focus and quality of this literature, and 307 articles addressing the subject of scene safety were assessed for information regarding the threats encountered at terrorist incidents. These articles demonstrate that emergency responders have been exposed to both direct terrorist threats and environmental scene hazards, including airborne particles, structural collapse, fire, and psychological stress. The emphasis of training and preparedness for terrorist incidents has been primarily on the direct threats, but the published literature suggests that the dominant causes of mortality and morbidity in responders after such incidents are the indirect environmental hazards. If the medical response to terrorist incidents is to be based on evidence rather than anecdote, analysis of the current literature should be incorporated into major incident training, and consistent collection of key data from future incidents is required.

  10. Access to medication and pharmacy services for resettled refugees: a systematic review.

    Science.gov (United States)

    Bellamy, Kim; Ostini, Remo; Martini, Nataly; Kairuz, Therese

    2015-01-01

    The difficulties that resettled refugees experience in accessing primary health-care services have been widely documented. In most developed countries, pharmacists are often the first health-care professional contacted by consumers; however, the ability of refugees to access community pharmacies and medication may be limited. This review systematically reviewed the literature and synthesised findings of research that explored barriers and/or facilitators of access to medication and pharmacy services for resettled refugees. This review adhered to guidelines for systematic reviews by PRISMA (preferred reporting items for systematic reviews and meta-analyses). Databases were searched during March 2014 and included Scopus, ProQuest Sociological Abstracts, PubMed, Embase and APAIS Health. The Australian and International grey literature was also explored. Nine studies met the quality and inclusion criteria. The research reported in seven of the nine studies was conducted in the US, one was conducted in Australia and the other in the UK. The majority of studies focussed on South-east Asian refugees. Themes identified across the studies included language and the use of interpreters; navigating the Western health-care system; culture and illness beliefs; medication non-adherence; use of traditional medicine; and family, peer and community support. There is a significant paucity of published research exploring barriers to medication and pharmacy services among resettled refugees. This systematic review highlights the need for appropriate interpreting and translation services, as well as pharmacy staff demonstrating effective cross-cultural communication skills.

  11. Building an environmentally accountable medical curriculum through international collaboration

    DEFF Research Database (Denmark)

    Walpole, Sarah Catherine; Vyas, Aditya; Maxwell, Janie

    2017-01-01

    Background: Global environmental change is associated with significant health threats. The medical profession can address this challenge through advocacy, health system adaptation and workforce preparedness. Stewardship of health systems with attention to their environmental impacts can contribute......: At the 2016 Association for Medical Education in Europe conference, medical educators, students and clinicians from six continents discussed these challenges in a participatory workshop. Here we reflect on emerging themes from the workshop and how to plan for curricular change. Firstly, we outline recent...

  12. The medical ethnobotany of Lesotho: a review

    Directory of Open Access Journals (Sweden)

    A. Moteetee

    2011-12-01

    Full Text Available Traditional healing in Lesotho is reviewed, focusing on four aspects: 1, cultural practices; 2, traditional health care practitioners; 3, dosage forms; 4, the materia medica. Cultural practices are strongly associated with the belief that intangible forces are responsible for human happiness and misery. A total of 303 plant species are used medicinally (including 25 alien species, representing eight pteridophyte and 75 angiosperm families, of which the most important are Asteraceae, Fabaceae, Hyacinthaceae, Apocynaceae, Scrophulariaceae, Lamiaceae and Poaceae. Dicoma anomala (used mainly for digestive ailments and Artemisia afra (used mainly for respiratory ailments appear to be the best known and most widely used medicinal plants amongst a total of 37 species that have been cited four or more times in the literature. About 50 species are variously employed for magic and sorcery. There are no new species records but 36 new uses are reported. Our conclusion is that the medicinal plants of Lesotho are relatively well recorded and that this review will allow detailed comparisons with other African healing cultures.

  13. Review of online educational resources for medical physicists.

    Science.gov (United States)

    Prisciandaro, Joann I

    2013-11-04

    Medical physicists are often involved in the didactic training of graduate students, residents (both physics and physicians), and technologists. As part of continuing medical education, we are also involved in maintenance of certification projects to assist in the education of our peers. As such, it is imperative that we remain current concerning available educational resources. Medical physics journals offer book reviews, allowing us an opportunity to learn about newly published books in the field. A similar means of communication is not currently available for online educational resources. This information is conveyed through informal means. This review presents a summary of online resources available to the medical physics community that may be useful for educational purposes.

  14. Medical journals' conflicts of interest in the publication of book reviews.

    Science.gov (United States)

    Davis, Ronald M; Neale, Anne Victoria; Monsur, Joseph C

    2003-10-01

    The purpose of the study was to assess medical journals' conflicts of interest in the publication of book reviews. We examined book reviews published in 1999, 2000, and 2001 (N = 1,876) in five leading medical journals: Annals of Internal Medicine, British Medical Journal (BMJ), Journal of the American Medical Association (JAMA), Lancet, and New England Journal of Medicine. The main outcome measure was journal publication of reviews of books that had been published by the journal's own publisher, that had been edited or authored by a lead editor of the journal, or that posed another conflict of interest. We also surveyed the editors-in-chief of the five journals about their policies on these conflicts of interests. During the study period, four of the five journals published 30 book reviews presenting a conflict of interest: nineteen by the BMJ, five by the Annals, four by JAMA, and two by the Lancet. These reviews represent 5.8%, 2.7%, 0.7%, and 0.7%, respectively, of all book reviews published by the journals. These four journals, respectively, published reviews of 11.9%, 25.0%, 0.9%, and 1.0% of all medical books published by the journals' publishers. Only one of the 30 book reviews included a disclosure statement addressing the conflict of interest. None of the journals had a written policy pertaining to the conflicts of interest assessed in this study, although four reported having unwritten policies. We recommend that scientific journals and associations representing journal editors develop policies on conflicts of interest pertaining to book reviews.

  15. Evaluating an interprofessional disease state and medication management review model.

    Science.gov (United States)

    Hoti, Kreshnik; Forman, Dawn; Hughes, Jeffery

    2014-03-01

    There is lack of literature data reporting an incorporation of medication management reviews in students' interprofessional education (IPE) and practice programs in aged care settings. This pilot study reports how an interprofessional disease state and medication management review program (DSMMR) was established in a residential aged care facility in Perth, Western Australia. Students from the professions of nursing, pharmacy and physiotherapy focused on a wellness check in the areas of cognition, falls and continence while integrating a medication management review. Students' attitudes were explored using a pre- and post-placement questionnaire. Students indicated positive experience with the IPE DSMMR program which also resulted in their positive attitudinal shift towards IPE and practice. These findings indicated that aged care can be a suitable setting for student interprofessional programs focusing on DSMMR.

  16. Glasgow marathons 1982-1987. A review of medical problems.

    Science.gov (United States)

    Ridley, S A; Rogers, P N; Wright, I H

    1990-02-01

    The race statistics, whether conditions and incidence of medical problems for the six consecutive years of the Glasgow Marathon are reviewed. The results suggest that the popularity of marathon running is declining but that the competitors are becoming more experienced, seeking medical assistance earlier and, as a result, experiencing fewer and less serious problems at the finish. The effect of weather conditions on the runners' performance is discussed.

  17. Medication review and transitions of care: a case report of a decade-old medication error.

    Science.gov (United States)

    Comer, Rachel; Lizer, Mitsi

    2015-03-01

    A 69-year-old Caucasian male with a 25-year history of paranoid schizophrenia was brought to the emergency department because of violence toward the staff in his nursing facility. He was diagnosed with a urinary tract infection and was admitted to the behavioral health unit for medication stabilization. History included a five-year state psychiatric hospital admission and nursing facility placement. Because of poor cognitive function, the patient was unable to corroborate medication history, so the pharmacy student on rotation performed an in-depth chart review. The review revealed a transcription error in 2003 deleting amantadine 100 mg twice daily and adding amiodarone 100 mg twice daily. Subsequent hospitalization resulted in another transcription error increasing the amiodarone to 200 mg twice daily. All electrocardiograms conducted were negative for atrial fibrillation. Once detected, the consulted cardiologist discontinued the amiodarone, and the primary care provider was notified via letter and discharge papers. An admission four months later revealed that the nursing facility restarted the amiodarone. Amiodarone was discontinued and the facility was again notified. This case reviews how a 10-year-old medication error went undetected in the electronic medical records through numerous medication reconciliations, but was uncovered when a single comprehensive medication review was conducted.

  18. Experience, awareness, and perceptions about medical emergencies among dental interns of Chennai city, India

    Directory of Open Access Journals (Sweden)

    L Leelavathi

    2016-01-01

    Full Text Available Introduction: Every dental health professional should have the essential knowledge to identify, assess and manage a potentially life-threatening situation. Aim: To assess the experience, awareness, and perceptions about medical emergencies among dental interns in Chennai city, India. Materials and Methods: A cross-sectional study carried out in four randomly selected dental colleges of Chennai city. Data were collected using a self-administered, structured, closed-ended 20-item questionnaire. It consists of questions on experience of medical emergencies encountered by interns during their graduation, awareness of the essential drugs and equipment, the amount of medical emergencies training undertaken by participants, preparedness of interns in handling medical emergencies. Descriptive statistics, independent sample t-test, were used. Results: Out of 335 interns, 157 (47% said that syncope was the most common medical emergency event encountered by the interns. Regarding awareness about essential drugs, about 161 (48% study participants answered oxygen, epinephrine, nitroglycerin, antihistamine, salbutamol, and aspirin as emergency drugs. About half of the study participants, 187 (56% were aware that pressure should be given to the affected site, with or without suturing if the greater palatine artery is inadvertently cut. The majority of the interns (93% preferred to have a specified training on the handling of medical emergencies in dental practice. Conclusions: Syncope was the most common medical emergency event. Awareness about the essential drugs, equipment, and preparedness of dental interns in handling medical emergencies was low.

  19. Pediatric psychotropic medication initiation and adherence: a literature review based on social exchange theory.

    Science.gov (United States)

    Hamrin, Vanya; McCarthy, Erin M; Tyson, Veda

    2010-08-01

    Psychotropic medication initiation and adherence is an identified problem. This literature review explores factors that determine families' decisions to initiate, sustain, or discontinue use of psychotropic medication in children and adolescents. Social exchange theory is used as a framework to explore decisions to initiate and adhere to psychotropic medications. Contributing factors related to psychotropic medication initiation, adherence, and discontinuation are explored. Themes in the literature encompassing costs and benefits of psychotropic medication adherence include family experiences with adverse effects, previous psychotropic medication experience, medication psychoeducation, stigma, societal views about psychotropic medication, particular diagnosis, the effect of comorbid diagnosis on adherence, attitudes and beliefs about medication by both children and parents, and relationships with the provider. The impact of family demographics including parent gender, age of the child, ethnicity, and parent educational level on psychotropic medication adherence is evaluated. International and U.S. studies from Medline, Cumulative Index for Nursing and Allied Health Literature and PsychInfo evaluating medication initiation and adherence in the pediatric psychiatric population and social exchange theory was incorporated from relevant textbook resources. Rewards experienced from medication treatment include improvement in symptoms, school performance and family relationships, and reduced level of parenting stress. Identified costs include impact of adverse side effects, social stigma, lack of response, fears of addiction, and changing the child's personality. Acceptance of the diagnosis influences adherence while medication education has varying effects. Families' attitudes, beliefs and perceptions about psychiatric illness and treatment play a large role in medication treatment decisions. A trusting provider relationship has a positive effect on adherence

  20. Medical Image Analysis by Cognitive Information Systems - a Review.

    Science.gov (United States)

    Ogiela, Lidia; Takizawa, Makoto

    2016-10-01

    This publication presents a review of medical image analysis systems. The paradigms of cognitive information systems will be presented by examples of medical image analysis systems. The semantic processes present as it is applied to different types of medical images. Cognitive information systems were defined on the basis of methods for the semantic analysis and interpretation of information - medical images - applied to cognitive meaning of medical images contained in analyzed data sets. Semantic analysis was proposed to analyzed the meaning of data. Meaning is included in information, for example in medical images. Medical image analysis will be presented and discussed as they are applied to various types of medical images, presented selected human organs, with different pathologies. Those images were analyzed using different classes of cognitive information systems. Cognitive information systems dedicated to medical image analysis was also defined for the decision supporting tasks. This process is very important for example in diagnostic and therapy processes, in the selection of semantic aspects/features, from analyzed data sets. Those features allow to create a new way of analysis.

  1. Interns as teachers of medical students: a pilot programme.

    LENUS (Irish Health Repository)

    Dunne, B

    2011-03-01

    In recent years, rising numbers of medical students and an increasingly demanding clinical workload has put pressures on the educational systems for medical students in the hospital. Bedside teaching remains central to education, but tutorial delivery by registrars, tutors and consultants has proven to be increasingly difficult with the greater numbers of students now in the undergraduate system.

  2. Rough sets and near sets in medical imaging: a review.

    Science.gov (United States)

    Hassanien, Aboul Ella; Abraham, Ajith; Peters, James F; Schaefer, Gerald; Henry, Christopher

    2009-11-01

    This paper presents a review of the current literature on rough-set- and near-set-based approaches to solving various problems in medical imaging such as medical image segmentation, object extraction, and image classification. Rough set frameworks hybridized with other computational intelligence technologies that include neural networks, particle swarm optimization, support vector machines, and fuzzy sets are also presented. In addition, a brief introduction to near sets and near images with an application to MRI images is given. Near sets offer a generalization of traditional rough set theory and a promising approach to solving the medical image correspondence problem as well as an approach to classifying perceptual objects by means of features in solving medical imaging problems. Other generalizations of rough sets such as neighborhood systems, shadowed sets, and tolerance spaces are also briefly considered in solving a variety of medical imaging problems. Challenges to be addressed and future directions of research are identified and an extensive bibliography is also included.

  3. Medical futility and its challenges: a review study

    Science.gov (United States)

    Aghabarary, Maryam; Dehghan Nayeri, Nahid

    2016-01-01

    Concerns over limited medical equipment and resources, particularly in intensive care units (ICUs), have raised the issue of medical futility. Medical futility draws a contrast between physician’s authority and patients’ autonomy and it is one of the major issues of end-of-life ethical decision-making. The aim of this study was to review medical futility and its challenges. In this systematized review study, a comprehensive search of the existing literature was performed using an internet search with broad keywords to access related articles in both Persian and English databases. Finally, 89 articles were selected and surveyed. Medical futility is a complex, ambiguous, subjective, situation-specific, value-laden, and goal-dependent concept which is almost always surrounded by some degrees of uncertainty; hence, there is no objective and valid criterion for its determination. This concept is affected by many different factors such as physicians’ and patients’ value systems, medical goals, and sociocultural and religious context, and individuals’ emotions and personal characteristics. It is difficult to achieve a clear consensus over the concept of medical futility; hence, it should be defined and determined at an individual level and based on the unique condition of each patient. PMID:28050241

  4. Assessment in undergraduate medical education: a review of course exams

    Directory of Open Access Journals (Sweden)

    Allison A. Vanderbilt

    2013-03-01

    Full Text Available Introduction: The purpose of this study is to describe an approach for evaluating assessments used in the first 2 years of medical school and report the results of applying this method to current first and second year medical student examinations. Methods: Three faculty members coded all exam questions administered during the first 2 years of medical school. The reviewers discussed and compared the coded exam questions. During the bi-monthly meetings, all differences in coding were resolved with consensus as the final criterion. We applied Moore's framework to assist the review process and to align it with National Board of Medical Examiners (NBME standards. Results: The first and second year medical school examinations had 0% of competence level questions. The majority, more than 50% of test questions, were at the NBME recall level. Conclusion: It is essential that multiple-choice questions (MCQs test the attitudes, skills, knowledge, and competency in medical school. Based on our findings, it is evident that our exams need to be improved to better prepare our medical students for successful completion of NBME step exams.

  5. Primary medication non-adherence after discharge from a general internal medicine service.

    Directory of Open Access Journals (Sweden)

    Brooks A Fallis

    Full Text Available BACKGROUND: Medication non-adherence frequently leads to suboptimal patient outcomes. Primary non-adherence, which occurs when a patient does not fill an initial prescription, is particularly important at the time of hospital discharge because new medications are often being prescribed to treat an illness rather than for prevention. METHODS: We studied older adults consecutively discharged from a general internal medicine service at a large urban teaching hospital to determine the prevalence of primary non-adherence and identify characteristics associated with primary non-adherence. We reviewed electronic prescriptions, electronic discharge summaries and pharmacy dispensing data from April to August 2010 for drugs listed on the public formulary. Primary non-adherence was defined as failure to fill one or more new prescriptions after hospital discharge. In addition to descriptive analyses, we developed a logistical regression model to identify patient characteristics associated with primary non-adherence. RESULTS: There were 493 patients eligible for inclusion in our study, 232 of whom were prescribed new medications. In total, 66 (28% exhibited primary non-adherence at 7 days after discharge and 55 (24% at 30 days after discharge. Examples of medications to which patients were non-adherent included antibiotics, drugs for the management of coronary artery disease (e.g. beta-blockers, statins, heart failure (e.g. beta-blockers, angiotensin converting enzyme inhibitors, furosemide, stroke (e.g. statins, clopidogrel, diabetes (e.g. insulin, and chronic obstructive pulmonary disease (e.g. long-acting bronchodilators, prednisone. Discharge to a nursing home was associated with an increased risk of primary non-adherence (OR 2.25, 95% CI 1.01-4.95. CONCLUSIONS: Primary non-adherence after medications are newly prescribed during a hospitalization is common, and was more likely to occur in patients discharged to a nursing home.

  6. Detection and management of medication errors in internal wards of a teaching hospital by clinical pharmacists.

    Science.gov (United States)

    Abbasinazari, Mohammad; Hajhossein Talasaz, Azita; Eshraghi, Azadeh; Sahraei, Zahra

    2013-08-07

    Any suboptimum treatment in the management of patients can lead to medication errors (MEs) that may increase morbidity and mortality in hospitalized individuals. By establishing well-designed patient care activities within the managed care setting, clinical pharmacists can cooperate with other health care professionals to provide quality care and maximize safety. The aim of this study was to evaluate the frequency and prevention of MEs by clinical pharmacists. This was a cross-sectional interventional study conducted in internal wards of a teaching hospital during a two-month period. During this period, patient records, and physician orders were reviewed by clinical pharmacists. Any prescription error identified was documented. Incorrect drug selection, dose, dosage form, frequency, or route of administration all were considered as medication errors. Then, the clinical pharmacist discuss about findings with the clinical fellows to change faulty orders. The frequency and types of MEs in different wards that were detected and prevented by clinical pharmacists was documented. During the study period, in 132 patients, 262 errors were detected (1.98 per each). Wrong frequency 71 (27%), forget to order 37 (14.1%), wrong selection 33 (12.5%), drug interactions 26 (9.9%), forget to discontinue 25 (9.5%) and inappropriate dose adjustment in renal impairment 25 (9.5%) were the most types of errors. Cardiovascular medications were the class with the highest detected errors (31.6%) followed by gastrointestinal agents (15.6%). Medication errors are common problems in medical wards that their frequency can be restricted by the intervention of clinical pharmacists.

  7. Detection and management of medication errors in internal wards of a teaching hospital by clinical pharmacists.

    Directory of Open Access Journals (Sweden)

    Mohammad Abbasinazari

    2013-07-01

    Full Text Available Any suboptimum treatment in the management of patients can lead to medication errors (MEs that may increase morbidity and mortality in hospitalized individuals. By establishing well-designed patient care activities within the managed care setting, clinical pharmacists can cooperate with other health care professionals to provide quality care and maximize safety. The aim of this study was to evaluate the frequency and prevention of MEs by clinical pharmacists. This was a cross-sectional interventional study conducted in internal wards of a teaching hospital during a two-month period. During this period, patient records, and physician orders were reviewed by clinical pharmacists. Any prescription error identified was documented. Incorrect drug selection, dose, dosage form, frequency, or route of administration all were considered as medication errors. Then, the clinical pharmacist discuss about findings with the clinical fellows to change faulty orders. The frequency and types of MEs in different wards that were detected and prevented by clinical pharmacists was documented. During the study period, in 132 patients, 262 errors were detected (1.98 per each. Wrong frequency 71 (27%, forget to order 37 (14.1%, wrong selection 33 (12.5%, drug interactions 26 (9.9%, forget to discontinue 25 (9.5% and inappropriate dose adjustment in renal impairment 25 (9.5% were the most types of errors. Cardiovascular medications were the class with the highest detected errors (31.6% followed by gastrointestinal agents (15.6%. Medication errors are common problems in medical wards that their frequency can be restricted by the intervention of clinical pharmacists.

  8. Utilizing national and international registries to enhance pre-market medical device regulatory evaluation.

    Science.gov (United States)

    Yue, Lilly Q; Campbell, Gregory; Lu, Nelson; Xu, Yunling; Zuckerman, Bram

    2016-01-01

    Regulatory decisions are made based on the assessment of risk and benefit of medical devices at the time of pre-market approval and subsequently, when post-market risk-benefit balance needs reevaluation. Such assessments depend on scientific evidence obtained from pre-market studies, post-approval studies, post-market surveillance studies, patient perspective information, as well as other real world data such as national and international registries. Such registries provide real world evidence and are playing a more and more important role in enhancing the safety and effectiveness evaluation of medical devices. While these registries provide large quantities of data reflecting real world practice and can potentially reduce the cost of clinical trials, challenges arise concerning (1) data quality adequate for regulatory decision-making, (2) bias introduced at every stage and aspect of study, (3) scientific validity of study designs, and (4) reliability and interpretability of study results. This article will discuss related statistical and regulatory challenges and opportunities with examples encountered in medical device regulatory reviews.

  9. Diabetic foot infections: a team-oriented review of medical and surgical management

    Directory of Open Access Journals (Sweden)

    Claire M Capobianco

    2010-09-01

    Full Text Available As the domestic and international incidence of diabetes and metabolic syndrome continues to rise, health care providers need to continue improving management of the long-term complications of the disease. Emergency department visits and hospital admissions for diabetic foot infections are increasingly commonplace, and a like-minded multidisciplinary team approach is needed to optimize patient care. Early recognition of severe infections, medical stabilization, appropriate antibiotic selection, early surgical intervention, and strategic plans for delayed reconstruction are crucial components of managing diabetic foot infections. The authors review initial medical and surgical management and staged surgical reconstruction of diabetic foot infections in the inpatient setting.

  10. Self-medication practice in Ethiopia: a systematic review

    Directory of Open Access Journals (Sweden)

    Ayalew MB

    2017-03-01

    Full Text Available Mohammed Biset Ayalew Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia Background: Self-medication patterns vary among different populations, and are influenced by many factors. No review has been done that comprehensively expresses self-medication practice in Ethiopia. The aim of this study was to provide an overview of the literature on self-medication practice in Ethiopia.Materials and methods: Databases (PubMed, Google Scholar, ResearchGate, and Hinari were searched for published studies on the practice of self-medication in Ethiopia without restriction in the year of publication or methodology. Some studies were also identified through manual Google search. Primary search terms were “self medication”, “Ethiopia”, “self care”, “non-prescription”, “OTC drug use”, “drug utilization”, and “drug hoarding”. Studies that measured knowledge only or attitude only or beliefs only and did not determine the practice of self-medication were excluded.Results: The database search produced a total of 450 papers. After adjustment for duplicates and inclusion and exclusion criteria, 21 articles were found suitable for the review. All studies were cross-sectional in nature. The prevalence of self-medication varied from 12.8% to 77.1%, with an average of 36.8%. Fever/headache, gastrointestinal tract diseases, and respiratory diseases were the commonest illnesses/symptoms for which self-medication was taken. The major reasons for practicing self-medication were previous experience of treating a similar illness and feeling that the illness was mild. Analgesics/antipyretics, antimicrobials, gastrointestinal drugs, and respiratory drugs were the common drug classes used in self-medication. Mainly, these drugs were obtained from drug-retail outlets. The use of self-medication was commonly suggested by pharmacy professionals and friends

  11. Peer review of medical practices: missed opportunities to learn.

    Science.gov (United States)

    Kadar, Nicholas

    2014-12-01

    Appropriately conducted peer review of medical practices provides the greatest opportunity for health care professionals to learn from their mistakes and improve the quality and safety of health care. But in practice, peer review has not been an effective learning tool because it is subjective and irreproducible. Physicians reviewing the same cases disagree over the cause(s) of adverse outcomes and the quality and appropriateness of care, and agreement is not improved by training, use of objective review criteria, or having the reviewers discuss the cases. The underlying reason is a general lack of understanding and an oversimplified view of the causes of medical errors in complex, high-risk organization and a preoccupation with attributing medical errors to particular individuals. This approach leads to judgments, not understanding, and creates a culture of blame that stops learning and undermines the potential for improvement. For peer review to have an impact on the quality of care and patient safety, it must be standardized to remove cognitive biases and subjectivity from the process.

  12. Self-perceived readiness of medical interns in performing basic ...

    African Journals Online (AJOL)

    SIN Yiga

    cFaculty of Health Sciences, School of Medicine, University of the Free State, Bloemfontein, South Africa ... complete their basic medical degree.1 This is considered a. 'bridging' .... The procedures practised at undergraduate level indicated.

  13. Narrative review of telemedicine consultation in medical practice

    Science.gov (United States)

    Di Cerbo, Alessandro; Morales-Medina, Julio Cesar; Palmieri, Beniamino; Iannitti, Tommaso

    2015-01-01

    Background The use of telemedicine has grown across several medical fields, due to the increasing number of “e-patients”. Objective This narrative review gives an overview of the growing use of telemedicine in different medical specialties, showing how its use can improve medical care. Methods A PubMed/Medline, Embase, Web of Science, and Scopus search was performed using the following keywords: telemedicine, teleconsultation, telehealth, e-health, and e-medicine. Selected papers from 1996 to 2014 were chosen on the basis of their content (quality and novelty). Results Telemedicine has already been applied to different areas of medical practice, and it is as effective as face-to-face medical care, at least for the diagnosis and treatment of some pathological conditions. Conclusion Telemedicine is time- and cost-effective for both patients and health care professionals, encouraging its use on a larger scale. Telemedicine provides specialist medical care to patients who have poor access to hospitals, and ensures continuity of care and optimal use of available health resources. The use of telemedicine opens new perspectives for patients seeking a medical second opinion for their pathology, since they can have remote access to medical resources that would otherwise require enormous costs and time. PMID:25609928

  14. 5th International Conference OTEH 2012 - defense technology (Proceedings review)

    OpenAIRE

    Vlado Petar Đurković

    2013-01-01

    This article gives an overview of all papers and events at the Fifth International ScientificConference on Defense Technologies OTEH 2012 held in Belgrade, in the Military Technical Institute (VTI), from 18th to 19th September 2012.The paper review presents the Conference Sections by subjects and guest-lectureres as well as the institutions of all authors who actively participated at the Conference.About the ConferenceThe Fifth International Scientific Conference on Defense Technologies OTEH ...

  15. [Internal audit in medical laboratory: what means of control for an effective audit process?].

    Science.gov (United States)

    Garcia-Hejl, Carine; Chianéa, Denis; Dedome, Emmanuel; Sanmartin, Nancy; Bugier, Sarah; Linard, Cyril; Foissaud, Vincent; Vest, Philippe

    2013-01-01

    To prepare the French Accreditation Committee (COFRAC) visit for initial certification of our medical laboratory, our direction evaluated its quality management system (QMS) and all its technical activities. This evaluation was performed owing an internal audit. This audit was outsourced. Auditors had an expertise in audit, a whole knowledge of biological standards and were independent. Several nonconformities were identified at that time, including a lack of control of several steps of the internal audit process. Hence, necessary corrective actions were taken in order to meet the requirements of standards, in particular, the formalization of all stages, from the audit program, to the implementation, review and follow-up of the corrective actions taken, and also the implementation of the resources needed to carry out audits in a pre-established timing. To ensure an optimum control of each step, the main concepts of risk management were applied: process approach, root cause analysis, effects and criticality analysis (FMECA). After a critical analysis of our practices, this methodology allowed us to define our "internal audit" process, then to formalize it and to follow it up, with a whole documentary system.

  16. MEDICAL vs. MEDICAL AND SURGICAL TREATMENT FOR BRUCELLA ENDOCARDITIS: A REVIEW OF THE LITERATURE

    Science.gov (United States)

    Keshtkar-Jahromi, Maryam; Razavi, Seyed-Mostafa; Gholamin, Sharareh; Keshtkar-Jahromi, Marzieh; Hossain, Mian; Sajadi, Mohammad

    2012-01-01

    This review was undertaken to determine the role of surgery in the treatment of brucella endocarditis. All English and French articles reporting brucella endocarditis (1966–2011) in Pubmed, Google and Scopus were reviewed. 308 cases were identified and Linear and Logistic regression was performed. Surgery improved outcomes by decreasing mortality from 32.7% in the medical treatment only group to 6.7% in the combined surgical and medical treatment group (p<.001). This association was still significant while controlling for other contributing factors. In the absence of a controlled trial, we recommend the utmost vigilance and consideration of surgical management in treating such patients. PMID:23102495

  17. Gamification and Multimedia for Medical Education: A Landscape Review.

    Science.gov (United States)

    McCoy, Lise; Lewis, Joy H; Dalton, David

    2016-01-01

    Medical education is rapidly evolving. Students enter medical school with a high level of technological literacy and an expectation for instructional variety in the curriculum. In response, many medical schools now incorporate technology-enhanced active learning and multimedia education applications. Education games, medical mobile applications, and virtual patient simulations are together termed gamified training platforms. To review available literature for the benefits of using gamified training platforms for medical education (both preclinical and clinical) and training. Also, to identify platforms suitable for these purposes with links to multimedia content. Peer-reviewed literature, commercially published media, and grey literature were searched to compile an archive of recently published scientific evaluations of gamified training platforms for medical education. Specific educational games, mobile applications, and virtual simulations useful for preclinical and clinical training were identified and categorized. Available evidence was summarized as it related to potential educational advantages of the identified platforms for medical education. Overall, improved learning outcomes have been demonstrated with virtual patient simulations. Games have the potential to promote learning, increase engagement, allow for real-word application, and enhance collaboration. They can also provide opportunities for risk-free clinical decision making, distance training, learning analytics, and swift feedback. A total of 5 electronic games and 4 mobile applications were identified for preclinical training, and 5 electronic games, 10 mobile applications, and 12 virtual patient simulation tools were identified for clinical training. Nine additional gamified, virtual environment training tools not commercially available were also identified. Many published studies suggest possible benefits from using gamified media in medical curriculum. This is a rapidly growing field. More

  18. The desirability of education in didactic skills according to medical interns.

    Science.gov (United States)

    Kloek, Anne T; Verbakel, Joshua R A; Bernard, Simone E; Evenboer, Januska; Hendriks, Eef J; Stam, Hanneke

    2012-12-01

    Since all doctors at some point in their career will be faced with their role as a teacher, it appears desirable that future doctors are educated in didactic skills. At present, however, there are no formal opportunities for developing didactic skills at the majority of Dutch medical faculties. The main question of this study is: How do medical interns perceive the quality and quantity of their education in didactic skills? The Dutch Association for Medical Interns (LOCA) ran a national survey among 1,008 medical interns that measured the interns' self-assessed needs for training in didactic skills during medical school. Almost 80 % of the respondents argue that the mastery of didactic skills composes an essential competency for doctors, with the skill of providing adequate feedback considered to be the most important didactic quality for doctors. Of the respondents, 41 % wish to be educated in didactic skills, both during their medical undergraduate degree and during their subsequent training to become a resident. Teaching while being observed and receiving feedback in this setting is regarded as a particularly valuable didactic method by 74 % of the medical interns. Of the respondents, 82 % would invest time to follow training for the development of didactic skills if it was offered. Medical interns stress the importance of doctors' didactic skills during their clinical internships. Compared with current levels, most interns desire increased attention to the formal development of didactic skills during medical school. Considering the importance of didactic skills and the need for more extensive training, the LOCA advises medical faculties to include more formal didactic training in the medical curriculum.

  19. Medical leaders or masters?-A systematic review of medical leadership in hospital settings.

    Science.gov (United States)

    Berghout, Mathilde A; Fabbricotti, Isabelle N; Buljac-Samardžić, Martina; Hilders, Carina G J M

    2017-01-01

    Medical leadership is increasingly considered as crucial for improving the quality of care and the sustainability of healthcare. However, conceptual clarity is lacking in the literature and in practice. Therefore, a systematic review of the scientific literature was conducted to reveal the different conceptualizations of medical leadership in terms of definitions, roles and activities, and personal-and context-specific features. Eight databases were systematically searched for eligible studies, including empirical studies published in peer-reviewed journals that included physicians carrying out a manager or leadership role in a hospital setting. Finally, 34 articles were included and their findings were synthesized and analyzed narratively. Medical leadership is conceptualized in literature either as physicians with formal managerial roles or physicians who act as informal 'leaders' in daily practices. In both forms, medical leaders must carry out general management and leadership activities and acts to balance between management and medicine, because these physicians must accomplish both organizational and medical staff objectives. To perform effectively, credibility among medical peers appeared to be the most important factor, followed by a scattered list of fields of knowledge, skills and attitudes. Competing logics, role ambiguity and a lack of time and support were perceived as barriers. However, the extent to which physicians must master all elicited features, remains ambiguous. Furthermore, the extent to which medical leadership entails a shift or a reallocation of tasks that are at the core of medical professional work remains unclear. Future studies should implement stronger research designs in which more theory is used to study the effect of medical leadership on professional work, medical staff governance, and subsequently, the quality and efficiency of care.

  20. Medical leaders or masters?—A systematic review of medical leadership in hospital settings

    Science.gov (United States)

    Fabbricotti, Isabelle N.; Buljac-Samardžić, Martina; Hilders, Carina G. J. M.

    2017-01-01

    Medical leadership is increasingly considered as crucial for improving the quality of care and the sustainability of healthcare. However, conceptual clarity is lacking in the literature and in practice. Therefore, a systematic review of the scientific literature was conducted to reveal the different conceptualizations of medical leadership in terms of definitions, roles and activities, and personal–and context-specific features. Eight databases were systematically searched for eligible studies, including empirical studies published in peer-reviewed journals that included physicians carrying out a manager or leadership role in a hospital setting. Finally, 34 articles were included and their findings were synthesized and analyzed narratively. Medical leadership is conceptualized in literature either as physicians with formal managerial roles or physicians who act as informal ‘leaders’ in daily practices. In both forms, medical leaders must carry out general management and leadership activities and acts to balance between management and medicine, because these physicians must accomplish both organizational and medical staff objectives. To perform effectively, credibility among medical peers appeared to be the most important factor, followed by a scattered list of fields of knowledge, skills and attitudes. Competing logics, role ambiguity and a lack of time and support were perceived as barriers. However, the extent to which physicians must master all elicited features, remains ambiguous. Furthermore, the extent to which medical leadership entails a shift or a reallocation of tasks that are at the core of medical professional work remains unclear. Future studies should implement stronger research designs in which more theory is used to study the effect of medical leadership on professional work, medical staff governance, and subsequently, the quality and efficiency of care. PMID:28910335

  1. 10 CFR 26.183 - Medical review officer.

    Science.gov (United States)

    2010-01-01

    ... has its place of business co-located with that of an MRO or MRO staff who review test results produced... permitted under this part; (C) Data transmission is secure; and (D) Drug test results are reported to the... personnel and may not reveal quantitative test results or any personal medical information about the donor...

  2. Stress Management in Medical Education: A Review of the Literature.

    Science.gov (United States)

    Shapiro, Shauna L.; Shapiro, Daniel E.; Schwartz, Gary E. R.

    2000-01-01

    Review of clinical studies providing empirical data on stress management programs in medical education found that student participants in such programs demonstrated improved immunologic functioning, decreased depression and anxiety, increased spirituality and empathy, enhanced knowledge of alternative therapies, improved knowledge of stress…

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

    Science.gov (United States)

    Perera, Chandrashan Mahendra; Chakrabarti, Rahul

    2015-02-01

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

  4. From international to zonal trials: the origins of the Nuremberg medical trial.

    Science.gov (United States)

    Weindling, P

    2000-01-01

    This article examines how plans to have a second International Military Tribunal led to the Medical Trial at Nuremberg. While the British opposed a second international trial because of their distrust of the Soviets, they supported a plan for a series of special zonal trials to be conducted by the American authorities at Nuremberg. In December 1945 the British became aware of the extent of medical war crimes committed by the Germans. Their investigation led to an eventual handover to the Americans of a group of German doctors for trial at Nuremberg. At the same time the British and French Supported an International Scientific Commission for the Investigation of Medical War Crimes.

  5. Self-medication practice in Ethiopia: a systematic review

    Science.gov (United States)

    Ayalew, Mohammed Biset

    2017-01-01

    Background Self-medication patterns vary among different populations, and are influenced by many factors. No review has been done that comprehensively expresses self-medication practice in Ethiopia. The aim of this study was to provide an overview of the literature on self-medication practice in Ethiopia. Materials and methods Databases (PubMed, Google Scholar, ResearchGate, and Hinari) were searched for published studies on the practice of self-medication in Ethiopia without restriction in the year of publication or methodology. Some studies were also identified through manual Google search. Primary search terms were “self medication”, “Ethiopia”, “self care”, “non-prescription”, “OTC drug use”, “drug utilization”, and “drug hoarding”. Studies that measured knowledge only or attitude only or beliefs only and did not determine the practice of self-medication were excluded. Results The database search produced a total of 450 papers. After adjustment for duplicates and inclusion and exclusion criteria, 21 articles were found suitable for the review. All studies were cross-sectional in nature. The prevalence of self-medication varied from 12.8% to 77.1%, with an average of 36.8%. Fever/headache, gastrointestinal tract diseases, and respiratory diseases were the commonest illnesses/symptoms for which self-medication was taken. The major reasons for practicing self-medication were previous experience of treating a similar illness and feeling that the illness was mild. Analgesics/antipyretics, antimicrobials, gastrointestinal drugs, and respiratory drugs were the common drug classes used in self-medication. Mainly, these drugs were obtained from drug-retail outlets. The use of self-medication was commonly suggested by pharmacy professionals and friends/relatives. Conclusion Self-medication practice is prevalent in Ethiopia and varies in different populations and regions of the country. Some of the self-medication practices are harmful and need

  6. A comparison of medical litigation filed against obstetrics and gynecology, internal medicine, and surgery departments.

    Science.gov (United States)

    Hamasaki, Tomoko; Hagihara, Akihito

    2015-10-24

    The aim of this study was to review the typical factors related to physician's liability in obstetrics and gynecology departments, as compared to those in internal medicine and surgery, regarding a breach of the duty to explain. This study involved analyzing 366 medical litigation case reports from 1990 through 2008 where the duty to explain was disputed. We examined relationships between patients, physicians, variables related to physician's explanations, and physician's breach of the duty to explain by comparing mean values and percentages in obstetrics and gynecology, internal medicine, and surgical departments with the t-test and χ(2) test. When we compared the reasons for decisions in cases where the patient won, we found that the percentage of cases in which the patient's claim was recognized was the highest for both physician negligence, including errors of judgment and procedural mistakes, and breach of the duty to explain, in obstetrics and gynecology departments; breach of the duty to explain alone in internal medicine departments; and mistakes in medical procedures alone in surgical departments (p = 0.008). When comparing patients, the rate of death was significantly higher than that of other outcomes in precedents where a breach of the duty to explain was acknowledged (p = 0.046). The proportion of cases involving obstetrics and gynecology departments, in which care was claimed to be substandard at the time of treatment, and that were not argued as breach of a duty to explain, was significantly higher than those of other evaluated departments (p obstetrics and gynecology departments, the proportion of cases in which it had been conceded that the duty to explain had been breached when seeking patient approval (or not) was significantly higher than in other departments (p = 0.002). It is important for physicians working in obstetrics and gynecology departments to carefully explain the risk of death associated with any planned procedure, and to obtain

  7. Determinants of effective medical intern training at a training hospital ...

    African Journals Online (AJOL)

    2012-07-11

    Jul 11, 2012 ... misunderstanding regarding skills and competencies of doctors that were generally ... such as team work, ethics, confidence, professionalism and ..... interpersonal relationship reduces the conflicts at the workplace and intern.

  8. EUROPEAN AND INTERNATIONAL STANDARDS ON MEDICAL DEVICES FOR DENTISTRY.

    OpenAIRE

    Jordan Deliversky; Mariela Yaneva-Deliverska; Maya Lyapina; Angelina Kisselova

    2015-01-01

    Standards are produced for many different products and services, and may be created for company, national, regional or global application. In Europe there are three different categories of standard: International standard – a standard adopted by an international standardization organization; European standard – a standard adopted by a European standardization body; National standard – a standard adopted by a national standardization body and made available to the public. Harmonized standards ...

  9. Interventional tools to improve medication adherence: review of literature

    Science.gov (United States)

    Costa, Elísio; Giardini, Anna; Savin, Magda; Menditto, Enrica; Lehane, Elaine; Laosa, Olga; Pecorelli, Sergio; Monaco, Alessandro; Marengoni, Alessandra

    2015-01-01

    Medication adherence and persistence is recognized as a worldwide public health problem, particularly important in the management of chronic diseases. Nonadherence to medical plans affects every level of the population, but particularly older adults due to the high number of coexisting diseases they are affected by and the consequent polypharmacy. Chronic disease management requires a continuous psychological adaptation and behavioral reorganization. In literature, many interventions to improve medication adherence have been described for different clinical conditions, however, most interventions seem to fail in their aims. Moreover, most interventions associated with adherence improvements are not associated with improvements in other outcomes. Indeed, in the last decades, the degree of nonadherence remained unchanged. In this work, we review the most frequent interventions employed to increase the degree of medication adherence, the measured outcomes, and the improvements achieved, as well as the main limitations of the available studies on adherence, with a particular focus on older persons. PMID:26396502

  10. Patterns of paging medical interns during night calls at two teaching hospitals.

    Science.gov (United States)

    Harvey, R; Jarrett, P G; Peltekian, K M

    1994-01-01

    OBJECTIVE: To assess the patterns of paging medical interns during night calls. DESIGN: Descriptive study; diaries were used to log calls between 7 pm and 7 am for 1 week in February 1991. SETTING: Two teaching hospitals in Halifax. PARTICIPANTS: All 10 interns assigned to the 15 medical units and nurses from 3 representative medical units. MAIN OUTCOME MEASURES: Number and nature of calls. RESULTS: The overall response rate was 90%. A total of 309 calls were logged by the interns and 107 by the nurses. Each intern had 17 calls on average (range 6 to 33) per 12-hour period. Of the calls 27% occurred after midnight, 25% disrupted sleeping, and 19% interrupted direct patient contact. Overall, the most common reasons for paging interns were related to prescribing of medications (42% of the calls), direct patient assessment (25%) and reporting of laboratory results (18%). According to the nurses, there were no delays in the interns' responding to the pages, and 61% of the calls led to a new physician order. CONCLUSIONS: Paging frequently interrupts interns during work and rest on night calls. Assessment of paging patterns may be useful in identifying specific interventions to reduce the number of calls so that interns will have fewer interruptions during patient encounters and more rest. The collection of data from nurses in a routine nursing audit may be useful for evaluating the communication between interns and nurses and, indirectly, for assessing interns' workload. PMID:8039084

  11. Improving medical education in Kenya: an international collaboration.

    Science.gov (United States)

    Mayo, Alexa

    2014-04-01

    This paper describes a partnership between the University of Nairobi College of Health Sciences (CHS) Library and the University of Maryland Health Sciences and Human Services Library (HS/HSL). The libraries are collaborating to develop best practices for the CHS Library as it meets the challenge of changing medical education information needs in a digital environment. The collaboration is part of a Medical Education Partnership Initiative. The library project has several components: an assessment of the CHS Library, learning visits in the United States and Kenya, development of recommendations to enhance the CHS Library, and ongoing evaluation of the program's progress. Development of new services and expertise at the CHS Library is critical to the project's success. A productive collaboration between the HS/HSL and CHS Library is ongoing. A successful program to improve the quality of medical education will have a beneficial impact on health outcomes in Kenya.

  12. On-call duty effects on sleep-state physiological stability in male medical interns.

    Directory of Open Access Journals (Sweden)

    Yu-Hsuan Lin

    Full Text Available BACKGROUND: On-call duty among medical interns is characterized by sleep deprivation and stressful working conditions, both of which alter cardiac autonomic modulation. We hypothesized that sleep stability decreased in medical interns during on-call duty. We used cardiopulmonary-coupling (CPC analysis to test our hypothesis. METHODS: We used electrocardiogram (ECG-based CPC analysis to quantify physiological parameters of sleep stability in 13 medical interns during on-call and on-call duty-free periods. There were ten 33.5-h on-call duty shifts per month for interns, each followed by 2 on-call duty-free days, over 3 months. Measurements during sleep were collected before, during, and after an on-call shift. Measurements were repeated 3 months later during an on-call duty-free period. RESULTS: The medical interns had significantly reduced stable sleep, and displayed increased latency to the first epoch of stable sleep during the on-call night shift, compared to the pre-call and on-call duty-free nights. Interns also had significantly increased rapid-eye-movement (REM sleep during the on-call night shift, compared to the pre-call and on-call duty-free nights. CONCLUSION: Medical interns suffer disrupted sleep stability and continuity during on-call night shifts. The ECG-based CPC analysis provides a straightforward means to quantify sleep quality and stability in medical staff performing shift work under stressful conditions.

  13. Moving beyond the language barrier: the communication strategies used by international medical graduates in intercultural medical encounters.

    Science.gov (United States)

    Jain, Parul; Krieger, Janice L

    2011-07-01

    To understand the communication strategies international medical graduates use in medical interactions to overcome language and cultural barriers. In-depth interviews were conducted with 12 international physicians completing their residency training in internal medicine in a large hospital in Midwestern Ohio. The interview explored (a) barriers participants encountered while communicating with their patients regarding language, affect, and culture, and (b) communication convergence strategies used to make the interaction meaningful. International physicians use multiple convergence strategies when interacting with their patients to account for the intercultural and intergroup differences, including repeating information, changing speaking styles, and using non-verbal communication. Understanding barriers to communication faced by international physicians and recognizing accommodation strategies they employ in the interaction could help in training of future international doctors who come to the U.S. to practice medicine. Early intervention could reduce the time international physicians spend navigating through the system and trying to learn by experimenting with different strategies which will allow these physicians to devote more time to patient care. We recommend developing a training manual that is instructive of the socio-cultural practices of the region where international physician will start practicing medicine. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  14. Systematic literature review of hospital medication administration errors in children

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    Ameer A

    2015-11-01

    Full Text Available Ahmed Ameer,1 Soraya Dhillon,1 Mark J Peters,2 Maisoon Ghaleb11Department of Pharmacy, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK; 2Paediatric Intensive Care Unit, Great Ormond Street Hospital, London, UK Objective: Medication administration is the last step in the medication process. It can act as a safety net to prevent unintended harm to patients if detected. However, medication administration errors (MAEs during this process have been documented and thought to be preventable. In pediatric medicine, doses are usually administered based on the child's weight or body surface area. This in turn increases the risk of drug miscalculations and therefore MAEs. The aim of this review is to report MAEs occurring in pediatric inpatients. Methods: Twelve bibliographic databases were searched for studies published between January 2000 and February 2015 using “medication administration errors”, “hospital”, and “children” related terminologies. Handsearching of relevant publications was also carried out. A second reviewer screened articles for eligibility and quality in accordance with the inclusion/exclusion criteria. Key findings: A total of 44 studies were systematically reviewed. MAEs were generally defined as a deviation of dose given from that prescribed; this included omitted doses and administration at the wrong time. Hospital MAEs in children accounted for a mean of 50% of all reported medication error reports (n=12,588. It was also identified in a mean of 29% of doses observed (n=8,894. The most prevalent type of MAEs related to preparation, infusion rate, dose, and time. This review has identified five types of interventions to reduce hospital MAEs in children: barcode medicine administration, electronic prescribing, education, use of smart pumps, and standard concentration. Conclusion: This review has identified a wide variation in the prevalence of hospital MAEs in children. This is attributed to

  15. [Development of medical tourism in Georgia. Problems and prospectiv (review)].

    Science.gov (United States)

    Gerzmava, O; Lomtadze, L; Kitovani, D; Kadjrishvili, M

    2011-10-01

    Medical tourism is the movement of patients through a global network of health services. Medical tourists seek affordable healthcare on a timely basis in a variety of destination nations. The expansion of global medical services has sparked immense economic growth in developing nations and has created a new market for advertising access to care. Beyond offering a unique untapped market of services, medical tourism has invited a host of liability, malpractice and ethical concerns. The explosion of off-shore "mini-surgical" vacations will surely incite global unification and increased access, quality and affordability of care. Medical tourism is a dynamic subset of global health care that incorporates a variety of services, procedures and venues of care. Health insurance coverage, the impact on domestic and global markets, and the use of international standards of care will be examined in combination with quality, access and cost parameters. The global nature of medical tourism invites a variety of legal and ethical issues and calls for an organizational body to monitor this new phenomenon. Finally, the future implications of the globalization of health services and systems will be discussed.

  16. CHeCS: International Space Station Medical Hardware Catalog

    Science.gov (United States)

    2008-01-01

    The purpose of this catalog is to provide a detailed description of each piece of hardware in the Crew Health Care System (CHeCS), including subpacks associated with the hardware, and to briefly describe the interfaces between the hardware and the ISS. The primary user of this document is the Space Medicine/Medical Operations ISS Biomedical Flight Controllers (ISS BMEs).

  17. Cultural differences in medical communication: a review of the literature.

    Science.gov (United States)

    Schouten, Barbara C; Meeuwesen, Ludwien

    2006-12-01

    Culture and ethnicity have often been cited as barriers in establishing an effective and satisfying doctor-patient relationship. The aim of this paper is to gain more insight in intercultural medical communication difficulties by reviewing observational studies on intercultural doctor-patient communication. In addition, a research model for studying this topic in future research is proposed. A literature review using online databases (Pubmed, Psychlit) was performed. Findings reveal major differences in doctor-patient communication as a consequence of patients' ethnic backgrounds. Doctors behave less affectively when interacting with ethnic minority patients compared to White patients. Ethnic minority patients themselves are also less verbally expressive; they seem to be less assertive and affective during the medical encounter than White patients. Most reviewed studies did not relate communication behaviour to possible antecedent culture-related variables, nor did they assess the effect of cultural variations in doctor-patient communication on outcomes, leaving us in the dark about reasons for and consequences of differences in intercultural medical communication. Five key predictors of culture-related communication problems are identified in the literature: (1) cultural differences in explanatory models of health and illness; (2) differences in cultural values; (3) cultural differences in patients' preferences for doctor-patient relationships; (4) racism/perceptual biases; (5) linguistic barriers. It is concluded that by incorporating these variables into a research model future research on this topic can be enhanced, both from a theoretical and a methodological perspective. Using a cultural sensitive approach in medical communication is recommended.

  18. A Review of Simulators with Haptic Devices for Medical Training.

    Science.gov (United States)

    Escobar-Castillejos, David; Noguez, Julieta; Neri, Luis; Magana, Alejandra; Benes, Bedrich

    2016-04-01

    Medical procedures often involve the use of the tactile sense to manipulate organs or tissues by using special tools. Doctors require extensive preparation in order to perform them successfully; for example, research shows that a minimum of 750 operations are needed to acquire sufficient experience to perform medical procedures correctly. Haptic devices have become an important training alternative and they have been considered to improve medical training because they let users interact with virtual environments by adding the sense of touch to the simulation. Previous articles in the field state that haptic devices enhance the learning of surgeons compared to current training environments used in medical schools (corpses, animals, or synthetic skin and organs). Consequently, virtual environments use haptic devices to improve realism. The goal of this paper is to provide a state of the art review of recent medical simulators that use haptic devices. In particular we focus on stitching, palpation, dental procedures, endoscopy, laparoscopy, and orthopaedics. These simulators are reviewed and compared from the viewpoint of used technology, the number of degrees of freedom, degrees of force feedback, perceived realism, immersion, and feedback provided to the user. In the conclusion, several observations per area and suggestions for future work are provided.

  19. Narrative review of telemedicine consultation in medical practice

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    Di Cerbo A

    2015-01-01

    Full Text Available Alessandro Di Cerbo,1,2 Julio Cesar Morales-Medina,3 Beniamino Palmieri,1,2 Tommaso Iannitti4 1Poliambulatorio del Secondo Parere, 2Department of General Surgery and Surgical Specialties, Surgical Clinic, University of Modena and Reggio Emilia Medical School, Modena, Italy; 3Centro de Investigación en Reproducción Animal, CINVESTAV, Universidad Autónoma de Tlaxcala, Tlaxcala de Xicohténcatl, Mexico; 4Department of Neuroscience, Sheffield Institute for Translational Neuroscience (SITraN, University of Sheffield, Sheffield, UK Background: The use of telemedicine has grown across several medical fields, due to the increasing number of “e-patients”.Objective: This narrative review gives an overview of the growing use of telemedicine in different medical specialties, showing how its use can improve medical care.Methods: A PubMed/Medline, Embase, Web of Science, and Scopus search was performed using the following keywords: telemedicine, teleconsultation, telehealth, e-health, and e-­medicine. Selected papers from 1996 to 2014 were chosen on the basis of their content (quality and novelty.Results: Telemedicine has already been applied to different areas of medical practice, and it is as effective as face-to-face medical care, at least for the diagnosis and treatment of some pathological conditions.Conclusion: Telemedicine is time- and cost-effective for both patients and health care professionals, encouraging its use on a larger scale. Telemedicine provides specialist medical care to patients who have poor access to hospitals, and ensures continuity of care and optimal use of available health resources. The use of telemedicine opens new perspectives for patients seeking a medical second opinion for their pathology, since they can have remote access to medical resources that would otherwise require enormous costs and time. Keywords: telemedicine, health care, patient

  20. The effect of early in-hospital medication review on health outcomes: a systematic review

    Science.gov (United States)

    Hohl, Corinne M; Wickham, Maeve E; Sobolev, Boris; Perry, Jeff J; Sivilotti, Marco L A; Garrison, Scott; Lang, Eddy; Brasher, Penny; Doyle-Waters, Mary M; Brar, Baljeet; Rowe, Brian H; Lexchin, Joel; Holland, Richard

    2015-01-01

    Aims Adverse drug events are an important cause of emergency department visits, unplanned admissions and prolonged hospital stays. Our objective was to synthesize the evidence on the effect of early in-hospital pharmacist-led medication review on patient-oriented outcomes based on observed data. Methods We systematically searched eight bibliographic reference databases, electronic grey literature, medical journals, conference proceedings, trial registries and bibliographies of relevant papers. We included studies that employed random or quasi-random methods to allocate subjects to pharmacist-led medication review or control. Medication review had to include, at a minimum, obtaining a best possible medication history and reviewing medications for appropriateness and adverse drug events. The intervention had to be initiated within 24 h of emergency department presentation or 72 h of admission. We extracted data in duplicate and pooled outcomes from clinically homogeneous studies of the same design using random effects meta-analysis. Results We retrieved 4549 titles of which seven were included, reporting the outcomes of 3292 patients. We pooled data from studies of the same design, and found no significant differences in length of hospital admission (weighted mean difference [WMD] –0.04 days, 95% confidence interval [CI] –1.63, 1.55), mortality (odds ratio [OR] 1.09, 95% CI 0.69, 1.72), readmissions (OR 1.15, 95% CI 0.81, 1.63) or emergency department revisits at 3 months (OR 0.60, 95% CI 0.27, 1.32). Two large studies reporting reductions in readmissions could not be included in our pooled estimates due to differences in study design. Conclusions Wide confidence intervals suggest that additional research is likely to influence the effect size estimates and clarify the effect of medication review on patient-oriented outcomes. This systematic review failed to identify an effect of pharmacist-led medication review on health outcomes. PMID:25581134

  1. Hepatitis-B Infection: Awareness among Medical, Dental Interns in India

    Directory of Open Access Journals (Sweden)

    Pazhaniaandi Tirounilacandin

    2010-06-01

    Full Text Available Aim: The aim of the study was to compare the level of awareness on Hepatitis-B infection among medical and dental interns in Pondicherry, India. Material and methods:Questionnaire containing a set of 20 different questions on Hepatitis B infection was distributed among 64 medical and 49 dental Interns of Arupadai Veedu Medical College and Mahatma Gandhi Dental College, Pondicherry, India, respectively. Results: The majority of interns (94.7% were aware that Hepatitis B virus is the major cause of Hepatitis. About 33.6 and 59.3% of interns had very good and moderate knowledge respectively. The study shows that dental interns (34.7% had better awareness than medical interns (32.8%. About 52.2% believed that Hepatitis B virus can be transmitted by semen and vaginal secretions. Only 39.9% of the interns believed that doctors, dentists infected with HBV should not have direct contact with patients. Conclusion: One- third of the interns had very good knowledge about Hepatitis B. The majority had good knowledge regarding the mode of transmission and attitude towards HBV patients. However, there is a misconception about prophylaxis, vaccination and treatment of HBV. Hence there is an imperative need for health education to improve the knowledge and attitude of the interns towards Hepatitis B.

  2. Metabolic and infectious pathologies in Brazilian medical literature: a review

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    Mauricio Rocha-e-Silva

    2010-06-01

    Full Text Available OBJECTIVE: This review of original reports on metabolic and infectious diseases that were recently published in Brazilian journals is designed to inform the readership of CLINICS about their content. METHODS: I conducted a search in PubMed for original research articles (clinical or basic research recently published (2008-2009 by Brazilian medical and biological periodicals. Papers on metabolic pathologies were retrieved by searching for appropriate keywords such as metabolic syndrome and obesity. Papers on infectious disease were obtained by entering 15 different keywords for the most commonly occurring pathologies. Review articles, editorials, letters to the editor, and case reports were manually excluded. Selected titles were then categorized into appropriate sub-categories. RESULTS: This search produced a total of 123 articles, which filtered down to 72 articles after eliminating editorials, review articles, letters to the Editor and case reports. Reviewed periodicals were Arquivos Brasileiros de Cardiologia, Arquivos Brasileiros de Endocrinologia e Metabologia, Brazilian Journal of Biological and Medical Research, Brazilian Journal of Infectious Diseases, Jornal de Pediatria, Jornal de Pneumologia, Revista da Associação Médica Brasileira, Revista da Escola de Enfermagem da Universidade de São Paulo, and São Paulo Medical Journal. The articles were then briefly summarized.

  3. Metabolic and infectious pathologies in Brazilian medical literature: a review.

    Science.gov (United States)

    Rocha-e-Silva, Mauricio

    2010-06-01

    This review of original reports on metabolic and infectious diseases that were recently published in Brazilian journals is designed to inform the readership of CLINICS about their content. I conducted a search in PubMed for original research articles (clinical or basic research) recently published (2008-2009) by Brazilian medical and biological periodicals. Papers on metabolic pathologies were retrieved by searching for appropriate keywords such as metabolic syndrome and obesity. Papers on infectious disease were obtained by entering 15 different keywords for the most commonly occurring pathologies. Review articles, editorials, letters to the editor, and case reports were manually excluded. Selected titles were then categorized into appropriate sub-categories. This search produced a total of 123 articles, which filtered down to 72 articles after eliminating editorials, review articles, letters to the Editor and case reports. Reviewed periodicals were Arquivos Brasileiros de Cardiologia, Arquivos Brasileiros de Endocrinologia e Metabologia, Brazilian Journal of Biological and Medical Research, Brazilian Journal of Infectious Diseases, Jornal de Pediatria, Jornal de Pneumologia, Revista da Associação Médica Brasileira, Revista da Escola de Enfermagem da Universidade de São Paulo, and São Paulo Medical Journal. The articles were then briefly summarized.

  4. Internal Grant Review to Increase Grant Funding for Junior Investigators.

    Science.gov (United States)

    Thomas, Heather S; Brodsky, Martin B; Ewen, Joshua B; Bergey, Gregory K; Lloyd, Thomas E; Haughey, Norman J; Marvel, Cherie L

    2017-09-04

    Decreasing biomedical research support over the past decade has driven many talented young scientists to seek careers outside academia. In 2011, the Department of Neurology at Johns Hopkins University School of Medicine developed an internal grant review program (IGRP) to systematically review career development awards (CDAs) and research grants (e.g., R01s) for junior investigators prior to NIH submission. With IGRP implementation, we observed significant increases in the number of CDAs and R-grants awarded to junior investigators. Thus, internal grant review is an effective means for supporting junior faculty and help them retain their research roles within academia. This article is protected by copyright. All rights reserved. © 2017 American Neurological Association.

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

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    Walzer S

    2014-03-01

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

  6. A national survey of international electives for medical students in Japan: 2009-2010.

    Science.gov (United States)

    Nishigori, Hiroshi; Takahashi, Osamu; Sugimoto, Naomi; Kitamura, Kiyoshi; McMahon, Graham T

    2012-01-01

    International electives can provide experiences for medical students to learn about health systems and foster critical self-reflection. So far, little is known about the status of Japanese students' engagement in international electives. We sought to provide information about the internationalization of Japanese medical education by clarifying the current situations of international electives. We undertook a cross-sectional national 17-item questionnaire survey of program officers in all medical schools in Japan in February 2010. Sixty-five (81.3%) of 80 Japanese medical schools responded to the questionnaire. 462 Japanese medical students (3% of all students in their clinical years) travelled to North America (45.5%), Asia (25.0%), or Western Europe (24.4%) to study abroad. The number of students who participated in international electives was significantly increased when academic credit was available (median 6 vs. 1, p students, p students were evaluated by means of written assignment on return. About 3% of Japanese medical students participate in international clinical exchanges. Academic credit and institutional affiliations appear to promote greater utilization of international exchange opportunities.

  7. The Burmese medic: an international physician assistant analogue.

    Science.gov (United States)

    Pedersen, Donald M; Pedersen, Kathy J; Santitamrongpan, Verapan

    2012-01-01

    Although there have been recent democratic reforms in Myanmar (formerly known as Burma), for nearly 60 years there has been a consistent history of human rights violations as part of a civil war waged by the Myanmar military, known as the Tatmadaw. Approximately 3,500 villages have been destroyed by the Tatmadaw during the half-century of civil war. Oppression against minority groups, including the Karen, Karenni, Kachin, Mon, Shan, Chin, and Muslims has adversely affected the health outcomes of these vulnerable populations. Since the mid 1990s, medics have been providing care for the ethnic minorities who were displaced from their homes by the civil war and who live in the jungles of eastern Burma as well as in the refugee camps and towns in the border areas of Thailand. This article will look at how these medics are providing care similar to that provided by physician assistants in the United States.

  8. Incretin-based medications for type 2 diabetes: an overview of reviews.

    Science.gov (United States)

    Gamble, J-M; Clarke, A; Myers, K J; Agnew, M D; Hatch, K; Snow, M M; Davis, E M

    2015-07-01

    To summarize evidence from and assess the quality of published systematic reviews evaluating the safety, efficacy and effectiveness of incretin-based medications used in the treatment of type 2 diabetes. We identified systematic reviews of randomized controlled trials or observational studies published in any language that evaluated the safety and/or effectiveness of glucagon-like peptide-1 (GLP-1) receptor agonists or dipeptidyl-peptidase-4 (DPP-4) inhibitors. Data sources used include the Cochrane Library, PubMed, EMBASE, Web of Science, International Pharmaceutical Abstracts, table of contents of diabetes journals, and hand-searching of reference lists and clinical practice guidelines. The methodological quality of systematic reviews was independently assessed by two reviewers using the Assessment of Multiple Systematic Reviews (AMSTAR) checklist. Our study protocol was registered with PROSPERO (2013:CRD42013005149). The primary outcomes were pooled treatment effect estimates for glycaemic control, macrovascular and microvascular complications, and hypoglycaemic events. We identified 467 unique citations of which 84 systematic reviews met our inclusion criteria. There were 51 reviews that evaluated GLP-1 receptor agonists and 64 reviews that evaluated DPP-4 inhibitors. The median (interquartile range) AMSTAR score was 6 (3) out of 11 for quantitative and 1 (1) for non-quantitative reviews. Among the 66 quantitative systematic reviews, there were a total of 718 pooled treatment effect estimates reported for our primary outcomes and 1012 reported pooled treatment effect estimates for secondary outcomes. Clinicians and policy makers, when using the results of systematic reviews to inform decision-making with regard to round clinical care or healthcare policies for incretin-based medications, should consider the variability in quality of reviews. © 2015 John Wiley & Sons Ltd.

  9. 76 FR 19174 - In the Matter of Centrack International, Inc., Alternafuels, Inc., Intelligent Medical Imaging...

    Science.gov (United States)

    2011-04-06

    ... From the Federal Register Online via the Government Publishing Office SECURITIES AND EXCHANGE COMMISSION In the Matter of Centrack International, Inc., Alternafuels, Inc., Intelligent Medical Imaging... Intelligent Medical Imaging, Inc. because it has not filed any periodic reports since the period ended...

  10. Gatekeepers of a Profession? Employability as Capital in the Recruitment of Medical Interns

    Science.gov (United States)

    Lindberg, Ola

    2013-01-01

    The present article concerns employability in physicians' professional practice. Drawing on interview data from recruiters at 21 Swedish hospitals with the most applicants for a medical internship, the article seeks to develop a theory of what constitutes an "employable medical intern". Using Pierre Bourdieu's concept of…

  11. En route: Transport and embodiment in international medical travel journeys between Indonesia and Malaysia

    NARCIS (Netherlands)

    Ormond, M.E.

    2015-01-01

    International medical travel is increasingly big business. Using Indonesian patient-consumers’transport experiences in the pursuit of private medical care in Malaysia, this paper explores howtransport operators and infrastructure are responding and adjusting to the embodied specificities of the grow

  12. Gatekeepers of a Profession? Employability as Capital in the Recruitment of Medical Interns

    Science.gov (United States)

    Lindberg, Ola

    2013-01-01

    The present article concerns employability in physicians' professional practice. Drawing on interview data from recruiters at 21 Swedish hospitals with the most applicants for a medical internship, the article seeks to develop a theory of what constitutes an "employable medical intern". Using Pierre Bourdieu's concept of capital, two…

  13. Advancing Medication Reconciliation in an Outpatient Internal Medicine Clinic through a Pharmacist-Led Educational Initiative

    Directory of Open Access Journals (Sweden)

    Sarah M. Westberg, Pharm.D.

    2010-01-01

    Full Text Available Objectives: To develop and deliver an effective pharmacist-led educational initiative to clinic staff to advance medication reconciliation in the electronic medical record of an outpatient internal medicine clinic.Methods: An educational initiative designed to improve the ability of nursing staff in medication reconciliation was launched in the outpatient internal medicine clinic of a regional healthcare system. The education was provided by the pharmacist to clinic nursing staff, including registered nurses, licensed practical nurses, and certified medical assistants. The impact of this training was measured through pre-initiation and post-implementation surveys, competency assessments and an audit. Results: The educational initiative was successfully designed and delivered to clinic nursing staff. Assessment of the initiative found that all nursing staff completing competency assessments successfully passed. Pre-initiation- and post-implementation- survey responses on the self-assessed ability to gather and document accurate medication lists did not show significant changes. Informal observations in the clinic indicated that this initiative changed the culture of the clinic, creating increased awareness of the importance of accurate medications and increased emphasis on medication reconciliation.Conclusions: The expertise of pharmacists can be utilized to educate nursing staff on the skills and abilities necessary to gather and document accurate medication lists. This study did not find measurable changes in the accuracy of medication lists in this clinic. Future research is needed to determine the best methods to train health professionals in medication reconciliation to ensure accurate medication lists in the outpatient setting.

  14. Faith-Based International Development Work: A Review

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    Dan Heist

    2016-02-01

    Full Text Available In the wake of the Faith-Based Initiative in the USA, substantial research has resulted in an increased awareness of religious congregations and faith-based organizations as welfare service providers. The next frontier appears to be the role of religious organizations in international social and economic development, a topic that only recently started to attract academic interest. In this paper, we review available literature on the role that religious, or faith-based, organizations play in international social and economic development. We also provide results from our own study of USA international NGOs1 that are faith-based. We divide the paper into the positive contributions of faith-based international NGOs and the drawbacks of these NGOs. We find that faith-based nonprofits constitute almost 60 percent of USA-based international development organizations, and their contribution to international social development is quite considerable. We conclude with a call for further research and nuanced understanding of the role religion plays in international development.

  15. Chaplains on the Medical Team: A Qualitative Analysis of an Interprofessional Curriculum for Internal Medicine Residents and Chaplain Interns.

    Science.gov (United States)

    Hemming, Patrick; Teague, Paula J; Crowe, Thomas; Levine, Rachel

    2016-04-01

    Improved collaboration between physicians and chaplains has the potential to improve patient experiences. To better understand the benefits and challenges of learning together, the authors conducted several focus groups with participants in an interprofessional curriculum that partnered internal medicine residents with chaplain interns in the clinical setting. The authors derived four major qualitative themes from the transcripts: (1) physician learners became aware of effective communication skills for addressing spirituality. (2) Chaplain interns enhanced the delivery of team-based patient-centered care. (3) Chaplains were seen as a source of emotional support to the medical team. (4) The partnership has three keys to success: adequate introductions for team members, clear expectations for participants, and opportunities for feedback. The themes presented indicate several benefits of pairing physicians and chaplains in the setting of direct patient care and suggest that this is an effective approach to incorporating spirituality in medical training.

  16. International scientific consensus on medical plantar pressure measurement devices: technical requirements and performance

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    Claudia Giacomozzi

    2012-01-01

    Full Text Available BACKGROUND: Since 2006, the Italian National Institute of Health (ISS has been conducting independent scientific activities to standardize the technical assessment of plantar pressure measurement devices (PMDs. MATERIAL AND METHODS: On the basis of the ISS results, in 2010 the Pedobarographic Group of the International Foot and Ankle Biomechanics community (i-FAB-PG promoted a consensus activity about the main technical requirements for the appropriate use of PMDs. The activity relied on a moodlebased on-line forum, documents exchange, discussions, reviews, meetings and a final survey. RESULTS: The participation of clinical and technical researchers, users, and manufacturers, contributed to the delivery of the hereby reported recommendations which specifically regard Medical PMDs in the form of platforms. CONCLUSIONS: The i-FAB-PG community reached overall agreement on the recommendations, with a few minor objections which are reported and commented in the document. RELEVANCE: The present document, the highest result achievable within a small scientific community, will hopefully represent the starting point of the wider process of establishing official international guidelines or standards, within scientific communities and standardization organizations.

  17. Personality factors and medical training: a review of the literature.

    Science.gov (United States)

    Doherty, Eva M; Nugent, Emmeline

    2011-02-01

    it has been acknowledged that certain personality characteristics influence both medical students' and doctors' performance. With regard to medical students, studies have been concerned with the role of personality, and performance indicators such as academic results and clinical competence. In addition, the link between personality and vulnerability to stress, which has implications for performance, has been investigated at both undergraduate and postgraduate levels. Most of the studies cited in the literature were published before the year 2000. The authors therefore undertook a literature search to determine whether any prospective systematic studies have been published since 2000. a review of the literature for 2000-2009 was performed, using the databases MEDLINE, PsycINFO and CINAHL. The search terms used were 'personality', 'performance', 'stress' and 'medical student'. Specific inclusion criteria required studies to be cohort studies carried out over a minimum period of 2 years, which measured medical student scores on valid and reliable personality tests, and used objective measures of performance and stress. the authors identified seven suitable studies. Four of these looked at personality factors and academic success, one looked at personality factors and clinical competence, and two looked at personality factors and stress. The main personality characteristic repeatedly identified in the literature was conscientiousness. the personality trait known as conscientiousness has been found to be a significant predictor of performance in medical school. The relationship between personality and performance becomes increasingly significant as learners advance through medical training. Additional traits concerning sociability (i.e. extraversion, openness, self-esteem and neuroticism) have also been identified as relevant, particularly in the applied medical environment. A prospective national study with the collaboration of all medical schools would make it

  18. Standardized sign-out reduces intern perception of medical errors on the general internal medicine ward.

    Science.gov (United States)

    Salerno, Stephen M; Arnett, Michael V; Domanski, Jeremy P

    2009-01-01

    Prior research on reducing variation in housestaff handoff procedures have depended on proprietary checkout software. Use of low-technology standardization techniques has not been widely studied. We wished to determine if standardizing the process of intern sign-out using low-technology sign-out tools could reduce perception of errors and missing handoff data. We conducted a pre-post prospective study of a cohort of 34 interns on a general internal medicine ward. Night interns coming off duty and day interns reassuming care were surveyed on their perception of erroneous sign-out data, mistakes made by the night intern overnight, and occurrences unanticipated by sign-out. Trainee satisfaction with the sign-out process was assessed with a 5-point Likert survey. There were 399 intern surveys performed 8 weeks before and 6 weeks after the introduction of a standardized sign-out form. The response rate was 95% for the night interns and 70% for the interns reassuming care in the morning. After the standardized form was introduced, night interns were significantly (p intern. However, the day teams thought there were significantly less perceived errors on the part of the night intern (p = .001) after introduction of the standardized sign-out sheet. There was no difference in mean Likert scores of resident satisfaction with sign-out before and after the intervention. Standardized written sign-out sheets significantly improve the completeness and effectiveness of handoffs between night and day interns. Further research is needed to determine if these process improvements are related to better patient outcomes.

  19. Applying the International Medical Graduate Program Model to Alleviate the Supply Shortage of Accounting Doctoral Faculty

    Science.gov (United States)

    HassabElnaby, Hassan R.; Dobrzykowski, David D.; Tran, Oanh Thikie

    2012-01-01

    Accounting has been faced with a severe shortage in the supply of qualified doctoral faculty. Drawing upon the international mobility of foreign scholars and the spirit of the international medical graduate program, this article suggests a model to fill the demand in accounting doctoral faculty. The underlying assumption of the suggested model is…

  20. Mediators for internalizing problems in adolescents of parents with chronic medical condition

    NARCIS (Netherlands)

    Sieh, D.S.; Oort, F.J.; Visser-Meily, J.M.A.; Meijer, A.M.

    2014-01-01

    Parents’ chronic medical condition (CMC) is related to internalizing problem behavior in adolescents. Following the transactional stress and coping (TSC) model of Hocking and Lochman, our study examines whether the effect of illness and demographic parameters on the child’s internalizing problems is

  1. Mediators for internalizing problems in adolescents of parents with chronic medical condition

    NARCIS (Netherlands)

    D.S. Sieh; F.J. Oort; J.M.A. Visser-Meily; A.M. Meijer

    2014-01-01

    Parents’ chronic medical condition (CMC) is related to internalizing problem behavior in adolescents. Following the transactional stress and coping (TSC) model of Hocking and Lochman, our study examines whether the effect of illness and demographic parameters on the child’s internalizing problems is

  2. The use of GP electronic medical records for international comparisons on prescription.

    NARCIS (Netherlands)

    Verheij, R.; Dijk, L. van; Pringle, M.; Elliott, C.; Fleming, D.M.

    2007-01-01

    Aims: Much international research on prescription does not take into account the associated diagnoses. Subsequently, large scale international comparisons on what is prescribed for which disease are relatively rare. Routinely collected GP electronic medical records, whose use is well established in

  3. The use of GP electronic medical records for international comparisons on prescription.

    NARCIS (Netherlands)

    Verheij, R.; Dijk, L. van; Pringle, M.; Elliott, C.; Fleming, D.M.

    2007-01-01

    Aims: Much international research on prescription does not take into account the associated diagnoses. Subsequently, large scale international comparisons on what is prescribed for which disease are relatively rare. Routinely collected GP electronic medical records, whose use is well established in

  4. Do calculation errors by nurses cause medication errors in clinical practice? A literature review.

    Science.gov (United States)

    Wright, Kerri

    2010-01-01

    This review aims to examine the literature available to ascertain whether medication errors in clinical practice are the result of nurses' miscalculating drug dosages. The research studies highlighting poor calculation skills of nurses and student nurses have been tested using written drug calculation tests in formal classroom settings [Kapborg, I., 1994. Calculation and administration of drug dosage by Swedish nurses, student nurses and physicians. International Journal for Quality in Health Care 6(4): 389 -395; Hutton, M., 1998. Nursing Mathematics: the importance of application Nursing Standard 13(11): 35-38; Weeks, K., Lynne, P., Torrance, C., 2000. Written drug dosage errors made by students: the threat to clinical effectiveness and the need for a new approach. Clinical Effectiveness in Nursing 4, 20-29]; Wright, K., 2004. Investigation to find strategies to improve student nurses' maths skills. British Journal Nursing 13(21) 1280-1287; Wright, K., 2005. An exploration into the most effective way to teach drug calculation skills to nursing students. Nurse Education Today 25, 430-436], but there have been no reviews of the literature on medication errors in practice that specifically look to see whether the medication errors are caused by nurses' poor calculation skills. The databases Medline, CINAHL, British Nursing Index (BNI), Journal of American Medical Association (JAMA) and Archives and Cochrane reviews were searched for research studies or systematic reviews which reported on the incidence or causes of drug errors in clinical practice. In total 33 articles met the criteria for this review. There were no studies that examined nurses' drug calculation errors in practice. As a result studies and systematic reviews that investigated the types and causes of drug errors were examined to establish whether miscalculations by nurses were the causes of errors. The review found insufficient evidence to suggest that medication errors are caused by nurses' poor

  5. Attitudes of medical students to medical leadership and management: a systematic review to inform curriculum development

    Directory of Open Access Journals (Sweden)

    Abbas Mark R

    2011-11-01

    Full Text Available Abstract Background There is a growing acknowledgement that doctors need to develop leadership and management competences to become more actively involved in the planning, delivery and transformation of patient services. We undertook a systematic review of what is known concerning the knowledge, skills and attitudes of medical students regarding leadership and management. Here we report the results pertaining to the attitudes of students to provide evidence to inform curriculum development in this developing field of medical education. Methods We searched major electronic databases and citation indexes within the disciplines of medicine, education, social science and management. We undertook hand searching of major journals, and reference and citation tracking. We accessed websites of UK medical institutions and contacted individuals working within the field. Results 26 studies were included. Most were conducted in the USA, using mainly quantitative methods. We used inductive analysis of the topics addressed by each study to identity five main content areas: Quality Improvement; Managed Care, Use of Resources and Costs; General Leadership and Management; Role of the Doctor, and Patient Safety. Students have positive attitudes to clinical practice guidelines, quality improvement techniques and multidisciplinary teamwork, but mixed attitudes to managed care, cost containment and medical error. Education interventions had variable effects on students' attitudes. Medical students perceive a need for leadership and management education but identified lack of curriculum time and disinterest in some activities as potential barriers to implementation. Conclusions The findings from our review may reflect the relatively little emphasis given to leadership and management in medical curricula. However, students recognise a need to develop leadership and management competences. Although further work needs to be undertaken, using rigorous methods, to identify

  6. Hypnosis before diagnostic or therapeutic medical procedures: a systematic review.

    Science.gov (United States)

    Cheseaux, Nicole; de Saint Lager, Alix Juillet; Walder, Bernhard

    2014-01-01

    The aim of this systematic review was to estimate the efficiency of hypnosis prior to medical procedures. Different databases were analyzed to identify randomized controlled trials (RCTs) comparing hypnosis to control interventions. All RCTs had to report pain or anxiety. Eighteen RCTs with a total of 968 patients were included; study size was from 20 to 200 patients (14 RCTs ≤ 60 patients). Fourteen RCTs included 830 adults and 4 RCTs included 138 children. Twelve of 18 RCTs had major quality limitations related to unclear allocation concealments, provider's experience in hypnosis, patient's adherence to hypnotic procedures, and intention-to-treat design. This systematic review observed major methodological limitations in RCTs on hypnosis prior to medical procedures.

  7. Medication review in hospitalised patients to reduce morbidity and mortality

    DEFF Research Database (Denmark)

    Christensen, Mikkel; Lundh, Andreas

    2016-01-01

    : We searched the Specialised Register of the Cochrane Effective Practice and Organisation of Care (EPOC) Group; the Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE; EMBASE; and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) to November 2014, as well......BACKGROUND: Pharmacotherapy in the elderly population is complicated by several factors that increase the risk of drug-related harms and less favourable effectiveness. The concept of medication review is a key element in improving the quality of prescribing and in preventing adverse drug events...... CRITERIA: We included randomised controlled trials (RCTs) of medication review in hospitalised adult patients. We excluded trials of outclinic and paediatric patients. Our primary outcome was all-cause mortality, and secondary outcomes included hospital readmissions, emergency department contacts...

  8. Psychology of medically unexplained symptoms: A practical review

    Directory of Open Access Journals (Sweden)

    Sirous Mobini

    2015-12-01

    Full Text Available Medically unexplained symptoms (MUS or functional neurological symptoms (FNS are commonly seen in the medical and rehabilitation settings. Clinicians often tend to describe patients with MUS as the “most difficult to help”. This practical review discusses epidemiology, clinical presentations, assessment and diagnosis of these psychiatric and neurological conditions, and summarises psychological models that have been linked to the development and maintenance of MUS. The final purpose of the present paper was to review the current literature in the treatment on the management and treatment of MUS. It concludes that future research should focus on a more integrated treatment approach which addresses various biological, psychological and social factors contributing to the onset and maintenance of these debilitating conditions.

  9. Medication adherence to oral anticancer drugs: systematic review.

    Science.gov (United States)

    Huang, Wen-Chuan; Chen, Chung-Yu; Lin, Shun-Jin; Chang, Chao-Sung

    2016-01-01

    Many studies have demonstrated that non-adherence to oral anticancer drugs (OACDs) has challenged treatment efficacy. Otherwise, few validated tools exist to measure patients' adherence to medication regimen in clinical practice. To synthesize previous studies on adherence by cancer patients taking OACDs, especially in targeted therapy, a systematic search of several electronic databases was conducted. We analyzed existing scales' contents for various cancer patients and outcomes of studies assessing adherence. However, a well-validated scale designed particularly for OACD adherence is still lacking. Most adherence scales used in the studies reviewed contain items focused on measuring patients' medication-taking behavior more than their barriers to medication compliance and beliefs. However, non-adherence to OACDs is a complex phenomenon, and drug-taking barriers and patient beliefs significantly affect patients' non-adherence. To understand the key drivers and predisposing factors for non-adherence, we need to develop a well-validated, multidimensional scale.

  10. Teamwork assessment in internal medicine: a systematic review of validity evidence and outcomes.

    Science.gov (United States)

    Havyer, Rachel D A; Wingo, Majken T; Comfere, Nneka I; Nelson, Darlene R; Halvorsen, Andrew J; McDonald, Furman S; Reed, Darcy A

    2014-06-01

    Valid teamwork assessment is imperative to determine physician competency and optimize patient outcomes. We systematically reviewed published instruments assessing teamwork in undergraduate, graduate, and continuing medical education in general internal medicine and all medical subspecialties. We searched MEDLINE, MEDLINE In-process, CINAHL and PsycINFO from January 1979 through October 2012, references of included articles, and abstracts from four professional meetings. Two content experts were queried for additional studies. Included studies described quantitative tools measuring teamwork among medical students, residents, fellows, and practicing physicians on single or multi-professional (interprofessional) teams. Instrument validity and study quality were extracted using established frameworks with existing validity evidence. Two authors independently abstracted 30 % of articles and agreement was calculated. Of 12,922 citations, 178 articles describing 73 unique teamwork assessment tools met inclusion criteria. Interrater agreement was intraclass correlation coefficient 0.73 (95 % CI 0.63-0.81). Studies involved practicing physicians (142, 80 %), residents/fellows (70, 39 %), and medical students (11, 6 %). The majority (152, 85 %) assessed interprofessional teams. Studies were conducted in inpatient (77, 43 %), outpatient (42, 24 %), simulation (37, 21 %), and classroom (13, 7 %) settings. Validity evidence for the 73 tools included content (54, 74 %), internal structure (51, 70 %), relationships to other variables (25, 34 %), and response process (12, 16 %). Attitudes and opinions were the most frequently assessed outcomes. Relationships between teamwork scores and patient outcomes were directly examined for 13 (18 %) of tools. Scores from the Safety Attitudes Questionnaire and Team Climate Inventory have substantial validity evidence and have been associated with improved patient outcomes. Review is limited to quantitative assessments of teamwork in internal

  11. Empirical research on international environmental migration: a systematic review.

    Science.gov (United States)

    Obokata, Reiko; Veronis, Luisa; McLeman, Robert

    2014-01-01

    This paper presents the findings of a systematic review of scholarly publications that report empirical findings from studies of environmentally-related international migration. There exists a small, but growing accumulation of empirical studies that consider environmentally-linked migration that spans international borders. These studies provide useful evidence for scholars and policymakers in understanding how environmental factors interact with political, economic and social factors to influence migration behavior and outcomes that are specific to international movements of people, in highlighting promising future research directions, and in raising important considerations for international policymaking. Our review identifies countries of migrant origin and destination that have so far been the subject of empirical research, the environmental factors believed to have influenced these migrations, the interactions of environmental and non-environmental factors as well as the role of context in influencing migration behavior, and the types of methods used by researchers. In reporting our findings, we identify the strengths and challenges associated with the main empirical approaches, highlight significant gaps and future opportunities for empirical work, and contribute to advancing understanding of environmental influences on international migration more generally. Specifically, we propose an exploratory framework to take into account the role of context in shaping environmental migration across borders, including the dynamic and complex interactions between environmental and non-environmental factors at a range of scales.

  12. Medication Adherence With Diabetes Medication: A Systematic Review of the Literature.

    Science.gov (United States)

    Capoccia, Kam; Odegard, Peggy S; Letassy, Nancy

    2016-02-01

    The primary purpose of this systematic review is to synthesize the evidence regarding risk factors associated with nonadherence to prescribed glucose-lowering agents, the impact of nonadherence on glycemic control and the economics of diabetes care, and the interventions designed to improve adherence. Medline, EMBASE, the Cochrane Collaborative, BIOSIS, and the Health and Psychosocial Instruments databases were searched for studies of medication adherence for the period from May 2007 to December 2014. Inclusion criteria were study design and primary outcome measuring or characterizing adherence. Published evidence was graded according to the American Association of Clinical Endocrinologists protocol for standardized production of clinical practice guidelines. One hundred ninety-six published articles were reviewed; 98 met inclusion criteria. Factors including age, race, health beliefs, medication cost, co-pays, Medicare Part D coverage gap, insulin use, health literacy, primary nonadherence, and early nonpersistence significantly affect adherence. Higher adherence was associated with improved glycemic control, fewer emergency department visits, decreased hospitalizations, and lower medical costs. Adherence was lower when medications were not tolerated or were taken more than twice daily, with concomitant depression, and with skepticism about the importance of medication. Intervention trials show the use of phone interventions, integrative health coaching, case managers, pharmacists, education, and point-of-care testing improve adherence. Medication adherence remains an important consideration in diabetes care. Health professionals working with individuals with diabetes (eg, diabetes educators) are in a key position to assess risks for nonadherence, to develop strategies to facilitate medication taking, and to provide ongoing support and assessment of adherence at each visit. © 2015 The Author(s).

  13. Medical ward round competence in internal medicine - an interview study towards an interprofessional development of an Entrustable Professional Activity (EPA).

    Science.gov (United States)

    Wölfel, Teresa; Beltermann, Esther; Lottspeich, Christian; Vietz, Elisa; Fischer, Martin R; Schmidmaier, Ralf

    2016-07-11

    The medical ward round is a central but complex activity that is of relevance from the first day of work. However, difficulties for young doctors have been reported. Instruction of ward round competence in medical curricula is hampered by the lack of a standardized description of the procedure. This paper aims to identify and describe physicians' tasks and relevant competences for conducting a medical ward round on the first day of professional work. A review of recent literature revealed known important aspects of medical ward rounds. These were used for the development of a semi-structured interview schedule. Medical ward round experts working at different hospitals were interviewed. The sample consisted of 14 ward physicians (M = 8.82 years of work experience) and 12 nurses (M = 14.55 years of work experience) working in different specializations of internal medicine. All interviews were audiotaped, fully transcribed, and analyzed using an inductive-deductive coding scheme. Nine fields of competences with 18 related sub-competences and 62 observable tasks were identified as relevant for conducting a medical ward round. Over 70 % of the experts named communication, collaborative clinical reasoning and organization as essential competences. Deeper analysis further unveiled the importance of self-management, management of difficult situations, error management and teamwork. The study is the first to picture ward round competences and related tasks in detail and to define an EPA "Conducting an internal medicine ward round" based on systematic interprofessional expert interviews. It thus provides a basis for integration of ward round competences in the medical curricula in an evidence based manner and gives a framework for the development of instructional intervention studies and comparative studies in other medical fields.

  14. [International Health Electives in developing countries for medical and nursing students: four experiences from French-speaking Switzerland].

    Science.gov (United States)

    Chastonay, Philippe; Baumann, Fritz; Chastonay, Oriane; Staudacher, Kevin; Verloo, Henk; Kabengele, Emmanuel; Mattig, Thomas; Michaud, Pierre-André; Bernheim, Laurent

    2015-06-10

    International Health Electives performed in developing countries by students of medical and nursing schools from industrialized nations have recently become a highly valued element in curricula of medical and nursing schools. We report here four examples of such electives developed over the years at the Faculties of medicine of Geneva and Lausanne, one involving both medical and nursing school students. These electives foster enthusiasm and commitment among students and host institutions abroad. A selective review of the literature highlights the many positive aspects of such electives for the professional and personal development of students. It also emphasizes what the host institutions can gain from these electives provided the latter are organized in a balanced partnership and that the students receive a careful preparation to avoid possible pitfalls.

  15. Organization and Management of the International Space Station (ISS) Multilateral Medical Operations

    Science.gov (United States)

    Duncan, J. M.; Bogomolov, V. V.; Castrucci, F.; Koike, Y.; Comtois, J. M.; Sargsyan, A. E.

    2007-01-01

    The goal of this work is to review the principles, design, and function of the ISS multilateral medical authority and the medical support system of the ISS Program. Multilateral boards and panels provide operational framework, direct, and supervise the ISS joint medical operational activities. The Integrated Medical Group (IMG) provides front-line medical support of the crews. Results of ongoing activities are reviewed weekly by physician managers. A broader status review is conducted monthly to project the state of crew health and medical support for the following month. All boards, panels, and groups function effectively and without interruptions. Consensus prevails as the primary nature of decisions made by all ISS medical groups, including the ISS medical certification board. The sustained efforts of all partners have resulted in favorable medical outcomes of the initial fourteen long-duration expeditions. The medical support system appears to be mature and ready for further expansion of the roles of all Partners, and for the anticipated increase in the size of ISS crews.

  16. [Regulatory Science in the Review of Drugs and Medical Devices].

    Science.gov (United States)

    Koide, Akihiro

    2016-01-01

    The review of drugs and medical devices is an integral part of regulatory science. The Pharmaceuticals and Medical Devices Agency (PMDA) evaluates the efficacy, safety, and quality of drugs and medical devices after applications are submitted for regulatory approval. The products are approved when their benefits exceed their risks, i.e., an application is approved if the efficacy of the product in patients was demonstrated and the safety of the product is acceptable in view of its observed benefits. However, drugs and medical devices for which efficacy was not clearly demonstrated in clinical trials makes the decision to approve a difficult process. Under those circumstances, the approval process is based on the totality of information, such as the reason why clinical trials did not succeed and medical needs in Japan. The Wingspan stent system, which was approved for the treatment of intracranial arterial stenosis, is an example of a product with a use different from that intended by the US Food and Drug Administration and PMDA.

  17. Internalized Homonegativity: A Systematic Mapping Review of Empirical Research.

    Science.gov (United States)

    Berg, Rigmor C; Munthe-Kaas, Heather M; Ross, Michael W

    2016-01-01

    Internalized homonegativity (IH) is an important variable affecting the wellbeing of lesbian, gay, and bisexual (LGB) persons. We included 201 studies in a systematic mapping review of IH. Most studies were conducted in North America and examined IH as a predictor of poor health. The primary focus of 14 studies was IH scale measurement, and, in total, these studies detailed nine distinct scales. Eighteen studies compared levels of IH in LGB populations, four described prevention programs, and one investigated IH using qualitative methods. Our review indicates that further research is needed, particularly qualitative research and ways to ameliorate IH.

  18. International medical graduates: lessons from the past and hopes for the future.

    Science.gov (United States)

    Trewby, Peter

    2008-06-01

    The high levels of unemployment among international medical graduates (IMGs) in the UK and the skewed career structure of the NHS may stem from the 1930 withdrawal of General Medical Council recognition for Indian degrees forcing Indian colleges to align more closely with Western medical practices. From 2001 emigration to the UK surged just when UK medical schools were increasing their output. The result was severe unemployment among IMGs. The visa restrictions put in place to correct this make it difficult for IMGs to come to the UK even for short periods of experience. However, the Medical Training Initiative visa category offers an alternative and allows them the opportunity to gain up to two years' UK experience. The NHS has been in debt to IMGs and the countries that trained them since its inception. We must look for new ways to maintain international links and for the NHS to play a positive role in the global health economy.

  19. A Review of Antecedents of International Strategic Alliance Performance

    DEFF Research Database (Denmark)

    Christoffersen, Jeppe

    2013-01-01

    This paper provides a systematic review of 165 empirical studies on the antecedents of performance in international strategic alliances. It provides the most detailed display of definitions, rationales, measures and findings currently available. Hence, this state-of-the art literature review...... creates an accessible pool of knowledge that is highly relevant for future research on international strategic alliances. Further, it draws on this knowledge pool to build a model which highlights the quite different rationales advanced by researchers to explain associations between the antecedents...... and performance. The model makes the different rationales explicit and will aid researchers in identifying tests that can be performed to examine the links between antecedents and performance as well as the mechanisms through which such associations operate. Finally, the synthesized evidence is used to suggest...

  20. Review of Economic Submissions to NICE Medical Technologies Evaluation Programme.

    Science.gov (United States)

    Alshreef, Abualbishr; Jenks, Michelle; Green, William; Dixon, Simon

    2016-12-01

    The economic evaluation of medical devices is increasingly used to inform decision making on adopting new or novel technologies; however, challenges are inevitable due to the unique characteristics of devices. Cost-consequence analyses are recommended and employed by the English National Institute for Health and Care Excellence (NICE) Medical Technologies Evaluation Programme (MTEP) to help address these challenges. The aim of this work was to review the critiques raised for previous MTEP submissions and explore if there were common problems across submissions. We reviewed a sample of 12 economic submissions to MTEP representing 50 % of 24 sets of guidance issued to July 2015. For each submission, we reviewed the External Assessment Centre's (EAC) report and the guidance document produced by NICE. We identified the main problems raised by the EAC's assessments and the committee's considerations for each submission, and explored strategies for improvement. We found that the identification and measurement of costs and consequences are the main shortcomings within economic submissions to MTEP. Together, these shortcomings accounted for 42 % of criticisms by the EACs among the reviewed submissions. In certain circumstances problems with these shortcomings may be unavoidable, for example, if there is a limited evidence base for the device being appraised. Nevertheless, strategies can often be adopted to improve submissions, including the use of more appropriate time horizons, whilst cost and resource use information should be taken, where possible, from nationally representative sources.

  1. Compiling a Medical Device File and a Proposal for an International Standard for Rehabilitation Robots

    NARCIS (Netherlands)

    Römer, GertWillem R.B.E.; Stuyt, Harry J.A.

    2007-01-01

    Medical devices produced by manufacturers are subject to regulatory review by authorities. Usually, medical devices are developed at universities and other research institutes. This implies that regulatory activities are to be carried out by the designer at these organizations also. And as early as

  2. Alternative assessment in physical education: a review of international literature

    OpenAIRE

    L??pez-Pastor, V??ctor Manuel; Kirk,David; Lorente-Catal??n, Eloisa; Macphail,Ann; Macdonald, Doune

    2013-01-01

    peer-reviewed Assessment is one of the most fraught and troublesome issues physical educators have had to deal with over the past 40 years or so. In light of the challenges this situation presents, in this paper we provide an overview of the international literature on assessment in school physical education. We give an account of both traditional and alternative forms of assessment, focusing in particular on recent approaches that may be considered belong to the latter category of assessm...

  3. Faith-Based International Development Work: A Review

    OpenAIRE

    Dan Heist; Cnaan, Ram A

    2016-01-01

    In the wake of the Faith-Based Initiative in the USA, substantial research has resulted in an increased awareness of religious congregations and faith-based organizations as welfare service providers. The next frontier appears to be the role of religious organizations in international social and economic development, a topic that only recently started to attract academic interest. In this paper, we review available literature on the role that religious, or faith-based, organizations play in i...

  4. Recurring themes arising during medical research ethics committee review.

    Science.gov (United States)

    Kelleher, E; Stanton, A; Vale, G; Smith, D

    2013-06-01

    A standard application form for the ethical review of health-related research studies has recently been adopted by many Irish medical research ethics committees. In order to assess the impact of the new form, we reviewed all comments made by the Beaumont Hospital Ethics Committee during two six-month periods, immediately prior to adoption of the new form (2010), and soon afterwards (2011). Neither volume nor comment type differed significantly between the two observation periods. Participant documentation (information leaflets and consent forms) accounted for the largest proportion of comments (2010; 44%, 2011; 37%). Other common areas prompting queries were study administration (7%), design (12%) and procedures (13%), participant selection and recruitmen (8%), and lastly data protection (9%). Because of these findings, the standard operating procedures of the committee have been revised--use of provided template participant documentation is strongly encouraged, and a "Recurring Review Themes" checklist is highlighted to all applicants.

  5. A review of economic impact of targeted oral anticancer medications.

    Science.gov (United States)

    Shen, Chan; Chien, Chun-Ru; Geynisman, Daniel M; Smieliauskas, Fabrice; Shih, Ya-Chen T

    2014-02-01

    There has been a rapid increase in the use of targeted oral anticancer medications (OAMs) in the past decade. As OAMs are often expensive, economic consideration play a significant role in the decision to prescribe, receive or cover them. This paper performs a systematic review of costs or budgetary impact of targeted OAMs to better understand their economic impact on the healthcare system, patients as well as payers. We present our review in a summary table that describes the method and main findings, take into account multiple factors, such as country, analytical approach, cost type, study perspective, timeframe, data sources, study population and care setting when we interpret the results from different papers, and discuss the policy and clinical implications. Our review raises a concern regarding the role of sponsorship on findings of economic analyses as the vast majority of pharmaceutical company-sponsored studies reported cost advantages toward the sponsor's drugs.

  6. Social media use in medical education: a systematic review.

    Science.gov (United States)

    Cheston, Christine C; Flickinger, Tabor E; Chisolm, Margaret S

    2013-06-01

    The authors conducted a systematic review of the published literature on social media use in medical education to answer two questions: (1) How have interventions using social media tools affected outcomes of satisfaction, knowledge, attitudes, and skills for physicians and physicians-in-training? and (2) What challenges and opportunities specific to social media have educators encountered in implementing these interventions? The authors searched the MEDLINE, CINAHL, ERIC, Embase, PsycINFO, ProQuest, Cochrane Library, Web of Science, and Scopus databases (from the start of each through September 12, 2011) using keywords related to social media and medical education. Two authors independently reviewed the search results to select peer-reviewed, English-language articles discussing social media use in educational interventions at any level of physician training. They assessed study quality using the Medical Education Research Study Quality Instrument. Fourteen studies met inclusion criteria. Interventions using social media tools were associated with improved knowledge (e.g., exam scores), attitudes (e.g., empathy), and skills (e.g., reflective writing). The most commonly reported opportunities related to incorporating social media tools were promoting learner engagement (71% of studies), feedback (57%), and collaboration and professional development (both 36%). The most commonly cited challenges were technical issues (43%), variable learner participation (43%), and privacy/security concerns (29%). Studies were generally of low to moderate quality; there was only one randomized controlled trial. Social media use in medical education is an emerging field of scholarship that merits further investigation. Educators face challenges in adapting new technologies, but they also have opportunities for innovation.

  7. Wikipedia vs peer-reviewed medical literature for information about the 10 most costly medical conditions.

    Science.gov (United States)

    Hasty, Robert T; Garbalosa, Ryan C; Barbato, Vincenzo A; Valdes, Pedro J; Powers, David W; Hernandez, Emmanuel; John, Jones S; Suciu, Gabriel; Qureshi, Farheen; Popa-Radu, Matei; San Jose, Sergio; Drexler, Nathaniel; Patankar, Rohan; Paz, Jose R; King, Christopher W; Gerber, Hilary N; Valladares, Michael G; Somji, Alyaz A

    2014-05-01

    Since its launch in 2001, Wikipedia has become the most popular general reference site on the Internet and a popular source of health care information. To evaluate the accuracy of this resource, the authors compared Wikipedia articles on the most costly medical conditions with standard, evidence-based, peer-reviewed sources. The top 10 most costly conditions in terms of public and private expenditure in the United States were identified, and a Wikipedia article corresponding to each topic was chosen. In a blinded process, 2 randomly assigned investigators independently reviewed each article and identified all assertions (ie, implication or statement of fact) made in it. The reviewer then conducted a literature search to determine whether each assertion was supported by evidence. The assertions found by each reviewer were compared and analyzed to determine whether assertions made by Wikipedia for these conditions were supported by peer-reviewed sources. For commonly identified assertions, there was statistically significant discordance between 9 of the 10 selected Wikipedia articles (coronary artery disease, lung cancer, major depressive disorder, osteoarthritis, chronic obstructive pulmonary disease, hypertension, diabetes mellitus, back pain, and hyperlipidemia) and their corresponding peer-reviewed sources (Ppeer-reviewed sources. Caution should be used when using Wikipedia to answer questions regarding patient care.

  8. MO-D-16A-01: International Day of Medical Physics

    Energy Technology Data Exchange (ETDEWEB)

    Cheung, K [Hong Kong Sanatorium ' Hospital, Happy Valley (Hong Kong); Damilakis, J [University of Crete, Crete, CRETE (Greece)

    2014-06-15

    International Organization for Medical Physics (IOMP) which represents medical physicists in more than 80 countries decided to celebrate 7th November, birth date of the Polish and naturalized-French physicist Marie Sklodowska-Curie, as International Day of Medical Physics (IDMP). The main purpose of the initiative is to raise the visibility and awareness of medical physicist in the global community, to introduce ourselves to the general public, and bring a message to the community that a group of health professionals, the medical physicists are there to help the patients and other health professionals. First celebration was done in 2013 and now IDMP will be celebrated every year. The theme of IDMP will be different each year. The theme for 2013 was ‘Radiation exposure from medical procedures, ask the Medical Physicist’. The inaugural event was celebrated in 23 countries and the amount of attention gained was remarkable. Main IDMP events were held in Poland, birthplace of Marie Curie, and France, workplace of Marie Curie. This year IOMP celebrates the 2nd IDMP and theme will be ‘Looking into the body-Advancement in Imaging through Medical Physics’ to draw attention to the profound contributions Medical Physics has made to the use of ionizing and non-ionizing radiation for the imaging of human body. A number of countries have informed about events that they are going to organize on IDMP. This gives wide attention to medical physics globally. AAPM is a major and important member of IOMP. It is hoped that AAPM will join in organizing activities. Learning Objectives: To learn about International Day of Medical Physics To become familiar with how first IDMP was celebrated in 2013 and learning achieved To understand on future plans for IDMPs.

  9. Quality of pharmaceutical advertisements in medical journals: a systematic review.

    Science.gov (United States)

    Othman, Noordin; Vitry, Agnes; Roughead, Elizabeth E

    2009-07-22

    Journal advertising is one of the main sources of medicines information to doctors. Despite the availability of regulations and controls of drug promotion worldwide, information on medicines provided in journal advertising has been criticized in several studies for being of poor quality. However, no attempt has been made to systematically summarise this body of research. We designed this systematic review to assess all studies that have examined the quality of pharmaceutical advertisements for prescription products in medical and pharmacy journals. Studies were identified via searching electronic databases, web library, search engine and reviewing citations (1950 - February 2006). Only articles published in English and examined the quality of information included in pharmaceutical advertisements for prescription products in medical or pharmacy journals were included. For each eligible article, a researcher independently extracted the data on the study methodology and outcomes. The data were then reviewed by a second researcher. Any disagreements were resolved by consensus. The data were analysed descriptively. The final analysis included 24 articles. The studies reviewed advertisements from 26 countries. The number of journals surveyed in each study ranged from four to 24 journals. Several outcome measures were examined including references and claims provided in advertisements, availability of product information, adherence to codes or guidelines and presentation of risk results. The majority of studies employed a convenience-sampling method. Brand name, generic name and indications were usually provided. Journal articles were commonly cited to support pharmaceutical claims. Less than 67% of the claims were supported by a systematic review, a meta-analysis or a randomised control trial. Studies that assessed misleading claims had at least one advertisement with a misleading claim. Two studies found that less than 28% of claims were unambiguous clinical claims

  10. Quality of pharmaceutical advertisements in medical journals: a systematic review.

    Directory of Open Access Journals (Sweden)

    Noordin Othman

    Full Text Available BACKGROUND: Journal advertising is one of the main sources of medicines information to doctors. Despite the availability of regulations and controls of drug promotion worldwide, information on medicines provided in journal advertising has been criticized in several studies for being of poor quality. However, no attempt has been made to systematically summarise this body of research. We designed this systematic review to assess all studies that have examined the quality of pharmaceutical advertisements for prescription products in medical and pharmacy journals. METHODS AND FINDINGS: Studies were identified via searching electronic databases, web library, search engine and reviewing citations (1950 - February 2006. Only articles published in English and examined the quality of information included in pharmaceutical advertisements for prescription products in medical or pharmacy journals were included. For each eligible article, a researcher independently extracted the data on the study methodology and outcomes. The data were then reviewed by a second researcher. Any disagreements were resolved by consensus. The data were analysed descriptively. The final analysis included 24 articles. The studies reviewed advertisements from 26 countries. The number of journals surveyed in each study ranged from four to 24 journals. Several outcome measures were examined including references and claims provided in advertisements, availability of product information, adherence to codes or guidelines and presentation of risk results. The majority of studies employed a convenience-sampling method. Brand name, generic name and indications were usually provided. Journal articles were commonly cited to support pharmaceutical claims. Less than 67% of the claims were supported by a systematic review, a meta-analysis or a randomised control trial. Studies that assessed misleading claims had at least one advertisement with a misleading claim. Two studies found that less

  11. Building a local medical workforce in Tasmania: where are international fee-paying medical graduates likely to work?

    Science.gov (United States)

    Cheek, Colleen; Hays, Richard; Allen, Penny; Walker, Gary; Shires, Lizzi

    2017-01-01

    Much of regional Australia continues to face challenges in recruitment and retention of medical practitioners, despite the apparently successful rural medical education initiatives funded by the Commonwealth Government. International fee-paying (IFP) medical students are a significant component of Australian medical education, contributing additional income and more diverse learning environments for universities. Their contribution to the Australian medical workforce is harder to determine. After obtaining registration, IFP graduates may apply to remain in Australia as skilled migrants. Since 1999 there has been a 325% increase in the number of international medical students in Australia, with approximately 73% of IFP graduates remaining in Australia for at least some postgraduate training. Recognising the potential contribution of IFP students to the Tasmanian medical workforce, the authors sought better understanding of the career intentions and work locations of IFP graduates from the medical program in Tasmania, Australia, through two studies. Firstly, a quantitative study was conducted of the locations of all IFP graduates from the Tasmanian medical program, and then a qualitative study exploring graduating students' intentions and factors that contribute to their decisions about work location choices. This was a cohort study of IFP students who graduated from the University of Tasmania School of Medicine over the period 2000-2015. Work locations for 2016 were mapped to a Modified Monash rurality classification. Semi-structured interviews were held with 15 final year IFP medical students, exploring career intentions and location preferences. There were 261 IFP graduates, 54.4% male. The most common country of origin was Malaysia (55.2%). In 2016, 189 (72.4 %) were working in Australia, 42 (16.1%) in Tasmania and 126 (66.7%) in areas categorised as Modified Monash 1. Recent graduates in postgraduate year 1/2 (71.3%) were more likely to be working in Tasmania

  12. Medical image segmentation on GPUs--a comprehensive review.

    Science.gov (United States)

    Smistad, Erik; Falch, Thomas L; Bozorgi, Mohammadmehdi; Elster, Anne C; Lindseth, Frank

    2015-02-01

    Segmentation of anatomical structures, from modalities like computed tomography (CT), magnetic resonance imaging (MRI) and ultrasound, is a key enabling technology for medical applications such as diagnostics, planning and guidance. More efficient implementations are necessary, as most segmentation methods are computationally expensive, and the amount of medical imaging data is growing. The increased programmability of graphic processing units (GPUs) in recent years have enabled their use in several areas. GPUs can solve large data parallel problems at a higher speed than the traditional CPU, while being more affordable and energy efficient than distributed systems. Furthermore, using a GPU enables concurrent visualization and interactive segmentation, where the user can help the algorithm to achieve a satisfactory result. This review investigates the use of GPUs to accelerate medical image segmentation methods. A set of criteria for efficient use of GPUs are defined and each segmentation method is rated accordingly. In addition, references to relevant GPU implementations and insight into GPU optimization are provided and discussed. The review concludes that most segmentation methods may benefit from GPU processing due to the methods' data parallel structure and high thread count. However, factors such as synchronization, branch divergence and memory usage can limit the speedup. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

  13. Awareness regarding the systemic effects of periodontal disease among medical interns in India

    Directory of Open Access Journals (Sweden)

    Arpita Gur

    2011-01-01

    Full Text Available Background: Medical curriculum does not provide required space for oral health; hence, many medical interns are unfamiliar with the oral cavity and oral health research. Aims: To study the level of awareness regarding systemic effects of periodontal disease among medical interns. Settings and design: A cross-sectional qualitative study recruiting medical interns from two medical institutions affiliated to two different universities in Southern India. Materials and Methods: Study was carried out in two medical institutions affiliated to two different universities in Southern India. A total of 143 interns participated in the study. Each participant was given a self-administered, pre-tested, multiple choice question-type questionnaire to solve on the spot. In order to summarise the awareness level, respondents were graded on a five-level scale as poor, fair, good, very good, and excellent. Statistical analysis used: Percentages, proportions. Results: A total of 67 respondents (47% had fair; 60(42%, poor; and 18(11%, good level of awareness regarding the systemic effects of periodontal disease. Only 23(16%, 17(12%, 12(8%, 6(4% and 4(3% respondents were aware that the periodontal disease may be the possible risk factor for coronary heart disease, cerebral infarction, diabetes mellitus, hospital-acquired pneumonia, and preterm labour (low birth-weight infants, respectively. Only 12 respondents (8% would seek dentist′s opinion for all patients with systemic diseases related to dental disease. Conclusions: Medical interns had inadequate awareness regarding the systemic effects of periodontal disease. Therefore, an integrated teaching of medical and dental sciences is recommended.

  14. 42 CFR 421.505 - Termination and extension of non-random prepayment complex medical review.

    Science.gov (United States)

    2010-10-01

    ... a provider or supplier must be on non-random prepayment complex medical review. There is no minimum... section, a contractor must terminate a provider or supplier from non-random prepayment complex medical... complex medical review if a provider or supplier stops billing the code under review, shifts billing...

  15. Integrated thermal treatment systems study. Internal review panel report

    Energy Technology Data Exchange (ETDEWEB)

    Cudahy, J.; Escarda, T.; Gimpel, R. [and others

    1995-04-01

    The U.S. Department of Energy (DOE) Office of Technology Development (OTD) commissioned two studies to evaluate nineteen thermal treatment technologies for treatment of DOE mixed low-level waste. These studies were called the Integrated Thermal Treatment System (ITTS) Phase I and Phase II. With the help of the DOE Office of Environmental Management (EM) Mixed Waste Focus Group, OTD formed an ITTS Internal Review Panel to review and comment on the ITTS studies. This Panel was composed of scientists and engineers from throughout the DOE complex, the U.S. Environmental Protection Agency, the California EPA, and private experts. The Panel met from November 15-18, 1994 to review the ITTS studies and to make recommendations on the most promising thermal treatment systems for DOE mixed low-level wastes and on research and development necessary to prove the performance of the technologies. This report describes the findings and presents the recommendations of the Panel.

  16. Characteristics of an Effective International Humanitarian Assistance: A Systematic Review

    Science.gov (United States)

    Moslehi, Shandiz; Ardalan, Ali; Waugh, William; Tirone, Daniel C.; Akbarisari, Ali

    2016-01-01

    Introduction: The objective of this study is to identify the effectiveness characteristics, review the definition of them, and develop a conceptual mapping of existing domains in the field of International Humanitarian Assistance (IHA). Methods: We conducted a systematic review and searched the major databases (Science Direct, Scopus, Springer and Pubmed) and grey literature, including references of potentially eligible articles and conference proceedings through March 2015. Articles were included if they focused on IHA effectiveness. Reviewers independently identified the eligible studies and extracted data. Results: 10 studies were included and 48 characteristics were identified. There is a lack of scientific studies and agreement on the characteristics of IHA effectiveness.  Conclusion: This study could be the step toward an understanding of IHA effectiveness characteristics and its definitions with the findings making a base line for more research in this area.  PMID:26981325

  17. Job burnout and organizational justice among medical interns in Shanghai, People's Republic of China.

    Science.gov (United States)

    Jin, Wei-Min; Zhang, Ying; Wang, Xiao-Ping

    2015-01-01

    New challenges are occurring in the medical education in Mainland China, and the main risk is the loss of excellent physician candidates. This is due to lack of respect; a large, strong labor force; relatively low remuneration; unstable relationships between patients and doctors; pressures from the public media; and the possible existence of organizational injustice within the hospital. The study reported here looked at one of the in-hospital risks, psychological job burnout and organizational justice, to identify the possible internal cause-effect relationship at the two major general hospitals both affiliated to Shanghai Jiao Tong University School of Medicine. The aim of the reported study was to analyze the related factors associated with job burnout in Chinese medical interns in Shanghai and to provide some suggestions to better their occupational development. A total of 135 medical interns were investigated and assessed by the Organizational Justice Scale and the Maslach Burnout Inventory - General Survey. There was a statistically significant negative correlation between organizational justice and job burnout (r=-0.298, P=0.000), suggesting the existence of job burnout among the participant interns. In particular, emotional exhaustion and cynicism were statistically more significant; the comparison between the N group (from Nanjing) and S group (Shanghai) showed significant difference in participation and reduced professional efficacy (POrganizational justice should be promoted more, and school authorities should pay more attention to outside "non-home" interns. Finally, it is essential that the medical interns themselves establish reasonable judgment of their valuable profession.

  18. A human rights view on access to controlled substances for medical purposes under the international drug control framework.

    Science.gov (United States)

    Gispen, Marie Elske C

    2013-11-05

    The world is confronted with a major public health deficit caused by poor access to controlled essential medicines under the international drug control framework. This is affecting millions of patients on a daily basis and resulting in numerous human rights violations. The present review contextualises this deficit from a human rights perspective. Drug control efforts are informed by a twofold objective stemming from the double nature of scheduled substances: free access for medical purposes should be ensured, though non-medical use of substances such as opium should be restricted. The international drug control framework is, in theory, based on this twofold notion, however at the level of interpretation, monitoring, and implementation, a one-sided emphasis is demonstrated. By tracing a parallel between the obligations of states under the international drug control framework and those that derive from human rights law, the review shows that the two systems seem incoherent and conflicting in nature and flags the importance of cross-disciplinary research into drug control and human rights.

  19. "Take ten minutes": a dedicated ten minute medication review reduces polypharmacy in the elderly.

    LENUS (Irish Health Repository)

    Walsh, E K

    2010-09-01

    Multiple and inappropriate medications are often the cause for poor health status in the elderly. Medication reviews can improve prescribing. This study aimed to determine if a ten minute medication review by a general practitioner could reduce polypharmacy and inappropriate prescribing in elderly patients. A prospective, randomised study was conducted. Patients over the age of 65 (n = 50) underwent a 10-minute medication review. Inappropriate medications, dosage errors, and discrepancies between prescribed versus actual medication being consumed were recorded. A questionnaire to assess satisfaction was completed following review. The mean number of medications taken by patients was reduced (p < 0.001). A medication was stopped in 35 (70%) patients. Inappropriate medications were detected in 27 (54%) patients and reduced (p < 0.001). Dose errors were detected in 16 (32%). A high level of patient satisfaction was reported. A ten minute medication review reduces polypharmacy, improves prescribing and is associated with high levels of patient satisfaction.

  20. "Take ten minutes": a dedicated ten minute medication review reduces polypharmacy in the elderly.

    LENUS (Irish Health Repository)

    Walsh, E K

    2012-02-01

    Multiple and inappropriate medications are often the cause for poor health status in the elderly. Medication reviews can improve prescribing. This study aimed to determine if a ten minute medication review by a general practitioner could reduce polypharmacy and inappropriate prescribing in elderly patients. A prospective, randomised study was conducted. Patients over the age of 65 (n = 50) underwent a 10-minute medication review. Inappropriate medications, dosage errors, and discrepancies between prescribed versus actual medication being consumed were recorded. A questionnaire to assess satisfaction was completed following review. The mean number of medications taken by patients was reduced (p < 0.001). A medication was stopped in 35 (70%) patients. Inappropriate medications were detected in 27 (54%) patients and reduced (p < 0.001). Dose errors were detected in 16 (32%). A high level of patient satisfaction was reported. A ten minute medication review reduces polypharmacy, improves prescribing and is associated with high levels of patient satisfaction.

  1. Partnered medication review and charting between the pharmacist and medical officer in the Emergency Short Stay and General Medicine Unit.

    Science.gov (United States)

    Tong, Erica Y; Roman, Cristina P; Smit, De Villiers; Newnham, Harvey; Galbraith, Kirsten; Dooley, Michael J

    2015-08-01

    A partnered medication review and charting model involving a pharmacist and medical officer was implemented in the Emergency Short Stay Unit and General Medicine Unit of a major tertiary hospital. The aim of the study was to describe the safety and effectiveness of partnered medication charting in this setting. A partnered medication review and charting model was developed. Credentialed pharmacists charted pre-admission medications and venous thromboembolism prophylaxis in collaboration with the admitting medical officer. The pharmacist subsequently had a clinical discussion with the treating nurse regarding the medication management plan for the patient. A prospective audit was undertaken of all patients from the initiation of the service. A total of 549 patients had medications charted by a pharmacist from the 14th of November 2012 to the 30th of April 2013. A total of 4765 medications were charted by pharmacists with 7 identified errors, corresponding to an error rate of 1.47 per 1000 medications charted. Partnered medication review and charting by a pharmacist in the Emergency Short Stay and General Medicine unit is achievable, safe and effective. Benefits from the model extend beyond the pharmacist charting the medications, with clinical value added to the admission process through early collaboration with the medical officer. Further research is required to provide evidence to further support this collaborative model. Copyright © 2015. Published by Elsevier Ltd.

  2. Data Sharing: a New Editorial Initiative from the International Committee of Medical Journal Editors. Implications for the Editors' Network.

    Science.gov (United States)

    Alfonso, Fernando

    2017-05-01

    The International Committee of Medical Journal Editors (ICMJE) provides recommendations to improve the editorial standards and scientific quality of biomedical journals. These recommendations range from uniform technical requirements to more complex and elusive editorial issues including ethical aspects of the scientific process. Recently, registration of clinical trials, conflicts of interest disclosure, and new criteria for authorship-emphasizing the importance of responsibility and accountability-, have been proposed. This year a new editorial initiative to foster sharing of clinical trial data has been launched. This review discusses this novel initiative with the aim of increasing awareness among readers, investigators, authors and Editors of the Editors' Network of the European Society of Cardiology.

  3. Data Sharing: A New Editorial Initiative of the International Committee of Medical Journal Editors. Implications for the Editors' Network.

    Science.gov (United States)

    Alfonso, Fernando; Adamyan, Karlen; Artigou, Jean-Yves; Aschermann, Michael; Boehm, Michael; Buendia, Alfonso; Chu, Pao-Hsien; Cohen, Ariel; Dei Cas, Livio; Dilic, Mirza; Doubell, Anton; Echeverri, Dario; Enç, Nuray; Ferreira-González, Ignacio; Filipiak, Krzysztof J; Flammer, Andreas; Fleck, Eckart; Gatzov, Plamen; Ginghina, Carmen; Goncalves, Lino; Haouala, Habib; Hassanein, Mahmoud; Heusch, Gerd; Huber, Kurt; Hulín, Ivan; Ivanusa, Mario; Krittayaphong, Rungroj; Lau, Chu-Pak; Marinskis, Germanas; Mach, François; Moreira, Luiz Felipe; Nieminen, Tuomo; Oukerraj, Latifa; Perings, Stefan; Pierard, Luc; Potpara, Tatjana; Reyes-Caorsi, Walter; Rim, Se-Joong; Rødevand, Olaf; Saade, Georges; Sander, Mikael; Shlyakhto, Evgeny; Timuralp, Bilgin; Tousoulis, Dimitris; Ural, Dilek; Piek, J J; Varga, Albert; Lüscher, Thomas F

    2017-01-01

    The International Committee of Medical Journal Editors (ICMJE) provides recommendations to improve the editorial standards and scientific quality of biomedical journals. These recommendations range from uniform technical requirements to more complex and elusive editorial issues including ethical aspects of the scientific process. Recently, registration of clinical trials, conflicts of interest disclosure, and new criteria for authorship - emphasizing the importance of responsibility and accountability - have been proposed. Last year, a new editorial initiative to foster sharing of clinical trial data was launched. This review discusses this novel initiative with the aim of increasing awareness among readers, investigators, authors and editors belonging to the Editors' Network of the European Society of Cardiology.

  4. Data sharing: A new editorial initiative of the International Committee of Medical Journal Editors : Implications for the Editors' Network.

    Science.gov (United States)

    Alfonso, F

    2017-05-01

    The International Committee of Medical Journal Editors (ICMJE) provides recommendations to improve the editorial standards and scientific quality of biomedical journals. These recommendations range from uniform technical requirements to more complex and elusive editorial issues including ethical aspects of the scientific process. Recently, registration of clinical trials, conflicts of interest disclosure, and new criteria for authorship - emphasising the importance of responsibility and accountability - have been proposed. Last year, a new editorial initiative to foster sharing of clinical trial data was launched. This review discusses this novel initiative with the aim of increasing awareness among readers, investigators, authors and editors belonging to the Editors' Network of the European Society of Cardiology.

  5. Data Sharing: A New Editorial Initiative of the International Committee of Medical Journal Editors. Implications for the Editors’ Network

    Directory of Open Access Journals (Sweden)

    Fernando Alfonso, MD

    2017-05-01

    Full Text Available The International Committee of Medical Journal Editors (ICMJE provides recommendations to improve the editorial standards and scientific quality of biomedical journals. These recommendations range from uniform technical requirements to more complex and elusive editorial issues including ethical aspects of the scientific process. Recently, registration of clinical trials, conflicts of interest disclosure, and new criteria for authorship -emphasizing the importance of responsibility and accountability-, have been proposed. Last year, a new editorial initiative to foster sharing of clinical trial data was launched. This review discusses this novel initiative with the aim of increasing awareness among readers, investigators, authors and editors belonging to the Editors’ Network of the European Society of Cardiology.

  6. Data sharing: A new editorial initiative of the International Committee of Medical Journal Editors. Implications for the editors’ network

    Directory of Open Access Journals (Sweden)

    Fernando Alfonso

    2017-06-01

    Full Text Available The International Committee of Medical Journal Editors (ICMJE provides recommendations to improve the editorial standards and scientific quality of biomedical journals. These recommendations range from uniform technical requirements to more complex and elusive editorial issues including ethical aspects of the scientific process. Recently, registration of clinical trials, conflicts of interest disclosure, and new criteria for authorship -emphasizing the importance of responsibility and accountability-, have been proposed. Last year, a new editorial initiative to foster sharing of clinical trial data was launched. This review discusses this novel initiative with the aim of increasing awareness among readers, investigators, authors and editors belonging to the Editors’ Network of the European Society of Cardiology.

  7. Evaluation in English-Medium Medical Book Reviews

    Directory of Open Access Journals (Sweden)

    María Ángeles Alcaraz Ariza

    2011-06-01

    Full Text Available The aim of this paper is twofold: 1 to identify the evaluative speech acts, either positive or negative, contained in a corpus of 30 English-written medical book reviews published in The British Medical Journal in the period 2000-2009; 2 to analyze the linguistic-rhetorical strategies used to convey this evaluation. Our main results illustrate that various mitigating strategies are used not only to soften criticism, but also to help maintain social harmony and solidarity with the reviewees. Moreover, negative evaluation is on many occasions voiced at aspects outside the book reviewed, which would mean that apart from showing their expertise in the field tackled, book reviewers also want to discuss certain issues of their concern and to put forward their cultural background.Este trabajo tiene dos objetivos: 1 identificar los actos de habla evaluativos, positivos y negativos, en un corpus de reseñas de 30 libros médicos escritas en inglés y publicadas en el British Medical Journal en el periodo 2000- 2009; 2 analizar las estrategias lingüístico-retóricas utilizadas para transmitir estos actos de habla. Nuestros resultados principales muestran que no sólo se utilizan diversos mecanismos lingüístico-retóricos para atenuar los actos críticos, sino también para ayudar a mantener un clima de armonía social y solidaridad con los autores de los libros reseñados. Además, la evaluación negativa se dirige en numerosas ocasiones a aspectos ajenos a los libros reseñados, lo que implica que aparte de mostrar su competencia en el campo abordado, los reseñadores también desean debatir determinados temas de su interés y hacer gala de su cultural general.

  8. A review of pharmacokinetic drug-drug interactions with the anthelmintic medications albendazole and mebendazole.

    Science.gov (United States)

    Pawluk, Shane Ashley; Roels, Craig Allan; Wilby, Kyle John; Ensom, Mary H H

    2015-04-01

    Medications indicated for helminthes and other parasitic infections are frequently being used in mass populations in endemic areas. Currently, there is a lack of guidance for clinicians on how to appropriately manage drug interactions when faced with patients requiring short-term anthelmintic therapy with albendazole or mebendazole while concurrently taking other agents. The objective of this review was to systematically summarize and evaluate published literature on the pharmacokinetics of albendazole or mebendazole when taken with other interacting medications. A search of MEDLINE (1946 to October 2014), EMBASE (1974 to October 2014), International Pharmaceutical Abstracts (1970 to October 2014), Google, and Google Scholar was conducted for articles describing the pharmacokinetics of albendazole or mebendazole when given with other medications (and supplemented by a bibliographic review of all relevant articles). Altogether, 17 articles were included in the review. Studies reported data on pharmacokinetic parameters for albendazole or mebendazole when taken with cimetidine, dexamethasone, ritonavir, phenytoin, carbamazepine, phenobarbital, ivermectin, praziquantel, diethylcarbamazine, azithromycin, and levamisole. Cimetidine increased the elimination half-life of albendazole and maximum concentration (Cmax) of mebendazole; dexamethasone increased the area under the plasma concentration-time curve (AUC) of albendazole; levamisole decreased the Cmax of albendazole; anticonvulsants (phenytoin, phenobarbital, carbamazepine) decreased the AUC of albendazole; praziquantel increased the AUC of albendazole; and ritonavir decreased the AUC of both albendazole and mebendazole. No major interactions were found with ivermectin, azithromycin, or diethylcarbamazine. Future research is required to clarify the clinical relevance of the interactions observed.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-07-01

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

  10. People and ideas in medical informatics - a half century review.

    Science.gov (United States)

    van Bemmel, J H

    2011-01-01

    OBJECTIVE. Reviewing the onset and the rapid changes to make realistic predictions on the future of medical informatics. METHODS. Pointing to the contributions of the early pioneers, who had their roots in other disciplines and by illustrating that from the onset an interdisciplinary approach was characteristic for our field. RESULTS. Some of the reasons for the changes in medical informatics are that nobody was able to predict the advent of the personal computer in the 1970s, the world-wide web in 1991, and the public start of the Internet in 1992, but foremost that nobody expected that it was not primarily the hardware or the software, but human factors that would be crucial for successful applications of computers in health care. In the past sometimes unrealistic expectations were held, such as on the impact of medical decision-support systems, or on the overly optimistic contributions of electronic health records. Although the technology is widely available, some applications appear to be far more complex than expected. Health care processes can seldom be fully standardized. Humans enter at least in two very different roles in the loop of information processing: as subjects conducting care - the clinicians - and as subjects that are the objects of care - the patients. CONCLUSIONS. Medical informatics lacks a specific methodology; methods are borrowed from adjacent disciplines such as physics, mathematics and, of course, computer science. Human factors play a major role in applying computers in health care. Everyone pursuing a career in biomedical informatics needs to be very aware of this. It is to be expected that the quality of health care will increasingly be assessed by computer systems to fulfill the requirements of medical evidence.

  11. Review article: medical education research: an overview of methods.

    Science.gov (United States)

    Boet, Sylvain; Sharma, Saroo; Goldman, Joanne; Reeves, Scott

    2012-02-01

    This article provides clinician-teachers with an overview of the process necessary to move from an initial idea to the conceptualization and implementation of an empirical study in the field of medical education. This article will allow clinician-teachers to become familiar with educational research methodology in order to a) critically appraise education research studies and apply evidence-based education more effectively to their practice and b) initiate or collaborate in medical education research. This review uses relevant articles published in the fields of medicine, education, psychology, and sociology before October 2011. The focus of the majority of research in medical education has been on reporting outcomes related to participants. There has been less assessment of patient care outcomes, resulting in informing evidence-based education to only a limited extent. This article explains the process necessary to develop a focused and relevant education research question and emphasizes the importance of theory in medical education research. It describes a range of methodologies, including quantitative, qualitative, and mixed methods, and concludes with a discussion of dissemination of research findings. A majority of studies currently use quantitative methods. This article highlights how further use of qualitative methods can provide insight into the nuances and complexities of learning and teaching processes. Research in medical education requires several successive steps, from formulating the correct research question to deciding the method for dissemination. Each approach has advantages and disadvantages and should be chosen according to the question being asked and the specific goal of the study. Well-conducted education research should allow progression towards the important goal of using evidence-based education in our teaching and institutions.

  12. Community and Interns' Perspectives on Community-Participatory Medical Education: From Passive to Active Participation.

    Science.gov (United States)

    Takamura, Akiteru; Misaki, Hidekazu; Takemura, Yousuke

    2017-07-01

    The use of community-based medical education as a method of learning primary care is now common worldwide. However, in many cases community participation remains passive. This study sought to explore the effects of introducing community members into medical education as active teachers. Medical education taught directly by community members might be a key to comprehensive community-based learning. This study was conducted in Japan at two postgraduate programs in community hospitals. We asked 10 community groups and 10 interns to join our 2-year "participatory" community curriculum continuously. Questionnaires completed by 10 interns and 77 community members were analyzed quantitatively. Audio-recorded and transcribed interview data from 10 interns and 39 community members were read iteratively and analyzed qualitatively. Community members who participated in groups with the interns gave higher scores on approval of and willingness to participate in such experiences. Interns scored higher on their view of the importance and preferences to work with the community. In the qualitative analysis, health-oriented behavior, social connectedness, and shaping community orientation among doctors emerged as important for community members. Important themes that emerged from the interns' interviews were: taking responsibility for shared understanding, community-oriented focus, valuing community nurses, and tension from competing demands. Interaction between interns and community members had positive effects for both. Community-participatory medical education could present a further step in the evolution of community-based medical education, one that is closest to community. Finding a balance between the time dedicated to working at the hospital and in the community proved to be essential to the success of this curriculum.

  13. Making short-term international medical volunteer placements work: a qualitative study

    Science.gov (United States)

    Elnawawy, Omnia; Lee, Andrew CK; Pohl, Gerda

    2014-01-01

    Background International medical volunteering has grown in recent decades. It has the potential to benefit and harm the volunteer and host countries; but there is a paucity of literature on the impacts of international medical volunteering and a need to find ways to optimise the benefits of such placements. Aim In this study, one example of international medical volunteering was examined involving British GPs on short-term placements in Nepal. The intention was to explore the expectations and experiences of the local health workers, volunteers, and host organisation to try and understand what makes volunteer placements work. Design Qualitative study of key informant interviews. Setting Stakeholders of a short-term international medical volunteer (IMV) placement programme in Nepal. Method Key informant interviews were carried out via face-to-face or telephone/internet interviews with five previous volunteers, three representatives from a non-governmental organisation providing placements, and five local health workers in Nepal who had had contact with the IMVs. Interviews were recorded, transcribed, and analysed using standard thematic framework approaches. Results All the stakeholders had their own specific motives for participating in the IMV programme. The relationship between volunteers and the Nepalese health workers was complex and characterised by discrepant and occasionally unrealistic expectations. Managing these different expectations was challenging. Conclusion Contextual issues and cultural differences are important considerations in medical volunteer programmes, and this study highlights the importance of robust preparation pre-placement for the volunteer and host to ensure positive outcomes. PMID:24868070

  14. Review of early assessment models of innovative medical technologies

    DEFF Research Database (Denmark)

    Fasterholdt, Iben; Krahn, Murray D; Kidholm, Kristian

    2017-01-01

    INTRODUCTION: Hospitals increasingly make decisions regarding the early development of and investment in technologies, but a formal evaluation model for assisting hospitals early on in assessing the potential of innovative medical technologies is lacking. This article provides an overview of models...... for early assessment in different health organisations and discusses which models hold most promise for hospital decision makers. METHODS: A scoping review of published studies between 1996 and 2015 was performed using nine databases. The following information was collected: decision context, decision...... problem, and a description of the early assessment model. RESULTS: 2362 articles were identified and 12 studies fulfilled the inclusion criteria. An additional 12 studies were identified and included in the review by searching reference lists. The majority of the 24 early assessment studies were variants...

  15. Properties and medical applications of polylactic acid: A review

    Directory of Open Access Journals (Sweden)

    K. Hamad

    2015-05-01

    Full Text Available Polylactic acid (PLA, one of the well-known biodegradable polyesters, has been studied extensively for tissue engineering and drug delivery systems, and it was also used widely in human medicine. A new method to synthesize PLA (ring-opening polymerization, which allowed the economical production of a high molecular weight PLA polymer, broadened its applications, and this processing would be a potential substitute for petroleum-based products. This review described the principles of the polymerization reactions of PLA and, then, outlined the various materials properties affecting the performance of PLA polymer, such as rheological, mechanical, thermal, and barrier properties as well as the processing technologies which were used to fabricate products based on PLA. In addition, the biodegradation processes of products which were shaped from PLA were discussed and reviewed. The potential applications of PLA in the medical fields, such as tissue engineering, wound management, drugs delivery, and orthopedic devices, were also highlighted.

  16. General practitioners' views of pharmacists' current and potential contributions to medication review and prescribing in New Zealand

    Directory of Open Access Journals (Sweden)

    Hatah E

    2013-09-01

    Full Text Available INTRODUCTION: Internationally, non-medical practitioners are increasingly involved in tasks traditionally undertaken by general practitioners (GPs, such as medication review and prescribing. This study aims to evaluate GPs' perceptions of pharmacists' contributions to those services. METHODS: Semi-structured interviews were carried out in two localities with GPs whose patients had and had not undergone a pharmacist-led adherence support Medication Use Review (MUR. GPs were asked their opinions of pharmacists' provision of MUR, clinical medication review and prescribing. Data were analysed thematically using NVivo 8 and grouped by strengths, weaknesses, opportunities and threats (SWOT category. FINDINGS: Eighteen GPs were interviewed. GPs mentioned their own skills, training and knowledge of clinical conditions. These were considered GPs' major strengths. GPs' perceived weaknesses were their time constraints and heavy workloads. GPs thought pharmacists' strengths were their knowledge of pharmacology and having more time for in-depth medication review than GPs. Nevertheless, GPs felt pharmacist-led medication reviews might confuse patients, and increase GP workloads. GPs were concerned that pharmacist prescribing might include pharmacists making a diagnosis. This is not the proposed model for New Zealand. In general, GPs were more accepting of pharmacists providing medication reviews than of pharmacist prescribing, unless appropriate controls, close collaboration and co-location of services took place. CONCLUSION: GPs perceived their own skills were well suited to reviewing medication and prescribing, but thought pharmacists might also have strengths and skills in these areas. In future, GPs thought that working together with pharmacists in these services might be possible in a collaborative setting.

  17. Complexity in graduate medical education: a collaborative education agenda for internal medicine and geriatric medicine.

    Science.gov (United States)

    Chang, Anna; Fernandez, Helen; Cayea, Danelle; Chheda, Shobhina; Paniagua, Miguel; Eckstrom, Elizabeth; Day, Hollis

    2014-06-01

    Internal medicine residents today face significant challenges in caring for an increasingly complex patient population within ever-changing education and health care environments. As a result, medical educators, health care system leaders, payers, and patients are demanding change and accountability in graduate medical education (GME). A 2012 Society of General Internal Medicine (SGIM) retreat identified medical education as an area for collaboration between internal medicine and geriatric medicine. The authors first determined a short-term research agenda for resident education by mapping selected internal medicine reporting milestones to geriatrics competencies, and listing available sample learner assessment tools. Next, the authors proposed a strategy for long-term collaboration in three priority areas in clinical medicine that are challenging for residents today: (1) team-based care, (2) transitions and readmissions, and (3) multi-morbidity. The short-term agenda focuses on learner assessment, while the long-term agenda allows for program evaluation and improvement. This model of collaboration in medical education combines the resources and expertise of internal medicine and geriatric medicine educators with the goal of increasing innovation and improving outcomes in GME targeting the needs of our residents and their patients.

  18. International infectious diseases teaching to undergraduate medical students: A successful European collaborative experience.

    Science.gov (United States)

    Charlier, Caroline; Johannessen, Ingólfur; Mackintosh, Claire L; Wilks, David; Cauda, Roberto; Wolf, Federica I; Le Jeunne, Claire

    2017-09-01

    The emerging global-health paradigm requires medical teaching to be continuously redefined and updated; to this end, transnational approaches should be encouraged and medical training harmonized. Infectious diseases (ID) teaching in the current context of emerging infections, fast-increasing bacterial resistance and large-scale human migration, was chosen to develop a common international course. We report the successful implementation of a joint European undergraduate course aiming to (i) develop a common ID core curriculum among European medical schools; (ii) promote mobility among teachers and students (iii) promote international cooperation among European teachers. The course was built around teachers' mobility. It was delivered in English by a team of European medical educators from Paris Descartes University, Università Cattolica del Sacro Cuore in Rome and the University of Edinburgh to groups of 25-30 undergraduate medical students at each university. Partner Institutions officially recognized the course as substitutive of or additive to the regular curriculum. The course has been running for 3 years and received excellent satisfaction scores by students and staff as regards to scientific content, pedagogy and international exchanges. This cooperative approach demonstrates the feasibility of a harmonized European undergraduate medical education, having ID as a test experiment for future developments.

  19. Loss of international medical experiences: knowledge, attitudes and skills at risk

    Directory of Open Access Journals (Sweden)

    Legome Eric

    2007-11-01

    Full Text Available Background Despite the great influence International Medical Experiences (IMs can have on young physicians and their impact on patients and communities, they are not offered in all training programs and are at risk of being reduced in some due to stringent guidelines for funding of graduate medical education. Discussion IMs provide unique experiences in clinical, epidemiologic, cultural, and political arenas. From an educational perspective, they broaden a physician's differential diagnostic skills and introduce clinical entities rarely seen in the U.S. Time spent in developing countries emphasizes the importance of community health and increases cultural and linguistic competence. Experience working with the underserved during an IM has been shown to increase interest in volunteerism, humanitarian efforts, and work with underserved populations both in the US and abroad. IMs also afford physicians the opportunity to learn about the delivery of health care abroad and are associated with an increase in primary care specialty choice. Summary It is time for the leaders in graduate medical education to prioritize international health opportunities. Leaders in academic medicine can press for changes in reimbursement patterns at the national level or special funds for international electives. Hospitals can set up separate accounts to help finance resident salaries and benefits while abroad. Individual departments must be flexible with resident schedules to allow elective time. Medical students and housestaff can organize and lobby larger organizations such as the American Medical Association (AMA, the American Association of Medical Colleges (AAMC, and specialty groups to make IMs universally accessible.

  20. Justification of diagnostic medical exposures: some practical issues. Report of an International Atomic Energy Agency Consultation.

    Science.gov (United States)

    Malone, J; Guleria, R; Craven, C; Horton, P; Järvinen, H; Mayo, J; O'reilly, G; Picano, E; Remedios, D; Le Heron, J; Rehani, M; Holmberg, O; Czarwinski, R

    2012-05-01

    The Radiation Protection of Patients Unit of the International Atomic Energy Agency (IAEA) is concerned about the effectiveness of justification of diagnostic medical exposures. Recent published work and the report of an initial IAEA consultation in the area gave grounds for such concerns. There is a significant level of inappropriate usage, and, in some cases, a poor level of awareness of dose and risk among some key groups involved. This article aims to address this. The IAEA convened a second group of experts in November 2008 to review practical and achievable actions that might lead to more effective justification. This report summarises the matters that this group considered and the outcome of their deliberations. There is a need for improved communication, both within professions and between professionals on one hand, and between professionals and the patients/public on the other. Coupled with this, the issue of consent to imaging procedures was revisited. The need for good evidence-based referral guidelines or criteria of acceptability was emphasised, as was the need for their global adaptation and dissemination. Clinical audit was regarded as a key tool in ensuring that justification becomes an effective, transparent and accountable part of normal radiological practice. In summary, justification would be facilitated by the "3 As": awareness, appropriateness and audit.

  1. Factors associated with intern noncompliance with the 2003 Accreditation Council for Graduate Medical Education's 30-hour duty period requirement.

    Science.gov (United States)

    Maloney, Christopher G; Antommaria, Armand H Matheny; Bale, James F; Ying, Jian; Greene, Tom; Srivastava, Rajendu

    2012-07-13

    In 2003 the Accreditation Council for Graduate Medical Education mandated work hour restrictions. Violations can results in a residency program being cited or placed on probation. Recurrent violations could results in loss of accreditation. We wanted to determine specific intern and workload factors associated with violation of a specific mandate, the 30-hour duty period requirement. Retrospective review of interns' performance against the 30-hour duty period requirement during inpatient ward rotations at a pediatric residency program between June 24, 2008 and June 23, 2009. The analytical plan included both univariate and multivariable logistic regression analyses. Twenty of the 26 (77%) interns had 80 self-reported episodes of continuous work hours greater than 30 hours. In multivariable analysis, noncompliance was inversely associated with the number of prior inpatient rotations (odds ratio: 0.49, 95% confidence interval (0.38, 0.64) per rotation) but directly associated with the total number of patients (odds ratio: 1.30 (1.10, 1.53) per additional patient). The number of admissions on-call, number of admissions after midnight and number of discharges post-call were not significantly associated with noncompliance. The level of noncompliance also varied significantly between interns after accounting for intern experience and workload factors. Subject to limitations in statistical power, we were unable to identify specific intern characteristics, such as demographic variables or examination scores, which account for the variation in noncompliance between interns. Both intern and workload factors were associated with pediatric intern noncompliance with the 30-hour duty period requirement during inpatient ward rotations. Residency programs must develop information systems to understand the individual and experience factors associated with noncompliance and implement appropriate interventions to ensure compliance with the duty hour regulations.

  2. Interns' Day in Surgery: improving intern performance through a simulation-based course for final year medical students.

    Science.gov (United States)

    Sinha, Sankar N; Page, Wendy

    2015-01-01

    The transition from final year medical student into the first year of clinical practice is known to be associated with anxiety and stress that ultimately affects job performance. Studies have shown that much of this stress and anxiety results from a junior doctor's lack of confidence in performing a number of basic tasks. We investigated if implementation of a half-day simulation-based course in the final year medical students results in increased confidence in performing these tasks. Final year medical students of the University of Tasmania's School of Medicine posted at the Royal Hobart Hospital participated in a half-day simulation course, comprised of multiple simulation stations, which required students to perform the basic tasks a competent surgical intern would be expected to complete. Students completed a survey which investigated their confidence with each task before and after the course. Overall, the majority of students thought that the Interns' Day in Surgery course was useful. The most significant improvements perceived were in case presentation (57.5% to 94.6%; P = 0.02) and communication with patients and other professional colleagues (55.5% to 75.5%; P = 0.01). A follow-up survey of doctors who attended this course reinforced its benefits. Simulation-based courses in clinical practice provide good learning opportunities for final year medical students within the curriculum. This study confirms significant gains in all skills categories practised during the course with perceived benefits subsequently identified by interns. This should lead to a less stressful and more successful transition from student to doctor and ultimately, better patient care. © 2014 Royal Australasian College of Surgeons.

  3. 77 FR 26824 - Agency Information Collection; Activity Under OMB Review; Reporting Required for International...

    Science.gov (United States)

    2012-05-07

    ...; Reporting Required for International Civil Aviation Organization (ICAO) AGENCY: Research & Innovative... Required for International Civil Aviation Organization (ICAO). Form No.: BTS Form EF. Type of Review... Convention on International Civil Aviation (Treaty), the United States is obligated to provide ICAO...

  4. Effect of Advanced Trauma Life Support program on medical interns' performance in simulated trauma patient management

    Institute of Scientific and Technical Information of China (English)

    Koorosh Ahmadi; Mohammad Sedaghat; Mahdi Safdarian; Amir Masoud Hashemian; Zahra Nezamdoust; Mohammad Vaseie; Vafa Rahimi-Movaghar

    2013-01-01

    Since appropriate and timetable methods in trauma care have an important impact on patients' outcome,we evaluated the effect of Advanced Trauma Life Support (ATLS) program on medical interns'performance in simulated trauma patient management.Methods:A descriptive and analytical study before and after the training was conducted on 24 randomly selected undergraduate medical interns from Imam Reza Hospital in Mashhad,Iran.On the first day,we assessed interns' clinical knowledge and their practical skill performance in confronting simulated trauma patients.After 2 days of ATLS training,we performed the same study and evaluated their score again on the fourth day.The two findings,preand post-ATLS periods,were compared through SPSS version 15.0 software.P values less than 0.05 were considered statistically significant.Results:Our findings showed that interns' ability in all the three tasks improved after the training course.On the fourth day after training,there was a statistically significant increase in interns' clinical knowledge of ATLS procedures,the sequence of procedures and skill performance in trauma situations (P<0.001,P=0.016 and P=0.01 respectively).Conclusion:ATLS course has an important role in increasing clinical knowledge and practical skill performance of trauma care in medical interns.

  5. Dosing antiretroviral medication when crossing time zones: a review.

    Science.gov (United States)

    Lewis, Joseph M; Volny-Anne, Alain; Waitt, Catriona; Boffito, Marta; Khoo, Saye

    2016-01-01

    International tourism continues to increase worldwide, and people living with HIV and their clinicians are increasingly confronted with the problem of how to dose antiretroviral therapy during transmeridian air travel across time zones. No guidance on this topic currently exists. This review is a response to requests from patient groups for clear, practical and evidence-based guidance for travelling on antiretroviral therapy; we present currently available data on the pharmacokinetic forgiveness and toxicity of various antiretroviral regimens, and synthesize this data to provide guidelines on how to safely dose antiretrovirals when travelling across time zones.

  6. Wind and solar energy curtailment: A review of international experience

    Energy Technology Data Exchange (ETDEWEB)

    Bird, Lori; Lew, Debra; Milligan, Michael; Carlini, E. Maria; Estanqueiro, Ana; Flynn, Damian; Gomez-Lazaro, Emilio; Holttinen, Hannele; Menemenlis, Nickie; Orths, Antje; Eriksen, Peter Børre; Smith, J. Charles; Soder, Lennart; Sorensen, Poul; Altiparmakis, Argyrios; Yasuda, Yoh; Miller, John

    2016-11-01

    Greater penetrations of variable renewable generation on some electric grids have resulted in increased levels of curtailment in recent years. Studies of renewable energy grid integration have found that curtailment levels may grow as the penetration of wind and solar energy generation increases. This paper reviews international experience with curtailment of wind and solar energy on bulk power systems in recent years, with a focus on eleven countries in Europe, North America, and Asia. It examines levels of curtailment, the causes of curtailment, curtailment methods and use of market-based dispatch, as well as operational, institutional, and other changes that are being made to reduce renewable energy curtailment.

  7. Loads Providing Ancillary Services: Review of International Experience

    Energy Technology Data Exchange (ETDEWEB)

    Heffner, Grayson; Goldman, Charles; Kintner-Meyer, Michael

    2007-05-01

    In this study, we examine the arrangements for and experiences of end-use loads providing ancillary services (AS) in five electricity markets: Australia, the United Kingdom (UK), the Nordic market, and the ERCOT and PJM markets in the United States. Our objective in undertaking this review of international experience was to identify specific approaches or market designs that have enabled customer loads to effectively deliver various ancillary services (AS) products. We hope that this report will contribute to the ongoing discussion in the U.S. and elsewhere regarding what institutional and technical developments are needed to ensure that customer loads can meaningfully participate in all wholesale electricity markets.

  8. BOOK REVIEW - International Law and Child Soldiers by Gus Waschefort

    Directory of Open Access Journals (Sweden)

    Robbie Robinson

    2015-11-01

    Full Text Available Long gone are the days that the law pertaining to children essentially dealt with the position of children within the parent-child relationship. On the contrary it has become a highly specialised legal discipline in which international and regional conventions progressively establish norms and standards to be adhered to. This book by Waschefort, the 53rd volume in the series Studies in International Law, bears ample testimony to this. It reviews all of the international instruments containing proscriptive norms to prohibit the use and recruitment of child soldiers. It commences with an analysis of the current state of child soldiering internationally, after which relevant international instruments are comprehensively discussed with a clear focus on the question of whether or not the prohibitive norms are optimally enforced – are they capable of better enforcement? The author adopts an “issues-based approach” in terms of which no specific regime of law, for instance International Humanitarian Law, is considered dominant. He assesses universal and regional human rights law together with International Human Rights Law and International Criminal Law to establish a mutually reinforcing web of protection for children. He also critically assesses the international judicial, quasi-judicial and non-judicial entities most relevant to child soldier prevention. He argues that the effective implementation of child soldier prohibitive norms does not require fundamental changes to any entity or functionary engaged in such prevention. In fact, what is required according to the author is the constant reassessment and refinement of all such entities and functionaries. The conclusions which are reached are ultimately tested against the background of a comprehensive case study on the use and recruitment of child soldiers in the Democratic Republic of the Congo. International Law and Child Soldiers is to be welcomed as a timely contribution to the evaluation

  9. Emotional intelligence in medical education: a critical review.

    Science.gov (United States)

    Cherry, M Gemma; Fletcher, Ian; O'Sullivan, Helen; Dornan, Tim

    2014-05-01

    Emotional intelligence (EI) is a term used to describe people's awareness of, and ability to respond to, emotions in themselves and other people. There is increasing research evidence that doctors' EI influences their ability to deliver safe and compassionate health care, a particularly pertinent issue in the current health care climate. This review set out to examine the value of EI as a theoretical platform on which to base selection for medicine, communication skills education and professionalism. We conducted a critical review with the aim of answering questions that clinical educators wishing to increase the focus on emotions in their curriculum might ask. Although EI seems, intuitively, to be a construct that is relevant to educating safe and compassionate doctors, important questions about it remain to be answered. Research to date has not established whether EI is a trait, a learned ability or a combination of the two. Furthermore, there are methodological difficulties associated with measuring EI in a medical arena. If, as has been suggested, EI were to be used to select for medical school, there would be a real risk of including and excluding the wrong people. Emotional intelligence-based education may be able to contribute to the teaching of professionalism and communication skills in medicine, but further research is needed before its wholesale adoption in any curriculum can be recommended. © 2014 John Wiley & Sons Ltd.

  10. Misuse of Prescription Opioid Medication among Women: A Scoping Review.

    Science.gov (United States)

    Hemsing, Natalie; Greaves, Lorraine; Poole, Nancy; Schmidt, Rose

    2016-01-01

    Background. National data from Canada and the United States identify women to be at greater risk than men for the misuse of prescription opioid medications. Various sex- and gender-based factors and patient and physician practices may affect women's use and misuse of prescription opioid drugs. Objectives. To explore the particular risks, issues, and treatment considerations for prescription opioid misuse among women who experience chronic noncancer pain and trauma. Methods. A scoping review for articles published between January 1990 and May 2014 was conducted on sex- and gender-based risks and treatment considerations among women who experience chronic noncancer pain and trauma. Results. A total of 57 articles were identified. The present narrative review summarizes the specific risks for the misuse of prescription opioid medication among women who have experienced violence and trauma, Aboriginal women, adolescents and young women, older women, pregnant women, women of a sexual minority, and transwomen. Discussion. The majority of the literature is descriptive, with few studies that evaluate approaches and interventions to respond to the issue of chronic pain, trauma, and misuse of prescription opioids among women, particularly vulnerable subgroups of women. Conclusions. Trauma-informed and women-centred approaches that address women's vulnerabilities and complex needs require further attention.

  11. Misuse of Prescription Opioid Medication among Women: A Scoping Review

    Directory of Open Access Journals (Sweden)

    Natalie Hemsing

    2016-01-01

    Full Text Available Background. National data from Canada and the United States identify women to be at greater risk than men for the misuse of prescription opioid medications. Various sex- and gender-based factors and patient and physician practices may affect women’s use and misuse of prescription opioid drugs. Objectives. To explore the particular risks, issues, and treatment considerations for prescription opioid misuse among women who experience chronic noncancer pain and trauma. Methods. A scoping review for articles published between January 1990 and May 2014 was conducted on sex- and gender-based risks and treatment considerations among women who experience chronic noncancer pain and trauma. Results. A total of 57 articles were identified. The present narrative review summarizes the specific risks for the misuse of prescription opioid medication among women who have experienced violence and trauma, Aboriginal women, adolescents and young women, older women, pregnant women, women of a sexual minority, and transwomen. Discussion. The majority of the literature is descriptive, with few studies that evaluate approaches and interventions to respond to the issue of chronic pain, trauma, and misuse of prescription opioids among women, particularly vulnerable subgroups of women. Conclusions. Trauma-informed and women-centred approaches that address women’s vulnerabilities and complex needs require further attention.

  12. A review of medical image watermarking requirements for teleradiology.

    Science.gov (United States)

    Nyeem, Hussain; Boles, Wageeh; Boyd, Colin

    2013-04-01

    Teleradiology allows medical images to be transmitted over electronic networks for clinical interpretation and for improved healthcare access, delivery, and standards. Although such remote transmission of the images is raising various new and complex legal and ethical issues, including image retention and fraud, privacy, malpractice liability, etc., considerations of the security measures used in teleradiology remain unchanged. Addressing this problem naturally warrants investigations on the security measures for their relative functional limitations and for the scope of considering them further. In this paper, starting with various security and privacy standards, the security requirements of medical images as well as expected threats in teleradiology are reviewed. This will make it possible to determine the limitations of the conventional measures used against the expected threats. Furthermore, we thoroughly study the utilization of digital watermarking for teleradiology. Following the key attributes and roles of various watermarking parameters, justification for watermarking over conventional security measures is made in terms of their various objectives, properties, and requirements. We also outline the main objectives of medical image watermarking for teleradiology and provide recommendations on suitable watermarking techniques and their characterization. Finally, concluding remarks and directions for future research are presented.

  13. BOOK REVIEW: Light, Visible and Invisible and its Medical Applications

    Science.gov (United States)

    Newing, Angela

    2000-09-01

    This book is based on various lectures given by Professor Newing over the last few years covering the centenaries of the discovery of x-rays, radioactivity, the electron and radium. It is a splendid follow-up read after studying the more formal presentations in A-level textbooks. The theory of each technique is touched on and the reader is provided with a full list of references for deeper analysis. Intermittently within the text are paragraphs of historical and developmental details, illustrated by contemporary drawings and photographs. These passages, which appear in a different typeface, add greatly to the enjoyment of the book, but could be skipped by an impatient reader seeking to gain an appropriate review knowledge of the subject of medical radiation physics. The areas of physiological measurement and medical engineering are not covered, neither is medical computing. Chapters discuss the diagnostic and therapeutic applications of x-rays. Different methods of scanning are outlined and the appropriateness of techniques brought up-to-date. Treatment with ionizing radiations is expanded to touch on electron radiotherapy, neutron therapy and brachytherapy. Phototherapy and photochemotherapy are considered in the section on treatments using non-ionizing radiations. The story starts with evidence from the ancient worlds of Egypt and Greece, accelerating through the nineteenth and twentieth centuries to the many treatments around today. The laser is shown to be a versatile and exact tool, available in a complete range of wavelengths for different surgical uses. The scientific principles and current applications of nuclear medicine, ultrasound and MRI are described. For each type of procedure, the author includes comments on advantages, disadvantages and operational safety. Dosimetry and quality assurance are touched upon. The book reflects Professor Newing's enthusiasm for her role as a medical physicist both as practitioner and teacher. To any students studying

  14. A systematic review of self-medication practices among adolescents.

    Science.gov (United States)

    Shehnaz, Syed Ilyas; Agarwal, Anoop Kumar; Khan, Nelofer

    2014-10-01

    The purpose was to systematically review the global trends and factors influencing self-medication (SM) among adolescents. Databases (Medline/Pubmed, Ingenta, Cochrane Library, EMBASE, CINAHL, Proquest, Scopus, and Google Scholar) were searched for peer-reviewed research published between January 2000 and December 2013 on SM among adolescents aged 13-18 years. Articles were scrutinized for country of origin, sample size, recall period, prevalence rates and associations, influencing factors, medicines used, self-medicated health complaints, sources of drug information, recommendation and procurement, knowledge about medicines, and adverse drug reactions. One hundred and sixty-three publications met the inclusion criteria. SM prevalence ranged from 2% to 92% in different countries. The most frequently self-medicated over-the-counter and prescription-only medicines were analgesics and antibiotics, respectively. Headache, allergies, and fever were the most common self-medicated health complaints reported. Misuse of both over-the-counter and prescription-only medicines reflected a risky trend. Female gender, older age, maternal education, and familial practices were associated with SM among adolescents. The primary sources of drug information, recommendation, and procurement included pharmacists, parents, and friends. High-risk practices such as diversion of prescription medicines and utilization of previous prescriptions were also reported. Most studies revealed gaps in drug knowledge, although adolescents self-rated it as satisfactory. However, few adverse drug reactions were reported, probably because of lack of awareness about the potential harmful effects of medicines. Recommendations for "responsible SM" have been made to minimize the adverse effects of SM. Understanding the links between various factors promoting SM can be helpful in deriving strategies aimed at reducing drug-related health risks among adolescents. Moreover, these will aid in creating awareness

  15. The shield of professional status: Comparing internationally educated nurses' and international medical graduates' experiences of discrimination.

    Science.gov (United States)

    Neiterman, Elena; Bourgeault, Ivy Lynn

    2015-11-01

    This article examines the intersecting roles of gender, ethnicity, and professional status in shaping the experiences of internationally educated health professionals in Canada. The article is based on 140 semi-structured qualitative interviews with internationally trained nurses and physicians who came to Canada within past 10 years with the intention to practice their profession. Describing the challenging process of professional integration in Canada, our participants highlighted incidents of discrimination they experienced along the way. Although some of the participants from both professional groups experienced racial discrimination, the context of those experiences differed. Physicians rarely reported instances of discrimination in communication with patients or nurses. Instead, they were concerned with instances of discrimination within their own professional group. Nurses, on the other hand, reported discrimination at the hands of patients and their families as well as racialization by physicians, management, and other nurses. We conclude our article with a reflection on the role that gender and professional status play in shaping the experiences of ethnic discrimination of internationally educated health professionals. © The Author(s) 2015.

  16. Physical activity counseling in medical school education: a systematic review

    Directory of Open Access Journals (Sweden)

    Marie L. Dacey

    2014-07-01

    Full Text Available Background: Despite a large evidence base to demonstrate the health benefits of regular physical activity (PA, few physicians incorporate PA counseling into office visits. Inadequate medical training has been cited as a cause for this. This review describes curricular components and assesses the effectiveness of programs that have reported outcomes of PA counseling education in medical schools. Methods: The authors systematically searched MEDLINE, EMBASE, PsychINFO, and ERIC databases for articles published in English from 2000 through 2012 that met PICOS inclusion criteria of medical school programs with PA counseling skill development and evaluation of outcomes. An initial search yielded 1944 citations, and 11 studies representing 10 unique programs met criteria for this review. These studies were described and analyzed for study quality. Strength of evidence for six measured outcomes shared by multiple studies was also evaluated, that is, students’ awareness of benefits of PA, change in students’ attitudes toward PA, change in personal PA behaviors, improvements in PA counseling knowledge and skills, self-efficacy to conduct PA counseling, and change in attitude toward PA counseling. Results: Considerable heterogeneity of teaching methods, duration, and placement within the curriculum was noted. Weak research designs limited an optimal evaluation of effectiveness, that is, few provided pre-/post-intervention assessments, and/or included control comparisons, or met criteria for intervention transparency and control for risk of bias. The programs with the most evidence of improvement indicated positive changes in students’ attitudes toward PA, their PA counseling knowledge and skills, and their self-efficacy to conduct PA counseling. These programs were most likely to follow previous recommendations to include experiential learning, theoretically based frameworks, and students’ personal PA behaviors. Conclusions: Current results provide

  17. Factor analysis methods and validity evidence: A systematic review of instrument development across the continuum of medical education

    Science.gov (United States)

    Wetzel, Angela Payne

    Previous systematic reviews indicate a lack of reporting of reliability and validity evidence in subsets of the medical education literature. Psychology and general education reviews of factor analysis also indicate gaps between current and best practices; yet, a comprehensive review of exploratory factor analysis in instrument development across the continuum of medical education had not been previously identified. Therefore, the purpose for this study was critical review of instrument development articles employing exploratory factor or principal component analysis published in medical education (2006--2010) to describe and assess the reporting of methods and validity evidence based on the Standards for Educational and Psychological Testing and factor analysis best practices. Data extraction of 64 articles measuring a variety of constructs that have been published throughout the peer-reviewed medical education literature indicate significant errors in the translation of exploratory factor analysis best practices to current practice. Further, techniques for establishing validity evidence tend to derive from a limited scope of methods including reliability statistics to support internal structure and support for test content. Instruments reviewed for this study lacked supporting evidence based on relationships with other variables and response process, and evidence based on consequences of testing was not evident. Findings suggest a need for further professional development within the medical education researcher community related to (1) appropriate factor analysis methodology and reporting and (2) the importance of pursuing multiple sources of reliability and validity evidence to construct a well-supported argument for the inferences made from the instrument. Medical education researchers and educators should be cautious in adopting instruments from the literature and carefully review available evidence. Finally, editors and reviewers are encouraged to recognize

  18. Measuring diversity in medical reports based on categorized attributes and international classification systems

    Directory of Open Access Journals (Sweden)

    Přečková Petra

    2012-04-01

    Full Text Available Abstract Background Narrative medical reports do not use standardized terminology and often bring insufficient information for statistical processing and medical decision making. Objectives of the paper are to propose a method for measuring diversity in medical reports written in any language, to compare diversities in narrative and structured medical reports and to map attributes and terms to selected classification systems. Methods A new method based on a general concept of f-diversity is proposed for measuring diversity of medical reports in any language. The method is based on categorized attributes recorded in narrative or structured medical reports and on international classification systems. Values of categories are expressed by terms. Using SNOMED CT and ICD 10 we are mapping attributes and terms to predefined codes. We use f-diversities of Gini-Simpson and Number of Categories types to compare diversities of narrative and structured medical reports. The comparison is based on attributes selected from the Minimal Data Model for Cardiology (MDMC. Results We compared diversities of 110 Czech narrative medical reports and 1119 Czech structured medical reports. Selected categorized attributes of MDMC had mostly different numbers of categories and used different terms in narrative and structured reports. We found more than 60% of MDMC attributes in SNOMED CT. We showed that attributes in narrative medical reports had greater diversity than the same attributes in structured medical reports. Further, we replaced each value of category (term used for attributes in narrative medical reports by the closest term and the category used in MDMC for structured medical reports. We found that relative Gini-Simpson diversities in structured medical reports were significantly smaller than those in narrative medical reports except the "Allergy" attribute. Conclusions Terminology in narrative medical reports is not standardized. Therefore it is nearly

  19. (Dis)Orientation of International Medical Graduates: An Approach to Foster Teaching, Learning, and Collaboration (TLC)

    Science.gov (United States)

    Tan, Adrienne; Hawa, Raed; Sockalingam, Sanjeev; Abbey, Susan E.

    2013-01-01

    Objective: The Teaching for Learning and Collaboration (TLC) Program is a teaching-skills program focusing on methods to improve student learning. This program was adopted to address the professional and personal challenges faced by International Medical Graduates (IMGs) completing a fellowship in psychosomatic medicine. Method: The authors…

  20. Preparing International Medical Graduates for Psychiatry Residency: A Multi-Site Needs Assessment

    Science.gov (United States)

    Sockalingam, Sanjeev; Hawa, Raed; Al-Battran, Mazin; Abbey, Susan E.; Zaretsky, Ari

    2012-01-01

    Objective: Despite the growing number of international medical graduates (IMGs) training in medicine in Canada and the United States, IMG-specific challenges early in psychiatry residency have not been fully explored. Therefore, the authors conducted a needs-assessment survey to determine the needs of IMGs transitioning into psychiatry residency.…

  1. A Roadmap for Observership Programs in Psychiatry for International Medical Graduates

    Science.gov (United States)

    Hamoda, Hesham M.; Sacks, Diane; Sciolla, Andres; Dewan, Mantosh; Fernandez, Antony; Gogineni, Rama Rao; Goldberg, Jeffrey; Kramer, Milton; Saunders, Ramotse; Sperber, Jacob; Rao, Nyapati R.

    2012-01-01

    Objective: International medical graduates (IMGs) constitute a significant proportion of the psychiatric workforce in the United States. Observership programs serve an important role in preparing IMGs for U.S. residency positions; yet there are limited resources with information available on establishing these observerships, and none specific to…

  2. The clinical skills assessment for international medical graduates in The Netherlands.

    NARCIS (Netherlands)

    Sonderen, M.J.; Denessen, E.; Cate, O.T.J. ten; Splinter, T.A.W.; Postma, C.T.

    2009-01-01

    AIM: A need was felt to improve the quality of admission and licensing procedures for international medical graduates in The Netherlands. METHOD: A clinical skills assessment was designed as part of a new procedure to realize a high-stakes, fair, transparent, and a time-limited path of admission for

  3. (Dis)Orientation of International Medical Graduates: An Approach to Foster Teaching, Learning, and Collaboration (TLC)

    Science.gov (United States)

    Tan, Adrienne; Hawa, Raed; Sockalingam, Sanjeev; Abbey, Susan E.

    2013-01-01

    Objective: The Teaching for Learning and Collaboration (TLC) Program is a teaching-skills program focusing on methods to improve student learning. This program was adopted to address the professional and personal challenges faced by International Medical Graduates (IMGs) completing a fellowship in psychosomatic medicine. Method: The authors…

  4. The Role of International Medical Graduate Psychiatrists in the United States Healthcare System

    Science.gov (United States)

    Boulet, John Robin; Cassimatis, Emmanuel G.; Opalek, Amy

    2012-01-01

    Objective: International medical graduates (IMGs) make up a substantial proportion of the United States physician workforce, including psychiatrists in practice. The purpose of this study was to describe, based on current data, the characteristics and qualities of IMG psychiatrists who provide patient care in the US. Method: Physician data from…

  5. Competency-Based Medical Education in the Internal Medicine Clerkship: A Report From the Alliance for Academic Internal Medicine Undergraduate Medical Education Task Force.

    Science.gov (United States)

    Fazio, Sara B; Ledford, Cynthia H; Aronowitz, Paul B; Chheda, Shobhina G; Choe, John H; Call, Stephanie A; Gitlin, Scott D; Muntz, Marty; Nixon, L James; Pereira, Anne G; Ragsdale, John W; Stewart, Emily A; Hauer, Karen E

    2017-09-14

    As medical educators continue to redefine learning and assessment across the continuum, implementation of competency-based medical education in the undergraduate setting has become a focus of many medical schools. While standards of competency have been defined for the graduating student, there is no uniform approach for defining competency expectations for students during their core clerkship year. The authors describe the process by which an Alliance for Academic Internal Medicine task force developed a paradigm for competency-based assessment of students during their inpatient internal medicine (IM) clerkship. Building on work at the resident and fellowship levels, the task force focused on the development of key learning outcomes as defined by entrustable professional activities (EPAs) that were specific to educational experiences on the IM clerkship, as well as identification of high-priority assessment domains. The work was informed by a national survey of clerkship directors.Six key EPAs emerged: generating a differential diagnosis, obtaining a complete and accurate history and physical exam, obtaining focused histories and clinically relevant physical exams, preparing an oral presentation, interpreting the results of basic diagnostic studies, and providing well-organized clinical documentation. A model for assessment was proposed, with descriptors aligned to the scale of supervision and mapped to Accreditation Council for Graduate Medical Education domains of competence. The proposed paradigm offers a standardized template that may be used across IM clerkships, and which would effectively bridge competency evaluation in the clerkship to fourth-year assessment as well as eventual postgraduate training.Written work prepared by employees of the Federal Government as part of their official duties is, under the U.S. Copyright Act, a "work of the United States Government" for which copyright protection under Title 17 of the United States Code is not available. As

  6. The relational underpinnings of quality internal auditing in medical clinics in Israel.

    Science.gov (United States)

    Carmeli, Abraham; Zisu, Malka

    2009-03-01

    Internal auditing is a key mechanism in enhancing organizational reliability. However, research on the ways quality internal auditing is enabled through learning, deterrence, motivation and process improvement is scant. In particular, the relational underpinnings of internal auditing have been understudied. This study attempts to address this need by examining how organizational trust, perceived organizational support and psychological safety enable internal auditing. Data collected from employees in medical clinics of one of the largest healthcare organizations in Israel at two points in time six months apart. Our results show that organizational trust and perceived organizational support are positively related to psychological safety (measured at time 1), which, in turn, is associated with internal auditing (measured at time 2).

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

    Science.gov (United States)

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

    2017-02-01

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

  8. PERCEPTIONS OF INTERNS TOWARDS A MODULE FOR TEACHING MEDICAL ETHICS USING THE ANDROID SMARTPHONE APPLICATION WHATSAPP

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    Archana

    2015-10-01

    Full Text Available Introduction of ethics and communication skills into the undergraduate medical curriculum is being contemplated by the medical council of India as a part of competency training. The methods of delivering the content are still in the formative process. Interns experience e thical dilemmas when they step into the real world clinical experiences albeit supervised. Delivering a curriculum to them is practically difficult because they are at different places and have different work shifts. This study is a pilot project to know t he extent to which interns felt engaged with medical ethics and how relevant they considered structured classes for learning principles of medical ethics and to explore the whatsapp messenger system in teaching medical ethics. MATERIALS AND METHODS: A what sapp group of consenting interns was formed and a series of short notes with activities were posted on the whatsapp group for them to learn. They were then assessed by 2 assessors in the form of responses to 4 short essay questions for 15 marks that they p osted on a google form, the link for which was also posted on the whatsapp group. RESULTS AND DISCUSSION: Out of 20 interns, 12 consented to participate in the study and the others could not as they did not have a smartphone. The average duration to comple te the responses was 4.5 days [ + 3.1 days]. Average marks obtained were 5.3[ + 4.1] out of 15 marks. Only 6 interns crossed the benchmark of 50%. Most of them liked whatsapp as a tool of education but found structured classes for ethics unnecessary. They expr essed the need for developing a module incorporating pictures, videos and multiple choice questions if whatsapp was to be used as a tool to learn ethics. CONCLUSIONS: There is need to reinforce the training of interns in medical ethics and professionalism. The present method of using whatsapp messenger as a teaching tool is met with a few barriers that need improvisation. LIMITATIONS: This study is limited by a

  9. Effect of Advanced Trauma Life Support program on medical interns' performance in simulated trauma patient management

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    Ahmadi Koorosh

    2013-06-01

    Full Text Available 【Abstract】Objective: Since appropriate and time-table methods in trauma care have an important impact on patients’ outcome, we evaluated the effect of Advanced Trauma Life Support (ATLS program on medical interns' performance in simulated trauma patient management. Methods: A descriptive and analytical study before and after the training was conducted on 24 randomly se-lected undergraduate medical interns from Imam Reza Hos-pital in Mashhad, Iran. On the first day, we assessed in-terns' clinical knowledge and their practical skill performance in confronting simulated trauma patients. After 2 days of ATLS training, we performed the same study and evaluated their score again on the fourth day. The two findings, pre-and post- ATLS periods, were compared through SPSS ver-sion 15.0 software. P values less than 0.05 were considered statistically significant. Results: Our findings showed that interns’ ability in all the three tasks improved after the training course. On the fourth day after training, there was a statistically significant increase in interns' clinical knowledge of ATLS procedures, the sequence of procedures and skill performance in trauma situations (P<0.001, P=0.016 and P=0.01 respectively. Conclusion: ATLS course has an important role in increasing clinical knowledge and practical skill performance of trauma care in medical interns. Key words: Advanced Trauma Life Support Care; Knowledge; Inservice training; Wounds and injuries

  10. The REEME project: a cooperative model for sharing international medical education materials.

    Science.gov (United States)

    Iserson, Kenneth V

    2008-07-01

    Although the Internet has become an excellent source of medical education materials, in many specialties, including Emergency Medicine (EM), most of the information is in English. Few international EM practitioners can attend costly specialty conferences, importing foreign experts to teach at these conferences is costly and, even then, these experts are available for a limited time to relatively few people. Countries with minimal health care or medical education budgets find providing even basic materials for professional medical education difficult. An exciting international project now freely distributes Spanish language educational programs to health care professionals on topics relating to EM. The Recursos Educacionales en Español para Medicina de Emergencia (REEME; Educational Resources in Spanish for EM) Project (www.reeme.arizona.edu) was developed to overcome some of these problems by providing language-specific specialty information and widespread international availability, and by promoting international cooperation among professional health care educators. It also provides a ready source of Spanish medical vocabulary for those trying to learn the language. With computer support from the University of Arizona's Learning and Technology Center, REEME first went "live" on November 1, 2004. Three years later, as of November 1, 2007, the site had 575 programs from 411 donors representing 19 countries and the United Nations. There are currently about 645 downloads per month to users in 73 countries. The REEME Project demonstrates the power of the Internet as a means to achieve international cooperation in medical education, and can serve as a model for similar projects in other specialties and languages.

  11. General surgical interns contributing to the clerkship learning environment of medical students.

    Science.gov (United States)

    Yu, Tzu-Chieh; Lemanu, Daniel P; Henning, Marcus; Maccormick, Andrew D; Hawken, Susan J; Hill, Andrew G

    2013-08-01

    Junior doctors are increasingly promoted as clinical teachers but there is limited understanding of how they contribute to medical student clerkship learning. To describe contributions made by general surgical interns to the student clerkship learning environment. The mixed-methods study involved two focus groups attended by volunteer interns and Year 4 students, and a student questionnaire collecting quantitative data. Focus group transcripts were evaluated using a qualitative analysis system. Six interns and five students attended focus groups in June and August 2011. Qualitative analysis found that intern contributions to student learning can be grouped under four distinct roles: physician, supervisor, teacher and person. Data from 85 questionnaires (response rate 57%) revealed that intern-student encounters occurred daily in the surgical wards and emergency department. Interns demonstrated bedside procedures, clerical/administrative tasks and interpretation of laboratory and radiological investigations. Appreciated for approachability, friendliness and ability to relate to students, interns also played a crucial role in integrating students into the surgical team. This significantly correlated to clerkship enjoyment. Surgical interns improve clerkship learning environments by demonstrating "personal" skills such as friendliness, approachability and relatedness. This has important implications for preparing interns as clinical preceptors.

  12. A review of cardiopulmonary research in Brazilian medical journals: clinical, surgical and epidemiological data.

    Science.gov (United States)

    Serrano, Carlos; Rocha e Silva, Mauricio

    2010-04-01

    Research in the field of cardiopulmonary disease in Brazil has been very active in recent decades. The combination of PUBMED, SCieLO, open access and online searching has provided a significant increase in the visibility of Brazilian journals. This newly acquired international visibility has in turn resulted in the appearance of more original research reports in the Brazilian scientific press. This review is intended to highlight part of this work for the benefit of the readers of "Clinics." We searched through PUBMED for noteworthy articles published in Brazilian medical journals included in the Journal of Citation Reports of the Institute of Scientific Information to better expose them to our readership. The following journals were examined: "Arquivos Brasileiros de Cardiologia," "Arquivos Brasileiros de Endocrinologia e Metabologia," "Brazilian Journal of Medical and Biological Reviews," "Jornal Brasileiro de Pneumologia," "Jornal de Pediatria," "Revista Brasileira de Cirurgia Cardiovascular," "Revista da Associação Médica Brasileira," Revista da Escola de Enfermagem U.S.P." and "São Paulo Medical Journal." These journals publish original investigations in the field of cardiopulmonary disease. The search produced 71 references, which are briefly examined.

  13. Learning effectiveness and satisfaction of international medical students: Introducing a Hybrid-PBL curriculum in biochemistry.

    Science.gov (United States)

    Yan, Qiu; Ma, Li; Zhu, Lina; Zhang, Wenli

    2017-07-08

    A biochemistry course is a fundamental but important subject in medical education in China. In recent years, the number of international medical students has increased. Curriculum reform in biochemistry teaching is needed because of the knowledge limitations of students, a close linkage of biochemical content with clinics, the shortcomings of lecture-centered teaching, and the requirements for early clinical practice training and competence. In this study, we analyzed a novel curriculum reform, "Hybrid-PBL," which combined problem-based learning (PBL) with biochemistry lectures and was implemented for biochemical teaching at Dalian Medical University (DMU) in China. The change in curriculum affected 189 international medical students. This study selected two PBL cases concerning the basic biochemical issues of carbohydrate metabolism and liver biochemistry for the analysis, and ten examples of learning issues for each case were reported by the international students. A questionnaire was utilized to evaluate students' perceptions of the Hybrid-PBL, and examination scores were analyzed to assess the curriculum reform in biochemistry teaching. A statistical analysis revealed that the Hybrid-PBL curriculum was well accepted by the international students as an effective supplement to lecture-centered teaching programs. The students obtained more abilities, higher examination scores, and an improved understanding of biomedical information from the Hybrid-PBL program than from conventional teaching methods. Our study was an innovative trial that applied a PBL curriculum to the specific discipline of biochemistry and may provide a potential and promising new teaching method that can be widely utilized. © 2017 by The International Union of Biochemistry and Molecular Biology, 45(4):336-342, 2017. © 2017 The International Union of Biochemistry and Molecular Biology.

  14. Job burnout and organizational justice among medical interns in Shanghai, People’s Republic of China

    Science.gov (United States)

    Jin, Wei-Min; Zhang, Ying; Wang, Xiao-Ping

    2015-01-01

    Background New challenges are occurring in the medical education in Mainland China, and the main risk is the loss of excellent physician candidates. This is due to lack of respect; a large, strong labor force; relatively low remuneration; unstable relationships between patients and doctors; pressures from the public media; and the possible existence of organizational injustice within the hospital. The study reported here looked at one of the in-hospital risks, psychological job burnout and organizational justice, to identify the possible internal cause–effect relationship at the two major general hospitals both affiliated to Shanghai Jiao Tong University School of Medicine. Objective The aim of the reported study was to analyze the related factors associated with job burnout in Chinese medical interns in Shanghai and to provide some suggestions to better their occupational development. Methods A total of 135 medical interns were investigated and assessed by the Organizational Justice Scale and the Maslach Burnout Inventory – General Survey. Results There was a statistically significant negative correlation between organizational justice and job burnout (r=−0.298, P=0.000), suggesting the existence of job burnout among the participant interns. In particular, emotional exhaustion and cynicism were statistically more significant; the comparison between the N group (from Nanjing) and S group (Shanghai) showed significant difference in participation and reduced professional efficacy (POrganizational justice should be promoted more, and school authorities should pay more attention to outside “non-home” interns. Finally, it is essential that the medical interns themselves establish reasonable judgment of their valuable profession. PMID:26345642

  15. Interventional tools to improve medication adherence: review of literature

    Directory of Open Access Journals (Sweden)

    Costa E

    2015-09-01

    review the most frequent interventions employed to increase the degree of medication adherence, the measured outcomes, and the improvements achieved, as well as the main limitations of the available studies on adherence, with a particular focus on older persons.Keywords: cognitive impairment, nonadherence, tools, compliance, chronic diseases, elderly

  16. A review of computer assisted learning in medical undergraduates

    Directory of Open Access Journals (Sweden)

    Lisha J John

    2013-01-01

    Full Text Available Laboratory based practical classes, have been the corner stone of undergraduate pharmacology learning. Ethical issues with the use of animals and rapid development of information technology has led to newer trends in teaching and learning such as computer assisted learning. Computer assisted learning (CAL software includes computer based packages, focusing on interactive instruction in a specific subject area, collection of animal experiments that encourage students to understand concepts in pharmacology. CAL offers a number of advantages to both students and teachers; most important being meeting the learning objectives. Few disadvantages and pitfalls to implementation in medical schools are also associated with CAL sessions. This article reviews the trend of CAL in pharmacology, advantages, disadvantages and pitfalls to the implementation of CAL.

  17. A review of computer assisted learning in medical undergraduates.

    Science.gov (United States)

    John, Lisha J

    2013-04-01

    Laboratory based practical classes, have been the corner stone of undergraduate pharmacology learning. Ethical issues with the use of animals and rapid development of information technology has led to newer trends in teaching and learning such as computer assisted learning. Computer assisted learning (CAL) software includes computer based packages, focusing on interactive instruction in a specific subject area, collection of animal experiments that encourage students to understand concepts in pharmacology. CAL offers a number of advantages to both students and teachers; most important being meeting the learning objectives. Few disadvantages and pitfalls to implementation in medical schools are also associated with CAL sessions. This article reviews the trend of CAL in pharmacology, advantages, disadvantages and pitfalls to the implementation of CAL.

  18. Job burnout and organizational justice among medical interns in Shanghai, People’s Republic of China

    Directory of Open Access Journals (Sweden)

    Jin WM

    2015-08-01

    Full Text Available Wei-Min Jin,1 Ying Zhang,2 Xiao-Ping Wang1 1Department of Neurology, Shanghai General Hospital, 2Department of Neuroscience, Shanghai Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of ChinaBackground: New challenges are occurring in the medical education in Mainland China, and the main risk is the loss of excellent physician candidates. This is due to lack of respect; a large, strong labor force; relatively low remuneration; unstable relationships between patients and doctors; pressures from the public media; and the possible existence of organizational injustice within the hospital. The study reported here looked at one of the in-hospital risks, psychological job burnout and organizational justice, to identify the possible internal cause–effect relationship at the two major general hospitals both affiliated to Shanghai Jiao Tong University School of Medicine.Objective: The aim of the reported study was to analyze the related factors associated with job burnout in Chinese medical interns in Shanghai and to provide some suggestions to better their occupational development.Methods: A total of 135 medical interns were investigated and assessed by the Organizational Justice Scale and the Maslach Burnout Inventory – General Survey.Results: There was a statistically significant negative correlation between organizational justice and job burnout (r=-0.298, P=0.000, suggesting the existence of job burnout among the participant interns. In particular, emotional exhaustion and cynicism were statistically more significant; the comparison between the N group (from Nanjing and S group (Shanghai showed significant difference in participation and reduced professional efficacy (P<0.05, with reduced professional efficacy in N group more significant than in S group, and participation in S group more significant than in N group.Conclusion: Job burnout existed among Chinese medical interns, and was associated

  19. A student-initiated and student-facilitated international health elective for preclinical medical students

    Directory of Open Access Journals (Sweden)

    Nirali Vora

    2010-02-01

    Full Text Available Introduction: Global health education is becoming more important for developing well-rounded physicians and may encourage students toward a career in primary care. Many medical schools, however, lack adequate and structured opportunities for students beginning the curriculum. Methods: Second-year medical students initiated, designed, and facilitated a pass–fail international health elective, providing a curricular framework for preclinical medical students wishing to gain exposure to the clinical and cultural practices of a developing country. Results: All course participants (N=30 completed a post-travel questionnaire within one week of sharing their experiences. Screening reflection essays for common themes that fulfill university core competencies yielded specific global health learning outcomes, including analysis of health care determinants. Conclusion: Medical students successfully implemented a sustainable global health curriculum for preclinical student peers. Financial constraints, language, and organizational burdens limit student participation. In future, long-term studies should analyze career impact and benefits to the host country.

  20. How payment scheme affects patients’ adherence to medications? A systematic review

    Science.gov (United States)

    Aziz, Hamiza; Hatah, Ernieda; Makmor Bakry, Mohd; Islahudin, Farida

    2016-01-01

    Background A previous systematic review reported that increase in patients’ medication cost-sharing reduced patients’ adherence to medication. However, a study among patients with medication subsidies who received medication at no cost found that medication nonadherence was also high. To our knowledge, no study has evaluated the influence of different medication payment schemes on patients’ medication adherence. Objective This study aims to review research reporting the influence of payment schemes and their association with patients’ medication adherence behavior. Methods This study was conducted using systematic review of published articles. Relevant published articles were located through three electronic databases Medline, ProQuest Medical Library, and ScienceDirect since inception to February 2015. Included articles were then reviewed and summarized narratively. Results Of the total of 2,683 articles located, 21 were included in the final analysis. There were four types of medication payment schemes reported in the included studies: 1) out-of-pocket expenditure or copayments; 2) drug coverage or insurance benefit; 3) prescription cap; and 4) medication subsidies. Our review found that patients with “lower self-paying constraint” were more likely to adhere to their medication (adherence rate ranged between 28.5% and 94.3%). Surprisingly, the adherence rate among patients who received medication as fully subsidized was similar (rate between 34% and 84.6%) as that of other payment schemes. The studies that evaluated patients with fully subsidized payment scheme found that the medication adherence was poor among patients with nonsevere illness. Conclusion Although medication adherence was improved with the reduction of cost-sharing such as lower copayment, higher drug coverage, and prescription cap, patients with full-medication subsidies payment scheme (received medication at no cost) were also found to have poor adherence to their medication. Future

  1. Web-Based Medical Appointment Systems: A Systematic Review

    Science.gov (United States)

    Zhao, Peng; Lavoie, Jaie; Lavoie, Beau James; Simoes, Eduardo

    2017-01-01

    Background Health care is changing with a new emphasis on patient-centeredness. Fundamental to this transformation is the increasing recognition of patients' role in health care delivery and design. Medical appointment scheduling, as the starting point of most non-urgent health care services, is undergoing major developments to support active involvement of patients. By using the Internet as a medium, patients are given more freedom in decision making about their preferences for the appointments and have improved access. Objective The purpose of this study was to identify the benefits and barriers to implement Web-based medical scheduling discussed in the literature as well as the unmet needs under the current health care environment. Methods In February 2017, MEDLINE was searched through PubMed to identify articles relating to the impacts of Web-based appointment scheduling. Results A total of 36 articles discussing 21 Web-based appointment systems were selected for this review. Most of the practices have positive changes in some metrics after adopting Web-based scheduling, such as reduced no-show rate, decreased staff labor, decreased waiting time, and improved satisfaction, and so on. Cost, flexibility, safety, and integrity are major reasons discouraging providers from switching to Web-based scheduling. Patients’ reluctance to adopt Web-based appointment scheduling is mainly influenced by their past experiences using computers and the Internet as well as their communication preferences. Conclusions Overall, the literature suggests a growing trend for the adoption of Web-based appointment systems. The findings of this review suggest that there are benefits to a variety of patient outcomes from Web-based scheduling interventions with the need for further studies. PMID:28446422

  2. Medication Errors in the Southeast Asian Countries: A Systematic Review.

    Directory of Open Access Journals (Sweden)

    Shahrzad Salmasi

    Full Text Available Medication error (ME is a worldwide issue, but most studies on ME have been undertaken in developed countries and very little is known about ME in Southeast Asian countries. This study aimed systematically to identify and review research done on ME in Southeast Asian countries in order to identify common types of ME and estimate its prevalence in this region.The literature relating to MEs in Southeast Asian countries was systematically reviewed in December 2014 by using; Embase, Medline, Pubmed, ProQuest Central and the CINAHL. Inclusion criteria were studies (in any languages that investigated the incidence and the contributing factors of ME in patients of all ages.The 17 included studies reported data from six of the eleven Southeast Asian countries: five studies in Singapore, four in Malaysia, three in Thailand, three in Vietnam, one in the Philippines and one in Indonesia. There was no data on MEs in Brunei, Laos, Cambodia, Myanmar and Timor. Of the seventeen included studies, eleven measured administration errors, four focused on prescribing errors, three were done on preparation errors, three on dispensing errors and two on transcribing errors. There was only one study of reconciliation error. Three studies were interventional.The most frequently reported types of administration error were incorrect time, omission error and incorrect dose. Staff shortages, and hence heavy workload for nurses, doctor/nurse distraction, and misinterpretation of the prescription/medication chart, were identified as contributing factors of ME. There is a serious lack of studies on this topic in this region which needs to be addressed if the issue of ME is to be fully understood and addressed.

  3. Web-Based Medical Appointment Systems: A Systematic Review.

    Science.gov (United States)

    Zhao, Peng; Yoo, Illhoi; Lavoie, Jaie; Lavoie, Beau James; Simoes, Eduardo

    2017-04-26

    Health care is changing with a new emphasis on patient-centeredness. Fundamental to this transformation is the increasing recognition of patients' role in health care delivery and design. Medical appointment scheduling, as the starting point of most non-urgent health care services, is undergoing major developments to support active involvement of patients. By using the Internet as a medium, patients are given more freedom in decision making about their preferences for the appointments and have improved access. The purpose of this study was to identify the benefits and barriers to implement Web-based medical scheduling discussed in the literature as well as the unmet needs under the current health care environment. In February 2017, MEDLINE was searched through PubMed to identify articles relating to the impacts of Web-based appointment scheduling. A total of 36 articles discussing 21 Web-based appointment systems were selected for this review. Most of the practices have positive changes in some metrics after adopting Web-based scheduling, such as reduced no-show rate, decreased staff labor, decreased waiting time, and improved satisfaction, and so on. Cost, flexibility, safety, and integrity are major reasons discouraging providers from switching to Web-based scheduling. Patients' reluctance to adopt Web-based appointment scheduling is mainly influenced by their past experiences using computers and the Internet as well as their communication preferences. Overall, the literature suggests a growing trend for the adoption of Web-based appointment systems. The findings of this review suggest that there are benefits to a variety of patient outcomes from Web-based scheduling interventions with the need for further studies.

  4. A two-decade Review of Medical Ethics in Iran

    Directory of Open Access Journals (Sweden)

    F Zahedi

    2009-03-01

    Full Text Available "nThe growing developments in science and technology have raised ethical challenges which should practically be addressed by scientists, regulatory bodies and policy makers. Likewise, challenging issues of medical ethics have also drawn a great deal of academic attention in Iran. In other words, recent decades have been an occasion of considerable development for contemporary bioethics in Iran. At first, the ongoing initiatives to arrange the national and regional research ethics commit­tees and to compile the national strategic plan for medical ethics is worth mentioning. Currently, research ethics committees are actively established in the universities and research centers across the country. Furthermore, the subject of ethics in dif­ferent fields of science, which was followed in a traditional approach previously, is an important object of discussion cur­rently. Much research is now being undertaken in various areas of bioethics nationwide. Consequently, during the period under review, considerable articles and books have been published in the emerging subjects of bioethics. Several educa­tional workshops and courses have been frequently taken place in the universities and research centers. Foundation of aca­demic courses and fellowship in bioethics are also among the recent activities in the realm of medical ethics education in Iran. Likewise, considering several areas of bioethics that need legislation or reconsideration of previous regulations; the authorities, policy-makers, and scientists have carried out some endeavors to prepare appropriate law, codes, and guidelines. This report summarizes the bioethical activities and achievements in different fields of policy-making, organizing, teaching, and putting ethics into practice in our country during two recent decades.

  5. Ultrasound in undergraduate medical education: a systematic and critical review.

    Science.gov (United States)

    Feilchenfeld, Zac; Dornan, Tim; Whitehead, Cynthia; Kuper, Ayelet

    2017-04-01

    The use of point-of-care ultrasound (POCUS) in clinical care is growing rapidly and advocates have recently proposed the integration of ultrasound into undergraduate medical education (UME). The evidentiary basis for this integration has not been evaluated critically or systematically. We conducted a critical and systematic review framed by the rationales enumerated in academic publications by advocates of ultrasound in UME. This research was conducted in two phases. First, the dominant discursive rationales for the integration of ultrasound in UME were identified from an archive of 403 academic publications using techniques from Foucauldian critical discourse analysis (CDA). We then sought empirical evidence in support of these rationales, using a critical synthesis methodology also adapted from CDA. We identified four dominant discursive rationales with different levels of evidentiary support. The use of ultrasound was not demonstrated to improve students' understanding of anatomy. The benefit of ultrasound in teaching physical examination was inconsistent and rests on minimal evidence. With POCUS, students' diagnostic accuracy was improved for certain pathologies, but findings were inconsistent for others. Finally, the rationale that ultrasound training in UME will improve the quality of patient care was difficult to evaluate. Our analysis has shown that the frequently repeated rationales for the integration of ultrasound in UME are not supported by a sufficient base of empirical research. The repetition of these dominant discursive rationales in academic publications legitimises them and may preclude further primary research. As the value of clinical ultrasound use by medical students remains unproven, educators must consider whether the associated financial and temporal costs are justified or whether more research is required. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

  6. Bottle characteristics of topical international glaucoma medications versus local brands in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Nasser Al-Jumaian

    2016-01-01

    Full Text Available What Is Known and Objective: Physical bottle characteristics differ of brand name topical glaucoma medications and local generic equivalents. This study compares the bottle characteristics of international topical glaucoma brands versus local brands from the Kingdom of Saudi Arabia. Methods: Data were collected on bottle drum volume, drop volume, bottle "squeezability," bottle tip diameter, labels and instructions, cap color coding, and clarity of the drug label. Density-based calculations of drops in bottle volume were assessed using an analytic balance. Bottle tip diameter was measured using 0.05 mm Vernier calipers. A Likert scale-based questionnaire was used to evaluate the subjective opinions of patients on bottle squeezability, clarity of usage and storage instructions, and the consistency of the cap color coding. Results: The volumes of international brands were statistically significantly higher than the local brands (P < 0.001. A number of drops per bottle and tip diameter were comparable between the international local brands. Cap color coding was inconsistent for international and local brands. Patients were dissatisfied with the label font size. Patients reported that the international and local brands were similar in terms of the ease of opening the bottle, instilling a drop, and the clarity of the instructions; but the local brands were subjectively easier to squeeze than international brands. What Is New and Conclusions: This is the first study to compare bottle characteristics of local Saudi Arabia brands with international brands. The bottle characteristics and patient feedback were similar between the local and international topical glaucoma medications. However, there were differences between the local and international brands in drug volume, bottle squeezability. Hence, patient compliance and drop dosage may differ based on the origin of manufacture.

  7. Medical Ethics in Plastic Surgery: A Mini Review.

    Science.gov (United States)

    Nejadsarvari, Nasrin; Ebrahimi, Ali; Ebrahimi, Azin; Hashem-Zade, Haleh

    2016-09-01

    Currently, cosmetic surgery is spread around the world. Several factors are involved in this rapidly evolving field such as socio-economic development, changes in cultural norms, globalization and the effects of Western culture, advertising, media, and mental disorders. Nowadays the cosmetic surgery is becoming a profitable business, which deals exclusively with human appearance and less from the perspective of beauty based on physical protests and considering factors such as sex, age, and race. The morality of plastic surgery subspecialty has undergone many moral dilemmas in the past few years. The role of the patient regardless of his unrealistic dreams has questionable ethical dimension. The problem is the loss of human values and replacing them with false values, of pride and glory to a charismatic person of higher status, that may underlie some of the posed ethical dilemmas. Cosmetic surgery has huge difference with the general principle of legal liability in professional orientation, because the objective for cosmetic surgeries is different from common therapeutic purposes. To observe excellence in the medical profession, we should always keep in mind that these service providers, often as a therapist (healer) must maintain a commitment and priority for patient safety and prior to any action, a real apply for this service recipient should be present. Also, patient-physician confidentiality is the cornerstone of medical ethics. In this review, we study the issues addressed and the ways that they can be resolved.

  8. Knowledge of addiction medicine among internal medicine residents and medical students.

    Science.gov (United States)

    Brown, Angel T; Kolade, Victor O; Staton, Lisa J; Patel, Neha K

    2013-03-01

    More than 22 million Americans are living with addiction, including nearly seven million who misuse prescription medications. However, most medical schools and residency programs provide little to no education addressing alcohol and drug addiction. Implementation of a new addiction medicine curriculum at a single internal medicine program provided an opportunity for knowledge assessment in a select population of health professionals. We hypothesized that knowledge of addiction medicine would not differ by training level or geographical location of medical school, but that knowledge would improve following a structured curriculum. Study participants included internal medicine and transitional year residents, as well as a group of medical students who were enrolled in a single internal medicine program at the time of the didactic series. A pre-test was administered prior to a four-week structured curriculum. The topics addressed included but were not limited to: 1) an overview of addiction, 2) opioids and chronic pain, 3) benzodiazepines and illicit stimulants, and 4) alcohol. A panel discussion was convened at the end of the fourth session. Following participation in the symposium, participants completed an online post-test. ANOVA was used to compare means. Paired t-tests were used to compare pre-test and post-test scores. 36 of 44 eligible medical students and residents completed the pre-test. Mean pre-test percentage scores were 64 percent for fourth year medical students and 62.5 percent for all residents. For residents, U.S. medical school trainees answered 65 percent of the pre-test questions correctly, versus 58.6 percent correct responses among their international medical graduate peers. No inter-group differences were statistically significant. Of the 36 participants, 20 completed both pre-tests and post-tests. The mean post-test score of 68.75 percent was higher than the mean pre-test score of 61.75 percent, p = 0.009. Knowledge of addiction medicine can be

  9. Psychological distress and academic self-perception among international medical students: the role of peer social support

    OpenAIRE

    Yamada, Yukari; Klugar, Miloslav; Ivanova, Katerina; Oborna, Ivana

    2014-01-01

    Background Psychological distress among medical students is commonly observed during medical education and is generally related to poor academic self-perception. We evaluated the role of peer social support at medical schools in the association between psychological distress and academic self-perception. Methods An online survey was conducted in a medical degree program for 138 international students educated in English in the Czech Republic. The Medical Student Well-Being Index was used to d...

  10. Evaluation of a Danish pharmacist student-physician medication review collaboration model

    DEFF Research Database (Denmark)

    Kaae, Susanne; Sørensen, Ellen Westh; Nørgaard, Lotte Stig

    2014-01-01

    Background Interprofessional collaboration between pharmacists and physicians to conduct joint home medication reviews (HMR) is important for optimizing the medical treatment of patients suffering from chronic illnesses. However, collaboration has proved difficult to achieve. The HMR programme...

  11. [An intervention program to improve the quality of the medical records in an Internal Medicine Department].

    Science.gov (United States)

    Wikman, A; Safont, P; Merino, J; Martínez Baltanás, A; Matarranz Del Amo, M; López Calleja, E

    2009-09-01

    The medical records are key documents for the patient's diagnosis, treatment and follow-up. Thus, the clinical histories must be made with high technical quality. Although some studies relate the quality of the clinical history with better control of a disease, as far as we know, there are few that evaluate the quality of the medical record itself. This study aims to analyze the quality of the clinical histories of our Internal Medicine Department and then evaluate the improvement achieved. A descriptive and intervention study with a before and after design was conducted. It included 186 medical records elaborated by the physicians of our Internal Medicine Department. A 16-item Likert-like scale was designed for the evaluation. The items were analyzed item by item and a score combining them was elaborated. A baseline analysis and a second analysis 3 months after making several interventions were made. Weak points were detected in the baseline analysis (described) and after the interventions. There was an improvement in almost all the items, this being very significant in the recording of allergies and habits. The global score also improved significantly. CONCLUSION. The study has allowed us to learn our weak points in the elaboration of the medical records. We have improved their quality with the interventions. We estimate that this intervention has also been useful for the training of internal medicine physicians, residents and students.

  12. Medication use by U.S. crewmembers on the International Space Station.

    Science.gov (United States)

    Wotring, Virginia E

    2015-11-01

    The environment on the International Space Station (ISS) includes a variety of potential physiologic stressors, including low gravity, elevated exposure to radiation, confined living and working quarters, a heavy workload, and high public visibility. This retrospective study examined medication use during long-duration spaceflights (>30 d). Medication records from 24 crewmembers on 20 missions longer than 30 d over a 10 yr period were examined for trends in usage rates, efficacy, and indication, as well as adverse event quality, frequency, and severity. Results were compared with those from crewmembers on shorter space shuttle missions (>16 d) and other reports of medication use by healthy adults. The most frequently used medications on the ISS were for sleep problems, pain, congestion, or allergy. Medication use during spaceflight missions was similar to that noted on the Space Shuttle and in adult ambulatory medicine, except that usage of sleep aids was about 10 times higher during spaceflight missions. There were also 2 apparent treatment failures in cases of skin rash, raising questions about the efficacy or suitability of the treatments used. Many spaceflight-related medication uses (at least 10%) were linked to extravehicular activities, exercise protocols, or equipment and operationally driven schedule changes. It seems likely that alterations in spaceflight mission operations (schedule-shifting and lighting) or hardware (extravehicular activity suits and exercise equipment) could reduce the need for a sizable fraction of medication uses.

  13. The short-term effect of interdisciplinary medication review on function and cost in ambulatory elderly people.

    Science.gov (United States)

    Williams, Mark E; Pulliam, Charles C; Hunter, Rebecca; Johnson, Ted M; Owens, Justine E; Kincaid, Jean; Porter, Carol; Koch, Gary

    2004-01-01

    To determine whether a medication review by a specialized team would promote regimen changes in elders taking multiple medications and to measure the effect of regimen changes on monthly cost and functioning. A randomized-controlled trial. Health center ambulatory clinic. Community-dwelling older adults taking five or more medications were assessed at baseline and 6 weeks. A medication-change intervention group of 57 elders was compared with a control group of 76 elder adults. The primary intervention was a comprehensive review and recommended modification of a patient's medication regimen. Changes were endorsed by each patient's primary physician and discussed with each patient. Measures were the Timed Manual Performance Test, Physical Performance Test, Functional Reach Assessment, subtests from the Wechsler Adult Intelligence Scale, a modified Randt Memory Test, the Center for Epidemiological Studies-Depression Scale, the Self-Rating Anxiety Scale, and the Rand 36-item Health Survey 1.0. Comorbidity was determined using the International Classification of Diseases, Ninth Revision, Clinical Modification. Medication usage was determined using brown bag review. Intervention subjects decreased their medications by an average of 1.5 drugs. No differences in functioning were observed between groups. Intervention subjects saved an average $26.92 per month in wholesale medication costs; control subjects saved $6.75 per month (P<.006). Although the intervention significantly reduced the medications taken and monthly cost, most patients were resistant to reducing medications to the recommended level. Further study is needed to understand patient resistance to reducing adverse polypharmacy and to devise better strategies for addressing this important problem in geriatric health. Greater focus on prescriber behavior is recommended.

  14. Radiation safety awareness among medical interns: are EU guidelines being implemented?

    Science.gov (United States)

    Lee, A M; Lee, M J

    2016-11-14

    European recommendations suggest that medical students should be taught radiation safety before entering clinical practice. The aim of this study was to produce a summative assessment of radiation protection training in medical school in Ireland. A web-based questionnaire was distributed to the 2014 intern population (n = 683) via network intern-coordinators. The survey encompassed knowledge of radiation dose in X-ray investigations, laws governing the prescribing of radiation and complications of radiation exposure to staff and patients. Response rate was 14.2% (97/683) with all Irish medical schools represented. 64% of interns reported no formal training in radiation safety. 80% correctly identified MRI and 94% US as not posing a radiation risk. 54% identified CT PET as emitting the highest radiation dose to patients. Only 32% correctly identified one CT abdomen/pelvis as equivalent to the dose from 300 to 500 chest X-rays and 22% correctly identified the theoretical lifetime risk of cancer induction from CT abdomen/pelvis as 1 in 2000. While 71% thought it was very important that prescribers should be aware of patient radiation dose and 28% thought it was moderately important, 74% were not aware of any laws governing the prescribing of radiology investigations. Currently, there is little formal radiation safety training in Irish medical schools. Knowledge of radiation dose and the laws governing prescribing is limited among qualifying interns. Implementation of a formal radiation safety curriculum in Irish Medical Schools would adhere to EU guidelines and improve prescriber knowledge, patient, and personal radiation safety.

  15. Modelling healthcare internal service supply chains for the analysis of medication delivery errors and amplification effects

    Directory of Open Access Journals (Sweden)

    Banafsheh Behzad

    2011-12-01

    Full Text Available Purpose: Healthcare is a universally used service that hugely affects economies and the quality of life. The research of service supply chains has found a significant role in the past decade. The main research goal of this paper is to model and simulate the internal service supply chains of a healthcare system to study the effects of different parameters on the outputs and capability measures of the processes. The specific objectives are to analyse medication delivery errors in a community hospital based on the results of the models and to explore the presence of bullwhip effect in the internal service supply chains of the hospital.Design/methodology/approach: System dynamics which is an approach for understanding the behaviour of complex systems, used as a methodology to model two internal service supply chains of the hospital with a sub-model created to simulate medication delivery errors in the hospital. The models are validated using the actual data of the hospital and the results are analyzed based on experimental design techniques.Findings: It is observed that the bullwhip effect may not occur in a hospital’s internal service supply chains. Furthermore the paper points out the conditions for reducing the medication delivery error in a hospital.Research limitations/implications: Because of the community hospital’s data availability the type of service supply chains modelled in this paper, are small service supply chains, representing only the tasks which are done inside the hospital. To better observe the bullwhip effect in healthcare service supply chains, the chains should be modelled more generally.Originality/value: The original system dynamics modelling of the internal service supply chains of a community hospital, with a sub-model simulating the medication delivery error.

  16. SU-F-E-12: Elective International Rotations in Medical Physics Residency Programs

    Energy Technology Data Exchange (ETDEWEB)

    Brown, D; Mundt, A; Einck, J; Pawlicki, T [University of California, San Diego, La Jolla, CA (United States)

    2016-06-15

    Purpose: The purpose of this educational program is to motivate talented, intelligent individuals to become stakeholders in the global effort to improve access to radiotherapy. Methods: The need to improve global access to radiotherapy has been clearly established and several organizations are making substantial progress in securing funding and developing plans to achieve this worthwhile goal. The incorporation of elective international rotations in residency programs may provide one possible mechanism to promote and support this future investment. We recently incorporated an elective 1-month international rotation into our CAMPEP accredited Medical Physics residency program, with our first rotation taking place in Vietnam. A unique aspect of this rotation was that it was scheduled collaboratively with our Radiation Oncology residency program such that Radiation Oncology and Medical Physics residents traveled to the same clinic at the same time. Results: We believe the international rotation substantially enhances the educational experience, providing additional benefits to residents by increasing cross-disciplinary learning and offering a shared learning experience. The combined international rotation may also increase benefit to the host institution by modeling positive multidisciplinary working relationships between Radiation Oncologists and Medical Physicists. Our first resident returned with several ideas designed to improve radiotherapy in resource-limited settings – one of which is currently being pursued in collaboration with a vendor. Conclusion: The elective international rotation provides a unique learning experience that has the potential to motivate residents to become stakeholders in the global effort to improve access to radiotherapy. What better way to prepare the next generation of Medical Physicists to meet the challenges of improving global access to radiotherapy than to provide them with training experiences that motivate them to be socially

  17. Office of Adolescent Health medical accuracy review process--helping ensure the medical accuracy of Teen Pregnancy Prevention Program materials.

    Science.gov (United States)

    Jensen, Jo Anne G; Moreno, Elizabeth L; Rice, Tara M

    2014-03-01

    The Office of Adolescent Health (OAH) developed a systematic approach to review for medical accuracy the educational materials proposed for use in Teen Pregnancy Prevention (TPP) programs. This process is also used by the Administration on Children, Youth, and Families (ACYF) for review of materials used in the Personal Responsibility Education Innovative Strategies (PREIS) Program. This article describes the review process, explaining the methodology, the team implementing the reviews, and the process for distributing review findings and implementing changes. Provided also is the definition of "medically accurate and complete" as used in the programs, and a description of what constitutes "complete" information when discussing sexually transmitted infections and birth control methods. The article is of interest to program providers, curriculum developers and purveyors, and those who are interested in providing medically accurate and complete information to adolescents.

  18. Medical treatment of osteoarthritis in the horse - a review.

    Science.gov (United States)

    Goodrich, Laurie R; Nixon, Alan J

    2006-01-01

    The medical treatment of osteoarthritis (OA) in the horse is one of the most utilized therapeutic regimens in the equine practice. It is important to understand the anatomy of synovial joints and the pathophysiology of the disease process to treat OA adequately. Once a thorough understanding of the disease process is comprehended the proper combination of systemic nonsteroidal anti-inflammatory drugs (NSAIDs), intraarticular steroids, viscosupplementation and chondroprotectants can be used to treat the disease and inhibit further progression of degenerative changes to the cartilage surface. The equine practitioner is faced with many choices for controlling inflammation in OA. This review presents the background and appropriate uses of various NSAIDs such as phenylbutazone, flunixin meglumine, ketoprofen, naproxen, and carprofen as well as their associated toxicities. Various steroid formulations exist for intraarticular (IA) administration and much has been learned in the past decade regarding correct dosage, frequency of administrations, indications and toxicity. This review presents IA steroids and their indications in addition to various chondroprotective drugs that also exist to control inflammation and provide viscosupplementation. Data are also given on disease modifying OA drugs such as glucosamine and chondroitin sulphate that have more recently become available to the equine practitioner.

  19. Wind and solar energy curtailment: A review of international experience

    DEFF Research Database (Denmark)

    Bird, Lori; Lew, Debra; Milligan, Michael

    2016-01-01

    Greater penetrations of variable renewable generation on some electric grids have resulted in increased levels of curtailment in recent years. Studies of renewable energy grid integration have found that curtailment levels may grow as the penetration of wind and solar energy generation increases....... This paper reviews international experience with curtailment of wind and solar energy on bulk power systems in recent years, with a focus on eleven countries in Europe, North America, and Asia. It examines levels of curtailment, the causes of curtailment, curtailment methods and use of market based dispatch......, as well as operational, institutional, and other changes that are being made to reduce renewable energy curtailment. (C) 2016 Elsevier Ltd. All rights reserved....

  20. Revisiting the internal consistency and factorial validity of the 8-item Morisky Medication Adherence Scale

    Directory of Open Access Journals (Sweden)

    Arsène Zongo

    2016-10-01

    Full Text Available Objective: To assess the internal consistency and factorial validity of the adapted French 8-item Morisky Medication Adherence Scale in assessing adherence to noninsulin antidiabetic drug treatment. Study Design and Setting: In a cross-sectional web survey of individuals with type 2 diabetes of the Canadian province of Quebec, self-reported adherence to the antidiabetes drug treatment was measured using the Morisky Medication Adherence Scale-8. We assessed the internal consistency of the Morisky Medication Adherence Scale-8 with Cronbach’s alpha, and factorial validity was assessed by identifying the underlying factors using exploratory factor analyses. Results: A total of 901 individuals completed the survey. Cronbach’s alpha was 0.60. Two factors were identified. One factor comprised five items: stopping medication when diabetes is under control, stopping when feeling worse, feeling hassled about sticking to the prescription, reasons other than forgetting and a cross-loading item (i.e. taking drugs the day before. The second factor comprised three other items that were all related to forgetfulness in addition to the cross-loading item. Conclusion: Cronbach’s alpha of the adapted French Morisky Medication Adherence Scale-8 was below the acceptable value of 0.70. This observed low internal consistency of the scale is probably related to the causal nature of the items of the scale but not necessarily a lack of reliability. The results suggest that the adapted French Morisky Medication Adherence Scale-8 is a two-factor scale assessing intentional (first factor and unintentional (second factor non-adherence to the noninsulin antidiabetes drug treatment. The scale could be used to separately identify these outcomes using scores obtained on each of the sub-scales.

  1. Feasibility of extracting data from electronic medical records for research: an international comparative study.

    Science.gov (United States)

    van Velthoven, Michelle Helena; Mastellos, Nikolaos; Majeed, Azeem; O'Donoghue, John; Car, Josip

    2016-07-13

    Electronic medical records (EMR) offer a major potential for secondary use of data for research which can improve the safety, quality and efficiency of healthcare. They also enable the measurement of disease burden at the population level. However, the extent to which this is feasible in different countries is not well known. This study aimed to: 1) assess information governance procedures for extracting data from EMR in 16 countries; and 2) explore the extent of EMR adoption and the quality and consistency of EMR data in 7 countries, using management of diabetes type 2 patients as an exemplar. We included 16 countries from Australia, Asia, the Middle East, and Europe to the Americas. We undertook a multi-method approach including both an online literature review and structured interviews with 59 stakeholders, including 25 physicians, 23 academics, 7 EMR providers, and 4 information commissioners. Data were analysed and synthesised thematically considering the most relevant issues. We found that procedures for information governance, levels of adoption and data quality varied across the countries studied. The required time and ease of obtaining approval also varies widely. While some countries seem ready for secondary uses of data from EMR, in other countries several barriers were found, including limited experience with using EMR data for research, lack of standard policies and procedures, bureaucracy, confidentiality, data security concerns, technical issues and costs. This is the first international comparative study to shed light on the feasibility of extracting EMR data across a number of countries. The study will inform future discussions and development of policies that aim to accelerate the adoption of EMR systems in high and middle income countries and seize the rich potential for secondary use of data arising from the use of EMR solutions.

  2. Medical Therapies for Adult Chronic Sinusitis: A Systematic Review.

    Science.gov (United States)

    Rudmik, Luke; Soler, Zachary M

    2015-09-01

    Chronic sinusitis is a common inflammatory condition defined by persistent symptomatic inflammation of the sinonasal cavities lasting longer than 3 months. It accounts for 1% to 2% of total physician encounters and is associated with large health care expenditures. Appropriate use of medical therapies for chronic sinusitis is necessary to optimize patient quality of life (QOL) and daily functioning and minimize the risk of acute inflammatory exacerbations. To summarize the highest-quality evidence on medical therapies for adult chronic sinusitis and provide an evidence-based approach to assist in optimizing patient care. A systematic review searched Ovid MEDLINE (1947-January 30, 2015), EMBASE, and Cochrane Databases. The search was limited to randomized clinical trials (RCTs), systematic reviews, and meta-analyses. Evidence was categorized into maintenance and intermittent or rescue therapies and reported based on the presence or absence of nasal polyps. Twenty-nine studies met inclusion criteria: 12 meta-analyses (>60 RCTs), 13 systematic reviews, and 4 RCTs that were not included in any of the meta-analyses. Saline irrigation improved symptom scores compared with no treatment (standardized mean difference [SMD], 1.42 [95% CI, 1.01 to 1.84]; a positive SMD indicates improvement). Topical corticosteroid therapy improved overall symptom scores (SMD, -0.46 [95% CI, -0.65 to -0.27]; a negative SMD indicates improvement), improved polyp scores (SMD, -0.73 [95% CI, -1.0 to -0.46]; a negative SMD indicates improvement), and reduced polyp recurrence after surgery (relative risk, 0.59 [95% CI, 0.45 to 0.79]). Systemic corticosteroids and oral doxycycline (both for 3 weeks) reduced polyp size compared with placebo for 3 months after treatment (P sinusitis. A short course of systemic corticosteroids (1-3 weeks), short course of doxycycline (3 weeks), or a leukotriene antagonist may be considered in patients with nasal polyps. A prolonged course (3 months) of macrolide

  3. NON-MEDICAL DRUG USE AMONG INTERNS AND HOUSE-OFFICERS

    Science.gov (United States)

    Choudhary, R. K.; Singh, Rajpal; Avasthi, Ajit; Gupta, Rajeev

    1980-01-01

    SUMMARY Self-administered questionnaire was given to a sample of 105 interns and house officers working in Govt. Medical College, Jammu. Questionnaire was designed to obtain information about socio-demographic characteristics, the frequency of non-medical drug use during the last one year and to enquire about “reasons” for drug intake. It was found that drugs commonly used were alcohol, tobacco, tranquillizers, amphetamines, cannabis. Most of the subjects used the same for ‘company’, festivity or curiosity. PMID:22058486

  4. [Medical intern or locum doctor--does job position affect learning?].

    Science.gov (United States)

    Mars, Nina; Kalske, Jaakko; Halttunen-Nieminen, Mervi; Pitkäranta, Anne

    2015-01-01

    At the University of Helsinki, the licentiate degree in medicine involves internships that can be conducted as a medical intern or locum doctor. The students and their supervisors fill out a feedback form, which helps in assessing the students' improvement in various areas. Based on the feedback form between 2008 and 2013, students having worked as locum doctor rated better improvement in their diagnostic skills, writing medical records, interacting with the patient, and operating in the work community. Supervisor evaluations did not show a similar clear difference between the job positions.

  5. Ensuring global standards for medical graduates: a pilot study of international standard-setting.

    Science.gov (United States)

    Stern, David T; Ben-David, Miriam Friedman; De Champlain, Andre; Hodges, Brian; Wojtczak, Andrzej; Schwarz, M Roy

    2005-05-01

    Increasing physician and patient mobility has led to a move toward internationalization of standards for physician competence. The Institute for International Medical Education proposed a set of outcome-based standards for student performance, which were then measured using three assessment tools in eight leading schools in China: a 150-item multiple-choice examination, a 15-station OSCE and a 16-item faculty observation form. The purpose of this study was to empanel a group of experts to determine whether international student-level performance standards could be set. The IIME convened an international panel of experts in student education with specialty and geographic diversity. The group was split into two, with each sub-group establishing standards independently. After a discussion of the borderline student, the sub-groups established minimally acceptable cut-off scores for performance on the multiple-choice examination (Angoff and Hofstee methods), the OSCE station and global rating performance (modified Angoff method and holistic criterion reference), and faculty observation domains (holistic criterion reference). Panelists within each group set very similar standards for performance. In addition, the two independent parallel panels generated nearly identical performance standards. Cut-off scores changed little before and after being shown pilot data but standard deviations diminished. International experts agreed on a minimum set of competences for medical student performance. In addition, they were able to set consistent performance standards with multiple examination types. This provides an initial basis against which to compare physician performance internationally.

  6. Job stress, satisfaction, and coping strategies among medical interns in a South Indian tertiary hospital

    Directory of Open Access Journals (Sweden)

    Susmita Chandramouleeswaran

    2014-01-01

    Full Text Available Background: It has previously been demonstrated that there is a significant drop in all domains of quality of life among interns during internship. Aims: A modified version of the health consultant′s job stress and satisfaction questionnaire (HCJSSQ was used to assess and quantify aspects of internship that were perceived as stressful and satisfying. Methods used to cope with work place stress were explored. Settings and Design: A prospective cohort study was undertaken among 93 medical interns doing a rotating internship at the Christian Medical College and Hospital, a tertiary-care hospital in southern India. Materials and Methods: After completion of 6 months of internship, the modified version of the HCJSSQ was administered to all participants. Statistical Analysis: The data were entered into Statistical Package for the Social Sciences (SPSS Version 9 by double data entry technique. Percentages of interns reporting high levels of stress, satisfaction were calculated. Results: While 63.4% of interns reported high levels of satisfaction, 45.2% of the interns experienced high levels of stress, 17.6% coped with work stress by using alcohol and nicotine, and 37% coped through unhealthy eating habits. Conclusion: More people found internship satisfying than stressful. However, a high proportion found it stressful, and many reported unhealthy coping mechanisms.

  7. Referral for competency committee review for poor performance on the internal medicine clerkship is associated with poor performance in internship.

    Science.gov (United States)

    Hemann, Brian A; Durning, Steven J; Kelly, William F; Dong, Ting; Pangaro, Louis N; Hemmer, Paul A

    2015-04-01

    To determine how students who are referred to a competency committee for concern over performance, and ultimately judged not to require remediation, perform during internship. Uniformed Services University of the Health Sciences' students who graduated between 2007 and 2011 were included in this study. We compared the performance during internship of three groups: students who were referred to the internal medicine competency committee for review who met passing criterion, students who were reviewed by the internal medicine competency committee who were determined not to have passed the clerkship and were prescribed remediation, and students who were never reviewed by this competency committee. Program Director survey results and United States Medical Licensing Examination (USMLE) Step 3 examination results were used as the outcomes of interest. The overall survey response rate for this 5-year cohort was 81% (689/853). 102 students were referred to this competency committee for review. 63/102 students were reviewed by this competency committee, given passing grades in the internal medicine clerkship, and were not required to do additional remediation. 39/102 students were given less than passing grades by this competency committee and required to perform additional clinical work in the department of medicine to remediate their performance. 751 students were never presented to this competency committee. Compared to students who were never presented for review, the group of reviewed students who did not require remediation was 5.6 times more likely to receive low internship survey ratings in the realm of professionalism, 8.6 times more likely to receive low ratings in the domain of medical expertise, and had a higher rate of USMLE Step 3 failure (9.4% vs. 2.8%). When comparing the reviewed group to students who were reviewed and also required remediation, the only significant difference between groups regarding professionalism ratings with 50% of the group requiring

  8. Evaluation of "Office-based" Course of Intern Students at Shahid Beheshti University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Behrokh Mahmoudzadeh

    2016-12-01

    Full Text Available Background and Purpose: "Office-based" course in General Medical Curriculum of Shahid Beheshti School of medicine (the reform program is a four-month course that is presented in the last six months of the program for interns. Office is a major practice setting after graduation for general practitioner in Iran and for this purpose physicians' offices in health care centers have been selected. Purpose of the course is to prepare interns to work independently and they have passed all their courses and had adequate knowledge to practice but they had not enough experience of office-based practice in the community and outpatient settings. This study was designed and implemented aimed to determine the program’s weaknesses and strengths in the range of the course stakeholders ‘questions (5 major questions, and provide proposed solutions to policy-makers in order to improve and promote the program of "office- based education internship" of Shahid Beheshti School of Medicine. Methods: The assessment was conducted in 3 descriptive study and the population under study included 44 interns and 36 physician mentor in 36 health care centers which were all centers under office based education plan in Shahid Beheshti medical school from October till December of 2014. The instruments used for data collection were questionnaires (mentor physician and intern students and a check list made by the researcher. Mentor physician questionnaire contained 23 items, student questionnaire contained 20 items and documentations review check list and evidence included contained 30 items. Twenty items were on a 4-point Likert-type (weak, less than expected, as expected as and higher than expected, 14 items on a 3-point Likert-type (none, partially, totally, 33 items on two-choice question (Yes/No and 6 as an open question. All items had the same value. Face and content validity were checked by Scientific Committee and evaluations of Shahid Beheshti University of Medical

  9. 32 CFR Appendix B to Part 327 - Internal Management Control Review Checklist

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 2 2010-07-01 2010-07-01 false Internal Management Control Review Checklist B... B to Part 327—Internal Management Control Review Checklist (a) Task: Personnel and/or Organization... See footnote 2 to this Appendix B. (1) I attest that the above listed internal controls...

  10. Contamination of cockroaches (Insecta: Blattaria) to medically fungi: A systematic review and meta-analysis.

    Science.gov (United States)

    Nasirian, H

    2017-05-11

    Fungal infections have emerged worldwide. Cockroaches have been proved vectors of medically fungi. A systematic meta-analysis review about cockroach fungal contamination was investigated. Relevant topics were collected between January 2016 and January 2017. After a preliminary review among 392 collected papers, 156 were selected to become part of the detailed systematic meta-analysis review. Cockroaches contaminated to 38 fungi species belonging to 19 families and 12 orders. About 38, 25 and 13 fungal species were recovered from the American, German and brown-banded cockroaches, respectively with a variety of medical importance. Except the fungi isolated from German and brown-banded cockroaches, 15 species have been isolated only from the American cockroaches. The global world mean and trend of cockroach fungal contamination were 84.1 and 50.6-100%, respectively in the human dwelling environments. There is a significant difference between cockroach fungal contamination in the urban and rural environments (P0.05). The external and internal cockroach fungal contamination is more dangerous than entire surfaces, while the internal is more dangerous than the external surface. The German and brown-banded cockroach fungal contamination are more dangerous than the American cockroaches in the hospital environments. The study indicates that globally cockroach fungal contamination has been increased recognizing as agents of human infections and associating with high morbidity and mortality in immune-compromised patients. These facts, along with insecticide resistance emergence and increasing globally cockroach infestation, reveal importance of cockroaches and need for their control more than ever. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  11. Simulation in Medical School Education: Review for Emergency Medicine

    OpenAIRE

    Shahram Lotfipour; T. Kent Denmark; Christopher Erik McCoy; Srinidhi Subraya Bhat; Elizabeth ter Haar; Bharath Chakravarthy

    2011-01-01

    Medical education is rapidly evolving. With the paradigm shift to small-group didactic sessions and focus on clinically oriented case-based scenarios, simulation training has provided educators a novel way to deliver medical education in the 21st century. The field continues to expand in scope and practice and is being incorporated into medical school clerkship education, and specifically in emergency medicine (EM). The use of medical simulation in graduate medical education is well documente...

  12. Vienna International Summer School on Experimental and Clinical Oncology for Medical Students : An Austrian Cancer Education Project

    NARCIS (Netherlands)

    Fromm-Haidenberger, Sabine; Pohl, Gudrun; Widder, Joachim; Kren, Gerhard; Fitzal, Florian; Bartsch, Rupert; de Vries, Jakob; Zielinski, Christoph; Poetter, Richard

    The "International Summer School on Experimental and Clinical Oncology for Medical Students" is organised at the Medical University of Vienna to teach a multidisciplinary approach to oncology to medical students in the final phase of their studies. The program includes biology, diagnosis, clinical

  13. The Association between Medical Education Accreditation and Examination Performance of Internationally Educated Physicians Seeking Certification in the United States

    Science.gov (United States)

    van Zanten, Marta; Boulet, John R.

    2013-01-01

    The purposes of this research were to examine medical education accreditation practices around the world, with special focus on the Caribbean, and to explore the association between medical school accreditation and graduates' examination performance. In addition to other requirements, graduates of international medical schools seeking to…

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

    Directory of Open Access Journals (Sweden)

    Alsharif Mohammed H

    2016-12-01

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

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

    Science.gov (United States)

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

    2010-08-01

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

  16. [Asymmetry in international relations, industrial property rights and anti-HIV medication].

    Science.gov (United States)

    Costa-Couto, Maria Helena; Nascimento, Alvaro César

    2008-01-01

    This paper analyzes the asymmetry in the international relations as refers to the recognition of industrial property rights in the pharmaceutical industry. It focuses on the impact of such relations upon the access to ARV medication, an issue of worldwide interest due to its connection with the development of the nations. Clashing interests and the position taken by some countries in their patent laws point to a scenario less favorable for the access of peripheral countries to anti-HIV/AIDS medication. On the other hand, it seems that the success of the Brazilian STD/AIDS program in negotiating ARV prices will open new possibilities. The solution may be the internal strengthening of the National States and the active role played by the Agencies of the United Nations System in defense of the collective human interests.

  17. Sustainability of professionals’ adherence to clinical practice guidelines in medical care: a systematic review

    Science.gov (United States)

    Ament, Stephanie M C; de Groot, Jeanny J A; Maessen, José M C; Dirksen, Carmen D; van der Weijden, Trudy; Kleijnen, Jos

    2015-01-01

    Objectives To evaluate (1) the state of the art in sustainability research and (2) the outcomes of professionals’ adherence to guideline recommendations in medical practice. Design Systematic review. Data sources Searches were conducted until August 2015 in MEDLINE, CINAHL, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL) and the Guidelines International Network (GIN) library. A snowball strategy, in which reference sections of other reviews and of included papers were searched, was used to identify additional papers. Eligibility criteria Studies needed to be focused on sustainability and on professionals’ adherence to clinical practice guidelines in medical care. Studies had to include at least 2 measurements: 1 before (PRE) or immediately after implementation (EARLY POST) and 1 measurement longer than 1 year after active implementation (LATE POST). Results The search retrieved 4219 items, of which 14 studies met the inclusion criteria, involving 18 sustainability evaluations. The mean timeframe between the end of active implementation and the sustainability evaluation was 2.6 years (minimum 1.5–maximum 7.0). The studies were heterogeneous with respect to their methodology. Sustainability was considered to be successful if performance in terms of professionals’ adherence was fully maintained in the late postimplementation phase. Long-term sustainability of professionals’ adherence was reported in 7 out of 18 evaluations, adherence was not sustained in 6 evaluations, 4 evaluations showed mixed sustainability results and in 1 evaluation it was unclear whether the professional adherence was sustained. Conclusions (2) Professionals’ adherence to a clinical practice guideline in medical care decreased after more than 1 year after implementation in about half of the cases. (1) Owing to the limited number of studies, the absence of a uniform definition, the high risk of bias, and the mixed results of studies, no firm conclusion about the

  18. International Linear Collider Technical Review Committee: Second Report, 2003

    Energy Technology Data Exchange (ETDEWEB)

    Loew, Gregory

    2003-02-21

    As this report is being published, the international high energy physics (HEP) community finds itself confronting a set of fascinating discoveries and new questions regarding the nature of matter and its fundamental particles and forces. The observation of neutrino oscillations that indicates that neutrinos have mass, measurements of the accelerating expansion of the universe that may be due to dark energy, and evidence for a period of rapid inflation at the beginning of the Big Bang are stimulating the entire field. Looming on the horizon are the potential discoveries of a Higgs particle that may reveal the origin of mass and of a whole family of supersymmetric particles that may be part of the cosmic dark matter. For the HEP community to elucidate these mysteries, new accelerators are indispensable. At this time, after careful deliberations, all three regional organizations of the HEP community (ACFA in Asia, HEPAP in North America, and ECFA in Europe) have reached the common conclusion that the next accelerator should be an electron-positron linear collider with an initial center-of-mass energy of 500 Giga-electronvolts (GeV), later upgradable to higher energies, and that it should be built and operated in parallel with the Large Hadron Collider under construction at CERN. Hence, this second report of the International Linear Collider Technical Review Committee (ILC-TRC) comes at a very timely moment. The report was requested by the International Committee on Future Accelerators (ICFA) in February 2001 to assess the current technical status of electron-positron linear collider designs in the various regions. Note that the ILC-TRC was not asked to concern itself with either cost studies or the ultimate selection process of a machine. This Executive Summary gives a short outline of the genesis of the report, the charge given to the committee, and its organization. It then presents a brief description of four electron-positron linear collider designs at hand. The

  19. Improving Confidence in Competencies for International Medical Trips Using a Curriculum with Simulation.

    Science.gov (United States)

    Birckhead, Brandon J; Mullikin, Trey C; Zubair, Adeel S; Alniemi, Dema; Franz, Walter B; Bachman, John W

    2015-01-01

    Many incoming medical and undergraduate students seek out international medical mission trips to supplement their education and training. However, few have the necessary skills to perform simple clinical tasks such as taking vital signs or conducting an initial patient interview. We conducted a small pilot study to assess the impact of simulation exercises on teaching incoming first-year medical students and undergraduate students basic clinical skills and teamwork. Our study population consisted of nine incoming medical students and 11 undergraduate students who participated in a training session involving simulated tasks prior to taking a medical mission trip to Nicaragua. Participants completed a survey before and after the simulation and at the end of the trip. All 20 indicated the simulation was effective in teaching clinical and team-building skills. In addition, the simulation exercise improved participants' confidence in their ability to perform certain clinical tasks and work as a team prior to the mission trip. We concluded that simulation is effective for incoming medical and undergraduate students and can be used prior to global health trips to increase their confidence in performing tasks required for a successful experience.

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

    Science.gov (United States)

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

    2017-02-03

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

  1. Preventing infection from reusable medical equipment: a systematic review

    Directory of Open Access Journals (Sweden)

    Hart Tony

    2002-03-01

    Full Text Available Abstract Background In 2000, the World Health Organization (WHO had eight sets of conflicting recommendations for decontaminating medical equipment. We conducted a systematic review of observational studies to assist WHO in reconciling the various guidelines. This paper summarises the methods developed and illustrates the results for three procedures – alcohol, bleach and povidone iodine. Methods We developed a Medline search strategy and applied inclusion criteria specifying the decontamination procedures of interest and an outcome of microbial destruction for a set of marker organisms. We developed protocols to assess the quality of studies and categorised them according to the reliability of the methods used. Through an iterative process we identified best practice for the decontamination methods and key additional factors required to ensure their effectiveness. We identified 88 published papers for inclusion, describing 135 separate studies of decontamination. Results For disinfection with alcohol, best practice was identified from 23 studies as an exposure to 70–80% ethanol or isopropanol for at least 5 minutes. Bleach was effective for sterilization at a concentration of 5000 ppm for 5 minutes and for disinfection at 1000 ppm for 10 minutes (33 studies. Povidone iodine was only partially effective for disinfection at a concentration of 1% for 15 minutes (15 studies. Conclusions Our findings provide an evidence base for WHO guidelines on decontaminating medical equipment. The results support the recommended use of bleach and show that alcohol could be used more widely than current guidelines suggest, provided best practice is followed. The effectiveness of povidone iodine is uncertain.

  2. International medical travel and the politics of therapeutic place-making in Malaysia

    OpenAIRE

    Ormond, M.E.

    2011-01-01

    Electronic version excludes material for which permission has not been granted by the rights holder This thesis examines the shifting relationship between the state and its subjects with regard to responsibility for and entitlement to care. Using Malaysia as a case study the research engages with international medical travel (IMT) as an outcome of the neoliberal retrenchment of the welfare state. I offer a critical reading of postcolonial development strategies that negotiate the benefit...

  3. 5th European Conference of the International Federation for Medical and Biological Engineering

    CERN Document Server

    European IFMBE MBEC : Cooperation for Effective Healthcare

    2012-01-01

    This volume presents the 5th European Conference of the International Federation for Medical and Biological Engineering (EMBEC),  held in Budapest, 14-18 September, 2011. The scientific discussion on the conference and in this conference proceedings include the following issues: - Signal & Image Processing - ICT - Clinical Engineering and Applications - Biomechanics and Fluid Biomechanics - Biomaterials and Tissue Repair - Innovations and Nanotechnology - Modeling and Simulation - Education and Professional

  4. Knowledge and attitude of medical undergraduate, interns and postgraduate students in India towards emergency contraception

    Directory of Open Access Journals (Sweden)

    Purushottam A Giri

    2013-01-01

    Full Text Available Background: Although India was the first country in the world to have national family planning policy, the acceptance of contraceptive methods has been unsatisfactory. Many women in their peak reproductive years, who wish to control their fertility, are not aware about the different methods of contraceptives available. Unregulated fertility results in unplanned pregnancies. Emergency contraceptive pills can avoid many such unplanned pregnancies. Aim: The study was to assess the knowledge and attitude about emergency contraception (EC among the undergraduate, interns and postgraduate medical science university students. Materials and Methods: A cross-sectional study was carried out among 180 medical students which include undergraduate (final year MBBS, interns, and postgraduate students (60 from each group studying at Rural Medical College and Pravara Rural Hospital of Pravara Institute of Medical Sciences University of central India by a convenient sample method over a period of February 2009 to May 2009. Data were collected by pre-designed, pre-tested, self-administered questionnaire. Data was analyzed in the form of percentage and proportions and Chi-square test was applied. Results: In this study, a total of 180 respondents, of which 110 (61.2% were male and 70 (38.8% were female. The knowledge about EC was highest (47.6% among postgraduates in comparison to interns (43.3% and undergraduate students (41.6%. Overall positive attitude toward EC was observed among 73.8% of the respondents. Conclusions: Considering the role of a medical graduate as counselor and health-care provider, the technical knowledge about different aspects of EC among the study population was inadequate.

  5. Reporting bias in medical research - a narrative review

    Directory of Open Access Journals (Sweden)

    Kölsch Heike

    2010-04-01

    Full Text Available Abstract Reporting bias represents a major problem in the assessment of health care interventions. Several prominent cases have been described in the literature, for example, in the reporting of trials of antidepressants, Class I anti-arrhythmic drugs, and selective COX-2 inhibitors. The aim of this narrative review is to gain an overview of reporting bias in the medical literature, focussing on publication bias and selective outcome reporting. We explore whether these types of bias have been shown in areas beyond the well-known cases noted above, in order to gain an impression of how widespread the problem is. For this purpose, we screened relevant articles on reporting bias that had previously been obtained by the German Institute for Quality and Efficiency in Health Care in the context of its health technology assessment reports and other research work, together with the reference lists of these articles. We identified reporting bias in 40 indications comprising around 50 different pharmacological, surgical (e.g. vacuum-assisted closure therapy, diagnostic (e.g. ultrasound, and preventive (e.g. cancer vaccines interventions. Regarding pharmacological interventions, cases of reporting bias were, for example, identified in the treatment of the following conditions: depression, bipolar disorder, schizophrenia, anxiety disorder, attention-deficit hyperactivity disorder, Alzheimer's disease, pain, migraine, cardiovascular disease, gastric ulcers, irritable bowel syndrome, urinary incontinence, atopic dermatitis, diabetes mellitus type 2, hypercholesterolaemia, thyroid disorders, menopausal symptoms, various types of cancer (e.g. ovarian cancer and melanoma, various types of infections (e.g. HIV, influenza and Hepatitis B, and acute trauma. Many cases involved the withholding of study data by manufacturers and regulatory agencies or the active attempt by manufacturers to suppress publication. The ascertained effects of reporting bias included the

  6. Internalization of Western Culture's Thin-Ideal: A Literature Review on Internalization and Individuals with Eating Disorders.

    Science.gov (United States)

    Albertson, Nicole K.

    This paper is a review of literature regarding internalization of Western culture's thin-ideal. The media's portrayal of a thin-ideal associates success and beauty with being thin. Research has shown that exposure to the culture's thin-ideal does not necessarily lead to eating pathology, but those who internalize the standard are more likely to…

  7. Kenyan women medical doctors and their motivations to pursue international research training.

    Science.gov (United States)

    Daniels, Joseph; Nduati, Ruth; Farquhar, Carey

    2013-01-01

    There is a need to understand the factors that influence African women medical doctors to pursue international health research training because they remain under-represented in research fields but increasingly represented in medicine. We conducted a program study with Kenyan women (N = 12) who participated in a US funded AIDS International Training and Research Program implemented by the University of Washington. Interviews were conducted to understand their clinical research career motivations and training pathways into global health research. The transcripts were analyzed for themes using predefined code areas. The findings outline entry into research, professional and career balance motivations, and two stages of a career path into research. Kenyan women medical clinical researchers shared similar motivations as US women but differed as well. Kenyan medical doctors pursued health research within a context of limited resources, but the ability to balance work and family while contributing to public health through research and leadership was highly valued. International training programs can effectively engage women in research training by developing women's health research areas, supportive family policies, and aligning program design with local training to develop career pathways for women.

  8. Proceedings of the International Symposium on Torture and the Medical Profession.

    Science.gov (United States)

    1991-12-01

    ... The main topic of this publication is the involvement of professional medical doctors in the course of torture in, generally speaking, the following ways: 1. Medical scientific knowledge and experience is used in the design of the methods and techniques of torture, for example pharmacological torture; 2. Doctors teach the torturers/perpetrators regarding the practical application of these methods; 3. Doctors actively participate in carrying out torture and in executions in relation to the death penalty; 4. Doctors are present -- "passive" -- during the implementation of torture (in more than sixty per cent of cases) for example monitoring the clinical condition of the victim in order to prevent death; are present when the death sentence is carried out, and then write out death certificates. Many of these are later shown by forensic documentation to be false.... This supplement is based on an international symposium, Torture and the Medical Profession, which was held at the University of Tromsø in June 1990....

  9. A STUDY ON AWARENESS OF TUBERCULOSIS AND RNTCP AMONG UNDERGRADUATE MEDICAL STUDENTS AND INTERNS

    Directory of Open Access Journals (Sweden)

    Chennaveerappa

    2014-07-01

    Full Text Available BACKGROUND: India is the highest TB burden country accounting for nearly one fifth of the global incidence. The diagnosis and treatment of TB is made available free of cost by Government of India’s Revised National Tuberculosis Control Programme (RNTCP. All TB patients registered in the RNTCP are treated under directly observed therapy (DOT. OBJECTIVE: To assess the knowledge and awareness of Tuberculosis and DOTS among final year medical students and interns of a Government medical college in South India. METHODOLOGY: A cross sectional questionnaire based survey was performed among 85 final year medical students and 76 interns. The Knowledge of participants regarding the diagnosis of TB, treatment and follow up under RNTCP was assessed and data was analyzed using descriptive statistics. RESULTS: Most of the students were aware of the current situation of TB in India and objectives of RNTCP. 33.5% participants could correctly state that a TB suspect with two negative smears should be subjected to chest X-ray. 57.8% participants opined that DOTS is equally effective as daily regimen. Only 37.3% students knew that family member cannot be a DOTS provider. CONCLUSION: This survey provides valuable information on the current levels of knowledge of undergraduate medical students. A moderate level of knowledge about tuberculosis and RNTCP was found among our study participants, which suggests innovative, effective active learning experiences to modify current scenario.

  10. Smartphones and professionalism: A cross-sectional study on interns and final-year medical students

    Directory of Open Access Journals (Sweden)

    Saleh Alqaryan

    2016-09-01

    Full Text Available The smartphone is a powerful tool that can be used to improve the health care system as long as certain checks and balances are implemented. It is commonly used by health care providers and medical students. A cross-sectional study conducted at Qassim University, Saudi Arabia. Final-year medical students and interns were included. A survey was distributed and divided into three sections: personal technology, experiences of using smartphones during clinical rotations, and attitudes about the usage of smartphones for clinical work. A total of 156 interns and students participated in the study. All of them owned a smartphone. Three-quarters of the respondents used their mobile for personal purposes, while 71.2% used them to look up medical references and resources. Respondents also used personal mobiles to keep in contact with team members regarding patient- (29.5% and non-patientrelated issues (26.3%. Some 16% of participants did not have any security features on their smartphones. Over half the participants did not get proper instructions about using their smartphones from either their medical college or senior residents or consultants. There is a lot to be done in this area, as certain regulations need to be carried out to lead toward a world that is pro-technology, health centered, and safe.

  11. 78 FR 70598 - Submission for Review: Request for External Review (3206-NEW); Model Notice of Final Internal...

    Science.gov (United States)

    2013-11-26

    ... Review (3206-NEW); Model Notice of Final Internal Adverse Benefit Determination and Case Intake Form... collection comprises two forms: (1) Model Notice of Final Internal Adverse Benefit Determination, and (2... benefit determinations is accepting requests for external review from MSP enrollees. In addition...

  12. The scholar role in the National Competence Based Catalogues of Learning Objectives for Undergraduate Medical Education (NKLM compared to other international frameworks

    Directory of Open Access Journals (Sweden)

    Hautz, Stefanie C.

    2015-11-01

    Full Text Available Background: In Germany, a national competence based catalogue of learning objectives in medicine (NKLM was developed by the Society for Medical Education and the Council of Medical Faculties. As many of its international counterparts the NKLM describes the qualifications of medical school graduates. The definition of such outcome frameworks indents to make medical education transparent to students, teachers and society. The NKLM aims to amend existing lists of medical topics for assessment with learnable competencies. All outcome frameworks are structured into chapters, domains or physician roles. The definition of the scholar-role poses a number of questions such as: What distinguishes necessary qualifications of a scientifically qualified physician from those of a medical scientist? Methods: 13 outcome frameworks were identified through a systematic three-step literature review and their content compared to the scholar role in the NKLM by means of a qualitative text analysis. The three steps consist of (1 search for outcome frameworks, (2 in- and exclusion, and (3 data extraction, categorization, and validation. The results were afterwards matched with the scholar role of the NKLM.Results: Extracted contents of all frameworks may be summarized into the components , and . Compared to the included frameworks the NKLM emphasises competencies necessary for research and teaching while clinical application is less prominently mentioned. Conclusion: The scholar role of the NKLM differs from other international outcome frameworks. Discussing these results shall increase propagation and understanding of the NKLM and thus contribute to the qualification of future medical graduates in Germany.

  13. 2009 review and revisions of the international standards for the neurological classification of spinal cord injury

    DEFF Research Database (Denmark)

    Waring, William P; Biering-Sorensen, Fin; Burns, Stephen;

    2010-01-01

    The International Standards for the Neurological Classification of Spinal Cord Injury (ISNCSCI) were recently reviewed by the ASIA's Education and Standards Committees, in collaboration with the International Spinal Cord Society's Education Committee. Available educational materials for the ISNCSCI...

  14. Assessment of knowledge, attitude and practice of prescription writing as per Medical Council of India guidelines among interns in a Medical College

    Directory of Open Access Journals (Sweden)

    Sumalatha R

    2016-02-01

    Full Text Available Objective: To assess the knowledge, attitude and practice of prescription writing among interns in medical college.Materials and Methods: A cross-sectional study was conducted among the interns in a Medical College, after taking approval from the Institutional Ethics Committee. Participants were asked to write prescription for a common ailment in a given prescription blank page. A structured questionnaire was designed based on new Medical Council of India (MCI prescription writing pattern to analyse the prescription. The data was analysed using descriptive statistics.Results: Among 84 interns, most of the participants had written the drug by generic name (95.2% and have signed in the prescription sheet (98%. None of them were aware of the latest prescription writing pattern recommended by Medical Council of India (MCI. The writing of generic name in capital letter was not done by 97.6% of interns.    Conclusion: Our study concluded that interns were not aware of new Medical Council of India (MCI prescription writing pattern. Majority of interns have made errors while writing the prescription. Thus there is a need for regular formal education regarding prescription writing, before the start of internship. They can be given training under medical education unit regarding the recent updates of prescription writing.

  15. Medication adherence and community pharmacy: a review of education, policy and research in England

    Directory of Open Access Journals (Sweden)

    Clifford S

    2010-06-01

    Full Text Available Objective: The objective of this narrative review was to identify and describe the current policy, education and research related to community pharmacy and medication adherence in England.Methods: Medline, Embase, International Pharmaceutical Abstracts and Pharmline were used to search for relevant research articles. Current policy documents were identified via the websites of the Department of Health in England, the Royal Pharmaceutical Society of Great Britain, the National Pharmacy Association, the Pharmaceutical Services Negotiating Committee and NHS Employers. All pharmacy schools in England were contacted to obtain information about the adherence-related courses they provide to undergraduate and postgraduate pharmacy students.Results: National policies and guidelines in England are conducive to an increasing role for community pharmacists to support patients with medication adherence. Many pharmacy schools cover the issue of adherence in their undergraduate and postgraduate courses. Research in this area has tested the effectiveness of pharmacists providing adherence support in the form of compliance aids, education, involvement in discharge planning, and tailored interventions. Conclusion: In community pharmacy in England, current policy and funding arrangements suggest there is great scope for pharmacists to support patients with medication adherence. Further research is necessary to identify the most useful, cost-effective and sustainable approach in practice.

  16. Evaluation of impact of teaching clinical pharmacology and rational therapeutics to medical undergraduates and interns

    Science.gov (United States)

    Desai, Mira K; Panchal, Jigar R; Shah, Samdih; Iyer, Geetha

    2016-01-01

    Objectives: To find out the impact of teaching clinical pharmacology and rational therapeutics (CPT) to medical undergraduates (UGs) and interns. Materials and Methods: This cross-sectional, prospective study was conducted on three UGs batches and interns using two pretested validated structured questionnaires, modified from the work of Tobaiqy et al. The study was approved by the Institutional Ethics Committee. ANOVA and Chi-square test were used for statistical analysis. The value of P < 0.05 was considered statistically significant. Results: A total of 379 UGs and 96 interns participated in this study. Mean knowledge score of interns was significantly reduced as compared to UGs (P < 0.0001). A significant increase in confidence for unsupervised prescribing of nonsteroidal anti-inflammatory drugs (99%), oral rehydration salt, iron salts was perceived among interns as compared to UGs (P < 0.05). However, 63.5% confessed problems in selection of drugs, drug–drug interactions, prescribing in special patient population. Although they were confident prescribing fixed dose combination for adult patients (89.5%), majority were hesitant to prescribe opioids (77%), steroids (76%), vaccines (75%), and antihypertensives (62%). Conclusion: The theoretical CPT teaching transfers knowledge to UGs; however, it is not retained in internship and does not adequately prepare interns to prescribe safe and rational drugs. PMID:27563589

  17. Female medical physicists: The results of a survey carried out by the International Organization for Medical Physics.

    Science.gov (United States)

    Tsapaki, Virginia; Rehani, Madan M

    2015-06-01

    The gender composition of the existing medical physicist (MP) workforce around the world is basically unknown. The International Organization for Medical Physics (IOMP) performed a survey in order to investigate the number of MPs in countries around the world and the percentage of women MPs compared to total number of MPs. A simple online questionnaire prepared as a Google Forms survey asking the country, the total number of MPs, the number of female MPs and finally the gender of the person providing the data was sent in mid-March 2013 to six regional member organizations of IOMP, as well as contact points in many member countries. Sixty-six countries responded to the survey by mid-July 2013. Fifty two percent of those who filled the form were females, the rest males. The total number of MPs was 17,024, of which 28% were female (4807). The median values of percentages of females were 21% in the USA, 47% in Europe, 35% in Asia, 33% in Africa and 24% in Latin America. This is the first international survey that investigates the number and percentage of female MPs around the world. There are European countries that are far away from the target set by European Commission (40%) whereas in countries in the Middle East and Asia, female MPs actually outnumber males. This study is the first step in a more in-depth study that needs to be taken in near future. Copyright © 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  18. Should authors submit previous peer-review reports when submitting research papers? Views of general medical journal editors.

    Science.gov (United States)

    Cals, Jochen W L; Mallen, Christian D; Glynn, Liam G; Kotz, Daniel

    2013-01-01

    Publishing research can be time consuming, as papers are often submitted and reviewed by multiple journals before final acceptance. We hypothesized that attaching previous peer-review reports to the next submission of the paper to a different journal (possibly with point-to-point responses and amendments) could decrease the workload for both reviewers and editors and could shorten the time from final draft to actual publication. We therefore performed an online survey to assess the views of the editors-in-chief of all 100 general medical journals from the citation impact factor report category "internal & general medicine" (ISI Web of Knowledge). Of contacted editors, 61% responded. One of 4 journals do currently receive peer-review reports on occasion. Editors recognized potential advantages but also concerns on using previous peer-review reports across 3 themes: scientific community, quality of papers, and the publication process. The use of previous peer-review reports has the potential to facilitate authors, reviewers, and editors in optimizing peer review in general medical science.

  19. Parental leave policies in graduate medical education: A systematic review.

    Science.gov (United States)

    Humphries, Laura S; Lyon, Sarah; Garza, Rebecca; Butz, Daniel R; Lemelman, Benjamin; Park, Julie E

    2017-10-01

    A thorough understanding of attitudes toward and program policies for parenthood in graduate medical education (GME) is essential for establishing fair and achievable parental leave policies and fostering a culture of support for trainees during GME. A systematic review of the literature was completed. Non-cohort studies, studies completed or published outside of the United States, and studies not published in English were excluded. Studies that addressed the existence of parental leave policies in GME were identified and were the focus of this study. Twenty-eight studies addressed the topic of the existence of formal parental leave policies in GME, which was found to vary across time and ranged between 22 and 90%. Support for such policies persisted across time. Attention to formal leave policies in GME has traditionally been lacking, but may be increasing. Negative attitudes towards parenthood in GME persist. Active awareness of the challenges faced by parent-trainees combined with formal parental leave policy implementation is important in supporting parenthood in GME. Copyright © 2017. Published by Elsevier Inc.

  20. A systematic review on critical thinking in medical education.

    Science.gov (United States)

    Chan, Zenobia C Y

    2016-04-18

    Critical thinking is the ability to raise discriminating questions in an attempt to search for better ideas, a deeper understanding and better solutions relating to a given issue. This systematic review provides a summary of efforts that have been made to enhance and assess critical thinking in medical education. Nine databases [Ovid MEDLINE(R), AMED, Academic Search Premier, ERIC, CINAHL, Web of Science, JSTOR, SCOPUS and PsycINFO] were searched to identify journal articles published from the start of each database to October 2012. A total of 41 articles published from 1981 to 2012 were categorised into two main themes: (i) evaluation of current education on critical thinking and (ii) development of new strategies about critical thinking. Under each theme, the teaching strategies, assessment tools, uses of multimedia and stakeholders were analysed. While a majority of studies developed teaching strategies and multimedia tools, a further examination of their quality and variety could yield some insights. The articles on assessment placed a greater focus on learning outcomes than on learning processes. It is expected that more research will be conducted on teacher development and students' voices.

  1. Quality Control Review of the Defense Finance and Accounting Service Internal Audit Organization

    Science.gov (United States)

    2014-12-01

    No. DODIG-2015-043 D E C E M B E R 1 , 2 0 1 4 Quality Control Review of the Defense Finance and Accounting Service Internal Audit Organization... FINANCE AND ACCOUNTING SERVICE SUBJECT: Quality Control Review of the Defense Finance and Accounting Service Internal Audit Organization (Report No...organization, Defense Finance and Accounting Service Office of Internal Review (DFAS IR), in effect for the period ended June 30, 2014. The generally

  2. Factors associated with dropout in medical education: a literature review

    DEFF Research Database (Denmark)

    O'Neill, Lotte Dyhrberg; Wallstedt, Birgitta; Eika, Berit

    2011-01-01

    Medical school dropout may have negative consequences for society, patients, the profession, schools and dropouts. To our knowledge, the literature dealing with dropout from medical school has never been systematically and critically appraised.......Medical school dropout may have negative consequences for society, patients, the profession, schools and dropouts. To our knowledge, the literature dealing with dropout from medical school has never been systematically and critically appraised....

  3. Usually Available Clinical and Laboratory Data Are Insufficient for a Valid Medication Review: A Crossover Study.

    Science.gov (United States)

    Hurkens, K P G M; Mestres-Gonzalvo, C; de Wit, H A J M; van der Kuy, P H M; Janknegt, R; Verhey, F; Schols, J M G A; Stehouwer, C D A; Winkens, B; Mulder, W

    2016-01-01

    To establish the quality of medication reviews performed by nursing home physicians, general practitioners and pharmacists. 15 Pharmacists, 13 general practitioners and 18 nursing home physicians performed a medication review for three cases (A, B and C), at three evaluation moments. First, they received the medication list. Secondly, they also received laboratory results and reason for admission and finally, we added medical history. Remarks were divided into 6 categories, i.e. indication without medication, medication without indication, contraindications/ interactions, dosage problems, double medication and wrong medication. Remarks were compared to the remarks made by our expert panel and scored according to our grading model as appropriate (0 to +3) or missed or potentially harmful (-1). For each medication error category, the percentage of participants who made this error was computed. After the first evaluation moment, the overall estimated mean percentage score was -1.7% for case A, 3.9% for case B, and 8.7% for case C. After the second review, this score was 15.0% for case A, 19.8% for case B, and 22.2% for case C. This further increased to 30.0% for case A, 36.7% for case B and 44% for case C at the final evaluation. The absence of medication where there was an indication (indication without medication) was frequently missed and did not improve after adding the extra information regarding laboratory results, reason for admission and finally medical history. Increasing clinical information helps physicians and pharmacists to improve their medication reviews, however, additional information was still related with a high margin of error. Detection of certain errors becomes easier with additional information, whereas other errors remain undetected. To achieve a high standard of medication review, we have to change the way medication reviews should be performed.

  4. [Mass-gathering medical strategies: The experience in the International Book Fair in Guadalajara].

    Science.gov (United States)

    Pérez-Gómez, Héctor Raúl; Ramos-Zúñiga, Rodrigo; Gutiérrez-Padilla, José Alfonso; Gutiérrez-González, Hugo; del Mar González-De la Peña, María; Preciado-Figueroa, Juan Pablo

    2015-01-01

    The Guadalajara International Book Fair (FIL) is a mass gathering, hosting publishing companies from 40 countries and more than 750,000 visitors. It is necessary to prioritize preventive measures focusing on earthquakes, fires, terrorist acts, and prevention of infections. The objective of this study is to describe and analyze the health problems encountered during FIL 2013 in order to improve civil protection services during future events. Descriptive, cross-sectional study, collecting medical histories in accordance with Mexican Official Standard NOM-004-SSA3-2012, and classifying respondents into age groups. A total of 794 medical sheets for patients who received assistance at the Mobile Health Units were analyzed. Altogether, 794 (0.1%) patients were medically evaluated out of 750,987 fair visitors during the study period. Of these, 32 patients were 50 years old. There were no complicated medical cases. A favorable impact of preventives strategies was observed. Non-complicated medical incidents were observed. It is necessary to increase the knowledge on health among the general public who attend this type of event. Training health professionals is a priority in prevention measures and providing care during mass events of this kind in Mexico's territory.

  5. What kind of mentoring do we need? A review of mentoring program studies for medical students.

    Science.gov (United States)

    Hur, Yera; Kim, Sun; Lee, Keumho

    2013-03-01

    Nearly every medical school in Korea has a student advisory program, regardless of its form or method, but it is plagued by efficiency. To examine efficient means of delivering student advisory programs, we chose 'mentoring' as one solution and reviewed the concepts of a mentor and mentoring, the qualities and roles of a mentor, and examples of national and international cases of mentoring. The concept of mentoring is diverse, but it connotes and stresses aspects, such as individual guidance, tutoring, life coaching, and role modeling. We conclude that the quality of many student advisory programs can be elevated by providing holistic and systematic guidance that meets the demands of the mentees; giving individual, continuous, and intimate coaching; and guiding a balanced academic and social life and career, which will develop good doctors who can provide a holistic health care.

  6. Data Sharing: A New Editorial Initiative of the International Committee of Medical Journal Editors. Implications for the Editors' Network.

    Science.gov (United States)

    Alfonso, Fernando; Adamyan, Karlen; Artigou, Jean-Yves; Aschermann, Michael; Boehm, Michael; Buendia, Alfonso; Chu, Pao-Hsien; Cohen, Ariel; Cas, Livio Dei; Dilic, Mirza; Doubell, Anton; Echeverri, Dario; Enç, Nuray; Ferreira-González, Ignacio; Filipiak, Krzysztof J; Flammer, Andreas; Fleck, Eckart; Gatzov, Plamen; Ginghina, Carmen; Goncalves, Lino; Haouala, Habib; Hassanein, Mahmoud; Heusch, Gerd; Huber, Kurt; Hulín, Ivan; Ivanusa, Mario; Krittayaphong, Rungroj; Lau, Chu-Pak; Marinskis, Germanas; Mach, François; Moreira, Luiz Felipe; Nieminen, Tuomo; Oukerraj, Latifa; Perings, Stefan; Pierard, Luc; Potpara, Tatjana; Reyes-Caorsi, Walter; Rim, Se-Joong; Rødevand, Olaf; Saade, Georges; Sander, Mikael; Shlyakhto, Evgeny; Timuralp, Bilgin; Tousoulis, Dimitris; Ural, Dilek; Piek, J J; Varga, Albert; Lüscher, Thomas F

    The International Committee of Medical Journal Editors (ICMJE) provides recommendations to improve the editorial standards and scientific quality of biomedical journals. These recommendations range from uniform technical requirements to more complex and elusive editorial issues including ethical aspects of the scientific process. Recently, registration of clinical trials, conflicts of interest disclosure, and new criteria for authorship - emphasizing the importance of responsibility and accountability -, have been proposed. Last year, a new editorial initiative to foster sharing of clinical trial data was launched. This review discusses this novel initiative with the aim of increasing awareness among readers, investigators, authors and editors belonging to the Editors' Network of the European Society of Cardiology. Copyright © 2017. Publicado por Masson Doyma México S.A.

  7. Improving the quality and safety of care on the medical ward: A review and synthesis of the evidence base.

    Science.gov (United States)

    Pannick, Samuel; Beveridge, Iain; Wachter, Robert M; Sevdalis, Nick

    2014-12-01

    Despite its place at the heart of inpatient medicine, the evidence base underpinning the effective delivery of medical ward care is highly fragmented. Clinicians familiar with the selection of evidence-supported treatments for specific diseases may be less aware of the evolving literature surrounding the organisation of care on the medical ward. This review is the first synthesis of that disparate literature. An iterative search identified relevant publications, using terms pertaining to medical ward environments, and objective and subjective patient outcomes. Articles (including reviews) were selected on the basis of their focus on medical wards, and their relevance to the quality and safety of ward-based care. Responses to medical ward failings are grouped into five common themes: staffing levels and team composition; interdisciplinary communication and collaboration; standardisation of care; early recognition and treatment of the deteriorating patient; and local safety climate. Interventions in these categories are likely to improve the quality and safety of care in medical wards, although the evidence supporting them is constrained by methodological limitations and inadequate investment in multicentre trials. Nonetheless, with infrequent opportunities to redefine their services, institutions are increasingly adopting multifaceted strategies that encompass groups of these themes. As the literature on the quality of inpatient care moves beyond its initial focus on the intensive care unit and operating theatre, physicians should be mindful of opportunities to incorporate evidence-based practice at a ward level. Copyright © 2014 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  8. Publication Rates of Public Health Theses in International and National Peer-Review Journals in Turkey

    Directory of Open Access Journals (Sweden)

    AO Karababa

    2012-09-01

    Full Text Available Background: Thesis is an important part of specialisation and doctorate education and requires intense work. The aim of this study was to investigate the publication rates of Turkish Public Health Doctorate Theses (PHDT and Public Health Specialization (PHST theses in international and Turkish national peer-review journals and to analyze the distribution of research areas. Methods: List of all theses upto 30 September 2009 were retrieved from theses database of the Council of Higher Education of the Republic of Turkey. The publication rates of these theses were found by searching PubMed, Science Citation Index-Expanded, Turkish Academic Network and Information Center (ULAKBIM Turkish Medical Database, and Turkish Medline databases for the names of thesis author and mentor. The theses which were published in journals indexed either in PubMed or SCI-E were considered as international publications. Results: Our search yielded a total of 538 theses (243 PHDT, 295 PHST. It was found that the overall publication rate in Turkish national journals was 18%. The overall publication rate in international journals was 11.9%. Overall the most common research area was occupational health. Conclusion: Publication rates of Turkish PHDT and PHST are low. A better understanding of factors affecting this publication rate is important for public health issues where national data is vital for better intervention programs and develop better public health policies.

  9. Medicare Program; termination of non-random prepayment complex medical review. Final rule.

    Science.gov (United States)

    2008-09-26

    This final rule implements requirements regarding the termination of non-random prepayment complex medical review as required under the Medicare Prescription Drug, Improvement and Modernization Act of 2003. This final rule sets forth the criteria CMS contractors will use for terminating a provider or supplier from non-random prepayment complex medical review.

  10. Medication effects on the rate of orthodontic tooth movement: a systematic literature review.

    NARCIS (Netherlands)

    Bartzela, T.; Turp, J.C.; Motschall, E.; Maltha, J.C.

    2009-01-01

    INTRODUCTION: Recently, several reviews have been published on the effects of medications on bone physiology and the clinical side effects in orthodontics. However, the effects of medications on the rate of orthodontic tooth movement have not been evaluated. METHODS: A systematic literature review o

  11. Description of a practice model for pharmacist medication review in a general practice setting

    DEFF Research Database (Denmark)

    Brandt, Mette; Hallas, Jesper; Hansen, Trine Graabæk

    2014-01-01

    and clinical or laboratory data. The medication review focuses on the diagnoses of the patient instead of the individual drugs. Patient interviews are not part of the model. The model was tested in a pilot study by conducting medical reviews on 50 polypharmacy patients (i.e. receiving 7 or more drugs...

  12. Medication effects on the rate of orthodontic tooth movement: a systematic literature review.

    NARCIS (Netherlands)

    Bartzela, T.; Turp, J.C.; Motschall, E.; Maltha, J.C.

    2009-01-01

    INTRODUCTION: Recently, several reviews have been published on the effects of medications on bone physiology and the clinical side effects in orthodontics. However, the effects of medications on the rate of orthodontic tooth movement have not been evaluated. METHODS: A systematic literature review

  13. 14 CFR 120.113 - Medical Review Officer, Substance Abuse Professional, and Employer Responsibilities.

    Science.gov (United States)

    2010-01-01

    ... Professional, and Employer Responsibilities. 120.113 Section 120.113 Aeronautics and Space FEDERAL AVIATION... Medical Review Officer, Substance Abuse Professional, and Employer Responsibilities. (a) The employer... Medical Review Officer, Substance Abuse Professional, and Employer Responsibilities Regarding 14 CFR part...

  14. Protocol for a realist review of workplace learning in postgraduate medical education and training.

    Science.gov (United States)

    Wiese, Anel; Kilty, Caroline; Bergin, Colm; Flood, Patrick; Fu, Na; Horgan, Mary; Higgins, Agnes; Maher, Bridget; O'Kane, Grainne; Prihodova, Lucia; Slattery, Dubhfeasa; Bennett, Deirdre

    2017-01-19

    Postgraduate medical education and training (PGMET) is a complex social process which happens predominantly during the delivery of patient care. The clinical learning environment (CLE), the context for PGMET, shapes the development of the doctors who learn and work within it, ultimately impacting the quality and safety of patient care. Clinical workplaces are complex, dynamic systems in which learning emerges from non-linear interactions within a network of related factors and activities. Those tasked with the design and delivery of postgraduate medical education and training need to understand the relationship between the processes of medical workplace learning and these contextual elements in order to optimise conditions for learning. We propose to conduct a realist synthesis of the literature to address the overarching questions; how, why and in what circumstances do doctors learn in clinical environments? This review is part of a funded projected with the overall aim of producing guidelines and recommendations for the design of high quality clinical learning environments for postgraduate medical education and training. We have chosen realist synthesis as a methodology because of its suitability for researching complexity and producing answers useful to policymakers and practitioners. This realist synthesis will follow the steps and procedures outlined by Wong et al. in the RAMESES Publication Standards for Realist Synthesis and the Realist Synthesis RAMESES Training Materials. The core research team is a multi-disciplinary group of researchers, clinicians and health professions educators. The wider research group includes experts in organisational behaviour and human resources management as well as the key stakeholders; doctors in training, patient representatives and providers of PGMET. This study will draw from the published literature and programme, and substantive, theories of workplace learning, to describe context, mechanism and outcome configurations for

  15. Medication Abortion within a Student Health Care Clinic: A Review of the First 46 Consecutive Cases

    Science.gov (United States)

    Godfrey, Emily M.; Bordoloi, Anita; Moorthie, Mydhili; Pela, Emily

    2012-01-01

    Objective: Medication abortion with mifepristone and misoprostol has been available in the United States since 2000. The authors reviewed the first 46 medication abortion cases conducted at a university-based student health care clinic to determine the safety and feasibility of medication abortion in this type of clinical setting. Participants:…

  16. Medication Abortion within a Student Health Care Clinic: A Review of the First 46 Consecutive Cases

    Science.gov (United States)

    Godfrey, Emily M.; Bordoloi, Anita; Moorthie, Mydhili; Pela, Emily

    2012-01-01

    Objective: Medication abortion with mifepristone and misoprostol has been available in the United States since 2000. The authors reviewed the first 46 medication abortion cases conducted at a university-based student health care clinic to determine the safety and feasibility of medication abortion in this type of clinical setting. Participants:…

  17. Peer-review and editorial process of the Ethiopian Medical Journal: ten years assessment of the status of submitted manuscripts.

    Science.gov (United States)

    Enquselassie, Fikre

    2013-04-01

    The Ethiopian Medical Journal (EMJ) is a peer-reviewed journal, now 50 years old. Many medical journals, including EMJ, follow a peer review system that has evolved from the 18th century process for reviewing submitted manuscripts. However, not much is known about peer review and editorial processes by many authors who submit manuscripts to the EMJ. To describe procedures related to EMJ peer-review and editorial decision making and asses the status of manuscripts submitted to the journal in the ten year period between 2001 and 2010. All the minutes of the editorial board meetings of the ten years period 2001-2010 and relevant documents were reviewed. The minutes have details including date of submission, dates to and from reviewers, date of decision, number of assigned peer reviewers and comments given by reviewers for each submitted manuscript. The length of time took in the processes and the decision made (accepted or rejected) for each submitted manuscript was calculated from the dates. All submitted manuscripts passed through three stages: internal per-review by an editorial board member, external peer review by selected reviewers and final editing stage by an assigned editorial member. A total of 615 manuscripts were submitted to EMJ in the ten years period 2001-2010. Five hundred and one (82.7%) manuscripts were accepted for publication by peer reviewers, while 74 (12.2%) were rejected and 31 (5.1%) were withdrawn. Acceptance was lowest among original articles (81.3%) followed by teaching or review articles (84.3%) and case reports (89.3%). Thirty-two (8.4%) manuscripts were accepted within 6 months following submission and 50% were accepted within in one year of submission. About 6% of manuscripts were delayed for more than two years with a maximum delay of 43 months. Even though, there is a decline trend on the delay of processing manuscripts, EMJ has long to go in order to improve the quality of the journal and shorten the slow peer review process

  18. International Linear Collider Technical Review Committee Report, 1995

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-12-01

    This 1995 report of the International Linear Collider Technical Review Committee is the first attempt to gather in one document the current status of all major e{sup +}e{sup {minus}} linear collider projects in the world. The report is the result of a collaborative effort of scientists from many laboratories working together over a period of about one year. A short description of the organization, origins and history of the report is given below. To get an idea of the organization, the reader should first refer to the Table of Contents. Chapter 1 is an introduction and general overview of the respective 500 GeV c.m. energy machines. In contrast, Chapter 2, cutting across individual machine boundaries, gives a comparative description and discussion of all the major machine sub-systems as well as particle physics experimentation, showing where these subjects stand today and what additional work needs to be done in the next few years to reach the point where complete design reports can be prepared. Chapter 3 describes the various paths to energy upgrades, and other experimental options ({gamma}{gamma}, e{sup {minus}}e{sup {minus}}, etc.). Chapter 4 gives a short status report of the machine experiments and test facilities being built in the world. Chapter 5 outlines current and other possible areas of collaboration and finally., Chapter 6 summarizes our principal conclusions.

  19. Use of Clinical Decision Guidance as a New Public Health Tool for the Medical Management of Internal Contamination in Radiological Mass Casualty Scenarios.

    Science.gov (United States)

    Wiley, Albert L

    2016-09-01

    This review is a discussion of special issues associated with the medical and public health management of persons at risk of internal contamination from radionuclides, following various radiological mass-casualty scenarios, as well as definition, discussion and use of the Clinical Decision Guidance (CDG) in such scenarios. Specific medical countermeasures are available for reducing the internal radiation dose and the subsequent stochastic and deterministic risks to persons internally contaminated with radionuclides from nuclear power plant, fuel processing and nuclear weapon accidents/incidents. There is a public health need for rapidly identifying and quantifying the 'source term' of such radiation exposures and assessment of the associated committed doses, so that appropriate medical countermeasure(s) can be given as soon as possible. The CDG, which was initially defined in NCRP-161, was specifically developed to be a new public health tool for facilitating the integration of local community healthcare professionals into the general medical, mass casualty, triage and treatment response of internally contaminated populations.

  20. Policy issues related to educating the future Israeli medical workforce: an international perspective.

    Science.gov (United States)

    Schoenbaum, Stephen C; Crome, Peter; Curry, Raymond H; Gershon, Elliot S; Glick, Shimon M; Katz, David R; Paltiel, Ora; Shapiro, Jo

    2015-01-01

    A 2014 external review of medical schools in Israel identified several issues of importance to the nation's health. This paper focuses on three inter-related policy-relevant topics: planning the physician and healthcare workforce to meet the needs of Israel's population in the 21(st) century; enhancing the coordination and efficiency of medical education across the continuum of education and training; and the financing of medical education. All three involve both education and health care delivery. The physician workforce is aging and will need to be replenished. Several physician specialties have been in short supply, and some are being addressed through incentive programs. Israel's needs for primary care clinicians are increasing due to growth and aging of the population and to the increasing prevalence of chronic conditions at all ages. Attention to the structure and content of both undergraduate and graduate medical education and to aligning incentives will be required to address current and projected workforce shortage areas. Effective workforce planning depends upon data that can inform the development of appropriate policies and on recognition of the time lag between developing such policies and seeing the results of their implementation. The preclinical and clinical phases of Israeli undergraduate medical education (medical school), the mandatory rotating internship (stáge), and graduate medical education (residency) are conducted as separate "silos" and not well coordinated. The content of basic science education should be relevant to clinical medicine and research. It should stimulate inquiry, scholarship, and lifelong learning. Clinical exposures should begin early and be as hands-on as possible. Medical students and residents should acquire specific competencies. With an increasing shift of medical care from hospitals to ambulatory settings, development of ambulatory teachers and learning environments is increasingly important. Objectives such as these

  1. Review of research in internal-wave and internal-tide deposits of China

    Directory of Open Access Journals (Sweden)

    Gao Zhenzhong

    2013-01-01

    Full Text Available Study of internal-wave and internal-tide deposits is a very young research field in deep-water sedimentology. It has been just twenty years since the first example of internal-wave and internal-tide deposits was identified in the stratigraphic record. Since that time, Chinese scholars have made unremitting efforts and gained some significant research achievements in this field. This paper briefly outlines the history and main achievements of research of internal-wave and internal-tide deposits in China, describes depositional characteristics, sedimentary successions, types of lithofacies, and depositional models of internal-wave and internal-tide deposits identified mainly from ancient strata, and summarizes the existing problems in this research field. New advances in marine physics should be applied to research of the subject of internal-wave and internal-tide deposition, whereas the sedimentary characteristics of internal-wave and internal-tide deposits may be used to deduce the physical processes of their creation. Flume experiments on internal-wave and internal-tide deposition should also be put in practice as often as possible, so that the mechanisms of internal-wave and internal-tide deposition can be explored.

  2. The support of medication reviews in hospitalised patients using a clinical decision support system

    OpenAIRE

    de Wit, Hugo A. J. M.; Hurkens, Kim P. G. M.; Mestres Gonzalvo, Carlota; Smid, Machiel; Sipers, Walther; Winkens, Bjorn; Mulder, Wubbo J; Janknegt, Rob; Verhey, Frans R; van der Kuy, Paul-Hugo M.; Schols, Jos M. G. A.

    2016-01-01

    Objectives First, to estimate the added value of a clinical decision support system (CDSS) in the performance of medication reviews in hospitalised elderly. Second, to identify the limitations of the current CDSS by analysing generated drug-related problems (DRPs). Methods Medication reviews were performed in patients admitted to the geriatric ward of the Zuyderland medical centre. Additionally, electronically available patient information was introduced into a CDSS. The DRP notifications gen...

  3. INTERNAL REPAIR OF PIPELINES REVIEW & EVALUATION OF INTERNAL PIPELINE REPAIR TRIALS REPORT

    Energy Technology Data Exchange (ETDEWEB)

    Robin Gordon; Bill Bruce; Ian Harris; Dennis Harwig; George Ritter; Bill Mohr; Matt Boring; Nancy Porter; Mike Sullivan; Chris Neary

    2004-09-01

    The two broad categories of fiber-reinforced composite liner repair and deposited weld metal repair technologies were reviewed and evaluated for potential application for internal repair of gas transmission pipelines. Both are used to some extent for other applications and could be further developed for internal, local, structural repair of gas transmission pipelines. Evaluation trials were conducted on pipe sections with simulated corrosion damage repaired with glass fiber-reinforced composite liners, carbon fiber-reinforced composite liners, and weld deposition. Additional un-repaired pipe sections were evaluated in the virgin condition and with simulated damage. Hydrostatic failure pressures for pipe sections repaired with glass fiber-reinforced composite liner were only marginally greater than that of pipe sections without liners, indicating that this type of liner is generally ineffective at restoring the pressure containing capabilities of pipelines. Failure pressure for pipe repaired with carbon fiber-reinforced composite liner was greater than that of the un-repaired pipe section with damage, indicating that this type of liner is effective at restoring the pressure containing capability of pipe. Pipe repaired with weld deposition failed at pressures lower than that of un-repaired pipe in both the virgin and damaged conditions, indicating that this repair technology is less effective at restoring the pressure containing capability of pipe than a carbon fiber-reinforced liner repair. Physical testing indicates that carbon fiber-reinforced liner repair is the most promising technology evaluated to-date. Development of a comprehensive test plan for this process is recommended for use in the next phase of this project.

  4. The Council for International Organizations and Medical Sciences (CIOMS) guidelines on ethics of clinical trials.

    Science.gov (United States)

    Macrae, Duncan J

    2007-05-01

    Numerous bodies from many countries, including governments, government regulatory departments, research organizations, medical professional bodies, and health care providers, have issued guidance or legislation on the ethical conduct of clinical trials. It is possible to trace the development of current guidelines back to the post-World War II Nuremburg war crimes trials, more specifically the "Doctors' Trial." From that trial emerged the Nuremburg Code, which set out basic principles to be observed when conducting research involving human subjects and which subsequently formed the basis for comprehensive international guidelines on medical research, such as the Declaration of Helsinki. Most recently, the Council for International Organizations and Medical Sciences (CIOMS) produced detailed guidelines (originally published in 1993 and updated in 2002) on the implementation of the principles outlined in the Declaration of Helsinki. The CIOMS guidelines set in an appropriate context the challenges of present-day clinical research, by addressing complex issues including HIV/AIDS research, availability of study treatments after a study ends, women as research subjects, safeguarding confidentiality, compensation for adverse events, as well guidelines on consent.

  5. Internal conflict: undergraduate nursing students' response to inadequate supervision during the administration of medication.

    Science.gov (United States)

    Reid-Searl, Kerry; Moxham, Lorna; Walker, Sandra; Happell, Brenda

    2009-01-01

    Current legislation in Queensland requires that undergraduate nursing students are personally supervised when administering restricted medication in the clinical setting. Previous research suggests this is not always the case. Exploration of the experiences of undergraduate nursing students was undertaken using grounded theory as the methodological framework. In-depth, semi-structured interviews were conducted with 28 students during their final year clinical placements. Data were analysed using a constant comparative approach. The focus of this paper is to examine the emergent theme of internal conflict, which is experienced by the participants as a consequence of the theory-practice gap. This conflict is reflected by the divergent requirements and expectations between the university and the registered nurses providing supervision in light of the role both play in student assessment. In addition, the participants voiced concerns about patient safety due to the potential for medication error. Internal conflict was identified by participants as the cause of considerable fear and anxiety about passing the course, getting a job and avoiding harm to patients. These findings raise serious concerns about the adequacy of the supervision for nursing students and highlighted the need for a more concerted approach to the theoretical and clinical education of students in relation to medication administration.

  6. East Asian International Students and Psychological Well-Being: A Systematic Review

    Science.gov (United States)

    Li, Jiaqi; Wang, Yanlin; Xiao, Feiya

    2014-01-01

    The present article reports a systematic review of the studies related to psychological well-being among East Asian international students. A total of 18 quantitative studies published in peer-reviewed journals from 2000 to 2011 were reviewed. Our review revealed three major results: (1) a majority of researchers (n = 13, 72.2%) tend to choose…

  7. International outsourcing of medical research by high-income countries: changes from 1995 to 2005.

    Science.gov (United States)

    Belforti, Raquel K; Wall, Michal Sarah; Lindenauer, Peter K; Pekow, Penelope S; Rothberg, Michael B

    2010-02-01

    Medical research outsourcing provides a financial benefit to those conducting research and financial incentives to the developing countries hosting the research. Little is known about how frequently outsourcing occurs or the type of research that is outsourced. To document changes in medical research outsourcing over a 10-year period, we conducted a cross-sectional comparison of 3 medical journals: Lancet, The New England Journal of Medicine, and JAMA: The Journal of the American Medical Association in the last 6 months of 1995 and 2005. The main outcome measure was the 10-year change in proportion of studies including patients from low-income countries. We reviewed 598 articles. During the 10-year period, the proportion of first authors from low-income countries increased from 3% to 6% (P = 0.21), whereas studies with participants from low-income countries increased from 8% to 22% (P = Outsourcing of medical research seems to be increasing. Additional studies are required to know if subjects from low-income countries are being adequately protected.

  8. Comparing International and American Students' Challenges: A Literature Review

    Science.gov (United States)

    Perry, Cody J.

    2016-01-01

    International student numbers have increased drastically in the past few years. International students provide benefits to universities and American students such as greater revenue, and more open-mindedness. There have been myriad studies that have examined the international student experience, but most have focused solely on international…

  9. CONFERENCE REVIEW:V. International Educational Technology Symposium

    Directory of Open Access Journals (Sweden)

    Reviewed by Mubin KIYICI

    2005-10-01

    Full Text Available 167V. International Educational Technology SymposiumWas held in Sakarya UniversityBetween 21 – 23 September 2005Reviewed by Mubin KIYICISakarya Universitymkiyici@anadolu.edu.trV. International Educational Technology Symposium was held in Sakarya University heldbetween 21 – 23 September 2005 by cooperation with Eastern Mediterranean University,Louisiana State University, Governors State University and Ohio University, and TOJET(The Turkish Online Journal of Educational Technology journal, at Sakarya UniversityCampus. Assoc. Prof. Dr. Aytekin ISMAN who was conference coordinator and Editor inchief of TOJET spoke at the opening ceremony of symposium. His speech was related todiffusion of distance education and diffusion of usage educational technology. And thenProf. Dr. Mehmet DURMAN who is Rector of Sakarya University, talked about aapplications of Distance Education which is applied by Sakarya University and educationaltechnology applications in Tukey. His Speech is here:168Dear GuestsWelcome to the “5th International Educational Technology ConferenceIETC/EGİTEK 2005. It is an international educational activity for academics,teachers and educators. This conference is now a well known educationaltechnology event and the number of paper submissions and attendeesincrease every year.This year, IETC-2005 received 268 applications. The conference academicadvisory board accepted 209 applications.IETC-2005 promotes the development and dissemination of theoreticalknowledge, conceptual research, and professional knowledge throughconference activities, the conference proceeding book, and the TurkishOnline Journal of Educational Technology (TOJET. Its focus is to create anddisseminate knowledge about the use instructional technology for learningand teaching in education.The main theme of IETC-2005 is distance education. Distance education is adelivery system of teaching and learning, when the teacher and the studentare separated by physical distance

  10. Checklists in Neurosurgery to Decrease Preventable Medical Errors: A Review

    Science.gov (United States)

    Enchev, Yavor

    2015-01-01

    Neurosurgery represents a zero tolerance environment for medical errors, especially preventable ones like all types of wrong site surgery, complications due to the incorrect positioning of patients for neurosurgical interventions and complications due to failure of the devices required for the specific procedure. Following the excellent and encouraging results of the safety checklists in intensive care medicine and in other surgical areas, the checklist was naturally introduced in neurosurgery. To date, the reported world experience with neurosurgical checklists is limited to 15 series with fewer than 20,000 cases in various neurosurgical areas. The purpose of this review was to study the reported neurosurgical checklists according to the following parameters: year of publication; country of origin; area of neurosurgery; type of neurosurgical procedure-elective or emergency; person in charge of the checklist completion; participants involved in completion; whether they prevented incorrect site surgery; whether they prevented complications due to incorrect positioning of the patients for neurosurgical interventions; whether they prevented complications due to failure of the devices required for the specific procedure; their specific aims; educational preparation and training; the time needed for checklist completion; study duration and phases; number of cases included; barriers to implementation; efforts to implementation; team appreciation; and safety outcomes. Based on this analysis, it could be concluded that neurosurgical checklists represent an efficient, reliable, cost-effective and time-saving tool for increasing patient safety and elevating the neurosurgeons’ self-confidence. Every neurosurgical department must develop its own neurosurgical checklist or adopt and modify an existing one according to its specific features and needs in an attempt to establish or develop its safety culture. The world, continental, regional and national neurosurgical societies

  11. International Literature Review on WHODAS II (World Health Organization Disability Assessment Schedule II

    Directory of Open Access Journals (Sweden)

    Federici, Stefano

    2009-06-01

    Full Text Available This review is a critical analysis regarding the study and utilization of the World Health Organization Disability Assessment Schedule II (WHODAS II as a basis for establishing specific criteria for evaluating relevant international scientific literature.The WHODAS II is an instrument developed by the World Health Organisation in order to assess behavioural limitations and restrictions related to an individual’s participation, independent from a medical diagnosis. This instrument was developed by the WHO’s Assessment, Classification and Epidemiology Group within the framework of the WHO/NIH Joint Project on Assessment and Classification of Disablements. To ascertain the international dissemination level of for WHODAS II’s utilization and, at the same time, analyse the studies regarding the psychometric validation of the WHODAS II translation and adaptation in other languages and geographical contests. Particularly, our goal is to highlight which psychometric features have been investigated, focusing on the factorial structure, the reliability, and the validity of this instrument. International literature was researched through the main data bases of indexed scientific production: the Cambridge Scientific Abstracts – CSA, PubMed, and Google Scholar, from 1990 through to December 2008.The following search terms were used:“whodas”, in the field query, plus “title” and “abstract”.The WHODAS II has been used in 54 studies, of which 51 articles are published in international journals, 2 conference abstracts, and one dissertation abstract. Nevertheless, only 7 articles are published in journals and conference proceedings regarding disability and rehabilitation. Others have been published in medical and psychiatric journals, with the aim of indentifying comorbidity correlations in clinical diagnosis concerning patients with mental illness. Just 8 out of 51 articles have studied the psychometric properties of the WHODAS II. The

  12. Barcode medication administration work-arounds: a systematic review and implications for nurse executives.

    Science.gov (United States)

    Voshall, Barbara; Piscotty, Ronald; Lawrence, Jeanette; Targosz, Mary

    2013-10-01

    Safe medication administration is necessary to ensure quality healthcare. Barcode medication administration systems were developed to reduce drug administration errors and the related costs and improve patient safety. Work-arounds created by nurses in the execution of the required processes can lead to unintended consequences, including errors. This article provides a systematic review of the literature associated with barcoded medication administration and work-arounds and suggests interventions that should be adopted by nurse executives to ensure medication safety.

  13. Non-medical use of methylphenidate: a review

    OpenAIRE

    Freese, Luana; Signor,Luciana; Machado,Cassio; Ferigolo, Maristela; Barros,Helena Maria Tannhauser

    2012-01-01

    INTRODUCTION: Methylphenidate is a psychostimulant medication used for the treatment of attention deficit hyperactivity disorder and narcolepsy. However, it has also been used for non-medical purposes, e.g. to produce euphoria, to increase self-esteem, and to achieve the so-called neurocognitive enhancement, decreasing the feeling of tiredness and increasing focus and attention. OBJECTIVE: To describe, from theoretical and contextual points of view, the potential for abuse and non-medical use...

  14. Review and expectation of integrated curriculum of basic medical sciences of Shanghai Jiao Tong University

    Institute of Scientific and Technical Information of China (English)

    Xiao-yin NIU; Song YU; Xiao-kui GUO

    2015-01-01

    Since early 1950 s,many domestic and foreign medical schools have carried out the integrated teaching reform of medical education. In our school of basic medical sciences,there have been three types of integrated curriculum reform carried out in history,i. e. horizontally integrated courses,problem-oriented basic medical sciences curriculum, and organ system-based integrated curriculum. This article reviews the experience of these three teaching reforms and the problems encountered and hopes to provide some references for the integration of basic medical sciences curriculum of other medical schools.

  15. International Organization for Migration: experience on the need for medical evacuation of refugees during the Kosovo crisis in 1999.

    Science.gov (United States)

    Szilard, Istvan; Cserti, Arpad; Hoxha, Ruhija; Gorbacheva, Olga; O'Rourke, Thomas

    2002-04-01

    The International Organization for Migration (IOM) developed and implemented a three-month project entitled Priority Medical Screening of Kosovar Refugees in Macedonia, within the Humanitarian Evacuation Program (HEP) for Kosovar refugees from FR Yugoslavia, which was adopted in May 1999. The project was based on an agreement with the office of United Nations High Commission for Refugees (UNHCR) and comprised the entry of registration data of refugees with medical condition (Priority Medical Database), and classification (Priority Medical Screening) and medical evacuation of refugees (Priority Medical Evacuation) in Macedonia. To realize the Priority