WorldWideScience

Sample records for international medical reviews

  1. Bioadhesives for internal medical applications: A review.

    Science.gov (United States)

    Zhu, Wenzhen; Chuah, Yon Jin; Wang, Dong-An

    2018-04-22

    Bioadhesives such as tissue adhesives, hemostatic agents, and tissue sealants have gained increasing popularity in different areas of clinical operations during the last three decades. Bioadhesives can be categorized into internal and external ones according to their application conditions. External bioadhesives are generally applied in topical medications such as wound closure and epidermal grafting. Internal bioadhesives are mainly used in intracorporal conditions with direct contact to internal environment including tissues, organs and body fluids, such as chronic organ leak repair and bleeding complication reduction. This review focuses on internal bioadhesives that, in contrast with external bioadhesives, emphasize much more on biocompatibility and adhesive ability to wet surfaces rather than on gluing time and intensity. The crosslinking mechanisms of present internal bioadhesives can be generally classified as follows: 1) chemical conjugation between reactive groups; 2) free radical polymerization by light or redox initiation; 3) biological or biochemical coupling with specificity; and 4) biomimetic adhesion inspired from natural phenomena. In this review, bioadhesive products of each class are summarized and discussed by comparing their designs, features, and applications as well as their prospects for future development. Despite the emergence of numerous novel bioadhesive formulations in recent years, thus far, the classification of internal and external bioadhesives has not been well defined and universally acknowledged. Many of the formulations have been proposed for treatment of several diseases even though they are not applicable for such conditions. This is because of the lack of a systematic standard or evaluation protocol during the development of a new adhesive product. In this review, the definition of internal and external bioadhesives is given for the first time, and with a focus on internal bioadhesives, the criteria of an ideal internal

  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. © The Author(s) 2014.

  3. Stakeholder views of rural community-based medical education: a narrative review of the international literature.

    Science.gov (United States)

    Somporn, Praphun; Ash, Julie; Walters, Lucie

    2018-03-30

    Rural community-based medical education (RCBME), in which medical student learning activities take place within a rural community, requires students, clinical teachers, patients, community members and representatives of health and government sectors to actively contribute to the educational process. Therefore, academics seeking to develop RCBME need to understand the rural context, and the views and needs of local stakeholders. The aim of this review is to examine stakeholder experiences of RCBME programmes internationally. This narrative literature review of original research articles published after 1970 utilises Worley's symbiosis model of medical education as an analysis framework. This model proposes that students experience RCBME through their intersection with multiple clinical, social and institutional relationships. This model seeks to provide a framework for considering the intersecting relationships in which RCBME programmes are situated. Thirty RCBME programmes are described in 52 articles, representing a wide range of rural clinical placements. One-year longitudinal integrated clerkships for penultimate-year students in Anglosphere countries were most common. Such RCBME enables students to engage in work-integrated learning in a feasible manner that is acceptable to many rural clinicians and patients. Academic results are not compromised, and a few papers demonstrate quality improvement for rural health services engaged in RCBME. These programmes have delivered some rural medical workforce outcomes to communities and governments. Medical students also provide social capital to rural communities. However, these programmes have significant financial cost and risk student social and educational isolation. Rural community-based medical education programmes are seen as academically acceptable and can facilitate symbiotic relationships among students, rural clinicians, patients and community stakeholders. These relationships can influence students' clinical

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

    Directory of Open Access Journals (Sweden)

    Kerstin Michalski

    Full Text Available 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

  5. 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

  6. International short-term medical missions: a systematic review of recommended practices.

    Science.gov (United States)

    Roche, Stephanie D; Ketheeswaran, Pavinarmatha; Wirtz, Veronika J

    2017-01-01

    To identify practices for conducting international short-term medical missions (STMMs) recommended in the literature and examine how these link STMMs to recipient countries' existing health systems. Systematic review of PubMed-indexed articles on STMMs and their bibliographies using preferred reporting items for systematic reviews and meta-analyses guidelines. Recommendations were organized using the World Health Organization Health Systems Framework. In 92 publications, 67 % offered at least one recommendation that would link STMMs to the recipient country's health system. Among these recommendations, most focused on service delivery and few on health financing and governance. There is a lack of consensus around a proper standard of care, patient selection, and trip duration. Comprehensive global standards are needed for STMM work to ensure that services are beneficial both to patients and to the broader healthcare systems of recipient countries. By providing an overview of the current recommendations and important gaps where practice recommendations are needed, this study can provide relevant input into the development of global standards for STMMs.

  7. Admission factors associated with international medical graduate certification success: a collaborative retrospective review of postgraduate medical education programs in Ontario.

    Science.gov (United States)

    Grierson, Lawrence E M; Mercuri, Mathew; Brailovsky, Carlos; Cole, Gary; Abrahams, Caroline; Archibald, Douglas; Bandiera, Glen; Phillips, Susan P; Stirrett, Glenna; Walton, J Mark; Wong, Eric; Schabort, Inge

    2017-11-24

    The failure rate on certification examinations of The College of Family Physicians of Canada (CFPC) and the Royal College of Physicians and Surgeons of Canada (RCPSC) is significantly higher for international medical graduates than for Canadian medical school graduates. The purpose of the current study was to generate evidence that supports or refutes the validity of hypotheses proposed to explain the lower success rates. We conducted retrospective analyses of admissions and certification data to determine the factors associated with success of international medical graduate residents on the certification examinations. International medical graduates who entered an Ontario residency program between 2005 and 2012 and had written a certification examination by the time of the analysis (2015) were included in the study. Data available at the time of admission for each resident, including demographic characteristics, previous experiences and previous professional experiences, were collected from each of the 6 Ontario medical schools and matched with certification examination results provided by The CFPC and the RCPSC. We developed logistic regression models to determine the association of each factor with success on the examinations. Data for 900 residents were analyzed. The models revealed resident age to be strongly associated with performance across all examinations. Fluency in English, female sex and the Human Development Index value associated with the country of medical school training had differential associations across the examinations. The findings should contribute to an improved understanding of certification success by international medical graduates, help residency programs identify at-risk residents and underpin the development of specific educational and remedial interventions. In considering the results, it should be kept in mind that some variables are not amenable to changes in selection criteria. Copyright 2017, Joule Inc. or its licensors.

  8. 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.

  9. 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.

  10. Initiatives promoting seamless care in medication management: an international review of the grey literature.

    Science.gov (United States)

    Claeys, Coraline; Foulon, Veerle; de Winter, Sabrina; Spinewine, Anne

    2013-12-01

    Patients' transition between hospital and community is a high-risk period for the occurrence of medication-related problems. The objective was to review initiatives, implemented at national and regional levels in seven selected countries, aiming at improving continuity in medication management upon admission and hospital discharge. We performed a structured search of grey literature, mainly through relevant websites (scientific, professional and governmental organizations). Regional or national initiatives were selected. For each initiative data on the characteristics, impact, success factors and barriers were extracted. National experts were asked to validate the initiatives identified and the data extracted. Most initiatives have been implemented since the early 2000 and are still ongoing. The principal actions include: development and implementation of guidelines for healthcare professionals, national information campaigns, education of healthcare professionals and development of information technologies to share data across settings of care. Positive results have been partially reported in terms of intake into practice or process measures. Critical success factors identified included: leadership and commitment to convey national and local forces, tailoring to local settings, development of a regulatory framework and information technology support. Barriers identified included: lack of human and financial resources, questions relative to responsibility and accountability, lack of training and lack of agreement on privacy issues. Although not all initiatives are applicable as such to a particular healthcare setting, most of them convey very interesting data that should be used when drawing recommendations and implementing approaches to optimize continuity of care.

  11. 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.

  12. International Conference Medical Radiations

    International Nuclear Information System (INIS)

    2010-01-01

    Full text : The second edition of the international conference Medical radiation : research and applications which took place in Marrakech (Morocco) from 7 to 9 April 2010, was designed to bring together researchers and physicians from different countries who dedicated their talents and time to this endeavour. The conference's program defined goals were is to identify the most reliable techniques among the several tested so far and to establish the most practical standardized methodologies, taking into account such recent technological development in radiation medical research. The scientific objectives of this conference are as follows : present the state of the art of the various topics of the congress, give a progress report on the impact of the interaction of the various scientific and technical disciplinary fields (Medicine, Biology, Mathematics, Physics,..) on the applications of radiations in medicine, promote the interdisciplinary efforts of research among researchers, present new technologies and research and development tasks prepared in the field of medical radiations, contribute to the emergence of new ideas of research and development of new collaborations [fr

  13. The impact of disease stage on direct medical costs of HIV management: a review of the international literature.

    Science.gov (United States)

    Levy, Adrian; Johnston, Karissa; Annemans, Lieven; Tramarin, Andrea; Montaner, Julio

    2010-01-01

    The global prevalence of HIV infection continues to grow, as a result of increasing incidence in some countries and improved survival where highly active antiretroviral therapy (HAART) is available. Growing healthcare expenditure and shifts in the types of medical resources used have created a greater need for accurate information on the costs of treatment. The objectives of this review were to compare published estimates of direct medical costs for treating HIV and to determine the impact of disease stage on such costs, based on CD4 cell count and plasma viral load. A literature review was conducted to identify studies meeting prespecified criteria for information content, including an original estimate of the direct medical costs of treating an HIV-infected individual, stratified based on markers of disease progression. Three unpublished cost-of-care studies were also included, which were applied in the economic analyses published in this supplement. A two-step procedure was used to convert costs into a common price year (2004) using country-specific health expenditure inflators and, to account for differences in currency, using health-specific purchasing power parities to express all cost estimates in US dollars. In all nine studies meeting the eligibility criteria, infected individuals were followed longitudinally and a 'bottom-up' approach was used to estimate costs. The same patterns were observed in all studies: the lowest CD4 categories had the highest cost; there was a sharp decrease in costs as CD4 cell counts rose towards 100 cells/mm³; and there was a more gradual decline in costs as CD4 cell counts rose above 100 cells/mm³. In the single study reporting cost according to viral load, it was shown that higher plasma viral load level (> 100,000 HIV-RNA copies/mL) was associated with higher costs of care. The results demonstrate that the cost of treating HIV disease increases with disease progression, particularly at CD4 cell counts below 100 cells

  14. '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.

  15. Review of Hanford international activities

    International Nuclear Information System (INIS)

    Panther, D.G.

    1993-01-01

    Hanford initiated a review of international activities to collect, review, and summarize information on international environmental restoration and waste management initiatives considered for use at Hanford. This effort focused on Hanford activities and accomplishments, especially international technical exchanges and/or the implementation of foreign-developed technologies

  16. 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.

  17. 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...

  18. 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.

  19. [Medical image compression: a review].

    Science.gov (United States)

    Noreña, Tatiana; Romero, Eduardo

    2013-01-01

    Modern medicine is an increasingly complex activity , based on the evidence ; it consists of information from multiple sources : medical record text , sound recordings , images and videos generated by a large number of devices . Medical imaging is one of the most important sources of information since they offer comprehensive support of medical procedures for diagnosis and follow-up . However , the amount of information generated by image capturing gadgets quickly exceeds storage availability in radiology services , generating additional costs in devices with greater storage capacity . Besides , the current trend of developing applications in cloud computing has limitations, even though virtual storage is available from anywhere, connections are made through internet . In these scenarios the optimal use of information necessarily requires powerful compression algorithms adapted to medical activity needs . In this paper we present a review of compression techniques used for image storage , and a critical analysis of them from the point of view of their use in clinical settings.

  20. 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.

  1. 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

  2. Medical students’ perceptions of international accreditation

    Science.gov (United States)

    Abdel-Razig, Sawsan; Nair, Satish C

    2015-01-01

    Objectives This study aimed to explore the perceptions of medical students in a developing medical education system towards international accreditation. Methods Applicants to an Internal Medicine residency program in an academic medical center in the United Arab Emirates (UAE) accredited by the Accreditation Council for Graduate Medical Education-International (ACGME-I) were surveyed between May and June 2014. The authors analysed responses using inductive qualitative thematic analysis to identify emergent themes. Results Seventy-eight of 96 applicants (81%) completed the survey. The vast majority of respondents 74 (95%) reported that ACGME-I accreditation was an important factor in selecting a residency program. Five major themes were identified, namely improving the quality of education, increasing opportunities, meeting high international standards, improving program structure, and improving patient care. Seven (10%) of respondents felt they would be in a position to pursue fellowship training or future employment in the United States upon graduation from an ACGME-I program. Conclusions UAE trainees have an overwhelmingly positive perception of international accreditation, with an emphasis on improving the quality of training provided. Misperceptions, however, exist about potential opportunities available to graduates of ACGME-I programs. As more countries adopt the standards of the ACGME-I or other international accrediting bodies, it is important to recognize and foster trainee “buy-in” of educational reform initiatives. PMID:26454402

  3. Medical students' perceptions of international accreditation.

    Science.gov (United States)

    Ibrahim, Halah; Abdel-Razig, Sawsan; Nair, Satish C

    2015-10-11

    This study aimed to explore the perceptions of medical students in a developing medical education system towards international accreditation. Applicants to an Internal Medicine residency program in an academic medical center in the United Arab Emirates (UAE) accredited by the Accreditation Council for Graduate Medical Education-International (ACGME-I) were surveyed between May and June 2014. The authors analysed responses using inductive qualitative thematic analysis to identify emergent themes. Seventy-eight of 96 applicants (81%) completed the survey. The vast majority of respondents 74 (95%) reported that ACGME-I accreditation was an important factor in selecting a residency program. Five major themes were identified, namely improving the quality of education, increasing opportunities, meeting high international standards, improving program structure, and improving patient care. Seven (10%) of respondents felt they would be in a position to pursue fellowship training or future employment in the United States upon graduation from an ACGME-I program. UAE trainees have an overwhelmingly positive perception of international accreditation, with an emphasis on improving the quality of training provided. Misperceptions, however, exist about potential opportunities available to graduates of ACGME-I programs. As more countries adopt the standards of the ACGME-I or other international accrediting bodies, it is important to recognize and foster trainee "buy-in" of educational reform initiatives.

  4. Defining and identifying concepts of medication literacy: An international perspective.

    Science.gov (United States)

    Pouliot, Annie; Vaillancourt, Régis; Stacey, Danielle; Suter, Philippe

    2017-11-08

    Multiple concepts to define health literacy in the context of medication use exist, such as medication literacy, pharmacotherapy literacy, pharmacy health literacy; however, no studies have looked at consensus among experts internationally. A Delphi process was used to achieve consensus on the statements about medication literacy. Experts for the Delphi were selected from a review of the literature and suggestions from an international survey conducted with members of the International Pharmaceutical Federation on medication literacy. The preliminary Delphi questionnaire was built using the statements about medication literacy found in the scientific literature. Responses and comments were analyzed using a pre-established method and communicated to the experts after each round of Delphi. Statements with an agreement of at least 80% were accepted and used to develop a definition of medication literacy. The Delphi process started with 21 experts and included 4 rounds. Overall, 30 statements regarding medication literacy were accepted and divided into 4 clusters representing: (1) type of information necessary for optimal and safe use of medication, (2) skills and abilities, (3) format of information, and (4) outcomes. These statements were used to propose 2 different definitions of medication literacy. One of the definitions was preferred by 75% of the expert panel, which provided further comments for improvements. Of the 11 experts who answered the final questionnaire, nine strongly agreed with the refined definition. Medication literacy is the degree to which individuals can obtain, comprehend, communicate, calculate and process patient-specific information about their medications to make informed medication and health decisions in order to safely and effectively use their medications, regardless of the mode by which the content is delivered (e.g. written, oral and visual). Future studies should focus on how this definition can be operationalized to support the role

  5. 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.

  6. 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.

  7. International student mobility literature review

    NARCIS (Netherlands)

    King, R.; Findlay, A.; Ahrens, J.

    2010-01-01

    To bring their understanding of patterns in students' study and work abroad up to date, HEFCE and the British Council, the UK National Agency for Erasmus, commissioned a review of international student mobility. Professor Russell King and Jill Ahrens of the University of Sussex, and Professor Allan

  8. Effective International Medical Disaster Relief: A Qualitative Descriptive Study.

    Science.gov (United States)

    Broby, Nicolette; Lassetter, Jane H; Williams, Mary; Winters, Blaine A

    2018-04-01

    Purpose The aim of this study was to assist organizations seeking to develop or improve their medical disaster relief effort by identifying fundamental elements and processes that permeate high-quality, international, medical disaster relief organizations and the teams they deploy. A qualitative descriptive design was used. Data were gathered from interviews with key personnel at five international medical response organizations, as well as during field observations conducted at multiple sites in Jordan and Greece, including three refugee camps. Data were then reviewed by the research team and coded to identify patterns, categories, and themes. The results from this qualitative, descriptive design identified three themes which were key characteristics of success found in effective, well-established, international medical disaster relief organizations. These characteristics were first, ensuring an official invitation had been extended and the need for assistance had been identified. Second, the response to that need was done in an effective and sustainable manner. Third, effective organizations strived to obtain high-quality volunteers. By following the three key characteristics outlined in this research, organizations are more likely to improve the efficiency and quality of their work. In addition, they will be less likely to impede the overall recovery process. Broby N , Lassetter JH , Williams M , Winters BA . Effective international medical disaster relief: a qualitative descriptive study. Prehosp Disaster Med. 2018;33(2):119-126.

  9. International Peer Reviews of Design Basis

    International Nuclear Information System (INIS)

    Hughes, Peter

    2013-01-01

    International peer reviews: Design and safety assessment review service: - Review of design requirements; - Review in support of licensing; - Review in support of severe accident management; - Review in support of modifications; - Review in relation to periodic safety, or life extension; - Reviews take place at any time in NPP lifecycle from concept, through design and operations

  10. The Biosphere International Peer Review

    International Nuclear Information System (INIS)

    Van Luik, Abraham

    2002-01-01

    Abe van Luik (US DOE- YM, USA), ended the presentation by giving feedback from the IAEA peer review on the biosphere modelling strategy developed by the DOE Yucca Mountain Site Characterisation Office (YMSCO). This review was based on available international standards and guidance. The peer review team was constituted of both experts from regulatory and waste management organisations and national advisory committees. The implementation of the review consisted of an examination of biosphere reports mainly regarding the modelling and question and answer exchanges. The final report was submitted in April 2000. It contained twenty-three recommendations within two broad classifications; one concerning the regulatory framework, the other one regarding the framework to increase stakeholders' confidence in modelling. The three main categories of recommendations were outlined, namely (i) the DOE' s Biosphere assessment Approach, (ii) the definition of the biosphere system, and (iii) the model development, data and results. Regarding in particular the treatment of the uncertainties in the biosphere, it was viewed as a key issue during the review and thus it will be re-evaluated in the future performance assessment. The summary highlighted most of the recommendations received are to be acted on, and are to be included in the License Application plan for biosphere modelling

  11. 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

  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 graduates and the cardiology workforce.

    Science.gov (United States)

    Kostis, John B; Ahmad, Busharat

    2004-09-15

    Recent publications have expressed the view that there is a shortage of cardiologists and it is growing worse. Both an increasing demand and a diminishing supply of cardiologists have been projected. An increase in the number of international medical graduates (IMGs) who enter cardiology practice has been proposed as a remedy for a projected shortage. The IMGs have to overcome challenges including clinical practice, language proficiency, and cultural differences before they are incorporated into the fabric of U.S. cardiology. With hard work, perseverance, excellence,compassionate care and support and mentoring, many have contributed to scientific and clinical cardiology in the U.S. Whether in the absence of a present crisis the projected shortage of cardiologists necessitates change in U.S. immigration policy is an open question.

  14. Medical effects of internal contamination with uranium.

    Science.gov (United States)

    Duraković, A

    1999-03-01

    The purpose of this work is to present an outline of the metabolic pathways of uranium isotopes and compounds, medical consequences of uranium poisoning, and an evaluation of the therapeutic alternatives in uranium internal contamination. The chemical toxicity of uranium has been recognized for more than two centuries. Animal experiments and human studies are conclusive about metabolic adverse affects and nephro- toxicity of uranium compounds. Radiation toxicity of uranium isotopes has been recognized since the beginning of the nuclear era, with well documented evidence of reproductive and developmental toxicity, as well as mutagenic and carcinogenic consequences of uranium internal contamination. Natural uranium (238U), an alpha emitter with a half-life of 4.5x10(9) years, is one of the primordial substances of the universe. It is found in the earth's crust, combined with 235U and 234U, alpha, beta, and gamma emitters with respective half-lives of 7.1x10(8) and 2.5x10(5) years. A special emphasis of this paper concerns depleted uranium. The legacy of radioactive waste, environmental and health hazards in the nuclear industry, and, more recently, the military use of depleted uranium in the tactical battlefield necessitates further insight into the toxicology of depleted uranium. The present controversy over the radiological and chemical toxicity of depleted uranium used in the Gulf War warrants further experimental and clinical investigations of its effects on the biosphere and human organisms.

  15. 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.

  16. 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.

  17. Module for Interns in Medical Ethics: A Developmental Diegesis.

    Science.gov (United States)

    Mahajan, Rajiv; Goyal, Parmod Kumar; Sidhu, Tanvir Kaur; Kaur, Upinder; Kaur, Sandeep; Gupta, Vitull

    2017-12-01

    Media report is rife with incidences of doctor-patients' conflict, and this partly is due to communication gap and unethical practices being adopted by the doctors. Our regular curriculum fails to impart any training in ethical issues in patient care. Imparting training to students in these soft-skills is the need of the hour. To develop a module for interns in medical ethics (MIME) in patient care, validate it and pilot run the module for standardization. After conducting faculty development workshop in curriculum designing and three rounds of Delphi with alumni, a module in medical ethics was developed and peer validated. The questionnaire for pilot run, questionnaire for future use of module delivery and pre- and post-test were also peer validated. The module was delivered to 17 interns as pilot run in the form of 4 days' workshop. After pilot run, the module was standardized to 10 broad topics and 3 days' workshop. The questionnaire for future delivery of module in regular routine was also validated during pilot run. Twenty-five faculty members participated in 1 day faculty development workshop and 59 alumni completed three rounds of Delphi. After peer review by five experts, a module of 11 broad areas was developed and was pilot run on 17 interns. Based on the feedback from pilot run, a standardized, validated 18 h teaching MIME in patient care was developed. Pilot study proves that curriculum innovation in the form of medical ethics training to interns; when as undergraduate students, they actively participate in patient care under supervision will go a long way in inculcating soft skills like ethics, compassion and communication in them.

  18. Book Reviews | Naidu | South African Medical Journal

    African Journals Online (AJOL)

    Book Review 1. Book Title: The Histogenesis of Thyroid Cancer. Book Author: N Simionescu. Illustrated. £9.0.0. London: William Heinemann Medical Books. 1970. Book Review 2. Book Title: The Hypertensive Vascular Crisis. An experimental study. Book Author: F.B. Byrom. Illustrated. £1.10.0. London: William Heinemann ...

  19. 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.

  20. International Standards for Radiation Sterilization of Medical Devices

    International Nuclear Information System (INIS)

    Miller, A.

    2007-01-01

    For a terminally sterilized medical device to be designated '' STERILE '', probability of finding the viable micro-organisms in the device shall be equal to or less than 1 x 10 -6 (EN 556-1:2001: Sterilization of medical devices - Requirements for medical devices to be designated '' STERILE '' - Part 1: Requirements for terminally sterilized medical devices). Author presents the main legal aspects of the international standards for radiation sterilization of medical devices

  1. 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.

  2. Burnout in medical students: a systematic review.

    Science.gov (United States)

    Ishak, Waguih; Nikravesh, Rose; Lederer, Sara; Perry, Robert; Ogunyemi, Dotun; Bernstein, Carol

    2013-08-01

    Burnout is a state of mental and physical exhaustion related to work or care-giving activities. Distress during medical school can lead to burnout, with significant consequences, particularly if burnout continues into residency and beyond. The authors reviewed literature pertaining to medical student burnout, its prevalence, and its relationship to personal, environmental, demographic and psychiatric factors. We ultimately offer some suggestions to address and potentially ameliorate the current dilemma posed by burnout during medical education. A literature review was conducted using a PubMed/Medline, and PsycInfo search from 1974 to 2011 using the keywords: 'burnout', 'stress', 'well-being', 'self-care', 'psychiatry' and 'medical students'. Three authors agreed independently on the studies to be included in this review. The literature reveals that burnout is prevalent during medical school, with major US multi-institutional studies estimating that at least half of all medical students may be affected by burnout during their medical education. Studies show that burnout may persist beyond medical school, and is, at times, associated with psychiatric disorders and suicidal ideation. A variety of personal and professional characteristics correlate well with burnout. Potential interventions include school-based and individual-based activities to increase overall student well-being. Burnout is a prominent force challenging medical students' well-being, with concerning implications for the continuation of burnout into residency and beyond. To address this highly prevalent condition, educators must first develop greater awareness and understanding of burnout, as well as of the factors that lead to its development. Interventions focusing on generating wellness during medical training are highly recommended. © 2013 John Wiley & Sons Ltd.

  3. Reflection in Medical Diagnosis: A Literature Review

    OpenAIRE

    Mamede, Silvia; Schmidt, Henk G.

    2017-01-01

    Purpose: Reflection in medical diagnosis has been said to prevent errors by minimizing flaws in clinical reasoning. This claim, however, has been much disputed. While some studies show reflective reasoning to improve diagnostic performance, others find it to add nothing. This paper presents a narrative review of the literature on reflection in medical diagnosis aimed at addressing two questions: (1) how reflective reasoning has been conceived in this literature; and (2) what is the effect of ...

  4. 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

  5. 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.

  6. International Journal of Development and Management Review

    African Journals Online (AJOL)

    International Journal of Development and Management Review ... social Development and Management practices and theories while providing an institutional ... The Igbo care for the elderly in contemporary times: an old testament evaluation ...

  7. Internal quality assurance reviews: challenges and processes ...

    African Journals Online (AJOL)

    Internal quality assurance reviews: challenges and processes – Walter Sisulu University\\'s Business, Management Sciences and Law Faculty. ... This article examines some of the challenges and processes followed by six of the departments ...

  8. Book Reviews | Naidu | South African Medical Journal

    African Journals Online (AJOL)

    Book Review 1. Book Title: Medical Radionuclides: Radiation Dose and Effects. Book Authors: R. J. Cloutier, C. L. Edwards & W. S. Snyder (Ed.) Pp. ix + 528. Illustrated. $3.00. Oak Ridge, Tenn.: US Atomic Energy Commission. 1970. Available from Clearinghouse for Federal Scientific and Technical Information, Springfield, ...

  9. Proceedings of IDMP 2013: first international day of medical physics

    International Nuclear Information System (INIS)

    Marinello, Ginette; Mazal, Alejandro; Francois, P.; Fournier-Bidoz, N.; Belshi, R.; Dutreix, M.; Heinrich, S.; Wessels, C.; Fourquet, A.; Aubert, Bernard; Le Du, Dominique; Lisbona, Albert; Dedieu, Veronique; Makovicka, Libor; Taisant, Daniel; Metayer, Yann; Roue, Amelie; Besbes, Mounir; Van Dyk, Jake; Hammadi, Akli; Meghzifene, Ahmed; Nuesslin, Fridtjof; Pipman, Yakov; Keller, Marc; Cheung, Kin Yin; Meghzifene, Ahmed; ); Maria del Rosario Perez; Buvat, Irene; Rosenwald, Jean-Claude; Cosset, Jean-Marc; Dutreix, Andree

    2013-11-01

    November 7 was the birth day of Marie Curie and was chosen by the International Organisation of Medical Physics (IOMP) to celebrate his 50 years of existence at the Institut Curie, the exact place of Marie Curie's lab. The aim of this conference day was to promote medical physics and to give grounds for common reflection about international cooperation, the medical physicist profession, medical physics teaching and research. The conference was jointly organised by the French Society of Medical Physics and the Paris area medical centres specialised in cancer and in the training of medical physicists. This document brings together the presentations (slides) presented during the conference and dealing with: 1 - 26 years of French-Chinese cooperation in radiotherapy and medical radio-physics (G. Marinello); 2 - Activities conducted by Medical Physicists Without Borders (PMSF, Daniel Taisant); 3 - Cooperation in response to MAE and IAEA request (Y. Metayer); 4 - Teaching in France provided to foreigners by the National Institute for Nuclear Sciences and Technologies (INSTN, A. Roue); 5 - Radiation oncology and medical physics in Tunisia (M. Besbes); 6 - Medical physics education and training in the Global village: issues, strategies and experiences (J. Van Dyk); 7 - CEA/INSTN participation to training courses abroad (A. Hammadi); 8 - Medical physics to the benefit of patients: the role of IAEA (A. Meghzifene); 9 - Actions, results and perspectives of national and international organisations directly involved in medical physics and oncology (F. Nuesslin); 10 - The AAPM's Cooperation in Medical Physics with Low and Middle Income Countries: Actions, Achievements and Future Prospects (Y. Pipman); 11 - Alliance of African and Mediterranean French Speaking leagues against cancer (ALIAM, M.R. Keller); 12 - Opening talk for the first international day of medical physics (F. Nuesslin); 13 - IAEA support 14 - Marie Curie's contribution to medical physics (J.C. Rosenwald); 15

  10. 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

  11. Factors associated with dropout in medical education: a literature review.

    Science.gov (United States)

    O'Neill, Lotte Dyhrberg; Wallstedt, Birgitta; Eika, Berit; Hartvigsen, Jan

    2011-05-01

    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. This review aimed to systematically and critically review studies dealing with factors found to be associated with dropping out of medical school. A systematic critical literature review of the international peer-reviewed research literature on medical education was performed. A primary search was conducted and subsequently supplemented with ancestry and descendancy searches. The population of interest was medical students and the outcome was dropout. Abstract/title screening and quality assessment were performed by two independent researchers. Studies were assessed on six domains of quality: study participation; study attrition; predictor measurement; measurement of and accounting for confounders; outcome measurement, and analysis. Only studies that accounted for confounding were included in the final analysis. Of 625 studies found, 48 were quality-assessed and 13 of these were eventually included based on their fulfilment of our quality-related criteria. A range of entry qualifications seemed to be associated with greater chances of a student dropping out (odds ratio [OR] = 1.65-4.00). Struggling academically in medical school may be strongly associated with dropout. By contrast, no specific pattern of demographic variables was particularly important in relation to dropout. The effects of socio-economic, psychological and educational variables on dropout were not well investigated. More research into causal models and theory testing, which considers the effects of education, organisation and institution, is necessary if we are to learn more about how we can actively prevent medical student withdrawal. © Blackwell Publishing Ltd 2011.

  12. 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.

  13. Developing Medical Geology in Uruguay: A Review

    Directory of Open Access Journals (Sweden)

    Nelly Mañay

    2010-04-01

    Full Text Available 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.

  14. 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…

  15. 10th International Seminar on Medical Physics and 1st AMDI International Oncology Symposium

    International Nuclear Information System (INIS)

    2017-01-01

    Preface The International Seminar on Medical Physics (ISMP) 2016 is a national medical physics conference organised every two years by the Malaysian Association of Medical Physics (MAMP). Previously the biennial conference is known as the National Seminar on Medical Physics (NSMP). The conference was held on 27 and 28 August 2016 in Bayview Batu Ferringhi Hotel, Penang, Malaysia in conjunction with an Oncology Symposium (IOS) organised by Advanced Medical and Dental Institute of Universiti Sains Malaysia. The conference was renamed the International Seminar on Medical Physics (ISMP) on the 10th anniversary to recognise the diversity of the nationality of the conference speakers and attendees in the 8th (2012) and 9th (2014) conference. The change is also to encourage more international participants especially from the neighbouring countries of Malaysia and beyond to come together in “Fostering Medical Physics Research and Clinical Practice for Better Healthcare” in this region. About 300 participants from universities and hospitals participated in the conference. 28 oral contributions and 22 posters were presented at the conference. We also had a few invited lectures by international experts. The conference was divided into two main themes, imaging physics and radiotherapy physics. The topics presented were radiation dosimetry, image quality, magnetic resonance imaging, nuclear medicine, quality assurance, particle therapy, image guided radiotherapy, brachytherapy and Monte Carlo simulation and modelling. The IOS held in parallel covered topics in clinical oncology, cancer imaging and cancer biology. 41 papers are included in the volume organised into three main themes, i.e., imaging physics (ISMP), radiotherapy physics (ISMP) and oncology (IOS). All papers published in this volume of Journal of Physics: Conference Series have been peer reviewed through processes administered by the proceedings Editor. Each paper was peer-reviewed by two reviewers from the

  16. Establishment of medical education upon internalization of virtue ethics: bridging the gap between theory and practice.

    Science.gov (United States)

    Madani, Mansoureh; Larijani, Bagher; Madani, Ensieh; Ghasemzadeh, Nazafarin

    2017-01-01

    During medical training, students obtain enough skills and knowledge. However, medical ethics accomplishes its goals when, together with training medical courses, it guides students behavior towards morality so that ethics-oriented medical practice is internalized. Medical ethics is a branch of applied ethics which tries to introduce ethics into physicians' practice and ethical decisions; thus, it necessitates the behavior to be ethical. Therefore, when students are being trained, they need to be supplied with those guidelines which turn ethical instructions into practice to the extent possible. The current text discusses the narrowing of the gap between ethical theory and practice, especially in the field of medical education. The current study was composed using analytical review procedures. Thus, classical ethics philosophy, psychology books, and related articles were used to select the relevant pieces of information about internalizing behavior and medical education. The aim of the present study was to propose a theory by analyzing the related articles and books. The attempt to fill the gap between medical theory and practice using external factors such as law has been faced with a great deal of limitations. Accordingly, the present article tries to investigate how and why medical training must take internalizing ethical instructions into consideration, and indicate the importance of influential internal factors. Virtue-centered education, education of moral emotions, changing and strengthening of attitudes through education, and the wise use of administrative regulations can be an effective way of teaching ethical practice in medicine.

  17. EAC training and medical support for International Space Station astronauts.

    Science.gov (United States)

    Messerschmid, E; Haignere, J P; Damian, K; Damann, V

    2000-11-01

    The operation of the International Space Station (ISS) will be a global multilateral endeavour. Each International Partner will be responsible for the operation of its elements and for providing a crew complement proportional to its share of the overall resources. The preparations of the European Astronaut Centre to furnish training and medical support for the ISS astronauts are described.

  18. 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.

  19. Medication-overuse headache: a perspective review

    Science.gov (United States)

    Westergaard, Maria Lurenda; Munksgaard, Signe Bruun; Bendtsen, Lars; Jensen, Rigmor Højland

    2016-01-01

    Medication-overuse headache (MOH) is a debilitating condition in which frequent and prolonged use of medication for the acute treatment of pain results in the worsening of the headache. The purpose of this paper is to review the most recent literature on MOH and discuss future avenues for research. MOH accounts for a substantial share of the global burden of disease. Prevalence is often reported as 1–2% but can be as high as 7% overall, with higher proportions among women and in those with a low socioeconomic position. Management consists of withdrawing pain medication, focusing on prophylactic and nonmedical treatments, and limiting acute symptomatic medication. Stress reduction and lifestyle interventions may support the change towards rational pain medication use. Support, follow up, and education are needed to help patients through the detoxification period. There is fertile ground for research in MOH epidemiology, pathophysiology, and neuroimaging. Randomized and long-term follow-up studies on MOH treatment protocols are needed. Further focused research could be of major importance for global health. PMID:27493718

  20. Literature review on medical incident command.

    Science.gov (United States)

    Rimstad, Rune; Braut, Geir Sverre

    2015-04-01

    It is not known what constitutes the optimal emergency management system, nor is there a consensus on how effectiveness and efficiency in emergency response should be measured or evaluated. Literature on the role and tasks of commanders in the prehospital emergency services in the setting of mass-casualty incidents has not been summarized and published. This comprehensive literature review addresses some of the needs for future research in emergency management through three research questions: (1) What are the basic assumptions underlying incident command systems (ICSs)? (2) What are the tasks of ambulance and medical commanders in the field? And (3) How can field commanders' performances be measured and assessed? A systematic literature search in MEDLINE, PubMed, PsycINFO, Embase, Cochrane Central Register of Controlled Trials, Cochrane Library, ISI Web of Science, Scopus, International Security & Counter Terrorism Reference Center, Current Controlled Trials, and PROSPERO covering January 1, 1990 through March 1, 2014 was conducted. Reference lists of included literature were hand searched. Included papers were analyzed using Framework synthesis. The literature search identified 6,049 unique records, of which, 76 articles and books where included in qualitative synthesis. Most ICSs are described commonly as hierarchical, bureaucratic, and based on military principles. These assumptions are contested strongly, as is the applicability of such systems. Linking of the chains of command in cooperating agencies is a basic difficulty. Incident command systems are flexible in the sense that the organization may be expanded as needed. Commanders may command by direction, by planning, or by influence. Commanders' tasks may be summarized as: conducting scene assessment, developing an action plan, distributing resources, monitoring operations, and making decisions. There is considerable variation between authors in nomenclature and what tasks are included or highlighted

  1. [A history of internal medicine: medical specialization: as old as antiquity].

    Science.gov (United States)

    Echenberg, Donald

    2007-11-28

    This article presents a short review of the history of medical specialization and the evolution of internal medicine within the last two centuries. Medical specialization, far from being a recent phenomenon, existed in the Hellenistic world and in Rome. The development of specialization during the latter part of the 19th century and early 20th century is credited to the rapid expansion of medical knowledge which made it impossible for a single doctor to encompass all the different spheres of the profession. The term innere medizin or internal medicine was adopted from German terminology in the 1880's. The Canadian society of internal medicine was formed in 1983 and its main goal is to promote a broad perspective of medical care and to master the complexity in medicine through a generalist approach.

  2. 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.

  3. Medical Rehabilitation in Natural Disasters: A Review.

    Science.gov (United States)

    Khan, Fary; Amatya, Bhasker; Gosney, James; Rathore, Farooq A; Burkle, Frederick M

    2015-09-01

    To present an evidence-based overview of the effectiveness of medical rehabilitation intervention in natural disaster survivors and outcomes that are affected. A literature search was conducted using medical and health science electronic databases (PubMed, MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, PsycINFO) up to September 2014. Two independent reviewers selected studies reporting outcomes for natural disaster survivors after medical rehabilitation that addressed functional restoration and participation. Two reviewers independently extracted data and assessed the methodologic quality of the studies using the Critical Appraisal Skills Program's appraisal tools. A meta-analysis was not possible because of heterogeneity among included trials; therefore, a narrative analysis was performed for best evidence synthesis. Ten studies (2 randomized controlled trials, 8 observational studies) investigated a variety of medical rehabilitation interventions for natural disaster survivors to evaluate best evidence to date. The interventions ranged from comprehensive multidisciplinary rehabilitation to community educational programs. Studies scored low on quality assessment because of methodologic limitations. The findings suggest some evidence for the effectiveness of inpatient rehabilitation in reducing disability and improving participation and quality of life and for community-based rehabilitation for participation. There were no data available for associated costs. The findings highlight the need to incorporate medical rehabilitation into response planning and disaster management for future natural catastrophes. Access to rehabilitation and investment in sustainable infrastructure and education are crucial. More methodologically robust studies are needed to build evidence for rehabilitation programs, cost-effectiveness, and outcome measurement in such settings. Copyright © 2015 American Congress of Rehabilitation Medicine

  4. Strategic Review of Medical Training and Career Structure Interim Report

    OpenAIRE

    Department of Health (Ireland)

    2013-01-01

    Click here to download Strategic Review of Medical Training and Career Structure Interim Report PDF 44kb Click here to download Strategic Review of Medical Training and Career Structure Terms of Reference PDF 59KB

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

    OpenAIRE

    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 li...

  6. Medical students and interns' knowledge about and attitude towards homosexuality.

    Science.gov (United States)

    Banwari, G; Mistry, K; Soni, A; Parikh, N; Gandhi, H

    2015-01-01

    Medical professionals' attitude towards homosexuals affects health care offered to such patients with a different sexual orientation. There is absence of literature that explores the attitudes of Indian medical students or physicians towards homosexuality. This study aimed to evaluate Indian medical students and interns' knowledge about homosexuality and attitude towards homosexuals. After IEC approval and written informed consent, a cross-sectional study was conducted on a purposive sample of undergraduate medical students and interns studying in one Indian medical college. The response rate was 80.5%. Only completely and validly filled responses (N = 244) were analyzed. The participants filled the Sex Education and Knowledge about Homosexuality Questionnaire (SEKHQ) and the Attitudes towards Homosexuals Questionnaire (AHQ). SEKHQ consisted of 32 statements with response chosen from 'true', 'false', or 'don't know'. AHQ consisted of 20 statements scorable on a 5-point Likert scale. Multiple linear regression was used to find the predictors of knowledge and attitude. Medical students and interns had inadequate knowledge about homosexuality, although they endorsed a neutral stance insofar as their attitude towards homosexuals is concerned. Females had more positive attitudes towards homosexuals. Knowledge emerged as the most significant predictor of attitude; those having higher knowledge had more positive attitudes. Enhancing knowledge of medical students by incorporation of homosexuality related health issues in the curriculum could help reduce prejudice towards the sexual minority and thus impact their future clinical practice.

  7. 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.

  8. 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.

  9. 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.

  10. Scoping review protocol: education initiatives for medical psychiatry collaborative care.

    Science.gov (United States)

    Shen, Nelson; Sockalingam, Sanjeev; Abi Jaoude, Alexxa; Bailey, Sharon M; Bernier, Thérèse; Freeland, Alison; Hawa, Aceel; Hollenberg, Elisa; Woldemichael, Bethel; Wiljer, David

    2017-09-03

    The collaborative care model is an approach providing care to those with mental health and addictions disorders in the primary care setting. There is a robust evidence base demonstrating its clinical and cost-effectiveness in comparison with usual care; however, the transitioning to this new paradigm of care has been difficult. While there are efforts to train and prepare healthcare professionals, not much is known about the current state of collaborative care training programmes. The objective of this scoping review is to understand how widespread these collaborative care education initiatives are, how they are implemented and their impacts. The scoping review methodology uses the established review methodology by Arksey and O'Malley. The search strategy was developed by a medical librarian and will be applied in eight different databases spanning multiple disciplines. A two-stage screening process consisting of a title and abstract scan and a full-text review will be used to determine the eligibility of articles. To be included, articles must report on an existing collaborative care education initiative for healthcare providers. All articles will be independently assessed for eligibility by pairs of reviewers, and all eligible articles will be abstracted and charted in duplicate using a standardised form. The extracted data will undergo a 'narrative review' or a descriptive analysis of the contextual or process-oriented data and simple quantitative analysis using descriptive statistics. Research ethics approval is not required for this scoping review. The results of this scoping review will inform the development of a collaborative care training initiative emerging from the Medical Psychiatry Alliance, a four-institution philanthropic partnership in Ontario, Canada. The results will also be presented at relevant national and international conferences and published in a peer-reviewed journal. © Article author(s) (or their employer(s) unless otherwise stated in

  11. Recommendations of the International Medical Informatics Association (IMIA) on Education in Health and Medical Informatics

    Czech Academy of Sciences Publication Activity Database

    Arokiasamy, J.; Ball, M.; Barnett, D.; Bearman, M.; Bemmel van, J.; Douglas, J.; Fisher, P.; Garrie, R.; Gatewood, L.; Goossen, W.; Grant, A.; Hales, J.; Hasman, A.; Haux, R.; Hovenga, E.; Johns, M.; Knaup, P.; Leven, F. J.; Lorenzi, N.; Murray, P.; Neame, R.; Protti, D.; Power, M.; Richard, J.; Schuster, E.; Swinkels, W.; Yang, J.; Zelmer, L.; Zvárová, Jana

    2001-01-01

    Roč. 40, č. 5 (2001), s. 267-277 ISSN 0026-1270 Institutional research plan: AV0Z1030915 Keywords : health informatics * medical informatics * education * recommendations * International Medical Informatics Association * IMIA Subject RIV: BB - Applied Statistics, Operational Research Impact factor: 1.254, year: 2001

  12. 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

  13. International medical law and its impact on the ukrainian health care legislation.

    Science.gov (United States)

    Pashkov, Vitalii; Udovyka, Larysa; Dichko, Hanna

    2018-01-01

    Introduction: The Ukrainian state has an urgent necessity of rapid search for essentially new legal and organizational forms of the healthcare system, reform of the legal regulation of healthcare services provision. In the context of European integration, the advancement of the medical industry reform is closely related to consideration of international standards and norms of health care. The aim: To study the impact of international medical law on the Ukrainian health care legislation. Materials and methods: International and Ukrainian regulations and documents on health care were used in the research. System and structural, functional and legal comparative methods as well as systematization, analysis and synthesis were determinative in the research process. Review: Systematization of international documents on health care was made. The major problems in the Ukrainian health care legislation were determined in terms of their conformity with the international legislative norms. The expediency of the Medical Code adoption was grounded and its structure was defined. Conclusions: Most health care international acts are ratified by Ukraine and their provisions are implemented in the legislation. Simultaneously, there is a row of problems, which hinder the Ukrainian health care development and place obstacles in the way of European integration. To remove these obstacles, it is expedient to create a codified act - the Medical Code, which would systematize the provisions of the current medical laws and regulations and fill in the existing gaps in the legal regulation of health care.

  14. [Monitoring medication errors in an internal medicine service].

    Science.gov (United States)

    Smith, Ann-Loren M; Ruiz, Inés A; Jirón, Marcela A

    2014-01-01

    Patients admitted to internal medicine services receive multiple drugs and thus are at risk of medication errors. To determine the frequency of medication errors (ME) among patients admitted to an internal medicine service of a high complexity hospital. A prospective observational study conducted in 225 patients admitted to an internal medicine service. Each stage of drug utilization system (prescription, transcription, dispensing, preparation and administration) was directly observed by trained pharmacists not related to hospital staff during three months. ME were described and categorized according to the National Coordinating Council for Medication Error Reporting and Prevention. In each stage of medication use, the frequency of ME and their characteristics were determined. A total of 454 drugs were prescribed to the studied patients. In 138 (30,4%) indications, at least one ME occurred, involving 67 (29,8%) patients. Twenty four percent of detected ME occurred during administration, mainly due to wrong time schedules. Anticoagulants were the therapeutic group with the highest occurrence of ME. At least one ME occurred in approximately one third of patients studied, especially during the administration stage. These errors could affect the medication safety and avoid achieving therapeutic goals. Strategies to improve the quality and safe use of medications can be implemented using this information.

  15. 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....

  16. 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...... for Sustainable Development (ESD) and an early look at the emergence of Climate Change Education (CCE), in 10 different nations. As with most international reports, the IALEI report provoked many questions, some of which are more broadly relevant to scholarship and practice. This paper introduces a review...

  17. Postgraduate Medical Physics Academic Programmes. Endorsed by the International Organization for Medical Physics (IOMP)

    International Nuclear Information System (INIS)

    2013-01-01

    The safe and effective implementation of technology in radiation medicine requires expert medical physics support. In order to fulfil their duties, medical physicists working as health professionals should demonstrate competency in their area of specialization by obtaining the appropriate educational qualification and clinical competency training in one or more aspects of medical physics. At the international level, there are very few established, accredited academic education programmes for medical physics students, and no international guidelines exist which provide the recommended requirements, outline and structure of such a programme. An increasing number of Member States with a 'critical mass' of medical physicists are seeking support to initiate their own national postgraduate education programmes. This publication, therefore, seeks to provide guidelines for the establishment of a postgraduate academic education programme in medical physics, which could also be used to achieve harmonized standards of competence worldwide. This publication was developed in support of the internationally harmonized guidelines given in IAEA Human Health Series No. 25 on the requirements for academic education and clinical training of clinically qualified medical physicists. In addition to academic education, medical physicists should obtain specialized clinical training. The IAEA has published three Training Course Series publications with accompanying handbooks, which provide guidelines and references to training material for clinical training programmes for medical physicists specializing in radiation oncology (TCS-37), diagnostic radiology (TCS-47) and nuclear medicine (TCS-50)

  18. Medication Adherence Apps: Review and Content Analysis.

    Science.gov (United States)

    Ahmed, Imran; Ahmad, Niall Safir; Ali, Shahnaz; Ali, Shair; George, Anju; Saleem Danish, Hiba; Uppal, Encarl; Soo, James; Mobasheri, Mohammad H; King, Dominic; Cox, Benita; Darzi, Ara

    2018-03-16

    Medication adherence is an expensive and damaging problem for patients and health care providers. Patients adhere to only 50% of drugs prescribed for chronic diseases in developed nations. Digital health has paved the way for innovative smartphone solutions to tackle this challenge. However, despite numerous apps available claiming to improve adherence, a thorough review of adherence apps has not been carried out to date. The aims of this study were to (1) review medication adherence apps available in app repositories in terms of their evidence base, medical professional involvement in development, and strategies used to facilitate behavior change and improve adherence and (2) provide a system of classification for these apps. In April 2015, relevant medication adherence apps were identified by searching the Apple App Store and the Google Play Store using a combination of relevant search terms. Data extracted included app store source, app price, documentation of health care professional (HCP) involvement during app development, and evidence base for each respective app. Free apps were downloaded to explore the strategies used to promote medication adherence. Testing involved a standardized medication regimen of three reminders over a 4-hour period. Nonadherence features designed to enhance user experience were also documented. The app repository search identified a total of 5881 apps. Of these, 805 fulfilled the inclusion criteria initially and were tested. Furthermore, 681 apps were further analyzed for data extraction. Of these, 420 apps were free for testing, 58 were inaccessible and 203 required payment. Of the 420 free apps, 57 apps were developed with HCP involvement and an evidence base was identified in only 4 apps. Of the paid apps, 9 apps had HCP involvement, 1 app had a documented evidence base, and 1 app had both. In addition, 18 inaccessible apps were produced with HCP involvement, whereas 2 apps had a documented evidence base. The 420 free apps were

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

    Science.gov (United States)

    Jego, Eric Hajime; Amengual, Olga

    2017-11-01

    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.

  20. 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

  1. Medical applications of infrared thermography: A review

    Science.gov (United States)

    Lahiri, B. B.; Bagavathiappan, S.; Jayakumar, T.; Philip, John

    2012-07-01

    Abnormal body temperature is a natural indicator of illness. Infrared thermography (IRT) is a fast, passive, non-contact and non-invasive alternative to conventional clinical thermometers for monitoring body temperature. Besides, IRT can also map body surface temperature remotely. Last five decades witnessed a steady increase in the utility of thermal imaging cameras to obtain correlations between the thermal physiology and skin temperature. IRT has been successfully used in diagnosis of breast cancer, diabetes neuropathy and peripheral vascular disorders. It has also been used to detect problems associated with gynecology, kidney transplantation, dermatology, heart, neonatal physiology, fever screening and brain imaging. With the advent of modern infrared cameras, data acquisition and processing techniques, it is now possible to have real time high resolution thermographic images, which is likely to surge further research in this field. The present efforts are focused on automatic analysis of temperature distribution of regions of interest and their statistical analysis for detection of abnormalities. This critical review focuses on advances in the area of medical IRT. The basics of IRT, essential theoretical background, the procedures adopted for various measurements and applications of IRT in various medical fields are discussed in this review. Besides background information is provided for beginners for better understanding of the subject.

  2. Andragogy and medical education: are medical students internally motivated to learn?

    Science.gov (United States)

    Misch, Donald A

    2002-01-01

    Andragogy - the study of adult education - has been endorsed by many medical educators throughout North America. There remains, however, considerable controversy as to the validity and utility of adult education principles as espoused by the field's founder, Malcolm Knowles. Whatever the utility of andragogic doctrine in general education settings, there is reason to doubt its wholesale applicability to the training of medical professionals. Malcolm Knowles' last tenet of andragogy holds that adult learners are more motivated by internal than by external factors. The validity of this hypothesis in medical education is examined, and it is demonstrated that medical students' internal and external motivation are context-dependent, not easily distinguishable, and interrelate with one another in complex ways. Furthermore, the psychological motivation for medical student learning is determined by a variety of factors that range from internal to external, unconscious to conscious, and individual to societal. The andragogic hypothesis of increased internal motivation to learn on the part of adults in general, and medical trainees in particular, is rejected as simplistic, misleading, and counterproductive to developing a greater understanding of the forces that drive medical students to learn.

  3. 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

  4. 78 FR 68853 - International Medical Device Regulators Forum; Medical Device Single Audit Program International...

    Science.gov (United States)

    2013-11-15

    ... its inaugural meeting in Singapore in 2012, identified a Work Group (WG) to develop specific documents... Assessment Method for the Recognition and Monitoring of Medical Device Auditing Organizations;'' and IMDRF...

  5. Burnout in medical students: a systematic review of experiences in Chinese medical schools

    Directory of Open Access Journals (Sweden)

    Wang Michael Chunming

    2017-11-01

    Full Text Available Abstract Background To identify the: extent to which medical students in China experience burnout; factors contributing to this; potential solutions to reduce and prevent burnout in this group; and the extent to which the experiences of Chinese students reflect the international literature. Methods Systematic review and narrative synthesis. Key words, synonyms and subject headings were used to search five electronic databases in addition to manual searching of relevant journals. Titles and abstracts of publications between 1st January 1989-31st July 2016 were screened by two reviewers and checked by a third. Full text articles were screened against the eligibility criteria. Data on design, methods and key findings were extracted and synthesised. Results Thirty-three studies were eligible and included in the review. Greater levels of burnout were generally identified in males, more senior medical students, and those who already experienced poorer psychological functioning. Few studies explored social or contextual factors influencing burnout, but those that did suggest that factors such as the degree of social support or the living environment surrounding a student may be a determinant of burnout. Conclusions Greater understanding of the social and contextual determinants of burnout amongst medical students in China is essential towards identifying solutions to reduce and prevent burnout in this group.

  6. Burnout in medical students: a systematic review of experiences in Chinese medical schools.

    Science.gov (United States)

    Chunming, Wang Michael; Harrison, Reema; MacIntyre, Raina; Travaglia, Joanna; Balasooriya, Chinthaka

    2017-11-16

    To identify the: extent to which medical students in China experience burnout; factors contributing to this; potential solutions to reduce and prevent burnout in this group; and the extent to which the experiences of Chinese students reflect the international literature. Systematic review and narrative synthesis. Key words, synonyms and subject headings were used to search five electronic databases in addition to manual searching of relevant journals. Titles and abstracts of publications between 1st January 1989-31st July 2016 were screened by two reviewers and checked by a third. Full text articles were screened against the eligibility criteria. Data on design, methods and key findings were extracted and synthesised. Thirty-three studies were eligible and included in the review. Greater levels of burnout were generally identified in males, more senior medical students, and those who already experienced poorer psychological functioning. Few studies explored social or contextual factors influencing burnout, but those that did suggest that factors such as the degree of social support or the living environment surrounding a student may be a determinant of burnout. Greater understanding of the social and contextual determinants of burnout amongst medical students in China is essential towards identifying solutions to reduce and prevent burnout in this group.

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

    Science.gov (United States)

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

    2013-08-01

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

  8. Protecting the health of medical students on international electives in low-resource settings.

    Science.gov (United States)

    Johnston, Niall; Sandys, Nichola; Geoghegan, Rosemary; O'Donovan, Diarmuid; Flaherty, Gerard

    2018-01-01

    Increasingly, medical students from developed countries are undertaking international medical electives in developing countries. Medical students understand the many benefits of these electives, such as the opportunity to develop clinical skills, to gain insight into global health issues and to travel to interesting regions of the world. However, they may be much less aware of the risk to their health and wellbeing while abroad. Compounding this problem, medical students may not seek advice from travel medicine practitioners and often receive inadequate or no information from their medical school prior to departure. The PubMed database was searched for relevant literature relating to the health of medical elective students. Combinations of the following key words were used as search terms: 'international health elective', 'medical student' and 'health risks'. Articles were restricted to those published in English from 1997 through June 2017. A secondary review of the reference lists of these articles was performed. The grey literature was also searched for relevant material. This narrative literature review outlines the risks of clinical electives in resource-poor settings which include exposure to infectious illness, trauma, sexual health problems, excessive sun exposure, mental health issues and crime. Medical students may mitigate these health risks by being informed and well prepared for high-risk situations. The authors provide evidence-based travel advice which aims to improve pre-travel preparation and maximize student traveller safety. A safer and more enjoyable elective may be achieved if students follow road safety advice, take personal safety measures, demonstrate cultural awareness, attend to their psychological wellbeing and avoid risk-taking behaviours. This article may benefit global health educators, international elective coordinators and travel medicine practitioners. For students, a comprehensive elective checklist, an inventory of health kit

  9. 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

  10. 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.

  11. [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. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  12. What motivates medical students to select medical studies: a systematic literature review.

    Science.gov (United States)

    Goel, Sonu; Angeli, Federica; Dhirar, Nonita; Singla, Neetu; Ruwaard, Dirk

    2018-01-17

    There is a significant shortage of health workers across and within countries. It is of utmost importance to determine the factors that motivate students to opt for medical studies. The objective of this study is to group and review all the studies that investigated the motivational factors that underpin students' selection of medical study in recent years. The literature search was carried out by two researchers independently in PubMed, Google Scholar, Wiley and IndMED databases for articles published from year 2006 till 2016. A total of 38 combinations of MeSH words were used for search purpose. Studies related to medical students and interns have been included. The application of inclusion and exclusion criteria and PRISMA guidelines for reporting systematic review led to the final selection of 24 articles. The majority of the studies (n = 16; 66.6%) were from high-income countries followed by an equal number from upper-middle and lower-middle income countries (n = 4,16.7%). None of the studies were from low-income countries. All of the studies were cross-sectional in nature. The main motivating factors that emerged were scientific (interest in science / medicine, social interest and academia, flexible work hours and work independence), societal (prestige, job security, financial security) and humanitarian (serving the poor and under priviledged) in high-, upper-middle and lower-middle income countries, respectively. The findings were comparable to Maslow's hierarchy of needs theory of motivation. This systematic review identifies the motivational factors influencing students to join medical studies in different parts of the globe. These factors vary per country depending on the level of income. This study offers cues to policy makers and educators to formulate policy in order to tackle the shortage of health workers, i.e. medical doctors. However, more research is needed to translate health policy into concrete and effective measures.

  13. 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....

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. A Review of Medical Emergencies in Dental Practice | Uyamadu ...

    African Journals Online (AJOL)

    A Review of Medical Emergencies in Dental Practice. ... are those adverse medical events that may present in the course of dental treatment. ... be available in a dental clinic, outline the prevention and management of such emergencies, ...

  20. The internal boundary layer — A review

    Science.gov (United States)

    Garratt, J. R.

    1990-03-01

    A review is given of relevant work on the internal boundary layer (IBL) associated with: (i) Small-scale flow in neutral conditions across an abrupt change in surface roughness, (ii) Small-scale flow in non-neutral conditions across an abrupt change in surface roughness, temperature or heat/moisture flux, (iii) Mesoscale flow, with emphasis on flow across the coastline for both convective and stably stratified conditions. The major theme in all cases is on the downstream, modified profile form (wind and temperature), and on the growth relations for IBL depth.

  1. 49 CFR 659.27 - Internal safety and security reviews.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Internal safety and security reviews. 659.27... State Oversight Agency § 659.27 Internal safety and security reviews. (a) The oversight agency shall... safety and security reviews in its system safety program plan. (b) The internal safety and security...

  2. Radioactive waste management: International peer reviews

    International Nuclear Information System (INIS)

    Warnecke, E.; Bonne, A.

    1995-01-01

    The Agency's peer review service for radioactive waste management - known as the Waste Management Assessment and Technical Review Programme (WATRP) - started in 1989, building upon earlier types of advisory programmes. WATRP's international experts today provide advice and guidance on proposed or ongoing radioactive waste management programmes; planning, operation, or decommissioning of waste facilities; or on legislative, organizational, and regulatory matters. Specific topics often cover waste conditioning, storage, and disposal concepts or facilities; or technical and other aspects of ongoing or planned research and development programmes. The missions can thus contributed to improving waste management systems and plans, and in raising levels of public confidence in them, as part of IAEA efforts to assist countries in the safe management of radioactive wastes. This article presents a brief overview of recent WATRP missions in Norway, Slovak Republic, Czech Republic and Finland

  3. 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...

  4. 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

  5. Preparing for International Travel and Global Medical Care.

    Science.gov (United States)

    Mahadevan, Swaminatha V; Strehlow, Matthew C

    2017-05-01

    Thorough pretravel preparation and medical consultation can mitigate avoidable health and safety risks. A comprehensive pretravel medical consultation should include an individualized risk assessment, immunization review, and discussion of arthropod protective measures, malaria prophylaxis, traveler's diarrhea, and injury prevention. Travel with children and jet lag reduction require additional planning and prevention strategies; travel and evacuation insurance may prove essential when traveling to less resourced countries. Consideration should also be given to other high-risk travel scenarios, including the provision of health care overseas, adventure and extreme sports, water environments and diving, high altitude, and terrorism/unstable political situations. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. 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.

  7. Factors Associated with Medical Knowledge Acquisition During Internal Medicine Residency

    Science.gov (United States)

    Zeger, Scott L.; Kolars, Joseph C.

    2007-01-01

    BACKGROUND Knowledge acquisition is a goal of residency and is measurable by in-training exams. Little is known about factors associated with medical knowledge acquisition. OBJECTIVE To examine associations of learning habits on medical knowledge acquisition. DESIGN, PARTICIPANTS Cohort study of all 195 residents who took the Internal Medicine In-Training Examination (IM-ITE) 421 times over 4 years while enrolled in the Internal Medicine Residency, Mayo Clinic, Rochester, MN. MEASUREMENTS Score (percent questions correct) on the IM-ITE adjusted for variables known or hypothesized to be associated with score using a random effects model. RESULTS When adjusting for demographic, training, and prior achievement variables, yearly advancement within residency was associated with an IM-ITE score increase of 5.1% per year (95%CI 4.1%, 6.2%; p international medical school graduation, −3.4% (95%CI −6.5%, −0.36%; p = .03). CONCLUSIONS Conference attendance and self-directed reading of an electronic knowledge resource had statistically and educationally significant independent associations with knowledge acquisition that were comparable to the benefit of a year in residency training. PMID:17468889

  8. World Federation for Medical Education Policy on international recognition of medical schools' programme.

    Science.gov (United States)

    Karle, Hans

    2008-12-01

    The increasing globalisation of medicine, as manifested in the migration rate of medical doctors and in the growth of cross-border education providers, has inflicted a wave of quality assurance efforts in medical education, and underlined the need for definition of standards and for introduction of effective and transparent accreditation systems. In 2004, reflecting the importance of the interface between medical education and the healthcare delivery sector, a World Health Organization (WHO)/World Federation for Medical Education (WFME) Strategic Partnership to improve medical education was formed. In 2005, the partnership published Guidelines for Accreditation of Basic Medical Education. The WHO/WFME Guidelines recommend the establishment of proper accreditation systems that are effective, independent, transparent and based on medical education-specific criteria. An important prerequisite for this development was the WFME Global Standards programme, initiated in 1997 and widely endorsed. The standards are now being used in all 6 WHO/WFME regions as a basis for quality improvement of medical education throughout its continuum and as a template for national and regional accreditation standards. Promotion of national accreditation systems will have a pivotal influence on future international appraisal of medical education. Information about accreditation status - the agencies involved and the criteria and procedure used - will be an essential component of new Global Directories of Health Professions Educational Institutions. According to an agreement between the WHO and the University of Copenhagen (UC), these Directories (the Avicenna Directories) will be developed and published by the UC with the assistance of the WFME, starting with renewal of the WHO World Directory of Medical Schools, and sequentially expanding to cover educational institutions for other health professions. The Directories will be a foundation for international meta-recognition ("accrediting the

  9. 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

  10. [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.

  11. 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.

  12. Magnetic particles in medical research - a review

    International Nuclear Information System (INIS)

    Sajid, K.M.

    2001-01-01

    Magnetic (or magnetizable) particles have assumed increasing importance in medical and biological research since 1966 when the effect of a magnetic field on the movement of suspended particles was initially studied. In fields like haematology, cell biology, microbiology, biochemistry and immunoassays, they currently provide the basis for separation techniques, which previously relied on gravitational forces. The body cells (e.g., blood cells) can be made magnetic by incubating them in a medium containing several Fe/sub 3/O/sub 4/ particles, which are adsorbed to the membrane surfaces. Some bacteria (also called magnetostatic bacteria) respond to externally applied magnetic lines of force due to their intracellular magnetic particles. These properties are useful in the isolation of these cells/bacteria. In biochemistry magnetic particles are used to immobilize enzymes without any loss of enzyme activity. The immobilized enzymes can facilitate the separation of end products without extensive instrumentation. In immunoassays the antibodies are covalently linked to polymer coated iron oxide particles. An electromagnet is used to sediment these particles after reaction. This excludes the use of centrifuge to separate antigen-antibody complexes. In pharmacy and pharmacology the magnetic particles are important in drug transport. In techniques like ferrography, nuclear magnetic resonance imaging (NMRI), spectroscopic studies and magnetic resonance imaging (MRI) the magnetic particles serve as contrast agents and give clinically important spatial resolution. Magnetic particles also find extensive applications in cancer therapy, genetic engineering, pneumology, nuclear medicine, radiology and many other fields. This article reviews these applications. (author)

  13. 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.

  14. 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

  15. 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

    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. 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. 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. 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.

  16. 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

  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. 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.

  19. 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

  20. 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.

  1. 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.

  2. 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

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

    DEFF Research Database (Denmark)

    Christensen, Mikkel; Lundh, Andreas

    2013-01-01

    Pharmacotherapy in the elderly population is complicated by several factors that increase the risk of drug related harms and poorer adherence. The concept of medication review is a key element in improving the quality of prescribing and the prevention of adverse drug events. While no generally...... 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...

  4. 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.

  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. Gendered specialities during medical education: a literature review

    NARCIS (Netherlands)

    Alers, M.; Leerdam, L. van; Dielissen, P.; Lagro-Janssen, A.

    2014-01-01

    The careers of male and female physicians indicate gender differences, whereas in medical education a feminization is occurring. Our review aims to specify gender-related speciality preferences during medical education. A literature search on gender differences in medical students' speciality

  7. 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.

  8. 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.

  9. The Canada-Guyana medical education partnership: using videoconferencing to supplement post-graduate medical education among internal medicine trainees

    Directory of Open Access Journals (Sweden)

    William Stokes

    2017-04-01

    Conclusion: The formation of a resident-led, videoconference teaching series is a mutually beneficial partnership for Canadian and Guyanese medical residents and fosters international collaboration in medical education.

  10. 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.

  11. Assessing Empathy Development in Medical Education: A Systematic Review

    Science.gov (United States)

    Sulzer, Sandra H.; Feinstein, Noah Weeth; Wendland, Claire

    2016-01-01

    Introduction 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 be measuring anything meaningful to clinical practice or to patient satisfaction. Methods We performed a systematic review to learn how empathy is conceptualized in medical education research. How do researchers define the central construct of empathy, and what do they choose to measure? How well do definitions and operationalizations match? Results Among the 109 studies that met our search criteria, 20% failed to define the central construct of empathy at all, and only 13% had an operationalization that was well-matched to the definition provided. The majority of studies were characterized by internal inconsistencies and vagueness in both the conceptualization and operationalization 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 empathic response. Discussion We suggest that future research should follow the lead of basic scientific research that conceptualizes empathy as relational—an engagement between a subject and an object—rather than a personal quality that may be modified wholesale through appropriate training. PMID:26896015

  12. Source of learning basic clinical skills by medical interns Tehran University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Meshkani Z

    2004-07-01

    Full Text Available Background: Effective clinical teaching is a major objective in general practitioner’s education at medical schools. Purpose: To identify the sources of clinical skills learning that medical student experience Methods: In this cross sectional study, interns of Tehran medical university who spent at least 12 months of their internship answered a questionnaire on the sources of clinical skills training. Chi2 test was used to examine the association of source of learning and students,’ specification such as sex, score of pre –internship exam, and marital status. Results: All 250 interns who were eligible participated. Over all 46.60% interns learned their clinical skills from residents or clinical teachers, 29.61% observed others performing the procedures, 16.25 learned the skills from hospital staff or nurses, 7.54% practiced their knowledge when confronted to an emergency situation Conclusion: Our results warrant a more attentive approach to clinical skills (specially procedural skills training Key words: LEARNING RESOURCES

  13. 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

  14. A pilot curriculum in international surgery for medical students.

    Science.gov (United States)

    Moren, Alexis; Cook, Mackenzie; McClain, Molly; Doberne, Julie; Kiraly, Laszlo; Perkins, Rosina Serene; Kwong, Karen

    2015-01-01

    As medical student interest in global surgical care grows, a comprehensive curriculum is necessary to understand surgical care in resource-limited environments. We developed a surgical elective encompassing a multiyear medical student curriculum, with the goal of improving students' understanding of global surgical care, consisting of a junior seminar and a senior clerkship. This student elective focused on the global burden of surgical disease, ethics of care in low-resource settings, and care of marginalized U.S. Students who participated in the fourth year clerkship at a tertiary center in Northern India completed a reflective essay on their experience. Qualitative analysis was conducted using constant comparison and axial coding to establish a grounded theory. Medical students showed a desire to serve the poor, build collaborative relationships, and integrate international health into their future career. This novel curriculum provides students a clinical and public health basis to understand challenges of surgical care in low-resource environments while laying the groundwork for students with a future career in global health. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  15. 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.

  16. International Experience in Upper Echelon Theory: Literature Review

    Directory of Open Access Journals (Sweden)

    Đerđa Dino

    2017-09-01

    Full Text Available Background: The international experience of top managers is an evolving research within the upper echelon theory; therefore this literature review summarizes everything made so far.

  17. International Medical Graduates in the US Physician Workforce and Graduate Medical Education: Current and Historical Trends.

    Science.gov (United States)

    Ahmed, Awad A; Hwang, Wei-Ting; Thomas, Charles R; Deville, Curtiland

    2018-04-01

    Data show that international medical graduates (IMGs), both US and foreign born, are more likely to enter primary care specialties and practice in underserved areas. Comprehensive assessments of representation trends for IMGs in the US physician workforce are limited. We reported current and historical representation trends for IMGs in the graduate medical education (GME) training pool and US practicing physician workforce. We compared representation for the total GME and active practicing physician pools with the 20 largest residency specialties. A 2-sided test was used for comparison, with P  < .001 considered significant. To assess significant increases in IMG GME trainee representation for the total pool and each of the specialties from 1990-2015, the slope was estimated using simple linear regression. IMGs showed significantly greater representation among active practicing physicians in 4 specialties: internal medicine (39%), neurology (31%), psychiatry (30%), and pediatrics (25%). IMGs in GME showed significantly greater representation in 5 specialties: pathology (39%), internal medicine (39%), neurology (36%), family medicine (32%), and psychiatry (31%; all P  < .001). Over the past quarter century, IMG representation in GME has increased by 0.2% per year in the total GME pool, and 1.1% per year for family medicine, 0.5% for obstetrics and gynecology and general surgery, and 0.3% for internal medicine. IMGs make up nearly a quarter of the total GME pool and practicing physician workforce, with a disproportionate share, and larger increases over our study period in certain specialties.

  18. 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

    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......) collection of information about the patient's medical treatment, (3) patient interview, (4) critical examination of the patient's medications and (5) recommendations for the hospital physician.Conclusions We have provided a detailed description of a procedure for pharmacist-led medication review. We do so...

  19. Internal safety review team at Comanche Peak SES

    Energy Technology Data Exchange (ETDEWEB)

    Davis, D [Comanche Peak Steam Electric Staion, Texas Utilities, TX (United States)

    1997-09-01

    The presentations describes the following issues: levels of defense in depth; internal safety review organizations; methods used to perform safety assessment; safety committee review; quality verification; root cause analysis; human performance program; industry operating experience.

  20. 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.

  1. A review of international underground laboratory developments

    International Nuclear Information System (INIS)

    Cheng Jianping; Yue Qian; Wu Shiyong; Shen Manbin

    2011-01-01

    Underground laboratories are essential for various important physics areas such as the search for dark matter, double beta decay, neutrino oscillation, and proton decay. At the same time, they are also a very important location for studying rock mechanics, earth structure evolution,and ecology. It is essential for a nation's basic research capability to construct and develop underground laboratories. In the past, China had no high-quality underground laboratory,in particular no deep underground laboratory,so her scientists could not work independently in major fields such as the search for dark matter,but had to collaborate with foreign scientists and share the space of foreign underground laboratories. In 2009, Tsinghua university collaborated with the Ertan Hydropower Development Company to construct an extremely deep underground laboratory, the first in China and currently the deepest in the world, in the Jinping traffic tunnel which was built to develop hydropower from the Yalong River in Sichuan province. This laboratory is named the China Jinping Underground Laboratory (CJPL) and formally opened on December 12, 2010. It is now a major independent platform in China and can host various leading basic research projects. We present a brief review of the development of various international underground laboratories,and especially describe CJPL in detail. (authors)

  2. 22nd International Conference on Medical Physics 2016, Bangkok, Thailand; Medical physics propelling global health.

    Science.gov (United States)

    Tsapaki, Virginia; Ibbott, Geoff; Krisanachinda, Anchali; Ng, Kwan-Hoong; Suh, Tae-Suk; Tabakov, Slavik; Damilakis, John

    2017-12-01

    As medical technology evolves and patient needs increase, the need for well-trained and highly professional medical physicists (MPs) becomes even more urgent. The roles and responsibilities of MPs in various departments within the hospital are diverse and demanding. It is obvious that training, continuing education and professional development of MPs have become essential. One of the ways for an MP to advance his or her knowledge is to participate in conferences and congresses. Last year, the 22nd International Conference of Medical Physics (ICMP 2016) took place in Bangkok, Thailand. The event attracted 584 delegates with most of the participants coming from Asia. It attracted also delegates from 42 countries. The largest delegations were from Thailand, Japan and South Korea. ICMP 2016 included 367 oral presentations and e-posters, most of these being in the fields of Radiation Therapy, Medical Imaging and Radiation Safety. All abstracts were published as an e-book of Abstracts in a supplement to the official IOMP Journal. Many companies had exhibition stands at ICMP2016, thus allowing the participants to see the latest developments in the medical physics-related industry. The conference included 42 mini-symposia, part of the first "IOMP School" activity, covering various topics of importance for the profession and this special issue follows from the success of the conference. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  3. 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

    in the patient record and the EMS. 15% of the discrepancies were potentially serious or fatal, 62% were potentially significant and 23% were potentially non-significant. A total of 129 DRPs were identified by medication review, 1.7 per patient. The most frequent DRPs were sub therapeutic dosage, inappropriate......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...

  4. 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.

  5. Book Reviews | Naidu | South African Medical Journal

    African Journals Online (AJOL)

    Book Review 1. Book Title: Histocompatibility Testing 1970. Book Author: P.I. Terasaki (Ed.) Pp. 658. Illustrated. Dan. Kr. 148,50. Copenhagen: Munksgaard. 1970. Book Review 2. Book Title: Chest Tubes and Chest Bottles. Book Author: A. von Hippel. Pp. xv + 96. $7.00. Springfield, Ill. Charles C. Thomas. 1969.

  6. Book Reviews | Naidu | South African Medical Journal

    African Journals Online (AJOL)

    Book Review 1. Book Title: Preventive Myocardiology. Book Author: W Raab. Pp. xviii + 227. Illustrated. $13.50. Springfield, Ill.: Charles C. Thomas. 1970. Book Review 2. Book Title: The Artificial Cardiac Pacemaker. Book Authors: H.J.T. Thalen, J.W. van den Berg, J.N.H. van der Heide & J. Nieveen. Pp. 359. Illustrated.

  7. Medication-related dental erosion: a review.

    Science.gov (United States)

    Thomas, Manuel S; Vivekananda Pai, A R; Yadav, Amit

    2015-10-01

    Dental erosion has become a major problem that affects the long-term health of the dentition. Among the various potential causes for erosive tooth wear, the different drugs prescribed for patients may be overlooked. Several therapeutic medications can directly or indirectly be associated with dental erosion. It is the responsibility of oral health providers to make both patients and colleagues aware of drugs that may contribute to this condition. Therefore, the purpose of this discussion is to provide an overview of the various therapeutic medications that can be related to tooth erosion. The authors also include precautionary measures-summarized as The 9 Rs-to avoid or at least reduce medication-induced erosion.

  8. 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.

  9. 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

  10. Medical insurance claims associated with international business travel.

    Science.gov (United States)

    Liese, B; Mundt, K A; Dell, L D; Nagy, L; Demure, B

    1997-07-01

    Preliminary investigations of whether 10,884 staff and consultants of the World Bank experience disease due to work related travel. Medical insurance claims filed by 4738 travellers during 1993 were compared with claims of non-travellers. Specific diagnoses obtained from claims were analysed overall (one or more v no missions) and by frequency of international mission (1, 2-3, or > or = 4). Standardised rate of claims ratios (SSRs) for each diagnostic category were obtained by dividing the age adjusted rate of claims for travellers by the age adjusted rate of claims for non-travellers, and were calculated for men and women travellers separately. Overall, rates of insurance claims were 80% higher for men and 18% higher for women travellers than their non-travelling counterparts. Several associations with frequency of travel were found. SRRs for infectious disease were 1.28, 1.54, and 1.97 among men who had completed one, two or three, and four or more missions, and 1.16, 1.28, and 1.61, respectively, among women. The greatest excess related to travel was found for psychological disorders. For men SRRs were 2.11, 3.13, and 3.06 and for women, SRRs were 1.47, 1.96, and 2.59. International business travel may pose health risks beyond exposure to infectious diseases. Because travellers file medical claims at a greater rate than non-travellers, and for many categories of disease, the rate of claims increases with frequency of travel. The reasons for higher rates of claims among travellers are not well understood. Additional research on psychosocial factors, health practices, time zones crossed, and temporal relation between travel and onset of disease is planned.

  11. An Artist in the University Medical Center. Review.

    Science.gov (United States)

    James, A. Everette, Jr.

    1991-01-01

    Reviews "An Artist in the University Medical Center" (M. Lesser, New Orleans: Tulane University Press, 1989), in which the artist captures the human side of the complex Tulane Medical Center in New Orleans (Louisiana). The interplay of drawings, etchings, watercolors, and prose conveys traditions of nurturing in the hospital. (SLD)

  12. 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.

  13. 8 CFR 287.10 - Expedited internal review process.

    Science.gov (United States)

    2010-01-01

    ... jurisdiction regarding criminal violations of law. [68 FR 35281, June 13, 2003] ... 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 for...

  14. A critical review of the core medical training curriculum in the UK: A medical education perspective.

    Science.gov (United States)

    Laskaratos, Faidon-Marios; Gkotsi, Despoina; Panteliou, Eleftheria

    2014-01-01

    This paper represents a systematic evaluation of the Core Medical Training Curriculum in the UK. The authors critically review the curriculum from a medical education perspective based mainly on the medical education literature as well as their personal experience of this curriculum. They conclude in practical recommendations and suggestions which, if adopted, could improve the design and implementation of this postgraduate curriculum. The systematic evaluation approach described in this paper is transferable to the evaluation of other undergraduate or postgraduate curricula, and could be a helpful guide for medical teachers involved in the delivery and evaluation of any medical curriculum.

  15. 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…

  16. 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.

  17. Offices of Industrial Security International: A Review

    National Research Council Canada - National Science Library

    Sands, W

    1998-01-01

    The Defense Security Service (DSS), formerly the Defense Investigative Service (DIS), handles many of its overseas industrial security issues through its Offices of Industrial Security International...

  18. 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

  19. 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.

  20. 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.

  1. 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.

  2. 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

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

    Directory of Open Access Journals (Sweden)

    Sung Soo Jung

    2017-09-01

    Full Text Available 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.

  4. Expert Involvement and Adherence to Medical Evidence in Medical Mobile Phone Apps: A Systematic Review.

    Science.gov (United States)

    Subhi, Yousif; Bube, Sarah Hjartbro; Rolskov Bojsen, Signe; Skou Thomsen, Ann Sofia; Konge, Lars

    2015-07-27

    Both clinicians and patients use medical mobile phone apps. Anyone can publish medical apps, which leads to contents with variable quality that may have a serious impact on human lives. We herein provide an overview of the prevalence of expert involvement in app development and whether or not app contents adhere to current medical evidence. To systematically review studies evaluating expert involvement or adherence of app content to medical evidence in medical mobile phone apps. We systematically searched 3 databases (PubMed, The Cochrane Library, and EMBASE), and included studies evaluating expert involvement or adherence of app content to medical evidence in medical mobile phone apps. Two authors performed data extraction independently. Qualitative analysis of the included studies was performed. Based on inclusion criteria, 52 studies were included in this review. These studies assessed a total of 6520 apps. Studies dealt with a variety of medical specialties and topics. As much as 28 studies assessed expert involvement, which was found in 9-67% of the assessed apps. Thirty studies (including 6 studies that also assessed expert involvement) assessed adherence of app content to current medical evidence. Thirteen studies found that 10-87% of the assessed apps adhered fully to the compared evidence (published studies, recommendations, and guidelines). Seventeen studies found that none of the assessed apps (n=2237) adhered fully to the compared evidence. Most medical mobile phone apps lack expert involvement and do not adhere to relevant medical evidence.

  5. 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.

  6. Book Reviews: Boekbesprekings | Polson | South African Medical ...

    African Journals Online (AJOL)

    Click on the link to view the book reviews. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions ...

  7. Boekbesprekings: Book Reviews | Graham | South African Medical ...

    African Journals Online (AJOL)

    Click on the link to view the book reviews. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions ...

  8. Book Reviews : Boekbesprekings | Spact | South African Medical ...

    African Journals Online (AJOL)

    Click on the link to view the book reviews. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions ...

  9. Overdiagnosis across medical disciplines : A scoping review

    NARCIS (Netherlands)

    Jenniskens, Kevin; De Groot, Joris A.H.; Reitsma, Johannes B.; Moons, Karel G.M.; Hooft, Lotty; Naaktgeboren, Christiana A.

    2017-01-01

    Objective To provide insight into how and in what clinical fields overdiagnosis is studied and give directions for further applied and methodological research. Design Scoping review. Data sources Medline up to August 2017. Study selection All English studies on humans, in which overdiagnosis was

  10. 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.

  11. A review of child medical radiation exposure

    International Nuclear Information System (INIS)

    Anon.

    2017-01-01

    During their first year, children may undergo a lot of X-ray exams: of hips at the age of 4 months to detect any deformities, of lungs to detect bronchiolitis, of bones to detect breaks, of jaw (dental panoramic) to prepare for possible medical care in orthodontics. A survey shows that the medical radiation dose received by children is less than 0.35 mSv a year while the average dose for an adult is 4.5 mSv. This figure is reassuring but children exposure needs to be carefully monitored as children are more sensitive to radiation because they are growing. The control of radiation exposure is made through a compulsory survey: every year radiologists must send to the IRSN (Institute for Radioprotection and Nuclear Safety) the radiation doses received by 30 patients for the most common radiological examinations and the IRSN will then define reference doses based on these figures. The feedback over the 2013-2015 period for children exposure is very low. A new methodology must be defined to compensate this lack of data. The strategy is to reduce the global dose by performing only fully justified examinations and to adapt the dose to the real size and weight of the child. (A.C.)

  12. Proceedings from the 9th Annual Meeting of International Society for Medical Publication Professionals Roundtable Session: key insights.

    Science.gov (United States)

    Simcoe, Donna; Juneja, Renu; Scott, Gayle Nicholas; Sridharan, Kanaka; Williams-Hughes, Celeste

    2014-03-01

    During the 9th Annual Meeting of the International Society for Medical Publication Professionals (ISMPP, April 29-May 1, 2013 in Baltimore, MD), ∼650 participants attended two of 13 available roundtable sessions. Participants included medical publication professionals from industry, communication agencies, and journals. DISCUSSION TOPICS: Roundtable participants discussed how to best interpret and implement various guidances, such as Good Publication Practices 2 (GPP2), the International Committee of Medical Journal Editors (ICMJE) guidelines, and the Physician Payment Sunshine Act. The impact of and compliance with Corporate Integrity agreements (CIAs) on medical publication planning practices was debated. Roundtable participants also discussed ways of advancing both advocacy for the medical publication professional field and internal and external collaborations. The development of review manuscripts, publications from regions newly emerging in publication planning, medical devices publications, and real-world experience publications were discussed. Participants also considered the benefits and uncertainties of new technologies in medical publications such as multimedia and social media. This is the first ever article to be published following the well-attended ISMPP roundtable sessions. The objective of this manuscript is to summarize key learnings that will aid continued discussions about challenges and opportunities facing medical publication professionals.

  13. Medication safety programs in primary care: a scoping review.

    Science.gov (United States)

    Khalil, Hanan; Shahid, Monica; Roughead, Libby

    2017-10-01

    Medication safety plays an essential role in all healthcare organizations; improving this area is paramount to quality and safety of any wider healthcare program. While several medication safety programs in the hospital setting have been described and the associated impact on patient safety evaluated, no systematic reviews have described the impact of medication safety programs in the primary care setting. A preliminary search of the literature demonstrated that no systematic reviews, meta-analysis or scoping reviews have reported on medication safety programs in primary care; instead they have focused on specific interventions such as medication reconciliation or computerized physician order entry. This scoping review sought to map the current medication safety programs used in primary care. The current scoping review sought to examine the characteristics of medication safety programs in the primary care setting and to map evidence on the outcome measures used to assess the effectiveness of medication safety programs in improving patient safety. The current review considered participants of any age and any condition using care obtained from any primary care services. We considered studies that focussed on the characteristics of medication safety programs and the outcome measures used to measure the effectiveness of these programs on patient safety in the primary care setting. The context of this review was primary care settings, primary healthcare organizations, general practitioner clinics, outpatient clinics and any other clinics that do not classify patients as inpatients. We considered all quantitative studied published in English. A three-step search strategy was utilized in this review. Data were extracted from the included studies to address the review question. The data extracted included type of medication safety program, author, country of origin, aims and purpose of the study, study population, method, comparator, context, main findings and outcome

  14. 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

  15. 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

  16. A review of electronic medical record keeping on mobile medical service trips in austere settings.

    Science.gov (United States)

    Dainton, Christopher; Chu, Charlene H

    2017-02-01

    Electronic medical records (EMRs) may address the need for decision and language support for Western clinicians on mobile medical service trips (MSTs) in low resource settings abroad, while providing improved access to records and data management. However, there has yet to be a review of this emerging technology used by MSTs in low-resource settings. The aim of this study is to describe EMR systems designed specifically for use by mobile MSTs in remote settings, and accordingly, determine new opportunities for this technology to improve quality of healthcare provided by MSTs. A MEDLINE, EMBASE, and Scopus/IEEE search and supplementary Google search were performed for EMR systems specific to mobile MSTs. Information was extracted regarding EMR name, organization, scope of use, platform, open source coding, commercial availability, data integration, and capacity for linguistic and decision support. Missing information was requested by email. After screening of 122 abstracts, two articles remained that discussed deployment of EMR systems in MST settings (iChart, SmartList To Go), and thirteen additional EMR systems were found through the Google search. Of these, three systems (Project Buendia, TEBOW, and University of Central Florida's internally developed EMR) are based on modified versions of Open MRS software, while three are smartphone apps (QuickChart EMR, iChart, NotesFirst). Most of the systems use a local network to manage data, while the remaining systems use opportunistic cloud synchronization. Three (TimmyCare, Basil, and Backpack EMR) contain multilingual user interfaces, and only one (QuickChart EMR) contained MST-specific clinical decision support. There have been limited attempts to tailor EMRs to mobile MSTs. Only Open MRS has a broad user base, and other EMR systems should consider interoperability and data sharing with larger systems as a priority. Several systems include tablet compatibility, or are specifically designed for smartphone, which may be

  17. 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.

  18. 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

  19. [Planned home versus planned hospital births: adverse outcomes comparison by reviewing the international literature].

    Science.gov (United States)

    Faucon, C; Brillac, T

    2013-06-01

    To assess the safety of planned home birth compared to hospital birth, in low-risk pregnancies. An international literature review was conducted. Mortality, adverse outcomes and medical interventions were compared. Home birth was not associated with higher mortality rates, but with lower maternal adverse outcomes. Perinatal adverse outcomes are not significantly different at home and in hospital. Medical interventions are more frequent in hospital births. Home birth attended by a well-trained midwife is not associated with increased mortality and morbidity rates, but with less medical interventions. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  20. Acculturation Needs of Pediatric International Medical Graduates: A Qualitative Study.

    Science.gov (United States)

    Osta, Amanda D; Barnes, Michelle M; Pessagno, Regina; Schwartz, Alan; Hirshfield, Laura E

    2017-01-01

    Phenomenon: International medical graduates (IMGs) play a key role in host countries' health systems but face unique challenges, which makes effective, tailored support for IMGs essential. Prior literature describing the acculturation needs of IMGs focused primarily on communication content and style. We conducted a qualitative study to explore acculturation that might be specific to IMG residents who care for children. In a study conducted from November 2011 to April 2012, we performed four 90-minute semistructured focus groups with 26 pediatric IMG residents from 12 countries. The focus group transcripts were analyzed using open and focused coding methodology. The focus groups and subsequent analysis demonstrated that pediatric IMG residents' socialization to their home culture impacts their transition to practice in the United States; they must adjust not only to a U.S. culture, different from their own, but also to the culture of medicine in the United States. We identified the following new acculturation themes: understanding the education system and family structure, social determinants of health, communication with African American parents, contraception, physician handoffs, physicians' role in prevention, adolescent health, and physicians' role in child advocacy. We further highlight the acculturation challenges faced by pediatric IMG residents and offer brief recommendations for the creation of a deliberate acculturation curriculum for pediatric IMG residents. Insight: Residency training is a unique period in physicians' personal and professional development and can be particularly challenging for IMGs. There is a significant gap in the identified acculturation needs and the current curricula available to IMG residents who care for children.

  1. Educational support for specialist international medical graduates in anaesthesia.

    Science.gov (United States)

    Higgins, Niall S; Taraporewalla, Kersi; Edirippulige, Sisira; Ware, Robert S; Steyn, Michael; Watson, Marcus O

    2013-08-19

    To measure specialist international medical graduates' (SIMGs) level of learning through participation in guided tutorials, face-to-face or through videoconferencing (VC), and the effect of tutorial attendance and quality of participation on success in specialist college examinations. Tutorials were conducted at the Royal Brisbane and Women's Hospital between 19 September 2007 and 23 August 2010, and delivered through VC to participants at other locations. Tutorials were recorded and transcribed, and speaker contributions were tagged and ranked using content analysis software. Summary examination results were obtained from the Australian and New Zealand College of Anaesthetists. Tutorial participation and attendance, and college examination pass and fail rates. Transcripts were obtained for 116 tutorials. The median participation percentage for those who subsequently failed the college examinations was 1% (interquartile range [IQR], 0%-1%), while for those who passed the exams it was 5% (IQR, 2%-8%; P technology was found to be a feasible method to assist SIMGs to become aware of the requirements of the exam and to prepare more effectively.

  2. 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…

  3. 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.

  4. New nuclear technology; International developments. Review 1995

    International Nuclear Information System (INIS)

    Devell, L.; Aggeryd, I.; Hultgren, Aa.; Lundell, B.; Pedersen, T.

    1995-09-01

    A summary review of the development of new nuclear rector technology is presented in this report. Fuel cycle strategies and waste handling developments are also commented. Different plans for dismantling nuclear weapons are presented. 18 refs

  5. International Journal of Development and Management Review ...

    African Journals Online (AJOL)

    2008) ... The Effects of Bureaucracy and its Implications for Adhocracy in the Workplace: A Study ... A Review of the Conflict between Environmental Rights and Human Rights: A ... Emerging Pattern of Forest Bio-Diversity in South West Nigeria: A ...

  6. International Journal of Development and Management Review ...

    African Journals Online (AJOL)

    Review of pension schemes of Ukraine and Argentina in comparison with Nigeria's 2014 pension reform act · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. JO Nweke, 81-94 ...

  7. Review of CdTe medical applications

    Energy Technology Data Exchange (ETDEWEB)

    Entine, G; Garcia, D A; Tow, D E

    1977-02-01

    CdTe sensors are now being used in several areas of nuclear medicine. CdTe probe technics, originally developed to study dental pathology in dog models, are being used clinically to diagnose venous thrombosis of the legs and to detect occult dental infections in patients scheduled for prosthetic cardiovascular and orthopedic surgery. Similar instrumentation is in use in animal research of myocardial infarction and synthetic tooth substitutes. Transmission technics have also been developed to diagnose pulmonary edema and to measure bone mineral changes in space flight. Investigations are also underway in the use of linear or two-dimensional arrays of CdTe gamma sensors for medical imaging. Economic considerations have slowed this work, but the technology appears to be available. Development of photoconductive CdTe X-ray detectors for scintigraphic scanners has also begun. Rapid detector improvement will be needed for success in this field, but the potential usefulness is very great. Together, the present application results are encouraging and wide use of CdTe detectors should occur within only a few years.

  8. 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.

  9. Overdiagnosis across medical disciplines: a scoping review.

    Science.gov (United States)

    Jenniskens, Kevin; de Groot, Joris A H; Reitsma, Johannes B; Moons, Karel G M; Hooft, Lotty; Naaktgeboren, Christiana A

    2017-12-27

    To provide insight into how and in what clinical fields overdiagnosis is studied and give directions for further applied and methodological research. Scoping review. Medline up to August 2017. All English studies on humans, in which overdiagnosis was discussed as a dominant theme. Studies were assessed on clinical field, study aim (ie, methodological or non-methodological), article type (eg, primary study, review), the type and role of diagnostic test(s) studied and the context in which these studies discussed overdiagnosis. From 4896 studies, 1851 were included for analysis. Half of all studies on overdiagnosis were performed in the field of oncology (50%). Other prevalent clinical fields included mental disorders, infectious diseases and cardiovascular diseases accounting for 9%, 8% and 6% of studies, respectively. Overdiagnosis was addressed from a methodological perspective in 20% of studies. Primary studies were the most common article type (58%). The type of diagnostic tests most commonly studied were imaging tests (32%), although these were predominantly seen in oncology and cardiovascular disease (84%). Diagnostic tests were studied in a screening setting in 43% of all studies, but as high as 75% of all oncological studies. The context in which studies addressed overdiagnosis related most frequently to its estimation, accounting for 53%. Methodology on overdiagnosis estimation and definition provided a source for extensive discussion. Other contexts of discussion included definition of disease, overdiagnosis communication, trends in increasing disease prevalence, drivers and consequences of overdiagnosis, incidental findings and genomics. Overdiagnosis is discussed across virtually all clinical fields and in different contexts. The variability in characteristics between studies and lack of consensus on overdiagnosis definition indicate the need for a uniform typology to improve coherence and comparability of studies on overdiagnosis. © Article author

  10. A systematic review of publications studies on medical tourism

    OpenAIRE

    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 ...

  11. Top Medical Education Studies of 2016: A Narrative Review.

    Science.gov (United States)

    Fromme, H Barrett; Ryan, Michael S; Darden, Alix; D'Alessandro, Donna M; Mogilner, Leora; Paik, Steve; Turner, Teri L

    2018-02-06

    Education, like clinical medicine, should be based on the most current evidence in the field. Unfortunately, medical educators can be overwhelmed by the sheer volume and range of resources for this literature. This article provides an overview of 15 articles from 2016 that the authors consider the top articles in the field of pediatric medical education. The 7 authors, all medical educators with combined leadership and expertise across the continuum of pediatric medical education, used an iterative 3-stage process to review more than 6339 abstracts published in 2016. This process was designed to identify a small subset of articles that were most relevant to educational practices and most applicable to pediatric medical education. In the first 2 stages, pairs of authors independently reviewed and scored abstracts in 13 medical education-related journals and reached consensus to identify the articles that best met these criteria. In the final stage, all articles were discussed using a group consensus model to select the final articles included in this review. This article presents summaries of the 15 articles that were selected. The results revealed a cluster of studies related to observed standardized clinical encounters, self-assessment, professionalism, clinical teaching, competencies/milestones, and graduate medical education management strategies. We provide suggestions on how medical educators can apply the findings to their own practice and educational settings. This narrative review offers a useful tool for educators interested in keeping informed about the most relevant and valuable information in the field. Copyright © 2018 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  12. Medication Review and Transitions of Care: A Case Report of a Decade-Old Medication Error.

    Science.gov (United States)

    Comer, Rachel; Lizer, Mitsi

    2017-10-01

    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.

  13. Internal combustion engines history - a review

    International Nuclear Information System (INIS)

    Gaviria Rios, Jorge Enrique; Mora Guzman, Jorge Hernan; Agudelo, John Ramiro

    2002-01-01

    In this article, a chronological analysis of the technologies and events that any way influenced in the evolution of the internal combustion engine is done everything it through the observation of the works carried out for scientific empiric and engineers whose technical and conceptual value meant the motivation of other people for the search of a better development in this engineering field

  14. Science review of internal combustion engines

    International Nuclear Information System (INIS)

    Taylor, Alex M.K.P.

    2008-01-01

    Internal combustion engines used in transportation produce about 23% of the UK's carbon dioxide emission, up from 14% in 1980. The current science described in this paper suggests that there could be 6-15% improvements in internal combustion fuel efficiency in the coming decade, although filters to meet emission legislation reduce these gains. Using these engines as hybrids with electric motors produces a reduction in energy requirements in the order of 21-28%. Developments beyond the next decade are likely to be dominated by four topics: emission legislation and emission control, new fuels, improved combustion and a range of advanced concepts for energy saving. Emission control is important because current methods for limiting nitrogen oxides and particulate emissions imply extra energy consumption. Of the new fuels, non-conventional fossil-derived fuels are associated with larger greenhouse gas emissions than conventional petroleum-based fuels, while a vehicle propelled by fuel cells consuming non-renewable hydrogen does not necessarily offer an improvement in emissions over the best hybrid internal combustion engines. Improved combustion may be developed for both gasoline and diesel fuels and promises better efficiency as well as lower noxious emissions without the need for filtering. Finally, four advanced concepts are considered: new thermodynamic cycles, a Rankine bottoming cycle, electric turbo-compounding and the use of thermoelectric devices. The latter three all have the common theme of trying to extract energy from waste heat, which represents about 30% of the energy input to an internal combustion engine

  15. International Medical Graduates in Radiation Oncology: Historical Trends and Comparison With Other Medical Specialties

    Energy Technology Data Exchange (ETDEWEB)

    Verma, Vivek, E-mail: vivek333@gmail.com [Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, Nebraska (United States); Shah, Chirag [Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio (United States); Lautenschlaeger, Tim [Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, Indiana (United States); Lin, Chi [Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, Nebraska (United States); Beriwal, Sushil [Department of Radiation Oncology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (United States); Zhen, Weining [Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, Nebraska (United States); Mehta, Minesh P. [Department of Radiation Oncology, Miami Cancer Institute, Coral Gables, Florida (United States); Zietman, Anthony L. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States)

    2016-07-15

    Purpose: This is the first National Resident Matching Program analysis evaluating historical patterns of international medical graduates (IMGs) in radiation oncology (RO) and providing comparison with American (MD) medical graduates (AMGs), osteopathic students (DOs), unfilled positions, and other specialties. Methods and Materials: National Resident Matching Program data for IMGs were available from 2003 to 2015, with limited data for other specialty matches. The following RO-specific figures were obtained per year: total positions available; total matched positions; number of unfilled positions; and number of IMG, AMG, and DO matches. In addition, the number of IMG matches and total matched positions were obtained for 19 other specialties. Fisher exact tests and χ{sup 2} tests were considered significant at α <.05. Results: From 2010 to 2015, 0.8% of RO matches were IMGs, a decline from 2.4% in 2003 to 2009 (P=.006). Proportions of DO matches during these intervals increased by 40% (from 1.0% to 1.4%), significantly lower than IMGs for 2003 to 2009 (P=.03) but not 2010 to 2015 (P=.26). From 2003 to 2015, the percentage of IMG matches, at 1.5%, was significantly lower than the percentage of unfilled seats, at 3.5% (P<.001). In comparison with other specialties (2003-2015), RO had the fewest IMG matches (1.5%), followed by otolaryngology (1.9%) and orthopedics (2.2%); specialties with the highest IMG proportions were internal medicine (37.1%), family medicine (35.7%), and neurology (31.1%). Conclusions: Presently, IMGs represent <1% of RO matches, the lowest among major specialties. There are several speculative factors associated with this low proportion. There are significantly more unfilled positions than those filled by IMGs; programs at risk of not matching could weigh the advantages and disadvantages of interviewing IMGs.

  16. Role of culture in international business: A synthetic review

    Directory of Open Access Journals (Sweden)

    Krzysztof Wach

    2016-10-01

    Full Text Available The main objective of the paper is to discuss the role of culture in international business and to present main dimensions and typologies of cultural behaviours while doing business internationally. The article is organised in two sections. At first, cultural context of international business and entrepreneurship is discussed, which constitutes a separate research stream within the international entrepreneurship domain. The second passage is dedicated to the various most important classifications and typologies of cultural behaviours in international business. The article is a typical literature review.

  17. Theorizing on entrepreneurial orientation in international business: A synthetic review

    Directory of Open Access Journals (Sweden)

    Vijay Narayanan

    2017-02-01

    Full Text Available Both, entrepreneurship and international business have been topics of interest for academicians, businessmen and policy-makers around the world. Now it is obvious that entrepreneurs also do business internationally. International entrepreneurship is still a new research domain within international business studies and current empirical investigations focus on entrepreneurial orientation while internationalizing. The main objective of the paper is to discuss the concept of the international entrepreneurial orientation, by linking entrepreneurial orientation and internationalisation of the firm. The article is based on in-depth literature review and its critics.

  18. Retrospective review of the medical management of ectopic ...

    African Journals Online (AJOL)

    Medical management of ectopic pregnancies is a safe and effective management option, as proven by international data, but at Tygerberg Hospital the safety of this treatment modality cannot be guaranteed because of poor follow-up. Improvement in patient selection with consideration of predictors of success and thorough ...

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

    Science.gov (United States)

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

    2018-01-01

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

  20. 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…

  1. [Review of: S. Okazaki Handbook of research on international advertising

    NARCIS (Netherlands)

    Neijens, P.

    2012-01-01

    In this book review, Peter Neijens considers the Handbook of Research on International Advertising edited by Shintaro Okazki to be a seminal work, with contributions by top scholars from all over the world. It covers a wide range of topics relevant to the field of international advertising, in eight

  2. External Program Reviews (2012) | IDRC - International ...

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

    2016-06-24

    Jun 24, 2016 ... These final evaluations are our primary accountability mechanism in terms of the results, effectiveness, and relevance of program spending. External program reviews aim to: account to IDRC's Board of Governors for the implementation of the program prospectus; provide input into programming for learning ...

  3. 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)

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

    Science.gov (United States)

    Heist, Brian S; Torok, Haruka Matsubara

    2018-01-01

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

  5. 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.

  6. 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

  7. 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

  8. 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...

  9. [Patient safety in home care - A review of international recommendations].

    Science.gov (United States)

    Czakert, Judith; Lehmann, Yvonne; Ewers, Michael

    2018-06-08

    In recent years there has been a growing trend towards nursing care at home in general as well as towards intensive home care being provided by specialized home care services in Germany. However, resulting challenges for patient safety have rarely been considered. Against this background we aimed to explore whether international recommendations for patient safety in home care in general and in intensive home care in particular already exist and how they can stimulate further practice development in Germany. A review of online English documents containing recommendations for patient safety in intensive home care was conducted. Available documents were analyzed and compared in terms of their form and content. Overall, a small number of relevant documents could be identified. None of these documents exclusively refer to the intensive home care sector. Despite their differences, however, the analysis of four selected documents showed similarities, e. g., regarding specific topics of patient safety (communication, involvement of patients and their relatives, risk assessment, medication management, qualification). Furthermore, strengths and weaknesses of the documents became apparent: e. g., an explicit understanding of patient safety, a literature-based introduction to safety topics or an adaptation of the recommendations to the specific features of home care were occasionally lacking. This document analysis provides interesting input to the formal and content-related development of specific recommendations and to practice development in Germany to improve patient safety in home care. Copyright © 2018. Published by Elsevier GmbH.

  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. NEA international peer reviews of post-accident protection policy

    International Nuclear Information System (INIS)

    Lazo, T.

    2011-01-01

    For many years, the NEA has offered international peer reviews of national, high-level radioactive waste management policies and approaches. Until recently, this service had not been requested in the area of radiological protection. However, the 3. International Nuclear Emergency Exercise (INEX-3, 2005-2006) addressed post-accident consequence management for the first time in a broad, international sense, and helped generate significant national reflections in this area. In particular, in 2005 the French government began an extensive programme of post-emergency consequence management planning, resulting in a draft national policy to address such situations. The Finnish government used the INEX-3 exercise as a vehicle to discuss post-emergency consequence management with a broad group of governmental and private stakeholders, and also began to develop national policy in this area. In order to further refine national efforts, the French Nuclear Safety Authority (ASN) invited the NEA to perform in April 2011 its first international peer review in the radiological protection area focusing on its post-emergency consequence management policy under development. Finnish experts participated in this peer review team, and as a result, subsequently invited the NEA to perform an international peer review of its developing policy in this area in September 2011. These draft national policies and their international peer reviews are briefly presented in this paper. Feedback from both the French ASN and the Finnish STUK suggests that the detailed, external input provided by the international peer review teams have been extremely valuable in refining the content of the guides so that they are more clear, concise, understandable and implementable. It should be recalled that both national policy documents reviewed are far more detailed and extensive than described here. The intent of this article was not to provide a review of the national policies themselves, but rather to give an

  12. 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

  13. Knowledge, attitudes, and practices evaluation about travel medicine in international travelers and medical students in Chile.

    Science.gov (United States)

    Guerrero-Lillo, Lisette; Medrano-Díaz, Jorge; Pérez, Carmen; Chacón, Rodrigo; Silva-Urra, Juan; Rodriguez-Morales, Alfonso J

    2009-01-01

    Because information about travel medicine in Chile is lacking, a knowledge, attitudes, and practices evaluation in international travelers and medical students was done. The travelers and medical students did not know the travel medicine and sanitary conditions of their destinations, although they perceived travel-associated health risks, but <10% had any vaccination and 5% got sick during international trips.

  14. 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…

  15. 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

  16. Genetic and Medical Considerations of Autism: A Literature Review.

    Science.gov (United States)

    Silver, Kathi O.

    This literature review, from 1990 to the present, discusses the characteristics of autism and the comorbidity of mental retardation and autism. Specific medical syndromes that complement the heterogeneity concept are described, including epilepsy, fragile X syndrome, Rett syndrome, tuberous sclerosis, and Asperger syndrome. The paper presents some…

  17. A Review of Outcome of Postgraduate Medical Training in Zambia ...

    African Journals Online (AJOL)

    A Review of Outcome of Postgraduate Medical Training in Zambia. K Bowa, F Goma, JINM Yikona, YF Mulla, SS Banda. Abstract. The University of Zambia School of Medicine was opened in 1966. Since inception, over 1200 undergraduate students have graduated with Bachelor of Medicine and Bachelor of Surgery.

  18. Systemic ototoxicity: a review | Shine | East African Medical Journal

    African Journals Online (AJOL)

    Objectives: To review the literature pertaining to the ototoxic potential of three frequently prescribed systemic medications in the sub-Saharan setting; quinine, furosemide and aminoglycoside antibiotics. The pathophysiology, clinical manifestations and risk factors and risk minimisation strategies regarding the ototoxicity ...

  19. Pre-departure training and the social accountability of International Medical Electives.

    Science.gov (United States)

    Wallace, Lauren J; Webb, Allison

    2014-01-01

    Due to widespread awareness of global inequities in health and development, participation and interest in International Medical Electives has grown. However, it has been suggested that the benefits of these electives for students and communities may not outweigh the harms. Pre-departure training (PDT) has been proposed as a route through which participants can adequately prepare for their elective experience. Through a review of the current literature, this article explores the ethics of international medical electives using a social accountability framework and assesses the success of PDT in mitigating harms for students and communities. We find that the literature on PDT is limited. What is clear from completed studies is that the focus of PDT has often been centered on the clinical experience, while theories of development and health inequity remain minor topics. We argue that a greater benefit for students and communities could be gained from framing health inequity from a critical perspective, and integrating mandatory global health education into medical school curricula. We suggest that attention to only PDT is not enough. In a socially accountable program, community partnerships must be bilateral and respect communities as primary stakeholders in the training of students and in program evaluation. Unfortunately, research to-date has focused on the student experience; further studies of the community perspective would help to elicit how PDT and partnership models can be strengthened, improving the experiences of both students and communities. Finally, individual medical schools and organizations that offer global health elective experiences must ensure that they take responsibility for monitoring PDT.

  20. 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.

  1. 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.

  2. 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

  3. 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.

  4. Use of methylphenidate among medical students: a systematic review

    Directory of Open Access Journals (Sweden)

    Guilherme Finger

    2013-06-01

    Full Text Available OBJECTIVE: To review the effects of methylphenidate on cognitive enhancement, memory, and performance in medical students. METHODS: A review of four databases (LILACS, PubMed, ScienceDirect, and SciELO, analyzing the title and of all articles published between 1990 and 2012 in English, Portuguese, and Spanish. Selected articles were read in entirety, including in the review those that met the established criteria. RESULTS: The prevalence of use among medical students reached 16%, with no gender difference. Most students began using the drug after entering the university, and the reasons cited to justify it are related to enhancing academic performance. CONCLUSION: There is no evidence in the literature that the use of methylphenidate is beneficial in terms of memory or learning. The drug simply increases wakefulness and alertness, reducing the time of sleep.

  5. Building an environmentally accountable medical curriculum through international collaboration

    DEFF Research Database (Denmark)

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

    2017-01-01

    to mitigation of and adaptation to negative health impacts of environmental change. Medical schools have an integral role in training doctors who understand the interdependence of ecosystems and human health. Yet integrating environmental perspectives into busy medical curricula is not a simple task. Content......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...

  6. Transformation of medical education through Decentralised Training Platforms: a scoping review.

    Science.gov (United States)

    Mlambo, Motlatso; Dreyer, Abigail; Dube, Rainy; Mapukata, Nontsikelelo; Couper, Ian; Cooke, Richard

    2018-03-01

    Medical education in South Africa is facing a major paradigm shift. The urgency to increase the number of suitable, qualified and socially accountable health sciences graduates has brought to the fore the need to identify alternative training platforms and learning environments, often in rural areas. Subsequently, the focus has now shifted towards strengthening primary health care and community based health services. This scoping review presents a synopsis of the existing literature on decentralized training platform (DTP) strategies for medical education internationally, outlining existing models within it and its impact. This scoping review followed Arksey and O'Malley's framework outlining five stages: (i) identification of a research question, (ii) identification of relevant studies, (iii) study selection criteria, (iv) data charting, and (v) collating, summarizing and reporting results. The literature for the scoping review was found using online databases, reference lists and hand searched journals. Data were charted and sorted inductively according to key themes. A final review included 59 articles ranging over the years 1987-2015 with the largest group of studies falling in the period 2011-2015 (47.5%). Studies mostly employed quantitative (32.2%), qualitative (20.3%), systematic/literature review (18.6%) and mixed methods research approaches (11.9%). The scoping review highlighted a range of DTP strategies for transforming medical education. These include training for rural workforce, addressing context specific competencies to promote social accountability, promoting community engagement, and medical education partnerships. Viable models of DTP include community based education, distributed community engaged learning, discipline based clinical rotations, longitudinal clerkships and dedicated tracks focusing on rural issues. Shorter rural placements and supplemental rural tracks are also described. This scoping review showed a considerable amount of

  7. Medications and Impaired Driving: A Review of the Literature

    Science.gov (United States)

    Hetland, Amanda; Carr, David B

    2013-01-01

    Objective To describe the association of specific medication classes with driving outcomes and provide clinical recommendations. Data sources The MEDLINE and EMBASE databases were searched for articles published from January 1973 to June 2013 on specific classes of medications known to be associated with driving impairment. The search included outcome terms such as automobile driving, motor vehicle crash, driving simulator, and road tests. Study selection and data extraction Only English-language articles that contained findings from observational or interventional designs were included. Cross-sectional studies, case series, and case reports were excluded. Studies of ≥ 10 subjects were included in this review. Data synthesis Driving is an important task and activity for the majority of adults. Unfortunately, some specific classes of commonly prescribed medications have been associated with driving impairment as measured by road performance, driving simulation, and/or motor vehicle crashes. This review of 30 studies identified findings with barbiturates, benzodiazepines, certain non-benzodiazepine hypnotics, various antidepressants, opioid and non-steroidal analgesics, anticonvulsants, antipsychotics, antiparkinsonian agents, skeletal muscle relaxants, antihistamines, anticholinergic medications, and hypoglycemic agents. Additional studies identifying medication impacts on sedation, sleep latency, and psychomotor function – as well as the role of alcohol – are also discussed. Conclusions Psychotropic agents and those with CNS side effects were associated with various measures of impaired driving performance. It is difficult to determine if such associations are actually a result of medication use or perhaps the medical diagnosis itself. Regardless, clinicians should be aware of the increased risk of impaired driving with specific populations and classes of medications when prescribing these agents, educate their patients, and/or consider safer alternatives

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

    Directory of Open Access Journals (Sweden)

    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

  9. Medical students' and interns' interest in orthopedic surgery: the gender factor.

    Science.gov (United States)

    Schroeder, Joshua E; Zisk-Rony, Rachel Y; Liebergall, Meir; Tandeter, Howard; Kaplan, Leon; Weiss, Yoram G; Weissman, Charles

    2014-01-01

    There is an extremely small proportion of female medical students choosing to specialize in orthopedic surgery. The aim of the study was to assess medical students' and interns' interests and perceptions of orthopedic surgery and explore why women are not interested in orthopedic surgery. Questionnaires were distributed to final-year medical students and interns assessing their interests and perception of orthopedic surgery. Final-year medical students and interns. Responses were obtained from 317 students and 199 interns. Among the medical students, 15% were interested in orthopedic surgery, but only 2% were women. Both male and female students perceived orthopedics as an "action"-packed, procedure-based profession, providing instant gratification, time in the operating room, high income, and the option for private practice. Female medical students considered it boring. Among interns, 11% were interested in orthopedic surgery; however, only 2% were women. When compared with the interns who were not interested in orthopedic surgery, a greater number of the interns interested in orthopedic surgery rated time with family and a procedure-intensive profession as important. Female students and interns were also interested in other surgical fields. The increasing majority of women among medical students will reshape the future of physician workforce by dictating changes in workforce participation, working conditions, and intercollegial relationships. Orthopedic surgery will need to adapt to these realities. Published by Elsevier Inc.

  10. A systematic review of patient medication error on self-administering medication at home.

    Science.gov (United States)

    Mira, José Joaquín; Lorenzo, Susana; Guilabert, Mercedes; Navarro, Isabel; Pérez-Jover, Virtudes

    2015-06-01

    Medication errors have been analyzed as a health professionals' responsibility (due to mistakes in prescription, preparation or dispensing). However, sometimes, patients themselves (or their caregivers) make mistakes in the administration of the medication. The epidemiology of patient medication errors (PEs) has been scarcely reviewed in spite of its impact on people, on therapeutic effectiveness and on incremental cost for the health systems. This study reviews and describes the methodological approaches and results of published studies on the frequency, causes and consequences of medication errors committed by patients at home. A review of research articles published between 1990 and 2014 was carried out using MEDLINE, Web-of-Knowledge, Scopus, Tripdatabase and Index Medicus. The frequency of PE was situated between 19 and 59%. The elderly and the preschooler population constituted a higher number of mistakes than others. The most common were: incorrect dosage, forgetting, mixing up medications, failing to recall indications and taking out-of-date or inappropriately stored drugs. The majority of these mistakes have no negative consequences. Health literacy, information and communication and complexity of use of dispensing devices were identified as causes of PEs. Apps and other new technologies offer several opportunities for improving drug safety.

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

    NARCIS (Netherlands)

    M. Berghout (Mathilde); I.N. Fabbricotti (Isabelle); M. Buljac-Samardzic (Martina); C.G.J.M. Hilders (Carina)

    2017-01-01

    textabstractMedical 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

  12. What motivates medical students to select medical studies : A systematic literature review

    NARCIS (Netherlands)

    Goel, Sonu; Angeli, F.; Dhirar, Nonita; Singla, Neetu; Ruwaard, Dirk

    2018-01-01

    Background: There is a significant shortage of health workers across and within countries. It is of utmost importance to determine the factors that motivate students to opt for medical studies. The objective of this study is to group and review all the studies that investigated the motivational

  13. Limitations of poster presentations reporting educational innovations at a major international medical education conference

    Directory of Open Access Journals (Sweden)

    Morris Gordon

    2013-02-01

    Full Text Available Background: In most areas of medical research, the label of ‘quality’ is associated with well-accepted standards. Whilst its interpretation in the field of medical education is contentious, there is agreement on the key elements required when reporting novel teaching strategies. We set out to assess if these features had been fulfilled by poster presentations at a major international medical education conference. Methods: Such posters were analysed in four key areas: reporting of theoretical underpinning, explanation of instructional design methods, descriptions of the resources needed for introduction, and the offering of materials to support dissemination. Results: Three hundred and twelve posters were reviewed with 170 suitable for analysis. Forty-one percent described their methods of instruction or innovation design. Thirty-three percent gave details of equipment, and 29% of studies described resources that may be required for delivering such an intervention. Further resources to support dissemination of their innovation were offered by 36%. Twenty-three percent described the theoretical underpinning or conceptual frameworks upon which their work was based. Conclusions: These findings suggest that posters presenting educational innovation are currently limited in what they offer to educators. Presenters should seek to enhance their reporting of these crucial aspects by employing existing published guidance, and organising committees may wish to consider explicitly requesting such information at the time of initial submission.

  14. Limitations of poster presentations reporting educational innovations at a major international medical education conference.

    Science.gov (United States)

    Gordon, Morris; Darbyshire, Daniel; Saifuddin, Aamir; Vimalesvaran, Kavitha

    2013-02-19

    In most areas of medical research, the label of 'quality' is associated with well-accepted standards. Whilst its interpretation in the field of medical education is contentious, there is agreement on the key elements required when reporting novel teaching strategies. We set out to assess if these features had been fulfilled by poster presentations at a major international medical education conference. Such posters were analysed in four key areas: reporting of theoretical underpinning, explanation of instructional design methods, descriptions of the resources needed for introduction, and the offering of materials to support dissemination. Three hundred and twelve posters were reviewed with 170 suitable for analysis. Forty-one percent described their methods of instruction or innovation design. Thirty-three percent gave details of equipment, and 29% of studies described resources that may be required for delivering such an intervention. Further resources to support dissemination of their innovation were offered by 36%. Twenty-three percent described the theoretical underpinning or conceptual frameworks upon which their work was based. These findings suggest that posters presenting educational innovation are currently limited in what they offer to educators. Presenters should seek to enhance their reporting of these crucial aspects by employing existing published guidance, and organising committees may wish to consider explicitly requesting such information at the time of initial submission.

  15. 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.

  16. Decontamination and dismantlement plan for international reviewing

    International Nuclear Information System (INIS)

    Wells, P.B.; Earle, O.K.; Klepikov, A.Kh.

    2000-01-01

    When developing a decommissioning plan, several factors need to be included. First and foremost is the issue of outline and scope. Specific to the BN-350, are issues related to short term tasks required to support the safe storage of the reactor for the next 50 years, and long term tasks required to dismantle the reactor, leaving some sort of final state, (brown field, green field, etc.) In addition, issues such as personnel and physical safety as well as environmental concerns must be addressed to ensure the shut down and dismantlement of the reactor is done in a safe manner, both for personnel and the environment. In addition to being the base document in which to support work, a D and D plan can also be utilized to obtain financial resources necessary to complete the plan, as is the case for the BN-350 Reactor located in Aktau, Kazakhstan. By providing a clear and complete D and D plan, which includes costs and schedules for each item, it is anticipated that donor countries will have the ability to review, approve, and provide financial support to complete the work described in the plan

  17. [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.

  18. Improving Pharmacists’ Targeting of Patients for Medication Review and Deprescription

    Directory of Open Access Journals (Sweden)

    Vanessa Marvin

    2018-04-01

    Full Text Available Background: In an acute hospital setting, a multi-disciplinary approach to medication review can improve prescribing and medicine selection in patients with frailty. There is a need for a clear understanding of the roles and responsibilities of pharmacists to ensure that interventions have the greatest impact on patient care. Aim: To use a consensus building process to produce guidance for pharmacists to support the identification of patients at risk from their medicines, and to articulate expected actions and escalation processes. Methods: A literature search was conducted and evidence used to establish a set of ten scenarios often encountered in hospitalised patients, with six or more possible actions. Four consultant physicians and four senior pharmacists ranked their levels of agreement with the listed actions. The process was redrafted and repeated until consensus was reached and interventions were defined. Outcome: Generalised guidance for reviewing older adults’ medicines was developed, alongside escalation processes that should be followed in a specific set of clinical situations. The panel agreed that both pharmacists and physicians have an active role to play in medication review, and face-to-face communication is always preferable to facilitate informed decision making. Only prescribers should deprescribe, however pharmacists who are not also trained as prescribers may temporarily “hold” medications in the best interests of the patient with appropriate documentation and a follow up discussion with the prescribing team. The consensus was that a combination of age, problematic polypharmacy, and the presence of medication-related problems, were the most important factors in the identification of patients who would benefit most from a comprehensive medication review. Conclusions: Guidance on the identification of patients on inappropriate medicines, and subsequent pharmacist-led intervention to prompt and promote deprescribing, has

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

    African Journals Online (AJOL)

    SIN Yiga

    frequently performed initial management of open fractures, application of plaster ... dehydration (92.7%) in patients in Paediatrics were the most frequently .... Medical and Dental Professions Board, Health Professions Council of South Africa.

  20. Management of stinging insect hypersensitivity: a 5-year retrospective medical record review.

    Science.gov (United States)

    Johnson, Thomas; Dietrich, Jeffrey; Hagan, Larry

    2006-08-01

    The Joint Task Force on Practice Parameters for Allergy and Immunology recommends that patients with a history of a systemic reaction to an insect sting be educated on ways to avoid insect stings, carry injectable epinephrine for emergency self-treatment, undergo specific IgE testing for stinging insect sensitivity, and be considered for immunotherapy. To review frontline providers' documented care and recommendations for imported fire ant and flying insect hypersensitivity reactions. A retrospective medical record review was performed of emergency department and primary care clinic visits between November 1, 1999, and November 30, 2004. Using International Classification of Diseases, Ninth Revision, codes, medical records were selected for review to identify patients with potential insect hypersensitivity. A total of 769 medical records from patients who experienced an insect sting were reviewed. Of 120 patients with a systemic reaction, 66 (55.0%) received a prescription for injectable epinephrine, and 14 (11.7%) were given information regarding avoidance of the offending insect. Forty-seven patients with systemic reactions (39.2%) were referred to an allergist. Of 28 patients who kept their appointments and underwent skin testing, 3 had negative results and 25 (89%) had positive results and were advised to start immunotherapy. Adherence to the stinging insect hypersensitivity practice parameter recommendations is poor. Many patients who have experienced a systemic reaction after an insect sting and have sought medical care are not afforded an opportunity for potentially lifesaving therapy.

  1. Narrative review of telemedicine consultation in medical practice

    Directory of Open Access Journals (Sweden)

    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

  2. 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.

  3. Review of Radiation Safety in Medical X-Ray Diagnosis

    International Nuclear Information System (INIS)

    Koteng, O.A.

    2015-01-01

    Medical X-Ray machines have been used for more than a century for non-invasive diagnosis of patients for the benefit of mankind. The safety of operators and patients during such practice has improved with time, but, still cases of detrimental effects to Radiation Workers in Kenya including cancer related deaths have been reported in the recent past. An ongoing study is reviewing the safety status of the worker and patients during medical and dental exposures. The study was initiated following complaint of recurrent headaches by a radiographer working in a busy Kenyan hospital. (author)

  4. Pharmacist-led discharge medication counselling: A scoping review.

    Science.gov (United States)

    Bonetti, Aline F; Reis, Wálleri C; Lombardi, Natália Fracaro; Mendes, Antonio M; Netto, Harli Pasquini; Rotta, Inajara; Fernandez-Llimos, Fernando; Pontarolo, Roberto

    2018-04-24

    Discharge medication counselling has produced improved quality of care and health outcomes, especially by reducing medication errors and readmission rates, and improving medication adherence. However, no studies have assembled an evidence-based discharge counselling process for clinical pharmacists. Thus, the present study aims to map the components of the pharmacist-led discharge medication counselling process. We performed a scoping review by searching electronic databases (Pubmed, Scopus, and DOAJ) and conducting a manual search to identify studies published up to July 2017. Studies that addressed pharmacist-led discharge medication counselling, regardless of the population, clinical conditions, and outcomes evaluated, were included. A total of 1563 studies were retrieved, with 75 matching the inclusion criteria. Thirty-two different components were identified, and the most prevalent were the indication of the medications and adverse drug reactions, which were reported in more than 50% of the studies. The components were reported similarly by studies from the USA and the rest of the world, and over the years. However, 2 differences were identified: the use of a dosage schedule, which was more frequent in studies published in 2011 or before and in studies outside the USA; and the teach-back technique, which was used more frequently in the USA. Poor quality reporting was also observed, especially regarding the duration of the counselling, the number of patients, and the medical condition. Mapping the components of the pharmacist-led discharge counselling studies through a scoping review allowed us to reveal how this service is performed around the world. Wide variability in this process and poor reporting were identified. Future studies are needed to define the core outcome set of this clinical pharmacy service to allow the generation of robust evidence and reproducibility in clinical practice. © 2018 John Wiley & Sons, Ltd.

  5. [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.

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

    Directory of Open Access Journals (Sweden)

    Walzer S

    2014-03-01

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

  7. International medical students and migration: the missing dimension in Australian workforce planning?

    Science.gov (United States)

    Hawthorne, Lesleyanne; Hamilton, Jan

    2010-09-06

    To investigate the potential contribution of international medical students at Australian universities to the Australian medical workforce. A prospective survey in 2006-2007 of 619 international medical students in their final 2 years of undergraduate- and graduate-entry medical courses across eight Australian universities, followed by a 2009 survey of 88 international medical graduates of the University of Melbourne (most of whom were respondents of the earlier survey), assessing the correlation between students' intended place of internship and their actual place of internship. The survey respondents' preferred internship location; the proportion of respondents who intended to remain in practice in Australia long term; and correlation between respondents' intended internship locations and actual placements in their first postgraduate year. Of the 619 international medical students surveyed in 2006, 358 (58%) responded. Most planned to undertake Australian internships and seek permanent-resident status, although a third were undecided about their long-term plans. Nationality was a highly significant variable. Most preferred city rather than regional or rural training locations and expressed interest in migrating to Australia. The 2009 survey of the University of Melbourne's 2008 medical graduates showed a high correlation between students' plans in their last two years of study and outcomes in their first postgraduate year, with 73% accepting Victorian internships for 2009. International medical students studying at Australian universities represent a substantial and highly acceptable medical workforce resource for Australia. Their requirement for internships needs to be considered in, and should influence, infrastructure planning.

  8. Correlation of United States Medical Licensing Examination and Internal Medicine In-Training Examination performance.

    Science.gov (United States)

    Perez, Jose A; Greer, Sharon

    2009-12-01

    The Internal Medicine In-Training Examination (ITE) is administered during residency training in the United States as a self-assessment and program assessment tool. Performance on this exam correlates with outcome on the American Board of Internal Medicine Certifying examination. Internal Medicine Program Directors use the United States Medical Licensing Examination (USMLE) to make decisions in recruitment of potential applicants. This study was done to determine a correlation of USMLE Steps 1, 2 and 3 results with ITE scores in each level of Internal Medicine training. A retrospective review of all residents graduating from an Internal Medicine program from 1999 to 2006 was done. Subjects included had data for all USMLE Steps and ITE during all years of training. Thirty-one subjects were included in the study. Correlations of USMLE Steps 1, 2 and 3 were done with ITE scores (percent correct) in each year of training. Pearson's correlation coefficient (r) was determined for each pairing and a t test to determine statistical significance of the correlation was done. Statistical significance was defined as P value ITE percent correct in PGY I, II and III were 0.46, 0.55 and 0.51 respectively. Corresponding r values for USMLE Step 2 and ITE percent correct were 0.79, 0.70 and 0.72; for USMLE Step 3 these values were 0.51, 0.37 and 0.51 respectively for each training year. USMLE scores are correlated with ITE scores. This correlation was strongest for USMLE Step 2.

  9. Renewing the International Monetary Fund: A Review of the Issues

    OpenAIRE

    Danielle Lecavalier; Eric Santor

    2007-01-01

    Given the rapid and ongoing integration of the global economy, the International Monetary Fund needs to renew its role, governance structure, and functions if it is to maintain its relevance as the institution charged with promoting global financial stability. Lecavalier and Santor examine the areas of possible reform, including quota, voice, and representation; internal governance; surveillance; lending instruments; finances; and the Fund's role in low-income countries. They also review curr...

  10. 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.

  11. 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 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 genuinely informed patient consent.

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

    Science.gov (United States)

    Abbas, Mark R; Quince, Thelma A; Wood, Diana F; Benson, John A

    2011-11-14

    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. 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. 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. 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 the most effective and cost-effective curriculum innovations, this

  13. Medical Consequences of Marijuana Use: A Review of Current Literature

    OpenAIRE

    Gordon, Adam J.; Conley, James W.; Gordon, Joanne M.

    2013-01-01

    With the advent of legalization of marijuana for medicinal and recreational purposes, and the increase use of marijuana, healthcare providers will be increasingly confronted with marijuana users as patients in clinical environments. While there is vast literature regarding the societal and mental health harms associated with marijuana use, there is a paucity of reviews of the potential consequences of marijuana use on physical health or medical conditions. We examine the recent literature on ...

  14. The use of medication in selective mutism: a systematic review.

    Science.gov (United States)

    Manassis, Katharina; Oerbeck, Beate; Overgaard, Kristin Romvig

    2016-06-01

    Despite limited evidence, selective serotonin reuptake inhibitors (SSRIs) and monoamine oxidase inhibitors (MAOIs) are used to reduce symptoms of selective mutism (SM) in children unresponsive to psychosocial interventions. We review existing evidence for the efficacy of these medications, limitations of the literature, and resulting treatment considerations. Bibliographic searches were conducted in Medline, Embase, PsycInfo, Web of Science and Cochrane up to June 2015. Two reviewers independently sought studies of children with SM as primary psychiatric diagnosis, which reported response to medication treatment. Abstracts were limited to those reporting original data. Two reviewers independently assessed the ten papers reporting on >2 subjects regarding study design, key results, and limitations. Heterogeneity of designs mandated a descriptive summary. Symptomatic improvement was found for 66/79 children treated with SSRIs and 4/4 children treated with phenelzine. Only 3/10 studies had unmedicated comparison groups and only two were double-blinded. This review may be affected by publication bias, missed studies, and variability of outcome measures in included studies. Although there is some evidence for symptomatic improvement in SM with medication, especially SSRIs, it is limited by small numbers, lack of comparative trials, lack of consistent measures, and lack of consistent reporting on tolerability. The clinician must weigh this paucity of evidence against the highly debilitating nature of SM, and its adverse effects on the development of those children whose progress with psychosocial interventions is limited or very slow. Studies of optimal dosage and timing of medications in relation to psychosocial treatments are also needed.

  15. The Medical Birth Registry of Norway – An international perspective

    Directory of Open Access Journals (Sweden)

    Allen J. Wilcox

    2007-01-01

    Full Text Available Some of the most practical questions of perinatal medicine are regarding couples who have had pregnancy problems in the past, and their risk of having such problems in future pregnancies. For example, if a couple has a child with a birth defect, what are their chances that their next child will have a defect? The key to answering such questions is the availability of linked data such as those provided by the Medical Birth Registry of Norway. Such linked data provide a unique resource for addressing a broad range of questions in perinatal epidemiology. The Medical Birth Registry of Norway has been a pioneer in answering such questions.

  16. The Medical Birth Registry of Norway – An international perspective

    Directory of Open Access Journals (Sweden)

    Allen J. Wilcox

    2009-10-01

    Full Text Available Some of the most practical questions of perinatal medicine are regarding couples who have had pregnancy problems in the past, and their risk of having such problems in future pregnancies. For example, if a couple has a child with a birth defect, what are their chances that their next child will have a defect? The key to answering such questions is the availability of linked data such as those provided by the Medical Birth Registry of Norway. Such linked data provide a unique resource for addressing a broad range of questions in perinatal epidemiology. The Medical Birth Registry of Norway has been a pioneer in answering such questions

  17. Economic impact of medication error: a systematic review.

    Science.gov (United States)

    Walsh, Elaine K; Hansen, Christina Raae; Sahm, Laura J; Kearney, Patricia M; Doherty, Edel; Bradley, Colin P

    2017-05-01

    Medication error is a significant source of morbidity and mortality among patients. Clinical and cost-effectiveness evidence are required for the implementation of quality of care interventions. Reduction of error-related cost is a key potential benefit of interventions addressing medication error. The aim of this review was to describe and quantify the economic burden associated with medication error. PubMed, Cochrane, Embase, CINAHL, EconLit, ABI/INFORM, Business Source Complete were searched. Studies published 2004-2016 assessing the economic impact of medication error were included. Cost values were expressed in Euro 2015. A narrative synthesis was performed. A total of 4572 articles were identified from database searching, and 16 were included in the review. One study met all applicable quality criteria. Fifteen studies expressed economic impact in monetary terms. Mean cost per error per study ranged from €2.58 to €111 727.08. Healthcare costs were used to measure economic impact in 15 of the included studies with one study measuring litigation costs. Four studies included costs incurred in primary care with the remaining 12 measuring hospital costs. Five studies looked at general medication error in a general population with 11 studies reporting the economic impact of an individual type of medication error or error within a specific patient population. Considerable variability existed between studies in terms of financial cost, patients, settings and errors included. Many were of poor quality. Assessment of economic impact was conducted predominantly in the hospital setting with little assessment of primary care impact. Limited parameters were used to establish economic impact. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  18. A systematic review of the effect of different models of after-hours primary medical care services on clinical outcome, medical workload, and patient and GP satisfaction.

    Science.gov (United States)

    Leibowitz, Ruth; Day, Susan; Dunt, David

    2003-06-01

    The organization of after-hours primary medical care services is changing in many countries. Increasing demand, economic considerations and changes in doctors' attitudes are fueling these changes. Information for policy makers in this field is needed. However, a comprehensive review of the international literature that compares the effects of one model of after-hours care with another is lacking. The aim of this study was to carry out a systematic review of the international literature to determine what evidence exists about the effect of different models of out-of-hours primary medical care service on outcome. Original studies and systematic reviews written since 1976 on the subject of 'after-hours primary medical care services' were identified. Databases searched were Medline/Premedline, CINAHL, HealthSTAR, Current Contents, Cochrane Reviews, DARE, EBM Reviews and EconLit. For each paper where the optimal design would have been an interventional study, the 'level' of evidence was assessed as described in the National Health and Medical Research Council Handbook. 'Comparative' studies (levels I, II, III and IV pre-/post-test studies) were included in this review. Six main models of after-hours primary care services (not mutually exclusive) were identified: practice-based services, deputizing services, emergency departments, co-operatives, primary care centres, and telephone triage and advice services. Outcomes were divided into the following categories: clinical outcomes, medical workload, and patient and GP satisfaction. The results indicate that the introduction of a telephone triage and advice service for after-hours primary medical care may reduce the immediate medical workload. Deputizing services increase immediate medical workload because of the low use of telephone advice and the high home visiting rate. Co-operatives, which use telephone triage and primary care centres and have a low home visiting rate, reduce immediate medical workload. There is little

  19. 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.

  20. 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.

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

    Science.gov (United States)

    Walzer, Stefan; Droeschel, Daniel; Nuijten, Mark; Chevrou-Séverac, Hélène

    2014-01-01

    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. 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. Fifty-three papers were identified and obtained via PubMed, or directly via journal webpages for further assessment. Thirty-two papers were finally included in a thorough data extraction procedure, including those identified by a "gray literature search" utilizing the Google search engine and cross-reference searches. Results regarding content of the studies showed that malnutrition was the underlying clinical condition in most cases (32%). In addition, gastrointestinal disorders (eg

  2. Recommendations of the International Medical Informatics Association (IMIA) on Education in Biomedical and Health Informatics. First Revision

    NARCIS (Netherlands)

    Mantas, John; Ammenwerth, Elske; Demiris, George; Hasman, Arie; Haux, Reinhold; Hersh, William; Hovenga, Evelyn; Lun, K. C.; Marin, Heimar; Martin-Sanchez, Fernando; Wright, Graham

    2010-01-01

    Objective: The International Medical Informatics Association (IMIA) agreed on revising the existing international recommendations in health informatics/medical informatics education. These should help to establish courses, course tracks or even complete programs in this field, to further develop

  3. Guidelines for IAEA International Regulatory Review Teams (IRRTs)

    International Nuclear Information System (INIS)

    1993-04-01

    This document is intended to be used by International regulatory review teams in reviewing the activities of a regulatory body as applicable to the regulation of nuclear power plants. The mission will, however, take note of any other activities of the regulatory body when drawing up the review report. The document does not specifically deal with the functions of a regulatory body responsible for other types of nuclear facilities or related nuclear activities, but it is intended that the concepts presented in the document could be applied where appropriate. Refs

  4. Online Lectures in Undergraduate Medical Education: Scoping Review.

    Science.gov (United States)

    Tang, Brandon; Coret, Alon; Qureshi, Aatif; Barron, Henry; Ayala, Ana Patricia; Law, Marcus

    2018-04-10

    The adoption of the flipped classroom in undergraduate medical education calls on students to learn from various self-paced tools-including online lectures-before attending in-class sessions. Hence, the design of online lectures merits special attention, given that applying multimedia design principles has been shown to enhance learning outcomes. The aim of this study was to understand how online lectures have been integrated into medical school curricula, and whether published literature employs well-accepted principles of multimedia design. This scoping review followed the methodology outlined by Arksey and O'Malley (2005). Databases, including MEDLINE, PsycINFO, Education Source, FRANCIS, ERIC, and ProQuest, were searched to find articles from 2006 to 2016 related to online lecture use in undergraduate medical education. In total, 45 articles met our inclusion criteria. Online lectures were used in preclinical and clinical years, covering basic sciences, clinical medicine, and clinical skills. The use of multimedia design principles was seldom reported. Almost all studies described high student satisfaction and improvement on knowledge tests following online lecture use. Integration of online lectures into undergraduate medical education is well-received by students and appears to improve learning outcomes. Future studies should apply established multimedia design principles to the development of online lectures to maximize their educational potential. ©Brandon Tang, Alon Coret, Aatif Qureshi, Henry Barron, Ana Patricia Ayala, Marcus Law. Originally published in JMIR Medical Education (http://mededu.jmir.org), 10.04.2018.

  5. Teaching history taking to medical students: a systematic review.

    Science.gov (United States)

    Keifenheim, Katharina E; Teufel, Martin; Ip, Julianne; Speiser, Natalie; Leehr, Elisabeth J; Zipfel, Stephan; Herrmann-Werner, Anne

    2015-09-28

    This paper is an up-to-date systematic review on educational interventions addressing history taking. The authors noted that despite the plethora of specialized training programs designed to enhance students' interviewing skills there had not been a review of the literature to assess the quality of each published method of teaching history taking in undergraduate medical education based on the evidence of the program's efficacy. The databases PubMed, PsycINFO, Google Scholar, opengrey, opendoar and SSRN were searched using key words related to medical education and history taking. Articles that described an educational intervention to improve medical students' history-taking skills were selected and reviewed. Included studies had to evaluate learning progress. Study quality was assessed using the Medical Education Research Study Quality Instrument (MERSQI). Seventy-eight full-text articles were identified and reviewed; of these, 23 studies met the final inclusion criteria. Three studies applied an instructional approach using scripts, lectures, demonstrations and an online course. Seventeen studies applied a more experiential approach by implementing small group workshops including role-play, interviews with patients and feedback. Three studies applied a creative approach. Two of these studies made use of improvisational theatre and one introduced a simulation using Lego® building blocks. Twenty-two studies reported an improvement in students' history taking skills. Mean MERSQI score was 10.4 (range 6.5 to 14; SD = 2.65). These findings suggest that several different educational interventions are effective in teaching history taking skills to medical students. Small group workshops including role-play and interviews with real patients, followed by feedback and discussion, are widespread and best investigated. Feedback using videotape review was also reported as particularly instructive. Students in the early preclinical state might profit from approaches helping

  6. 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.

  7. 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.

  8. Radiation Oncology in Undergraduate Medical Education: A Literature Review

    International Nuclear Information System (INIS)

    Dennis, Kristopher E.B.; Duncan, Graeme

    2010-01-01

    Purpose: To review the published literature pertaining to radiation oncology in undergraduate medical education. Methods and Materials: Ovid MEDLINE, Ovid MEDLINE Daily Update and EMBASE databases were searched for the 11-year period of January 1, 1998, through the last week of March 2009. A medical librarian used an extensive list of indexed subject headings and text words. Results: The search returned 640 article references, but only seven contained significant information pertaining to teaching radiation oncology to medical undergraduates. One article described a comprehensive oncology curriculum including recommended radiation oncology teaching objectives and sample student evaluations, two described integrating radiation oncology teaching into a radiology rotation, two described multidisciplinary anatomy-based courses intended to reinforce principles of tumor biology and radiotherapy planning, one described an exercise designed to test clinical reasoning skills within radiation oncology cases, and one described a Web-based curriculum involving oncologic physics. Conclusions: To the authors' knowledge, this is the first review of the literature pertaining to teaching radiation oncology to medical undergraduates, and it demonstrates the paucity of published work in this area of medical education. Teaching radiation oncology should begin early in the undergraduate process, should be mandatory for all students, and should impart knowledge relevant to future general practitioners rather than detailed information relevant only to oncologists. Educators should make use of available model curricula and should integrate radiation oncology teaching into existing curricula or construct stand-alone oncology rotations where the principles of radiation oncology can be conveyed. Assessments of student knowledge and curriculum effectiveness are critical.

  9. Audit Oversight: Quality Control Review of the Defense Finance and Accounting Service Office of Internal Review

    National Research Council Canada - National Science Library

    2004-01-01

    .... The Government Auditing Standards (GAS) require that an audit organization performing Government audits have an appropriate internal quality control system and undergo an external quality control review every 3 years by an organization...

  10. Eligibility criteria in systematic reviews published in prominent medical journals: a methodological review.

    Science.gov (United States)

    McCrae, Niall; Purssell, Edward

    2015-12-01

    Clear and logical eligibility criteria are fundamental to the design and conduct of a systematic review. This methodological review examined the quality of reporting and application of eligibility criteria in systematic reviews published in three leading medical journals. All systematic reviews in the BMJ, JAMA and The Lancet in the years 2013 and 2014 were extracted. These were assessed using a refined version of a checklist previously designed by the authors. A total of 113 papers were eligible, of which 65 were in BMJ, 17 in The Lancet and 31 in JAMA. Although a generally high level of reporting was found, eligibility criteria were often problematic. In 67% of papers, eligibility was specified after the search sources or terms. Unjustified time restrictions were used in 21% of reviews, and unpublished or unspecified data in 27%. Inconsistency between journals was apparent in the requirements for systematic reviews. The quality of reviews in these leading medical journals was high; however, there were issues that reduce the clarity and replicability of the review process. As well as providing a useful checklist, this methodological review informs the continued development of standards for systematic reviews. © 2015 John Wiley & Sons, Ltd.

  11. Attitudes and preferences toward the provision of medication abortion in an urban academic internal medicine practice.

    Science.gov (United States)

    Page, Cameron; Stumbar, Sarah; Gold, Marji

    2012-06-01

    Mifepristone offers internal medicine doctors the opportunity to greatly expand access to abortion for their patients. Almost 70% of pregnancy terminations, however, still occur in specialized clinics. No studies have examined the preferences of Internal Medicine patients specifically. Determine whether patient preference is a reason for the limited uptake of medication abortion among internal medicine physicians. Women aged 18-45 recruited from the waiting room in an urban academic internal medicine clinic. A semi-structured questionnaire was used to determine risk of unintended pregnancy and attitudes toward abortion. Support for provision of medication abortion in the internal medicine clinic was assessed with a yes/no question, followed by the open-ended question, "Why do you think this clinic should or should not offer medication abortion?" Subjects were asked whether it was very important, somewhat important, or not important for the internal medicine clinic to provide medication abortion. Of 102 women who met inclusion criteria, 90 completed the survey, yielding a response rate of 88%. Twenty-two percent were at risk of unintended pregnancy. 46.7% had had at least one lifetime abortion. Among those who would consider having an abortion, 67.7% responded yes to the question, "Do you think this clinic should offer medication abortions?" and 83.9% stated that it was "very important" or "somewhat important" to offer this service. Of women open to having an abortion, 87.1% stated that they would be interested in receiving a medication abortion from their primary care doctor. A clinically significant proportion of women in this urban internal medicine clinic were at risk of unintended pregnancy. Among those open to having an abortion, a wide majority would consider receiving it from their internal medicine doctor. The provision of medication abortion by internal medicine physicians has the potential to greatly expand abortion access for women.

  12. Editorial policies and good practices in editing the journal 'International Medical Journal--Medicus'.

    Science.gov (United States)

    Pollozhani, Aziz

    2014-01-01

    Ten years ago the Association of Albanian Physicians in Macedonia undertook the very brave step of publishing a scientific medical journal, Medicus, as a platform for publishing biomedical research papers. Medical journal MEDICUS is an international peer-review journal of biomedical science. The first issue was published in 2004, starting with publishing two issues per year. From 2013, the journal delivered three issues per year, namely in January, May and September. Editor-in-Chief of the journal is Prof. Dr. Aziz Pollozhani. This year marks the tenth anniversary since publication of the first issue of Medicus, a fact that makes us proud and happy. The journal has its own official website (www.imjm.mk), where papers can be submitted and published in electronic form. In addition, the journal also comes out in print form to be distributed mainly in the region. Taking into account the specific socio-cultural characteristics of the region, the journal attempts to promote research activities in the region, while seeking to serve as an educational tool to promote scientific work in such a setting. As a result, Medicus accepts manuscripts for publication in English, Albanian and Macedonian, with a mandatory abstract in English for all papers. The journal Medicus represents a solid platform of biomedical sciences that will serve to advance scientific research and promote professional achievements in medicine.

  13. Herbal medications for surgical patients: a systematic review protocol.

    Science.gov (United States)

    Arruda, Ana Paula Nappi; Ayala, Ana Patricia; Lopes, Luciane C; Bergamaschi, Cristiane C; Guimarães, Caio; Grossi, Mariana Del; Righesso, Leonardo A R; Agarwal, Arnav; El Dib, Regina

    2017-07-26

    Postoperative nausea and vomiting (PONV) affect approximately 80% of surgical patients and is associated with increased length of hospital stay and systemic costs. Preoperative and postoperative pain, anxiety and depression are also commonly reported. Recent evidence regarding their safety and effectiveness has not been synthesised. The aim of this systematic review is to evaluate the efficacy and safety of herbal medications for the treatment and prevention of anxiety, depression, pain and PONV in patients undergoing laparoscopic, obstetrical/gynaecological and cardiovascular surgical procedures. The following electronic databases will be searched up to 1 October 2016 without language or publication status restrictions: CENTRAL, MEDLINE, EMBASE, CINAHL, Web of Science and LILACS. Randomised clinical trials enrolling adult surgical patients undergoing laparoscopic, obstetrical/gynaecological and cardiovascular surgeries and managed with herbal medication versus a control group (placebo, no intervention or active control) prophylactically or therapeutically will be considered eligible. Outcomes of interest will include the following: anxiety, depression, pain, nausea and vomiting. A team of reviewers will complete title and abstract screening and full-text screening for identified hits independently and in duplicate. Data extraction, risk of bias assessments and evaluation of the overall quality of evidence for each relevant outcome reported will be conducted independently and in duplicate using the Grading of Recommendations Assessment Development and Evaluation classification system. Dichotomous data will be summarised as risk ratios; continuous data will be summarised as standard average differences with 95% CIs. This is one of the first efforts to systematically summarise existing evidence evaluating the use of herbal medications in laparoscopic, obstetrical/gynaecological and cardiovascular surgical patients. The findings of this review will be disseminated

  14. 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

    2017-01-01

    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…

  15. 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…

  16. The educational yield of the international summer school "Oncology for medical students"

    NARCIS (Netherlands)

    de Vries, Jakob; Szabo, BG; Sleijfer, DT

    2002-01-01

    Background. The international summer school "Oncology for Medical Students" (ISOMS) is a two-week summer program for medical students aiming to increase knowledge of cancer care in general health practice, to reduce fear related to contacts with patients with malignant disease, and to expose them to

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

    Directory of Open Access Journals (Sweden)

    Noordin Othman

    2009-07-01

    Full Text Available 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

  18. Brazilian oral herbal medication for osteoarthritis: a systematic review protocol.

    Science.gov (United States)

    Moura, Mariana Del Grossi; Lopes, Luciane Cruz; Biavatti, Maique Weber; Busse, Jason W; Wang, Li; Kennedy, Sean Alexander; Bhatnaga, Neera; Bergamaschi, Cristiane de Cássia

    2016-05-21

    Osteoarthritis affects 1 % of the world's population and is the most common cause of musculoskeletal impairment in the elderly. Herbal medications are commonly used in Brazil to manage symptoms associated with osteoarthritis, and some of them are financed by the Brazilian government; however, the effectiveness of most of these agents is uncertain. The aim was to systematically review the efficacy and safety of 13 oral herbal medications used in Brazil for the treatment of osteoarthritis. Randomized clinical trials eligible for our systematic review will enroll adults with osteoarthritis treated by a Brazilian herbal medication or a control group (placebo or active control). Using terms to include all forms of osteoarthritis combined with herbal medications, we will search the following electronic databases: Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE; EMBASE; CINAHL; Web of Science; Health Star; AMED, the database of the Cochrane Complementary Medicine Field, LILACS; CAB abstracts, Clinical trial.gov, WHO trials registry, and Bank of Brazil Thesis (CAPES), to 31 January 2016, without restrictions concerning language or status of publication. Outcomes of interest include the following: symptom relief (e.g., pain), adverse events (gastrointestinal bleeding, epigastric pain, nausea, and allergic reactions), discontinuation due to adverse events, quality of life, and the satisfaction with the treatment. Dichotomous data will be summarized as risk ratios; continuous data will be given as standard average differences with 95 % confidence intervals. A team of reviewers will assess each citation independently for eligibility and in duplicate it. For eligible studies, the same reviewers will perform data extraction, bias risk assessment, and determination of the overall quality of evidence for each of the outcomes using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) classification system. This is the first study that will

  19. Coping, perceived stress, and job satisfaction among medical interns: The mediating effect of mindfulness

    Directory of Open Access Journals (Sweden)

    M Vinothkumar

    2016-01-01

    Full Text Available Background: Past research studies on the exploration of attributes to the stress of doctors/medical interns were reported more often than the types of coping strategies, healthy practices to strengthen their internal resources to deal effectively with the stressful situations. Objectives: The present study was conducted to find such internal resource – “mindfulness” as a mediator of coping, perceived stress, and job satisfaction among medical interns. Methods: A cross-sectional descriptive study comprised 120 medical interns forms from various medical colleges in Mangalore were recruited and completed the assessment on mindfulness, cognitive-emotive regulation, coping strategies, perceived stress, and job satisfaction from doctoral interns were collected. Results: Initial correlation analysis results indicate that adaptive coping strategies significantly associate with greater mindfulness and less perceived stress. In turn, mindfulness is negatively correlated with nonadaptive coping strategies and perceived. Job satisfaction showed no significant relationship with any of the other variables. Mediational models indicate that the relationship between adaptive coping strategies and perceived stress was significantly mediated by mindfulness. Furthermore, partial mediation between nonadaptive strategies and perceived stress through mindfulness indicates that respondents reported a high level of nonadaptive strategy experience and a lower level of mindfulness can be counterproductive as they encourage the ineffective way to deal with the stresses. Conclusion: The implication of the results were discussed with suggesting a possible intervention to improve the adaptive strategies and mindfulness among the medical interns.

  20. Coping, perceived stress, and job satisfaction among medical interns: The mediating effect of mindfulness.

    Science.gov (United States)

    Vinothkumar, M; Arathi, A; Joseph, Merin; Nayana, Prasad; Jishma, E Joshy; Sahana, U

    2016-01-01

    Past research studies on the exploration of attributes to the stress of doctors/medical interns were reported more often than the types of coping strategies, healthy practices to strengthen their internal resources to deal effectively with the stressful situations. The present study was conducted to find such internal resource - "mindfulness" as a mediator of coping, perceived stress, and job satisfaction among medical interns. A cross-sectional descriptive study comprised 120 medical interns forms from various medical colleges in Mangalore were recruited and completed the assessment on mindfulness, cognitive-emotive regulation, coping strategies, perceived stress, and job satisfaction from doctoral interns were collected. Initial correlation analysis results indicate that adaptive coping strategies significantly associate with greater mindfulness and less perceived stress. In turn, mindfulness is negatively correlated with nonadaptive coping strategies and perceived. Job satisfaction showed no significant relationship with any of the other variables. Mediational models indicate that the relationship between adaptive coping strategies and perceived stress was significantly mediated by mindfulness. Furthermore, partial mediation between nonadaptive strategies and perceived stress through mindfulness indicates that respondents reported a high level of nonadaptive strategy experience and a lower level of mindfulness can be counterproductive as they encourage the ineffective way to deal with the stresses. The implication of the results were discussed with suggesting a possible intervention to improve the adaptive strategies and mindfulness among the medical interns.

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

    Directory of Open Access Journals (Sweden)

    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.

  2. 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.

  3. The Effect of Plan Type and Comprehensive Medication Reviews on High-Risk Medication Use.

    Science.gov (United States)

    Almodovar, Armando Silva; Axon, David Rhys; Coleman, Ashley M; Warholak, Terri; Nahata, Milap C

    2018-05-01

    In 2007, the Centers for Medicare & Medicaid Services (CMS) instituted a star rating system using performance outcome measures to assess Medicare Advantage Prescription Drug (MAPD) and Prescription Drug Plan (PDP) providers. To assess the relationship between 2 performance outcome measures for Medicare insurance providers, comprehensive medication reviews (CMRs), and high-risk medication use. This cross-sectional study included Medicare Part C and Part D performance data from the 2014 and 2015 calendar years. Performance data were downloaded per Medicare contract from the CMS. We matched Medicare insurance provider performance data with the enrollment data of each contract. Mann Whitney U and Spearman rho tests and a hierarchical linear regression model assessed the relationship between provider characteristics, high-risk medication use, and CMR completion rate outcome measures. In 2014, an inverse correlation between CMR completion rate and high-risk medication use was identified among MAPD plan providers. This relationship was further strengthened in 2015. No correlation was detected between the CMR completion rate and high-risk medication use among PDP plan providers in either year. A multivariate regression found an inverse association with high-risk medication use among MAPD plan providers in comparison with PDP plan providers in 2014 (beta = -0.358, P plan providers and higher CMR completion rates were associated with lower use of high-risk medications among beneficiaries. No outside funding supported this study. Silva Almodovar reports a fellowship funded by SinfoniaRx, Tucson, Arizona, during the time of this study. The other authors have nothing to disclose.

  4. 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.

  5. 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…

  6. 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

  7. Leadership Training in Graduate Medical Education: A Systematic Review.

    Science.gov (United States)

    Sadowski, Brett; Cantrell, Sarah; Barelski, Adam; O'Malley, Patrick G; Hartzell, Joshua D

    2018-04-01

    Leadership is a critical component of physician competence, yet the best approaches for developing leadership skills for physicians in training remain undefined. We systematically reviewed the literature on existing leadership curricula in graduate medical education (GME) to inform leadership program development. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, we searched MEDLINE, ERIC, EMBASE, and MedEdPORTAL through October 2015 using search terms to capture GME leadership curricula. Abstracts were reviewed for relevance, and included studies were retrieved for full-text analysis. Article quality was assessed using the Best Evidence in Medical Education (BEME) index. A total of 3413 articles met the search criteria, and 52 were included in the analysis. Article quality was low, with 21% (11 of 52) having a BEME score of 4 or 5. Primary care specialties were the most represented (58%, 30 of 52). The majority of programs were open to all residents (81%, 42 of 52). Projects and use of mentors or coaches were components of 46% and 48% of curricula, respectively. Only 40% (21 of 52) were longitudinal throughout training. The most frequent pedagogic methods were lectures, small group activities, and cases. Common topics included teamwork, leadership models, and change management. Evaluation focused on learner satisfaction and self-assessed knowledge. Longitudinal programs were more likely to be successful. GME leadership curricula are heterogeneous and limited in effectiveness. Small group teaching, project-based learning, mentoring, and coaching were more frequently used in higher-quality studies.

  8. Review of 40-year MD theses in Medical Oncology

    International Nuclear Information System (INIS)

    Zeeneldin, A.; Diyaa, A.; Elgammal, M.; Buhoush, W.; Manar Moneer, M.

    2014-01-01

    Background and objective: It is almost 40 years since the foundation of the Medical Oncology (MO) Department. We aimed to appraise the clinical research to fulfill the Medical Doctorate (MD) degree in MO at the National Cancer Institute, Cairo University (NCI, CU). Methods: This review included 62 MD theses containing 66 studies. They were reviewed regarding aims, type of study, clinical trial phase, design and methodology, statistical tests, results, limitations, consent and IRB approval. Theses were grouped into 3 periods: 1970-1989, 1990-1999 and 2000- 2008. Results: Almost 76% of the studies were interventional and 24% were observational. Informed consent and Institutional Review Board approval were mentioned in 18 and 2 studies, respectively. While all studies mentioned the aims, none, clearly mentioned the research question. Outcomes were mainly efficacy followed by safety. Study design was inadequately considered, especially in 70’s–80’s period (p = 0.038). Median sample size and study duration were almost stable through the three periods (p = 0.441, 0.354, respectively). Most of the studies used both descriptive and analytical statistical methods. In a descending order, researched cancers were lymphoma, breast, leukemia, liver, urinary bladder, lung and colorectal. The commonest stages researched were IV and III. The number of studies focused on assessing biomarkers, biomarkers plus drugs/procedures, drugs and procedures are 20, 20, 16 and 6, respectively. Conclusion: With time, research within MD theses in MO increased quantitatively and qualitatively. Improvements were noticeable in documentation of study design.

  9. Reducing hospital noise: a review of medical device alarm management.

    Science.gov (United States)

    Konkani, Avinash; Oakley, Barbara; Bauld, Thomas J

    2012-01-01

    Increasing noise in hospital environments, especially in intensive care units (ICUs) and operating rooms (ORs), has created a formidable challenge for both patients and hospital staff. A major contributing factor for the increasing noise levels in these environments is the number of false alarms generated by medical devices. This study focuses on discovering best practices for reducing the number of false clinical alarms in order to increase patient safety and provide a quiet environment for both work and healing. The researchers reviewed Pub Med, Web of Knowledge and Google Scholar sources to obtain original journal research and review articles published through January 2012. This review includes 27 critically important journal articles that address different aspects of medical device alarms management, including the audibility, identification, urgency mapping, and response time of nursing staff and different solutions to such problems. With current technology, the easiest and most direct method for reducing false alarms is to individualize alarm settings for each patient's condition. Promoting an institutional culture change that emphasizes the importance of individualization of alarms is therefore an important goal. Future research should also focus on the development of smart alarms.

  10. "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.

  11. "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.

  12. 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.

  13. Systematic Review of International Colposcopy Quality Improvement Guidelines.

    Science.gov (United States)

    Mayeaux, Edward J; Novetsky, Akiva P; Chelmow, David; Choma, Kim; Garcia, Francisco; Liu, Angela H; Papasozomenos, Theognosia; Einstein, Mark H

    2017-10-01

    The American Society for Colposcopy and Cervical Pathology Colposcopy Standards Committee organized multiple working groups to draft colposcopy standards for the United States. As part of this project, international quality assurance and improvement measures were examined. The quality improvement working group performed a systematic review of the literature to collate international guidelines related to quality improvement. Source guidelines were collected using searches in Medline, Google Scholar, the International Federation of Cervical Pathology and Colposcopy Web site, other regional colposcopy group's Web sites, and communications with International Federation of Cervical Pathology and Colposcopy board of directors' members and other expert members of various national groups. Once identified, the sources were reviewed by multiple workgroup members for potential guideline materials. Fifty-six unique documents were identified, of which 18 met inclusion criteria and contributed data to the analysis. Information was abstracted and grouped by related subject. Wide variation exists in colposcopy guidance and quality indicators from regional and national colposcopy societies. Abstracted international guidelines are presented.

  14. 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.

  15. 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

  16. Supporting international medical graduates' transition to their host-country: realist synthesis.

    Science.gov (United States)

    Kehoe, Amelia; McLachlan, John; Metcalf, Jane; Forrest, Simon; Carter, Madeline; Illing, Jan

    2016-10-01

    Many health services and systems rely on the contribution of international medical graduates (IMGs) to the workforce. However, concern has grown around their regulation and professional practice. There is a need, in the absence of strong evidence and a robust theoretical base, for a deeper understanding of the efficacy of interventions used to support IMGs' transition to their host countries. This study seeks to explore and synthesise evidence relating to interventions developed for IMGs. It aims to provide educators and policy makers with an understanding of how interventions should be developed to support IMGs in their transition to the workplace, particularly looking to identify how and why they are effective. The realist synthesis involved an initial systematic search of the literature for the period January 1990 to April 2015. Secondary searches were conducted throughout the review in order to inform and test the developing programme theory. The context, mechanism and outcome data were extracted from all sources meeting the inclusion criteria. Fourteen case studies were included to further aid theory refinement. Sixty-two articles were identified, describing diverse interventions of varying intensity. A further 26 articles were identified through a secondary search. The findings illustrate that, alongside a developed programme, ongoing support and cultural awareness at organisational and training levels are crucial. Individual differences must also be taken into consideration. This will ensure that IMGs engage in transformative learning, increase their levels of self-efficacy and cultural health capital, and reduce feelings of stress and anxiety. These factors will have an impact on work, interactions and cultural adjustment. Organisational, training and individual contexts all play a role in IMGs' adjustment during the transition process. Establishing ongoing support is critical. A list of recommendations for implementation is given. © 2016 The Authors

  17. Review of research in internal-wave and internal-tide deposits of China: Discussion

    Directory of Open Access Journals (Sweden)

    G. Shanmugam

    2014-10-01

    Full Text Available This discussion of a review article by [27], published in the Journal of Palaeogeography (2(1: 56– 65, is aimed at illustrating that interpretations of ten ancient examples in China and one in the central Appalachians (USA as deep-water deposits of internal waves and internal tides are unsustainable. This critical assessment is based on an in-depth evaluation of oceanographic and sedimentologic data on internal waves and internal tides derived from 332 print and online published works during 1838–January 2013, which include empirical data on the physical characteristics of modern internal waves and internal tides from 51 regions of the world’s oceans [108]. In addition, core and outcrop descriptions of deep-water strata from 35 case studies worldwide carried out by the author during 1974–2011, and a selected number of case studies published by other researchers are evaluated for identifying the sedimentological challenges associated with distinguishing types of bottom-current reworked sands in the ancient sedimentary record. The emerging conclusion is that any interpretation of ancient strata as deposits of internal waves and internal tides is premature.

  18. [Medication reconciliation: an innovative experience in an internal medicine unit to decrease errors due to inacurrate medication histories].

    Science.gov (United States)

    Pérennes, Maud; Carde, Axel; Nicolas, Xavier; Dolz, Manuel; Bihannic, René; Grimont, Pauline; Chapot, Thierry; Granier, Hervé

    2012-03-01

    An inaccurate medication history may prevent the discovery of a pre-admission iatrogenic event or lead to interrupted drug therapy during hospitalization. Medication reconciliation is a process that ensures the transfer of medication information at admission to the hospital. The aims of this prospective study were to evaluate the interest in clinical practice of this concept and the resources needed for its implementation. We chose to include patients aged 65 years or over admitted in the internal medicine unit between June and October 2010. We obtained an accurate list of each patient's home medications. This list was then compared with medication orders. All medication variances were classified as intended or unintended. An internist and a pharmacist classified the clinical importance of each unintended variance. Sixty-one patients (mean age: 78 ± 7.4 years) were included in our study. We identified 38 unintended discrepancies. The average number of unintended discrepancies was 0.62 per patient. Twenty-five patients (41%) had one or more unintended discrepancies at admission. The contact with the community pharmacist permitted us to identify 21 (55%) unintended discrepancies. The most common errors were the omission of a regularly used medication (76%) and an incorrect dosage (16%). Our intervention resulted in order changes by the physician for 30 (79%) unintended discrepancies. Fifty percent of the unintended variances were judged by the internist and 76% by the pharmacist to be clinically significant. The admission to the hospital is a critical transition point for the continuity of care in medication management. Medication reconciliation can identify and resolve errors due to inaccurate medication histories. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  19. Medical Management of Oral Lichen Planus: A Systematic Review

    Science.gov (United States)

    Chokshi, Krunal; Desai, Sachin; Malu, Rahul; Chokshi, Achala

    2016-01-01

    Introduction Oral Lichen Planus (OLP) is a chronic inflammatory, T-cell-mediated autoimmune oral mucosal disease with unclear aetiology. The clinical management of OLP poses considerable difficulties to the oral physician. Aim The aim was to assess the efficacy of any form of intervention used to medically manage OLP. Materials and Methods We searched and analysed the following databases (from January 1990 to December 2014):- Cochrane Oral Health Group Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE. All Randomised Controlled Trials (RCTs) for the medical management of OLP which compared active treatment with placebo or between active treatments were considered in this systematic review. Participants of any age, gender or race having symptomatic OLP (including mixed forms), unconnected to any identifiable cause (e.g. lichenoid drug reactions) and confirmed by histopathology have been included. Interventions of all types, including topical treatments or systemic drugs of variable dosage, duration & frequency of delivery have been considered. All the trials identified were appraised by five review authors and the data for all the trials were synthesised using specifically designed data extraction form. Binary data has been presented as risk ratios (RR) with 95% confidence intervals (CI) and continuous data as mean differences (MD) with 95% CIs. Results A total of 35 RCTs were included in this systematic review on medical management of OLP. No strong evidence suggesting superiority of any specific intervention in reducing pain and clinical signs of OLP were shown by the RCTs included here. Conclusion Future RCTs on a larger scale, adopting standardized outcome assessing parameters should be considered. PMID:27042598

  20. 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

  1. Study of the Status of Physicians-Patient Communication among Medical Interns

    Directory of Open Access Journals (Sweden)

    Sa’eedeh Farajzadeh

    2009-02-01

    Full Text Available Background and purpose: Proper communication between a physician and a patient is the key to diagnosis and management of diseases.Communication skills are essential for gathering information from patients, enhancing patients trust on physicians, relaxing them and managing them .The main purpose of this study was to determine the states of communication skills of medical interns to communicate with patients.Method: In this cross sectional study, communication skills of 72 medical interns of Kerman Medical University was assessed based on a checklist completed with direct observation and a questionnaire completed through interview with patients.The checklist included two parts: the first part for individual characteristics and the second part for 24 specifications related to initiation of an interview, conducting an interview and completion of aninterview.Another questionnaire with a similar structure was developed to gather patients’ comments about communication of medical interns with them.Results: Communication skills of medical interns were weak in 29.3%, moderate in 85.4% and good in 15.9% of interns. An agreement between observed communication skills and patients’ survey results about greeting, asking patients’ names and calling them by their names, acceptable physicians’ appearance, listening to patients’ words, friendly doctor- patient encounter, empathizing with patients (0.37, 0.26, 0.22.0.41and 0.44 respectively was seen. Results of individual variables show that relationship between age of patient and his or her opinion about communication was significant.Based on patient’s survey, the communication score given to the student increases with age of the patient.Conclusion: The study shows deficits in doctor-patient communication of medical interns in history taking. Given the importance of communication skills, the necessity to teach them in clinical skill centers before real contact with patients is obvious

  2. Medical physics in Europe following recommendations of the International Atomic Energy Agency

    International Nuclear Information System (INIS)

    Casar, Bozidar; Lopes, Maria do Carmo; Drljević, Advan; Gershkevitsh, Eduard; Pesznyak, Csilla

    2016-01-01

    Medical physics is a health profession where principles of applied physics are mostly directed towards the application of ionizing radiation in medicine. The key role of the medical physics expert in safe and effective use of ionizing radiation in medicine was widely recognized in recent European reference documents like the European Union Council Directive 2013/59/EURATOM (2014), and European Commission Radiation Protection No. 174, European Guidelines on Medical Physics Expert (2014). Also the International Atomic Energy Agency (IAEA) has been outspoken in supporting and fostering the status of medical physics in radiation medicine through multiple initiatives as technical and cooperation projects and important documents like IAEA Human Health Series No. 25, Roles and Responsibilities, and Education and Training Requirements for Clinically Qualified Medical Physicists (2013) and the International Basic Safety Standards, General Safety Requirements Part 3 (2014). The significance of these documents and the recognition of the present insufficient fulfilment of the requirements and recommendations in many European countries have led the IAEA to organize in 2015 the Regional Meeting on Medical Physics in Europe, where major issues in medical physics in Europe were discussed. Most important outcomes of the meeting were the recommendations addressed to European member states and the survey on medical physics status in Europe conducted by the IAEA and European Federation of Organizations for Medical Physics. Published recommendations of IAEA Regional Meeting on Medical Physics in Europe shall be followed and enforced in all European states. Appropriate qualification framework including education, clinical specialization, certification and registration of medical physicists shall be established and international recommendation regarding staffing levels in the field of medical physics shall be fulfilled in particular. European states have clear legal and moral

  3. Medical physics in Europe following recommendations of the International Atomic Energy Agency.

    Science.gov (United States)

    Casar, Bozidar; Lopes, Maria do Carmo; Drljević, Advan; Gershkevitsh, Eduard; Pesznyak, Csilla

    2016-03-01

    Medical physics is a health profession where principles of applied physics are mostly directed towards the application of ionizing radiation in medicine. The key role of the medical physics expert in safe and effective use of ionizing radiation in medicine was widely recognized in recent European reference documents like the European Union Council Directive 2013/59/EURATOM (2014), and European Commission Radiation Protection No. 174, European Guidelines on Medical Physics Expert (2014). Also the International Atomic Energy Agency (IAEA) has been outspoken in supporting and fostering the status of medical physics in radiation medicine through multiple initiatives as technical and cooperation projects and important documents like IAEA Human Health Series No. 25, Roles and Responsibilities, and Education and Training Requirements for Clinically Qualified Medical Physicists (2013) and the International Basic Safety Standards, General Safety Requirements Part 3 (2014). The significance of these documents and the recognition of the present insufficient fulfilment of the requirements and recommendations in many European countries have led the IAEA to organize in 2015 the Regional Meeting on Medical Physics in Europe, where major issues in medical physics in Europe were discussed. Most important outcomes of the meeting were the recommendations addressed to European member states and the survey on medical physics status in Europe conducted by the IAEA and European Federation of Organizations for Medical Physics. Published recommendations of IAEA Regional Meeting on Medical Physics in Europe shall be followed and enforced in all European states. Appropriate qualification framework including education, clinical specialization, certification and registration of medical physicists shall be established and international recommendation regarding staffing levels in the field of medical physics shall be fulfilled in particular. European states have clear legal and moral

  4. Medical physics in Europe following recommendations of the International Atomic Energy Agency

    Science.gov (United States)

    Lopes, Maria do Carmo; Drljević, Advan; Gershkevitsh, Eduard; Pesznyak, Csilla

    2016-01-01

    Background Medical physics is a health profession where principles of applied physics are mostly directed towards the application of ionizing radiation in medicine. The key role of the medical physics expert in safe and effective use of ionizing radiation in medicine was widely recognized in recent European reference documents like the European Union Council Directive 2013/59/EURATOM (2014), and European Commission Radiation Protection No. 174, European Guidelines on Medical Physics Expert (2014). Also the International Atomic Energy Agency (IAEA) has been outspoken in supporting and fostering the status of medical physics in radiation medicine through multiple initiatives as technical and cooperation projects and important documents like IAEA Human Health Series No. 25, Roles and Responsibilities, and Education and Training Requirements for Clinically Qualified Medical Physicists (2013) and the International Basic Safety Standards, General Safety Requirements Part 3 (2014). The significance of these documents and the recognition of the present insufficient fulfilment of the requirements and recommendations in many European countries have led the IAEA to organize in 2015 the Regional Meeting on Medical Physics in Europe, where major issues in medical physics in Europe were discussed. Most important outcomes of the meeting were the recommendations addressed to European member states and the survey on medical physics status in Europe conducted by the IAEA and European Federation of Organizations for Medical Physics. Conclusions Published recommendations of IAEA Regional Meeting on Medical Physics in Europe shall be followed and enforced in all European states. Appropriate qualification framework including education, clinical specialization, certification and registration of medical physicists shall be established and international recommendation regarding staffing levels in the field of medical physics shall be fulfilled in particular. European states have clear

  5. Educational Activity: A Preliminary Review and Some International Experiences

    Directory of Open Access Journals (Sweden)

    Salem Ali Al Qahtani

    2017-11-01

    Full Text Available This paper reviews the history of the educational activity which was entered through John Dewey’s Experimental School, founded in 1896, the first school to use the activity curriculum. It sheds the light on the stages that activity has gone through till today. The Islamic view and a number of quotes from a number of Islamic thinkers and educators also were reviewed. The importance of the activity, its basics, functions, types and classifications were also discussed. The research concluded with a number of international experiences which gave great importance to the activity in their curricula and educational plans. The most important recommendations are: 1 Offering advanced training programs for teachers on educational activity; 2 Adding educational activity as an independent material in educational colleges; 3 Expanding the scope of study for international experiences in educational activity; and 4 Making use of technology and employing it in the educational activity.

  6. Russian MINATOM nuclear safety research strategic plan. An international review

    International Nuclear Information System (INIS)

    1999-03-01

    The 'Safety Research Strategic Plan for Russian Nuclear Power Plants' was published in draft form at the Russian International Nuclear Safety Centre (RINSC) by a working group of fifteen senior Russian experts. The Plan consists of 12 chapters, each addressing a specific technical area and containing a number of proposed research programmes and projects to advance the state-of-knowledge in that area. In part because a strong Recommendation to undertake such a Plan was made by the 1998 OECD/NEA study, the OECD Nuclear Energy Agency was asked by the Director of RINSC and the Director of USINSC to organize an international review of the Plan when the English-language version became available in October, 1998. This report represents the results of that review. (R.P.)

  7. Russian Minatom nuclear safety research strategic plan. An international review

    International Nuclear Information System (INIS)

    Royen, J.

    1999-01-01

    An NEA study on safety research needs of Russian-designed reactors, carried out in 1996, strongly recommended that a strategic plan for safety research be developed with respect to Russian nuclear power plants. Such a plan was developed at the Russian International Nuclear Safety Centre (RINSC) of the Russian Ministry of Atomic Energy (Minatom). The Strategic Plan is designed to address high-priority safety-research needs, through a combination of domestic research, the application of appropriate foreign knowledge, and collaboration. It represents major progress toward developing a comprehensive and coherent safety-research programme for Russian nuclear power plants (NPPs). The NEA undertook its review of the Strategic Plan with the objective of providing independent verification on the scope, priority, and content of the research described in the Plan based upon the experience of the international group of experts. The principal conclusions of the review and the general comments of the NEA group are presented. (K.A.)

  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. An international basic science and clinical research summer program for medical students.

    Science.gov (United States)

    Ramjiawan, Bram; Pierce, Grant N; Anindo, Mohammad Iffat Kabir; Alkukhun, Abedalrazaq; Alshammari, Abdullah; Chamsi, Ahmad Talal; Abousaleh, Mohannad; Alkhani, Anas; Ganguly, Pallab K

    2012-03-01

    An important part of training the next generation of physicians is ensuring that they are exposed to the integral role that research plays in improving medical treatment. However, medical students often do not have sufficient time to be trained to carry out any projects in biomedical and clinical research. Many medical students also fail to understand and grasp translational research as an important concept today. In addition, since medical training is often an international affair whereby a medical student/resident/fellow will likely train in many different countries during his/her early training years, it is important to provide a learning environment whereby a young medical student experiences the unique challenges and value of an international educational experience. This article describes a program that bridges the gap between the basic and clinical research concepts in a unique international educational experience. After completing two semester curricula at Alfaisal University in Riyadh, Kingdom of Saudi Arabia, six medical students undertook a summer program at St. Boniface Hospital Research Centre, in Winnipeg, MB, Canada. The program lasted for 2 mo and addressed advanced training in basic science research topics in medicine such as cell isolation, functional assessment, and molecular techniques of analysis and manipulation as well as sessions on the conduct of clinical research trials, ethics, and intellectual property management. Programs such as these are essential to provide a base from which medical students can decide if research is an attractive career choice for them during their clinical practice in subsequent years. An innovative international summer research course for medical students is necessary to cater to the needs of the medical students in the 21st century.

  10. Review of The Conduct of Inquiry in International Relations

    OpenAIRE

    McArthur, Daniel

    2011-01-01

    Book reviews in this journal usually proceed by considering the value of the book in question for Dewey scholarship. In this case I would rather say that this book is of interest to Dewey Scholars. Jackson's general project is heavily informed by Dewey's pluralistic brand of pragmatism. As Jackson notes “Dewey's Logic... stand[s] firmly in the tradition leading to this book” (216). Dewey scholars will greet Jackson's extension of this approach to the study of international relations warmly.

  11. Time required for institutional review board review at one Veterans Affairs medical center.

    Science.gov (United States)

    Hall, Daniel E; Hanusa, Barbara H; Stone, Roslyn A; Ling, Bruce S; Arnold, Robert M

    2015-02-01

    Despite growing concern that institutional review boards (IRBs) impose burdensome delays on research, little is known about the time required for IRB review across different types of research. To measure the overall and incremental process times for IRB review as a process of quality improvement. After developing a detailed process flowchart of the IRB review process, 2 analysts abstracted temporal data from the records pertaining to all 103 protocols newly submitted to the IRB at a large urban Veterans Affairs medical center from June 1, 2009, through May 31, 2011. Disagreements were reviewed with the principal investigator to reach consensus. We then compared the review times across review types using analysis of variance and post hoc Scheffé tests after achieving normally distributed data through logarithmic transformation. Calendar days from initial submission to final approval of research protocols. Initial IRB review took 2 to 4 months, with expedited and exempt reviews requiring less time (median [range], 85 [23-631] and 82 [16-437] days, respectively) than full board reviews (median [range], 131 [64-296] days; P = .008). The median time required for credentialing of investigators was 1 day (range, 0-74 days), and review by the research and development committee took a median of 15 days (range, 0-184 days). There were no significant differences in credentialing or research and development times across review types (exempt, expedited, or full board). Of the extreme delays in IRB review, 80.0% were due to investigators' slow responses to requested changes. There were no systematic delays attributable to the information security officer, privacy officer, or IRB chair. Measuring and analyzing review times is a critical first step in establishing a culture and process of continuous quality improvement among IRBs that govern research programs. The review times observed at this IRB are substantially longer than the 60-day target recommended by expert panels

  12. International symposium on standards and codes of practice in medical radiation dosimetry. Book of extended synopses

    International Nuclear Information System (INIS)

    2002-01-01

    The development of radiation measurement standards by National Metrology Institutes (NMIs) and their dissemination to Secondary Standard Dosimetry Laboratories (SSDLs), cancer therapy centres and hospitals represent essential aspects of the radiation dosimetry measurement chain. Although the demands for accuracy in radiotherapy initiated the establishment of such measurement chains, similar traceable dosimetry procedures have been implemented, or are being developed, in other areas of radiation medicine (e.g. diagnostic radiology and nuclear medicine), in radiation protection and in industrial applications of radiation. In the past few years the development of primary standards of absorbed dose to water in 60 Co for radiotherapy dosimetry has made direct calibrations in terms of absorbed dose to water available in many countries for the first time. Some laboratories have extended the development of these standards to high energy photon and electron beams and to low and medium energy x-ray beams. Other countries, however, still base their dosimetry for radiotherapy on air kerma standards. Dosimetry for conventional external beam radiotherapy was probably the field where standardized procedures adopted by medical physicists at hospitals were developed first. Those were related to exposure and air kerma standards. The recent development of Codes of Practice (or protocols) based on the concept of absorbed dose to water has led to changes in calibration procedures at hospitals. The International Code of Practice for Dosimetry Based on Standards of Absorbed Dose to Water (TRS 398) was sponsored by the International Atomic Energy Agency (IAEA), World Health Organization (WHO), Pan-American Health Organization (PAHO) and the European Society for Therapeutic Radiology and Oncology (ESTRO) and is expected to be adopted in many countries worldwide. It provides recommendations for the dosimetry of all types of beams (except neutrons) used in external radiotherapy and satisfies

  13. International symposium on standards and codes of practice in medical radiation dosimetry. Book of extended synopses

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2002-07-01

    The development of radiation measurement standards by National Metrology Institutes (NMIs) and their dissemination to Secondary Standard Dosimetry Laboratories (SSDLs), cancer therapy centres and hospitals represent essential aspects of the radiation dosimetry measurement chain. Although the demands for accuracy in radiotherapy initiated the establishment of such measurement chains, similar traceable dosimetry procedures have been implemented, or are being developed, in other areas of radiation medicine (e.g. diagnostic radiology and nuclear medicine), in radiation protection and in industrial applications of radiation. In the past few years the development of primary standards of absorbed dose to water in {sup 60}Co for radiotherapy dosimetry has made direct calibrations in terms of absorbed dose to water available in many countries for the first time. Some laboratories have extended the development of these standards to high energy photon and electron beams and to low and medium energy x-ray beams. Other countries, however, still base their dosimetry for radiotherapy on air kerma standards. Dosimetry for conventional external beam radiotherapy was probably the field where standardized procedures adopted by medical physicists at hospitals were developed first. Those were related to exposure and air kerma standards. The recent development of Codes of Practice (or protocols) based on the concept of absorbed dose to water has led to changes in calibration procedures at hospitals. The International Code of Practice for Dosimetry Based on Standards of Absorbed Dose to Water (TRS 398) was sponsored by the International Atomic Energy Agency (IAEA), World Health Organization (WHO), Pan-American Health Organization (PAHO) and the European Society for Therapeutic Radiology and Oncology (ESTRO) and is expected to be adopted in many countries worldwide. It provides recommendations for the dosimetry of all types of beams (except neutrons) used in external radiotherapy and

  14. 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.

  15. A systematic review of leadership training for medical students.

    Science.gov (United States)

    Lyons, Oscar; Su'a, Bruce; Locke, Michelle; Hill, Andrew

    2018-01-19

    Leadership is increasingly being recognised as an essential requirement for doctors. Many medical schools are in the process of developing formal leadership training programmes, but it remains to be elucidated what characteristics make such programmes effective, and to what extent current programmes are effective, beyond merely positive learner reactions. This review's objective was to investigate the effectiveness of undergraduate medical leadership curricula and to explore common features of effective curricula. A systematic literature search was conducted. Articles describing and evaluating undergraduate medical leadership curricula were included. Outcomes were stratified and analysed according to a modified Kirkpatrick's model for evaluating educational outcomes. Eleven studies met inclusion criteria. Leadership curricula evaluated were markedly heterogeneous in their duration and composition. The majority of studies utilised pre- and post- intervention questionnaires for evaluation. Two studies described randomised controlled trials with objective measures. Outcomes were broadly positive. Only one study reported neutral outcomes. A wide range of leadership curricula have shown subjective effectiveness, including short interventions. There is limited objective evidence however, and few studies have measured effectiveness at the system and patient levels. Further research is needed investigating objective and downstream outcomes, and use of standard frameworks for evaluation will facilitate effective comparison of initiatives.

  16. Medical Wikis Dedicated to Clinical Practice: A Systematic Review

    Science.gov (United States)

    Llorca, Guy; Letrilliart, Laurent

    2015-01-01

    Background Wikis may give clinician communities the opportunity to build knowledge relevant to their practice. The only previous study reviewing a set of health-related wikis, without specification of purpose or audience, globally showed a poor reliability. Objective Our aim was to review medical wiki websites dedicated to clinical practices. Methods We used Google in ten languages, PubMed, Embase, Lilacs, and Web of Science to identify websites. The review included wiki sites, accessible and operating, having a topic relevant for clinical medicine, targeting physicians or medical students. Wikis were described according to their purposes, platform, management, information framework, contributions, content, and activity. Purposes were classified as “encyclopedic” or “non-encyclopedic”. The information framework quality was assessed based on the Health On the Net (HONcode) principles for collaborative websites, with additional criteria related to users’ transparency and editorial policy. From a sample of five articles per wikis, we assessed the readability using the Flesch test and compared articles according to the wikis’ main purpose. Annual editorial activities were estimated using the Google engine. Results Among 25 wikis included, 11 aimed at building an encyclopedia, five a textbook, three lessons, two oncology protocols, one a single article, and three at reporting clinical cases. Sixteen wikis were specialized with specific themes or disciplines. Fifteen wikis were using MediaWiki software as-is, three were hosted by online wiki farms, and seven were purpose-built. Except for one MediaWiki-based site, only purpose-built platforms managed detailed user disclosures. The owners were ten organizations, six individuals, four private companies, two universities, two scientific societies, and one unknown. Among 21 open communities, 10 required users’ credentials to give editing rights. The median information framework quality score was 6 out of 16

  17. 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

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

    International Nuclear Information System (INIS)

    Cheung, K; Damilakis, J

    2014-01-01

    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

  19. 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.

  20. Important Aspects of Pharmacist-led Medication Reviews in an Acute Medical Ward

    DEFF Research Database (Denmark)

    Bülow, Cille; Faerch, Kirstine Ullitz; Armandi, Helle

    2018-01-01

    In some hospitals, clinical pharmacists review the medication to find drug-related problems (DRPs) in acutely admitted patients. We aimed to identify the nature of identified DRPs and investigate factors of potential importance for the clinical implementation of pharmacist suggestions. In 100.......05). The most frequently implemented suggestions were based on DRPs concerning 'indication for drug treatment not noticed', 'inappropriate drug form' and 'drug dose too low', with implementation rates of 83%, 67% and 63%, respectively. In our sample, the pharmacist's MR suggestions were only implemented...

  1. Do internationally adopted children in the Netherlands use more medication than their non-adopted peers?

    Science.gov (United States)

    van Ginkel, Joost R; Juffer, Femmie; Bakermans-Kranenburg, Marian J; van IJzendoorn, Marinus H

    2016-05-01

    Empirical evidence has shown that international adoptees present physical growth delays, precocious puberty, behavioral problems, and mental health referrals more often than non-adoptees. We hypothesized that the higher prevalence of (mental) health problems in adoptees is accompanied by elevated consumption of prescription drugs, including antidepressants, attention deficit hyperactivity disorder (ADHD) medication, and medication for growth inhibition/stimulation. In an archival, population-based Dutch cohort study, data on medication use were available from the Health Care Insurance Board by Statistics Netherlands from 2006 to 2011. The Dutch population born between 1994 and 2005 and alive during the period of measurement was included (2,360,450 including 10,602 international adoptees, of which 4447 from China). Their mean age was 6.5 years at start (range 1-12 years) and 11.5 years at the end of the measurement period (range 6-17 years). Chinese female adoptees used less medication for precocious puberty (as treatment for precocious puberty; odds ratio (OR) = 0.57, effect size Cohen's d = -0.31) and contraception (OR = 0.65, d = -0.24) than non-adoptees. For both males and females, non-Chinese adoptees used more medication for ADHD than non-adoptees (males: OR = 1.22, females: OR = 1.32), but the effect was small (males: d = 0.11, females: d = 0.15). Adoptees in the Netherlands generally do not use more medication than their non-adopted peers. • Meta-analytical evidence shows that international adoptees present physical growth delays and mental health referrals more often than non-adopted controls. • With the exception of one Swedish study on ADHD medication, there is no other systematic research on medication use of international adoptees. What is New: • All differences in medication use between international adoptees in the Netherlands and non-adopted controls were below the threshold of a small effect with the exception

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

    Science.gov (United States)

    Dacey, Marie L.; Kennedy, Mary A.; Polak, Rani; Phillips, Edward M.

    2014-01-01

    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 some support for

  3. 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

  4. Discrimination against international medical graduates in the United States residency program selection process.

    Science.gov (United States)

    Desbiens, Norman A; Vidaillet, Humberto J

    2010-01-25

    Available evidence suggests that international medical graduates have improved the availability of U.S. health care while maintaining academic standards. We wondered whether studies had been conducted to address how international graduates were treated in the post-graduate selection process compared to U.S. graduates. We conducted a Medline search for research on the selection process. Two studies provide strong evidence that psychiatry and family practice programs respond to identical requests for applications at least 80% more often for U.S. medical graduates than for international graduates. In a third study, a survey of surgical program directors, over 70% perceived that there was discrimination against international graduates in the selection process. There is sufficient evidence to support action against discrimination in the selection process. Medical organizations should publish explicit proscriptions of discrimination against international medical graduates (as the American Psychiatric Association has done) and promote them in diversity statements. They should develop uniform and transparent policies for program directors to use to select applicants that minimize the possibility of non-academic discrimination, and the accreditation organization should monitor whether it is occurring. Whether there should be protectionism for U.S. graduates or whether post-graduate medical education should be an unfettered meritocracy needs to be openly discussed by medicine and society.

  5. A novel method for improving chest tube insertion skills among medical interns

    Science.gov (United States)

    Tatli, Ozgur; Turkmen, Suha; Imamoglu, Melih; Karaca, Yunus; Cicek, Mustafa; Yadigaroglu, Metin; Bayrak, Selen T.; Asik, Olgun; Topbas, Murat; Turedi, Suleyman

    2017-01-01

    Objectives: To develop a low-cost biomaterial-covered chest tube simulation model and assess its possible usefulness for developing the chest tube insertion skills among medical interns. Methods: This mannequin-based interventional study was performed in a University hospital setting. We included 63 physicians performing emergency medicine internship at the Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey, between January 2015 and March 2015. A dummy was prepared for training simulation using a display mannequin. Medical interns received instruction concerning pneumothorax and the chest tube procedure. A total of 63 medical interns participating in this interventional study were asked to insert a chest tube in a biomaterial-covered mannequin. A senior trainee scored their performance using a check list and the mean of the total scores was calculated (21 items; total score, 42). Results: The mean procedural score was 40.9 ± 1.3 of a possible 42. The maximum score of 42 was achieved by 39.7% of the medical interns, while another 33.3% achieved a score of 41. Of the participants, 85% succeeded in inserting the tube via an appropriate technique, achieving a score of 40 or more. Conclusion: Our results indicated that this model could be useful for effective training of medical interns for chest tube insertion, which is an important skill in emergency medicine. This biomaterial-covered model is inexpensive and its use can potentially be widened to improve training methods without significant financial demand. PMID:28917064

  6. Narrative review: the promotion of gabapentin: an analysis of internal industry documents.

    Science.gov (United States)

    Steinman, Michael A; Bero, Lisa A; Chren, Mary-Margaret; Landefeld, C Seth

    2006-08-15

    Internal documents from the pharmaceutical industry provide a unique window for understanding the structure and methods of pharmaceutical promotion. Such documents have become available through litigation concerning the promotion of gabapentin (Neurontin, Pfizer, Inc., New York, New York) for off-label uses. To describe how gabapentin was promoted, focusing on the use of medical education, research, and publication. Court documents available to the public from United States ex. rel David Franklin vs. Pfizer, Inc., and Parke-Davis, Division of Warner-Lambert Company, mostly from 1994-1998. All documents were reviewed by 1 author, with selected review by coauthors. Marketing strategies and tactics were identified by using an iterative process of review, discussion, and re-review of selected documents. The promotion of gabapentin was a comprehensive and multifaceted process. Advisory boards, consultants meetings, and accredited continuing medical education events organized by third-party vendors were used to deliver promotional messages. These tactics were augmented by the recruitment of local champions and engagement of thought leaders, who could be used to communicate favorable messages about gabapentin to their physician colleagues. Research and scholarship were also used for marketing by encouraging "key customers" to participate in research, using a large study to advance promotional themes and build market share, paying medical communication companies to develop and publish articles about gabapentin for the medical literature, and planning to suppress unfavorable study results. Most available documents were submitted by the plaintiff and may not represent a complete picture of marketing practices. Activities traditionally considered independent of promotional intent, including continuing medical education and research, were extensively used to promote gabapentin. New strategies are needed to ensure a clear separation between scientific and commercial activity.

  7. 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.

  8. Nurses' clinical reasoning practices that support safe medication administration: An integrative review of the literature.

    Science.gov (United States)

    Rohde, Emily; Domm, Elizabeth

    2018-02-01

    To review the current literature about nurses' clinical reasoning practices that support safe medication administration. The literature about medication administration frequently focuses on avoiding medication errors. Nurses' clinical reasoning used during medication administration to maintain medication safety receives less attention in the literature. As healthcare professionals, nurses work closely with patients, assessing and intervening to promote mediation safety prior to, during and after medication administration. They also provide discharge teaching about using medication safely. Nurses' clinical reasoning and practices that support medication safety are often invisible when the focus is medication errors avoidance. An integrative literature review was guided by Whittemore and Knafl's (Journal of Advanced Nursing, 5, 2005 and 546) five-stage review of the 11 articles that met review criteria. This review is modelled after Gaffney et al.'s (Journal of Clinical Nursing, 25, 2016 and 906) integrative review on medical error recovery. Health databases were accessed and systematically searched for research reporting nurses' clinical reasoning practices that supported safe medication administration. The level and quality of evidence of the included research articles were assessed using The Johns Hopkins Nursing Evidence-Based Practice Rating Scale©. Nurses have a central role in safe medication administration, including but not limited to risk awareness about the potential for medication errors. Nurses assess patients and their medication and use knowledge and clinical reasoning to administer medication safely. Results indicated nurses' use of clinical reasoning to maintain safe medication administration was inadequately articulated in 10 of 11 studies reviewed. Nurses are primarily responsible for safe medication administration. Nurses draw from their foundational knowledge of patient conditions and organisational processes and use clinical reasoning that

  9. International experiences in nursing education: a review of the literature.

    Science.gov (United States)

    Kulbok, Pamela A; Mitchell, Emma M; Glick, Doris F; Greiner, Doris

    2012-04-24

    Service learning and study abroad opportunities have become increasingly popular in nursing education in the past decade. The purpose of this systematic review was to explore existing literature concerning global health experiences in nursing education. Twenty-three empirical articles from 2003 to 2010 were reviewed, building upon existing reviews of international nursing education literature. Research on two-way exchange experiences and models for best practice were found to be lacking. While an array of countries were represented as the visiting or hosting side of the experience, few co-authors from host countries were found, particularly in literature originating from the U.S. The authors recommend that two-way exchange programs be evaluated to identify successful strategies and barriers to success. Ongoing evaluation of exchanges is necessary to ensure continued sustainable partnership and exchange in immersion experiences for nursing students.

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

    International Nuclear Information System (INIS)

    Cudahy, J.; Escarda, T.; Gimpel, R.

    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

  11. The Bockus International Society of Gastroenterology: Historical review

    Science.gov (United States)

    Chaun, Hugh

    2012-01-01

    The Bockus International Society of Gastroenterology was founded in 1958 in honour of Dr Henry L Bockus (1894–1982) by his former students, residents and fellows at the Graduate School of Medicine of the University of Pennsylvania, Philadelphia, USA. It was a celebrated tribute to Dr Bockus’ outstanding leadership in the development and teaching of clinical gastroenterology as a subspecialty, which was in its infancy in the post-World War II era. He established the first formal training course in clinical gastroenterology in America. His department of gastroenterology became the leading graduate school of clinical gastroenterology in the world, training many clinical gastroenterologists in America and from many regions around the world. For many years, Dr Bockus was the most prominent American in world gastroenterology. The Bockus Society holds biennial scientific congresses in different continents, thus continuing to foster Dr Bockus’ lifelong interest and vision to promote international medical friendship, and excellence in education and research collaboration. PMID:22506261

  12. Review of 40-year MD theses in medical oncology.

    Science.gov (United States)

    Zeeneldin, Ahmed; Diyaa, Amira; Moneer, Manar; Elgammal, Mosaad; Buhoush, Wafa

    2014-09-01

    It is almost 40 years since the foundation of the Medical Oncology (MO) Department. We aimed to appraise the clinical research to fulfill the Medical Doctorate (MD) degree in MO at the National Cancer Institute, Cairo University (NCI, CU). This review included 62 MD theses containing 66 studies. They were reviewed regarding aims, type of study, clinical trial phase, design and methodology, statistical tests, results, limitations, consent and IRB approval. Theses were grouped into 3 periods: 1970-1989, 1990-1999 and 2000-2008. Almost 76% of the studies were interventional and 24% were observational. Informed consent and Institutional Review Board approval were mentioned in 18 and 2 studies, respectively. While all studies mentioned the aims, none, clearly mentioned the research question. Outcomes were mainly efficacy followed by safety. Study design was inadequately considered, especially in 70's-80's period (p=0.038). Median sample size and study duration were almost stable through the three periods (p=0.441, 0.354, respectively). Most of the studies used both descriptive and analytical statistical methods. In a descending order, researched cancers were lymphoma, breast, leukemia, liver, urinary bladder, lung and colorectal. The commonest stages researched were IV and III. The number of studies focused on assessing biomarkers, biomarkers plus drugs/procedures, drugs and procedures are 20, 20, 16 and 6, respectively. With time, research within MD theses in MO increased quantitatively and qualitatively. Improvements were noticeable in documentation of study design. Copyright © 2014. Production and hosting by Elsevier B.V.

  13. Domestic/family violence death reviews: an international comparison.

    Science.gov (United States)

    Bugeja, Lyndal; Dawson, Myrna; McIntyre, Sara-Jane; Walsh, Carolyn

    2015-04-01

    Domestic/Family Violence Death Reviews (D/FVDRs) have been established in a number of high-income countries since 1990 as a mechanism to inform prevention-focused interventions to reduce domestic/family violence. D/FVDRs differ in their structure, governance, case identification processes and inclusion criteria, review measures, and outputs. Outside of the United States, the extent of heterogeneity across and within countries has not been explored. This study comprised an international comparison of D/FVDRs and their core elements to inform the establishment of D/FVDRs in other developed countries, and potentially low- and middle-income countries where violence is a leading cause of death. Such a review is also a necessary foundation for any future evaluation D/FVDRs. The review identified 71 jurisdictions where a D/FVDRs had been established in the past two decades, 25 of which met the inclusion criteria. All D/FVDRs examined stated a reduction in deaths as a goal of the review process; however, none reported an actual reduction. The focus of the D/FVDRs examined was on intimate partner homicides; however, more recently established D/FVDRs include other familial relationships. Almost one third of the D/FVDRs examined reported changes to the domestic/family system that occurred as a result of recommendations made from the review process. While similar in many ways, D/FVDRs differ along a number of important dimensions that make it difficult to identify best practices for jurisdictions considering the establishment of such an initiative. To share knowledge, existing networks should be expanded nationally and internationally to include jurisdictions that may be considering this initiative. © The Author(s) 2013.

  14. Medical Updates Number 5 to the International Space Station Probability Risk Assessment (PRA) Model Using the Integrated Medical Model

    Science.gov (United States)

    Butler, Doug; Bauman, David; Johnson-Throop, Kathy

    2011-01-01

    The Integrated Medical Model (IMM) Project has been developing a probabilistic risk assessment tool, the IMM, to help evaluate in-flight crew health needs and impacts to the mission due to medical events. This package is a follow-up to a data package provided in June 2009. The IMM currently represents 83 medical conditions and associated ISS resources required to mitigate medical events. IMM end state forecasts relevant to the ISS PRA model include evacuation (EVAC) and loss of crew life (LOCL). The current version of the IMM provides the basis for the operational version of IMM expected in the January 2011 timeframe. The objectives of this data package are: 1. To provide a preliminary understanding of medical risk data used to update the ISS PRA Model. The IMM has had limited validation and an initial characterization of maturity has been completed using NASA STD 7009 Standard for Models and Simulation. The IMM has been internally validated by IMM personnel but has not been validated by an independent body external to the IMM Project. 2. To support a continued dialogue between the ISS PRA and IMM teams. To ensure accurate data interpretation, and that IMM output format and content meets the needs of the ISS Risk Management Office and ISS PRA Model, periodic discussions are anticipated between the risk teams. 3. To help assess the differences between the current ISS PRA and IMM medical risk forecasts of EVAC and LOCL. Follow-on activities are anticipated based on the differences between the current ISS PRA medical risk data and the latest medical risk data produced by IMM.

  15. Economic evaluation of pharmacist-led medication reviews in residential aged care facilities.

    Science.gov (United States)

    Hasan, Syed Shahzad; Thiruchelvam, Kaeshaelya; Kow, Chia Siang; Ghori, Muhammad Usman; Babar, Zaheer-Ud-Din

    2017-10-01

    Medication reviews is a widely accepted approach known to have a substantial impact on patients' pharmacotherapy and safety. Numerous options to optimise pharmacotherapy in older people have been reported in literature and they include medication reviews, computerised decision support systems, management teams, and educational approaches. Pharmacist-led medication reviews are increasingly being conducted, aimed at attaining patient safety and medication optimisation. Cost effectiveness is an essential aspect of a medication review evaluation. Areas covered: A systematic searching of articles that examined the cost-effectiveness of medication reviews conducted in aged care facilities was performed using the relevant databases. Pharmacist-led medication reviews confer many benefits such as attainment of biomarker targets for improved clinical outcomes, and other clinical parameters, as well as depict concrete financial advantages in terms of decrement in total medication costs and associated cost savings. Expert commentary: The cost-effectiveness of medication reviews are more consequential than ever before. A critical evaluation of pharmacist-led medication reviews in residential aged care facilities from an economical aspect is crucial in determining if the time, effort, and direct and indirect costs involved in the review rationalise the significance of conducting medication reviews for older people in aged care facilities.

  16. 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

  17. 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.

  18. 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.

  19. Using Google Glass in Nonsurgical Medical Settings: Systematic Review.

    Science.gov (United States)

    Dougherty, Bryn; Badawy, Sherif M

    2017-10-19

    Wearable technologies provide users hands-free access to computer functions and are becoming increasingly popular on both the consumer market and in various industries. The medical industry has pioneered research and implementation of head-mounted wearable devices, such as Google Glass. Most of this research has focused on surgical interventions; however, other medical fields have begun to explore the potential of this technology to support both patients and clinicians. Our aim was to systematically evaluate the feasibility, usability, and acceptability of using Google Glass in nonsurgical medical settings and to determine the benefits, limitations, and future directions of its application. This review covers literature published between January 2013 and May 2017. Searches included PubMed MEDLINE, Embase, INSPEC (Ebsco), Cochrane Central Register of Controlled Trials (CENTRAL), IEEE Explore, Web of Science, Scopus, and Compendex. The search strategy sought all articles on Google Glass. Two reviewers independently screened titles and abstracts, assessed full-text articles, and extracted data from articles that met all predefined criteria. Any disagreements were resolved by discussion or consultation by the senior author. Included studies were original research articles that evaluated the feasibility, usability, or acceptability of Google Glass in nonsurgical medical settings. The preferred reporting results of systematic reviews and meta-analyses (PRISMA) guidelines were followed for reporting of results. Of the 852 records examined, 51 met all predefined criteria, including patient-centered (n=21) and clinician-centered studies (n=30). Patient-centered studies explored the utility of Google Glass in supporting patients with motor impairments (n=8), visual impairments (n=5), developmental and psychiatric disorders (n=2), weight management concerns (n=3), allergies (n=1), or other health concerns (n=2). Clinician-centered studies explored the utility of Google Glass

  20. Review of early assessment models of innovative medical technologies.

    Science.gov (United States)

    Fasterholdt, Iben; Krahn, Murray; Kidholm, Kristian; Yderstræde, Knud Bonnet; Pedersen, Kjeld Møller

    2017-08-01

    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. 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. 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 of traditional cost-effectiveness analysis. Around one fourth of the studies presented an evaluation model with a broader focus than cost-effectiveness. Uncertainty was mostly handled by simple sensitivity or scenario analysis. This review shows that evaluation models using known methods assessing cost-effectiveness are most prevalent in early assessment, but seems ill-suited for early assessment in hospitals. Four models provided some usable elements for the development of a hospital-based model. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

  1. Research Ranking of Iranian Universities of Medical Sciences Based on International Indicators: An Experience From I.R. of Iran.

    Science.gov (United States)

    Baradaran Eftekhari, Monir; Sobhani, Zahra; Eltemasi, Masoumeh; Ghalenoee, Elham; Falahat, Katayoun; Habibi, Elham; Djalalinia, Shirin; Paykari, Niloofar; Ebadifar, Asghar; Akhondzadeh, Shahin

    2017-11-01

    In recent years, international ranking systems have been used by diverse users for various purposes. In most of these rankings, different aspects of performance of universities and research institutes, especially scientific performance, have been evaluated and ranked. In this article, we aimed to report the results of research ranking of Iranian universities of medical sciences (UMSs) based on some international indicators in 2015. In this study, after reviewing the research indicators of the majority of international ranking systems, with the participation of key stakeholders, we selected eight research indicators, namely research output, high-quality publications, leadership, total citations, citations per paper in 2015, papers per faculty member and h-index. The main sources for data gathering were Scopus, PubMed, and ISI, Web of Science. Data were extracted and normalized for Iranian governmental UMSs for 2015. A total of 18023 articles were indexed in 2015 in Scopus with affiliations of UMSs affiliation. Almost 17% of all articles were published in top journals and 15% were published with international collaborations. The maximum h-index (h-index = 110) belonged to Tehran University of Medical Sciences. The average paper per faculty member was 1.14 (Max = 2.5, Min = 0.13). The mean citation per published articles in Scopus was 0.33. Research ranking of Iranian UMSs can create favorable competition among them towards knowledge production.

  2. 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

    BACKGROUND: Practical descriptions of procedures used for pharmacists' medication reviews are sparse. OBJECTIVE: To describe a model for medication review by pharmacists tailored to a general practice setting. METHODS: A stepwise model is described. The model is based on data from the medical chart...... no indication (n=47, 23%). Most interventions were aimed at cardiovascular drugs. CONCLUSION: We have provided a detailed description of a practical approach to pharmacists' medication review in a GP setting. The model was tested and found to be usable, and to deliver a medication review with high acceptance...

  3. Decentralised training for medical students: a scoping review

    Directory of Open Access Journals (Sweden)

    Marietjie de Villiers

    2017-11-01

    Full Text Available Abstract Background Increasingly, medical students are trained at sites away from the tertiary academic health centre. A growing body of literature identifies the benefits of decentralised clinical training for students, the health services and the community. A scoping review was done to identify approaches to decentralised training, how these have been implemented and what the outcomes of these approaches have been in an effort to provide a knowledge base towards developing a model for decentralised training for undergraduate medical students in lower and middle-income countries (LMICs. Methods Using a comprehensive search strategy, the following databases were searched, namely EBSCO Host, ERIC, HRH Global Resources, Index Medicus, MEDLINE and WHO Repository, generating 3383 references. The review team identified 288 key additional records from other sources. Using prespecified eligibility criteria, the publications were screened through several rounds. Variables for the data-charting process were developed, and the data were entered into a custom-made online Smartsheet database. The data were analysed qualitatively and quantitatively. Results One hundred and five articles were included. Terminology most commonly used to describe decentralised training included ‘rural’, ‘community based’ and ‘longitudinal rural’. The publications largely originated from Australia, the United States of America (USA, Canada and South Africa. Fifty-five percent described decentralised training rotations for periods of more than six months. Thematic analysis of the literature on practice in decentralised medical training identified four themes, each with a number of subthemes. These themes were student learning, the training environment, the role of the community, and leadership and governance. Conclusions Evident from our findings are the multiplicity and interconnectedness of factors that characterise approaches to decentralised training. The student

  4. Exploiting the systematic review protocol for classification of medical abstracts.

    Science.gov (United States)

    Frunza, Oana; Inkpen, Diana; Matwin, Stan; Klement, William; O'Blenis, Peter

    2011-01-01

    To determine whether the automatic classification of documents can be useful in systematic reviews on medical topics, and specifically if the performance of the automatic classification can be enhanced by using the particular protocol of questions employed by the human reviewers to create multiple classifiers. The test collection is the data used in large-scale systematic review on the topic of the dissemination strategy of health care services for elderly people. From a group of 47,274 abstracts marked by human reviewers to be included in or excluded from further screening, we randomly selected 20,000 as a training set, with the remaining 27,274 becoming a separate test set. As a machine learning algorithm we used complement naïve Bayes. We tested both a global classification method, where a single classifier is trained on instances of abstracts and their classification (i.e., included or excluded), and a novel per-question classification method that trains multiple classifiers for each abstract, exploiting the specific protocol (questions) of the systematic review. For the per-question method we tested four ways of combining the results of the classifiers trained for the individual questions. As evaluation measures, we calculated precision and recall for several settings of the two methods. It is most important not to exclude any relevant documents (i.e., to attain high recall for the class of interest) but also desirable to exclude most of the non-relevant documents (i.e., to attain high precision on the class of interest) in order to reduce human workload. For the global method, the highest recall was 67.8% and the highest precision was 37.9%. For the per-question method, the highest recall was 99.2%, and the highest precision was 63%. The human-machine workflow proposed in this paper achieved a recall value of 99.6%, and a precision value of 17.8%. The per-question method that combines classifiers following the specific protocol of the review leads to better

  5. Quality of life, burnout, educational debt, and medical knowledge among internal medicine residents.

    Science.gov (United States)

    West, Colin P; Shanafelt, Tait D; Kolars, Joseph C

    2011-09-07

    Physician distress is common and has been associated with negative effects on patient care. However, factors associated with resident distress and well-being have not been well described at a national level. To measure well-being in a national sample of internal medicine residents and to evaluate relationships with demographics, educational debt, and medical knowledge. Study of internal medicine residents using data collected on 2008 and 2009 Internal Medicine In-Training Examination (IM-ITE) scores and the 2008 IM-ITE survey. Participants were 16,394 residents, representing 74.1% of all eligible US internal medicine residents in the 2008-2009 academic year. This total included 7743 US medical graduates and 8571 international medical graduates. Quality of life (QOL) and symptoms of burnout were assessed, as were year of training, sex, medical school location, educational debt, and IM-ITE score reported as percentage of correct responses. Quality of life was rated "as bad as it can be" or "somewhat bad" by 2402 of 16,187 responding residents (14.8%). Overall burnout and high levels of emotional exhaustion and depersonalization were reported by 8343 of 16,192 (51.5%), 7394 of 16,154 (45.8%), and 4541 of 15,737 (28.9%) responding residents, respectively. In multivariable models, burnout was less common among international medical graduates than among US medical graduates (45.1% vs 58.7%; odds ratio, 0.70 [99% CI, 0.63-0.77]; P $200,000 relative to no debt). Residents reporting QOL "as bad as it can be" and emotional exhaustion symptoms daily had mean IM-ITE scores 2.7 points (99% CI, 1.2-4.3; P ITE scores 5.0 points (99% CI, 4.4-5.6; P ITE scores.

  6. Qualitative Literature Review of the Prevalence of Depression in Medical Students Compared to Students in Non-medical Degrees.

    Science.gov (United States)

    Bacchi, Stephen; Licinio, Julio

    2015-06-01

    The purpose of this study is to review studies published in English between 1 January 2000 and 16 June 2014, in peer-reviewed journals, that have assessed the prevalence of depression, comparing medical students and non-medical students with a single evaluation method. The databases PubMed, Medline, EMBASE, PsycINFO, and Scopus were searched for eligible articles. Searches used combinations of the Medical Subject Headings medical student and depression. Titles and abstracts were reviewed to determine eligibility before full-text articles were retrieved, which were then also reviewed. Twelve studies met eligibility criteria. Non-medical groups surveyed included dentistry, business, humanities, nursing, pharmacy, and architecture students. One study found statistically significant results suggesting that medical students had a higher prevalence of depression than groups of non-medical students; five studies found statistically significant results indicating that the prevalence of depression in medical students was less than that in groups of non-medical students; four studies found no statistically significant difference, and two studies did not report on the statistical significance of their findings. One study was longitudinal, and 11 studies were cross-sectional. While there are limitations to these comparisons, in the main, the reviewed literature suggests that medical students have similar or lower rates of depression compared to certain groups of non-medical students. A lack of longitudinal studies meant that potential common underlying causes could not be discerned, highlighting the need for further research in this area. The high rates of depression among medical students indicate the continuing need for interventions to reduce depression.

  7. Proceedings of the international conference on medical physics and biomedical engineering. Vol. 1

    Energy Technology Data Exchange (ETDEWEB)

    Spyrou, S; Christofides, S; Pattichis, C S; Keravnou, E; Schizas, C N; Christodoulides, G [eds.

    1994-12-31

    This is the first of two volumes of the proceedings of the International Conference on Medical Physics and Biomedical Engineering, held in Nicosia, Cyprus, between 3-7 May, 1994. It contains 47 papers. Nine of these fall within the scope of INIS and are dealing with stereolithography, computer tomography, scintigraphy, positron emission tomography, medical imaging, non linear spectral estimation techniques, image compression techniques and x-ray phosphor screens.

  8. Proceedings of the international conference on medical physics and biomedical engineering. Vol. 1

    International Nuclear Information System (INIS)

    Spyrou, S.; Christofides, S.; Pattichis, C.S.; Keravnou, E.; Schizas, C.N.; Christodoulides, G.

    1994-01-01

    This is the first of two volumes of the proceedings of the International Conference on Medical Physics and Biomedical Engineering, held in Nicosia, Cyprus, between 3-7 May, 1994. It contains 47 papers. Nine of these fall within the scope of INIS and are dealing with stereolithography, computer tomography, scintigraphy, positron emission tomography, medical imaging, non linear spectral estimation techniques, image compression techniques and x-ray phosphor screens

  9. Proceedings of the international conference on medical physics and biomedical engineering (MPBE `94). Vol. 2

    Energy Technology Data Exchange (ETDEWEB)

    Spyrou, S; Christofides, S; Pattichis, C S; Keravnou, E; Schizas, C N; Christodoulides, G [eds.

    1994-12-31

    This is the second of two volumes of the proceedings of the International Conference on Medical Physics and Biomedical Engineering, held in Nicosia, Cyprus, between 3-7 May, 1994. It contains 50 papers. Eleven of these fall within the scope of INIS and are dealing with natural radioactivity, dose equivalents, nuclear medicine, quality control, positron emission tomography, computerized tomography, scintiscanning, medical examinations, x-ray radiography, radiotherapy, neural networks.

  10. Proceedings of the international conference on medical physics and biomedical engineering (MPBE '94). Vol. 2

    International Nuclear Information System (INIS)

    Spyrou, S.; Christofides, S.; Pattichis, C.S.; Keravnou, E.; Schizas, C.N.; Christodoulides, G.

    1994-01-01

    This is the second of two volumes of the proceedings of the International Conference on Medical Physics and Biomedical Engineering, held in Nicosia, Cyprus, between 3-7 May, 1994. It contains 50 papers. Eleven of these fall within the scope of INIS and are dealing with natural radioactivity, dose equivalents, nuclear medicine, quality control, positron emission tomography, computerized tomography, scintiscanning, medical examinations, x-ray radiography, radiotherapy, neural networks

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

    Science.gov (United States)

    Elnawawy, Omnia; Lee, Andrew C K; Pohl, Gerda

    2014-06-01

    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. 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. Qualitative study of key informant interviews. Stakeholders of a short-term international medical volunteer (IMV) placement programme in Nepal. 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. 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. 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. © British Journal of General Practice 2014.

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

    Directory of Open Access Journals (Sweden)

    Sarah M. Westberg

    2010-06-01

    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. Type: Original Research

  13. 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.

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

    Science.gov (United States)

    Grudzen, Corita R; Legome, Eric

    2007-11-28

    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. 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. 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.

  15. [Effects of social origins and professional socialization on the vocational preferences of medical interns in Mexico].

    Science.gov (United States)

    Frenk, J

    1985-01-01

    Using data from a survey of 923 medical interns in Mexico, this article analyzes preferences for type of medical activity (general or specialized practice), type of site (ambulatory or hospital), and type of medical care institution (public assistance, social security, or private). Four independent variables are examined: social origin, medical school, place of internship, and assimilation to the internship hospital. The great majority of the interns expressed a preference for specialty practice, hospitals, and social security institutions. The role of social origin was to selectively direct students into different medical schools. From then on, the structural attributes of the school itself and of the place of internship, as well as the socialization experiences that took place there, emerged as the most important determinants of career preferences. Such a process, however, tended to produce a "social specialization" of interns in terms of the role they expect to play in the medical field. It is argued that this kind of specialization has negative implications for the professional status of physicians, although it also poses a challenge to the development of innovative theories about the process of professionalization in medicine.

  16. 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.

  17. 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.

  18. Internal dose evaluation of workers involved in radioisotopes and radiopharmaceuticals handling for medical use

    International Nuclear Information System (INIS)

    Cesar, R.B.P.; Mesquita, C.H. de

    1987-01-01

    The internal dose levels of IPEN workers, involved in the production of radioisotopes and radiopharmaceuticals for medical use are surveyed. In this production, the workers were splited in six group: research and development, routine production, quality control, packaging, radiological protection and maintenance. The internal dose was evaluated according to the models described by ICRP-30, from the results obtained in the whole body counters monitoring. (C.G.C.) [pt

  19. Internal dosimetry from IPEN workers involved in the medical radioisotopes production

    International Nuclear Information System (INIS)

    Cesar, R.B.P.; Mesquita, C.H. de

    1988-01-01

    The internal dose from IPEN workers involved in the medical radioisotopes products is related. In the workers population, six groups were classified: development and research, routine production, quality control, package, radioprotection supervision and maintenance. The internal doses were calculated according to the methodology described by the ICRP-30, using resuls from a whole-body counter. The results described were obtained from 970 whole-body radioactivity measurements during the last three years (1985 a 1987). (author) [pt

  20. 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.

  1. 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.

  2. 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.

  3. The international development of forensic science standards - A review.

    Science.gov (United States)

    Wilson-Wilde, Linzi

    2018-04-16

    Standards establish specifications and procedures designed to ensure products, services and systems are safe, reliable and consistently perform as intended. Standards can be used in the accreditation of forensic laboratories or facilities and in the certification of products and services. In recent years there have been various international activities aiming at developing forensic science standards and guidelines. The most significant initiative currently underway within the global forensic community is the development of International Organization for Standardization (ISO) standards. This paper reviews the main bodies working on standards for forensic science, the processes used and the implications for accreditation. This paper specifically discusses the work of ISO Technical Committee TC272, the future TC272 work program for the development of forensic science standards and associated timelines. Also discussed, are the lessons learnt to date in navigating the complex environment of multi-country stakeholder deliberations in standards development. Crown Copyright © 2018. Published by Elsevier B.V. All rights reserved.

  4. Report From the International Linear Collider Technical Review Committee

    International Nuclear Information System (INIS)

    Loew, Gregory A.

    2003-01-01

    The International Linear Collider Technical Review Committee (ILC-TRC), formed in 1994, was reconvened in February 2001 by the International Committee for Future Accelerators (ICFA) to assess the current technical status of all electron-positron linear collider designs at hand in the world: TESLA, JLC-C, JLC-X/NLC and CLIC. The ILC-TRC worked for exactly two years and submitted its report to ICFA in February 2003. This paper presents the motivation behind the study, the charge to the committee and its organization, a table of machine parameters for 500 GeV c.m. energy and later upgrades to higher energies, the methodology used to assess the designs, and a ranked list of R and D tasks still deemed necessary between now and the time any one of the projects is selected by the HEP community and begins construction. Possible future developments are briefly discussed

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

    Science.gov (United States)

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

    2013-01-01

    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. 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, pre- and post- ATLS periods, were compared through SPSS version 15.0 software. P values less than 0.05 were considered statistically significant. 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 less than 0.001, P equal to 0.016 and P equal to 0.01 respectively). ATLS course has an important role in increasing clinical knowledge and practical skill performance of trauma care in medical interns.

  6. 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.

  7. Contemporary Medical Management of Primary Hyperparathyroidism: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Julius Simoni Leere

    2017-04-01

    Full Text Available IntroductionPrimary hyperparathyroidism is increasingly an asymptomatic disease at diagnosis, but the recognized guidelines for management are based on evidence obtained from studies on patients with symptomatic disease, and surgery is not always indicated. Other patients are unable to undergo surgery, and thus a medical treatment is warranted. This systematic review provides an overview of the existing literature on contemporary pharmaceutical options available for the medical management of primary hyperparathyroidism.MethodsDatabases of medical literature were searched for articles including terms for primary hyperparathyroidism and each of the included drugs. Data on s-calcium, s-parathyroid hormone, bone turnover markers, bone mineral density (BMD and hard endpoints were extracted and tabulated, and level of evidence was determined. Changes in s-calcium were estimated and a meta-regression analysis was performed.ResultsThe 1,999 articles were screened for eligibility and 54 were included in the review. Weighted mean changes calculated for each drug in s-total calcium (mean change from baseline ± SEM were pamidronate (0.31 ± 0.034 mmol/l; alendronate (0.07 ± 0.05 mmol/l; clodronate (0.20 ± 0.040 mmol/l; mixed bisphosphonates (0.16 ± 0.049 mmol/l; and cinacalcet (0.37 ± 0.013 mmol/l. The meta-analysis revealed a significant decrease of effect on s-calcium with time for the bisphosphonates (Coef. −0.049 ± 0.023, p = 0.035, while cinacalcet proved to maintain its effect on s-calcium over time. Bisphosphonates improved BMD while cinacalcet had no effect.DiscussionThe included studies demonstrate advantages and drawbacks of the available pharmaceutical options that can prove helpful in the clinical setting. The great variation in how primary hyperparathyroidism is manifested requires that management should rely on an individual evaluation when counseling patients. Combining resorptive agents with

  8. Examining changes in certification/licensure requirements and the international medical graduate examinee pool.

    Science.gov (United States)

    McKinley, Danette W; Hess, Brian J; Boulet, John R; Lipner, Rebecca S

    2014-03-01

    Changes in certification requirements and examinee characteristics are likely to influence the validity of the evidence associated with interpretations made based on test data. We examined whether changes in Educational Commission for Foreign Medical Graduates (ECFMG) certification requirements over time were associated with changes in internal medicine (IM) residency program director ratings and certification examination scores. Comparisons were made between physicians who were ECFMG-certified before and after the Clinical Skills Assessment (CSA) requirement. A multivariate analysis of covariance was conducted to examine the differences in program director ratings based on CSA cohort and whether the examinees emigrated for undergraduate medical education (national vs. international students). A univariate analysis of covariance was conducted to examine differences in scores from the American Board of Internal Medicine (ABIM) Internal Medicine Certification Examination. For both analyses, United States Medical Licensing Examination (USMLE) Step 1 and Step 2 scores were used as covariates. Results indicate that, of those certified by ECFMG between 1993 and 1997, 17 % (n = 1,775) left their country of citizenship for undergraduate medical education. In contrast, 38 % (n = 1,874) of those certified between 1999 and 2003 were international students. After adjustment by covariates, the main effect of cohort membership on the program director ratings was statistically significant (Wilks' λ = 0.99, F 5, 15391 = 19.9, P migration status was statistically significant and weak (Wilks' λ = 0.98, F 5,15391 = 45.3, P Internal Medicine Certification Examination scores based on whether or not CSA were required was statistically significant, although the magnitude of the association between these variables was very small. The findings suggest that the implementation of an additional evaluation of skills (e.g., history-taking, physical examination) as a

  9. 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.

  10. 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

  11. Medical review practices for driver licensing volume 3: guidelines and processes in the United States.

    Science.gov (United States)

    2017-04-01

    This is the third of three reports examining driver medical review practices in the United States and how : they fulfill the basic functions of identifying, assessing, and rendering licensing decisions on medically or : functionally at-risk drivers. ...

  12. 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

  13. An international review of patient safety measures in radiotherapy practice

    International Nuclear Information System (INIS)

    Shafiq, Jesmin; Barton, Michael; Noble, Douglas; Lemer, Claire; Donaldson, Liam J.

    2009-01-01

    Errors from radiotherapy machine or software malfunction usually are well documented as they affect hundreds of patients, whereas random errors affecting individual patients are more difficult to be discovered and prevented. Although major clinical radiotherapy incidents have been reported, many more have remained unrecognised or have not been reported. The literature in this field is limited as it is mostly published as a result of investigation of major errors. We present a review of radiotherapy incidents internationally with the aim of identifying the domains where most errors occur through extensive review and synthesis of published reports, unpublished 'Grey literature' and departmental incident data. Our review of radiotherapy-related events in the last three decades (1976-2007) identified more than seven thousand (N = 7741) incidents and near misses. Three thousand one hundred and twenty-five incidents reported patient harm of variable intensity ranging from underdose increasing the risk of recurrence, to overdose causing toxicity, and even death for 1% (N = 38); 4616 events were near misses with no recognisable patient harm. Based on our review, a radiotherapy risk profile has been published by the WHO World Alliance for Patient Safety that highlights the role of communication, training and strict adherence to guidelines/protocols in improving the safety of radiotherapy process.

  14. 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. Published by Elsevier Inc.

  15. A selective review of medical cannabis in cancer pain management.

    Science.gov (United States)

    Blake, Alexia; Wan, Bo Angela; Malek, Leila; DeAngelis, Carlo; Diaz, Patrick; Lao, Nicholas; Chow, Edward; O'Hearn, Shannon

    2017-12-01

    Insufficient management of cancer-associated chronic and neuropathic pain adversely affects patient quality of life. Patients who do not respond well to opioid analgesics, or have severe side effects from the use of traditional analgesics are in need of alternative therapeutic op-tions. Anecdotal evidence suggests that medical cannabis has potential to effectively manage pain in this patient population. This review presents a selection of representative clinical studies, from small pilot studies conducted in 1975, to double-blind placebo-controlled trials conducted in 2014 that evaluated the efficacy of cannabinoid-based therapies containing tetrahydrocannabinol (THC) and cannabidiol (CBD) for reducing cancer-associated pain. A review of literature published on Medline between 1975 and 2017 identified five clinical studies that evaluated the effect of THC or CBD on controlling cancer pain, which have been reviewed and summarised. Five studies that evaluated THC oil capsules, THC:CBD oromucosal spray (nabiximols), or THC oromucosal sprays found some evidence of cancer pain reduction associated with these therapies. A variety of doses ranging from 2.7-43.2 mg/day THC and 0-40 mg/day CBD were administered. Higher doses of THC were correlated with increased pain relief in some studies. One study found that significant pain relief was achieved in doses as low as 2.7-10.8 mg THC in combination with 2.5-10.0 mg CBD, but there was conflicting evidence on whether higher doses provide superior pain relief. Some reported side effects include drowsiness, hypotension, mental clouding, and nausea and vomiting. There is evidence suggesting that medical cannabis reduces chronic or neu-ropathic pain in advanced cancer patients. However, the results of many studies lacked statistical power, in some cases due to limited number of study subjects. Therefore, there is a need for the conduct of further double-blind, placebo-controlled clinical trials with large sample sizes in order to

  16. Calling Orientations of Junior Doctors and Medical Interns in India: Cultural, Occupational and Relational Perspectives

    Science.gov (United States)

    Nath, Vandana

    2017-01-01

    This study examines the factors that shape calling orientations within the Indian context. Based on the narratives of 72 junior doctors and medical interns, it is found that participants identify with harbouring a calling both prior and subsequent to occupational entry. Although factors such as self-recognition of talent and sensemaking of work as…

  17. 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…

  18. 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.…

  19. Impact of Pharmacist-Conducted Comprehensive Medication Reviews for Older Adult Patients to Reduce Medication Related Problems.

    Science.gov (United States)

    Kiel, Whitney J; Phillips, Shaun W

    2017-12-31

    Older adults are demanding increased healthcare attention with regards to prescription use due in large part to highly complex medication regimens. As patients age, medications often have a more pronounced effect on older adults, negatively impacting patient safety and increasing healthcare costs. Comprehensive medication reviews (CMRs) optimize medications for elderly patients and help to avoid inappropriate medication use. Previous literature has shown that such CMRs can successfully identify and reduce the number of medication-related problems and improve acute healthcare utilization. The purpose of this pharmacy resident research study is to examine the impact of pharmacist-conducted geriatric medication reviews to reduce medication-related problems within a leading community health system in southwest Michigan. Furthermore, the study examines type of pharmacist interventions made during medication reviews, acute healthcare utilization, and physician assessment of the pharmacist's value. The study was conducted as a retrospective post-hoc analysis on ambulatory patients who received a CMR by a pharmacist at a primary care practice. Inclusion criteria included patients over 65 years of age with concurrent use of at least five medications who were a recent recipient of a CMR. Exclusion criteria included patients with renal failure, or those with multiple providers involved in primary care. The primary outcome was the difference in number of medication-related problems, as defined by the START and STOPP Criteria (Screening Tool to Alert doctors to Right Treatment/Screening Tool of Older Persons' Prescriptions). Secondary outcomes included hospitalizations, emergency department visits, number and type of pharmacist interventions, acceptance rate of pharmacist recommendations, and assessment of the pharmacist's value by clinic providers. There were a total of 26 patients that received a comprehensive medication review from the pharmacist and were compared to a

  20. Viewpoints of the interns on their future career in Qazvin University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Saeed Asefzadeh

    2002-10-01

    Full Text Available Background The imbalance between the public needs and the number of the medical graduates has created problems in recruitment of young physicians who are trained to provide medical and health services in the country. Purpose To assess the attitudes of interns at Qazvin University of Medical Sciences toward'i their future profession in 200I-2002. Methods This descriptive study assesses the viewpoints of all I20 interns through a self-administered questionnaire. Results The findings indicated that 77.5% of the students were in the age range of 22 to 27 with the average of 26. ./ years. of all cases 67.5% wished to continue their training to become a specialist and 6.7% decided to work as a general practitioner. of all students, 95.8% expected their future income to be low, to an extent which will not provide a comfortable life for them. of all cases. 89.2% believed that the present system of medical education does not give them the necessary capabilities and skills to practice efficiently in the future. Conclusion. The students• viewpoints on fulfillment of their economic needs and provision of a comfortable life for them and their families were negative; however, regarding fulfillment of their mental and emotional needs and participation in a scientific field, they were positive. Key word: intern, Medical profession

  1. 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.

  2. Development of Safety Review Guide for the Periodic Safety Review of Reactor Vessel Internals

    International Nuclear Information System (INIS)

    Park, Jeongsoon; Ko, Hanok; Kim, Seonjae; Jhung, Myungjo

    2013-01-01

    Aging management of the reactor vessel internals (RVIs) is one of the important issues for long-term operation of nuclear power plants (NPPs). Safety review on the assessment and management of the RVI aging is conducted through the process of a periodic safety review (PSR). The regulatory body should check that reactor facilities sustain safety functions in light of degradation due to aging and that the operator of a nuclear power reactor establishes and implements management program to deal with degradation due to aging in order to guarantee the safety functions and the safety margin as a result of PSR. KINS(Korea Institute of Nuclear Safety) has utilized safety review guides (SRG) which provide guidance to KINS staffs in performing safety reviews in order to assure the quality and uniformity of staff safety reviews. The KINS SRGs for the continued operation of pressurized water reactors (PWRs) published in 2006 contain areas of review regarding aging management of RVIs in chapter 2 (III.2.15, Appendix 2.0.1). However unlike the SRGs for the continued operation, KINS has not officially published the SRGs for the PSR of PWRs, but published them as a form of the research report. In addition to that, the report provides almost same review procedures for aging assessment and management of RVIs with the ones provided in the SRGs for the continued operation, it cannot provide review guidance specific to PSRs. Therefore, a PSR safety review guide should be developed for RVIs in PWRs. In this study, a draft PSR safety review guide for reactor vessel internals in PWRs is developed and provided. In this paper, a draft PSR safety review guide for reactor vessel internals (PSR SRG-RVIs) in PWRs is introduced and main contents of the draft are provided. However, since the PSR safety review guides for areas other than RVIs in the pressurized water reactors (PWRs) are expected to be developed in the near future, the draft PSR SRG-RVIs should be revisited to be compatible with

  3. Isotopes in medical diagnosis. New techniques reviewed at Vienna symposium

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1959-04-15

    The medical uses of radioisotopes cover diagnosis and therapy as well as clinical research. There is specialized equipment not only detects the radiations from a radioactive substance inside the body, but also produces a two-dimensional visual image of the size and functional condition of tissue that absorbs this substance. This is known as medical radioisotope scanning, aimed at determining the distribution of a radioisotope within an organ which specifically concentrates a radioisotope. Methods of scanning are exceedingly complex, and although a variety of equipment is now available for the automatic determination of the distribution of a radioisotope in an organ, experience of their use is still limited. To facilitate an adequate exchange of views and a pooling of experience in this field, the International Atomic Energy Agency and the World Health Organization recently arranged a seminar to discuss the techniques and results of scanning. Topics discussed included problems of collimation, sensitivity patterns of various collimating systems, optimum isotope concentrations, essential requirements for obtaining satisfactory visualization by a scanner, basic principles of scintillation counting, a the scintillation camera, isotope scanning for studies on liver disorders and liver tumours, radiogold used for liver scanning, scanning the liver and pancreas with the help of positron-emitting isotopes, measuring the distribution of radioisotopes in deep lying tissues by detection of 'bremsstrahlen', 'profile counting', brain tumour scanning with the usage of radioarsenic or radioiodine-labelled albumen, different aspects of thyroid scanning, value and methods of scanning in thyroid cancer as well as scanning procedures in non-cancerous thyroid disease. During the discussions Dr. Keroe (IAEA) demonstrated a new electronic device, the use of which results in a substantial increase of contrast and resolution of the recordings of a scanning machine, and which is the first

  4. 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).

  5. Efforts made for health and medical care by International Atomic Energy Agency

    International Nuclear Information System (INIS)

    Watanabe, Naoyuki

    2016-01-01

    The author, being a former senior medical officer and currently a consultant of the Nuclear Medicine Section, the Division of Human Health, the Department of Nuclear Sciences and Applications, the International Atomic Energy Agency (IAEA) to standardize the isotope and radiation technologies for health and medical care and transfer them to the IAEA member states to address their health issues, participated in an international cooperation project to survey the current situation of the health and medical care in Viet Nam and exchange opinions with the World Health Organization Western Pacific Regional Office Viet Nam Office and the Viet Nam Health Department coordinated by the Japan Public Health Association from 10th to 15th January 2016 and perceived efforts made and action plans for the health and medical care in Viet Nam by the international organizations of the IAEA and the World Health Organization (WHO). IAEA has verified various isotopes and radiation technologies up to now in the international field of health and medical care and has being offered them to the member states under the sustainable frame work of technical co-operation. However, the activity in the health and medical care field of IAEA is hardly recognized by the public health professionals in Japan. In order to attain the objective to improve and maintain human health under the umbrella of the United Nations system, the peaceful use of nuclear technology has been promoted in the field of non-electric applications of nuclear energy including human health and medical care by the IAEA. There are several discrepancies seen with the field and tactics of health and medical care between the IAEA and the WHO. In terms of measures to fight NCDs which should be an urgent issue in most of the member states, a comprehensive approach is often needed beyond the capability of IAEA as isotopes and radiation technologies. The IAEA should strive to solve issues on human health and medical care maintaining much

  6. Internalized Stigma of Mental Illness (ISMI) scale: a multinational review.

    Science.gov (United States)

    Boyd, Jennifer E; Adler, Emerald P; Otilingam, Poorni G; Peters, Townley

    2014-01-01

    The Internalized Stigma of Mental Illness (ISMI) scale is a 29-item questionnaire measuring self-stigma among persons with psychiatric disorders. It was developed with substantial consumer input and has been widely used, but its psychometric qualities have not been comprehensively evaluated across multiple versions. Here we review the 55 known versions, and provide the 47 available versions, including: Arabic, Armenian, Bengali, Bulgarian, Chinese (Mainland, Taiwan, Hong Kong), Croatian, Dutch, English (USA, South Africa), Estonian, Farsi, Finnish, French, German, Greek, Hebrew, Hindi, Japanese, Khmer, Korean, Lithuanian, Lugandan, Maltese, Polish, Portuguese (Portugal, Brazil), Romanian, Russian, Samoan, Slovenian, Spanish (Spain), Swahili, Swedish, Tongan, Turkish, Urdu, and Yoruba, and qualitative English and Swahili versions, as well as versions for depression, schizophrenia, substance abuse, eating disorders, epilepsy, inflammatory bowel disease, leprosy, smoking, parents and caregivers of people with mental illness, and ethnicity. The various versions show reliability and validity across a wide range of languages, cultures, and writing systems. The most commonly reported findings of studies using the ISMI are that internalized stigma correlates with higher depression, lower self esteem, and higher symptom severity. Initial studies of ways to reduce internalized stigma are promising and warrant further investigation. © 2014.

  7. International military operations and mental health--A review.

    Science.gov (United States)

    Kaikkonen, Noora M; Laukkala, Tanja

    2016-01-01

    Volunteering in international military missions has been scrutinized for its effects on mental health. Different kinds of exposures to traumatic events are associated with a variety of mental disorders, mainly heightened rates of post-traumatic stress disorder (PTSD) and alcohol abuse. Based on the literature we discuss risk and protective factors concerning the psychological well-being of soldiers attending to international military operations. A systematic literature search was carried out using relevant search terms to identify the articles for this review. The ability to recognize and treat acute stress reactions during deployments is important. Post-deployment psychosocial support and services have a role in lowering barriers to care, diminishing stigma and also in recognizing individuals who suffer from psychological distress or psychiatric symptoms, to connect them with appropriate care. Further investigation of gender differences and the role of stigmatization is warranted. Most of those participating in international military operations are repatriated without problems, but repeated exposure to combat situations and other stressors may affect mental health in various ways. Stigmatization is still a barrier to care.

  8. 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.

  9. Nursing Associated Medication Errors: Are Internationally Educated Nurses Different from U.S. Educated Nurses?

    Directory of Open Access Journals (Sweden)

    Jay J. Shen

    2018-02-01

    Full Text Available Medication errors can be detrimental to patient safety and contribute to additional costs in healthcare. The United States has seen a steady increase in internationally-educated nurses (IENs entering the nursing workforce. The current study builds upon the existing research examining the relationship between IENs and medication errors by controlling for confounding factors and testing whether IENs were more likely to make multiple medication errors compared to USENs. This study was a quasi-case control study. The 2006 and 2010 medication error incident data from hospital risk management departments were used. The final sample was 1,773, representing 788 registered nurse in the case group and 985 registered nurses in the control group. Multivariable analyses were conducted to examine single medication error, multiple errors, and consequence of medication errors, in comparing the IENs to USENs. IENs tended to have multiple errors more often than USENs in 2006 (31.7% for IENs and 20.5% for USENs, p = 0.03, but these differences became marginally significant after combining both years of data and completing the multivariable models adjusting for covariates (Odds ratio = 1.38, p = 0.06. No significant differences in making a single error and medication error consequences were observed between IENs and USENs. Although no significant differences between IENs and USENs in having medication error incidents were observed, IENs might be more likely to have multiple medication error incidents in a year compared to USENs. Policies that encourage targeted orientation addressing implicit belief systems about the nursing role and explains patient safety expectations as well as procedures for medication administration may be beneficial for IENs. Supportive leadership that is culturally competent, ensures ongoing continuing education in pharmacology, and provides culturally appropriate incentives for self-reporting medication errors are important.

  10. 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.

  11. Contamination of cockroaches (Insecta: Blattaria) to medically fungi: A systematic review and meta-analysis.

    Science.gov (United States)

    Nasirian, H

    2017-12-01

    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.

  12. Different contributions of internal reviewers and external experts to labelling decisions on therapeutic indications in new drug reviews in Japan.

    Science.gov (United States)

    Yokota, M; Kusama, M; Matsuki, N; Ono, S

    2013-12-01

    External experts play an important role in shaping regulatory decisions in the new drug review process in the United States, Europe and Japan. No rigorous study has been performed addressing how and to what extent external experts, in contrast to internal reviewers in the agency, influence the regulatory decisions during new drug reviews. We examined their contributions in Japanese regulatory reviews in contrast to the internal reviewers, focusing on the labelling decision on therapeutic indications. With the data set of 219 new molecular entities (NMEs) approved in Japan from 2000 to 2009, we observed how proposed indications in labelling were modified in a stepwise manner during the review process and conducted multinomial logistic analysis to examine the possible mechanism behind. We found that interim assessment of indications by the internal reviewers was modified substantially by the influence of the external experts in about 20% of the 219 NMEs. Our analysis suggested that internal reviewers provided their opinion mainly based on strict review discipline, whereas external experts added flexibility and reality to their reviews. Our analysis revealed different evaluations between internal reviewers and external experts during regulatory discussions in new drug reviews and how the external panel contributes to changing internal decisions. This study provides a new and quantitative approach to better label setting by emphasizing the contributions of each stakeholder in new drug reviews, which would improve the efficiency, quality and transparency of new drug reviews to enhance public health. © 2013 John Wiley & Sons Ltd.

  13. 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

  14. 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.

  15. A student-initiated and student-facilitated international health elective for preclinical medical students.

    Science.gov (United States)

    Vora, Nirali; Chang, Mina; Pandya, Hemang; Hasham, Aliya; Lazarus, Cathy

    2010-02-15

    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. 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. 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. 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.

  16. 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

  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. 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

    2015-12-29

    To evaluate (1) the state of the art in sustainability research and (2) the outcomes of professionals' adherence to guideline recommendations in medical practice. Systematic review. 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. 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). 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. (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 sustainability of professionals' adherence to guidelines in medical practice can be drawn

  19. [Analysis of the current situation the oral medical interns' awareness on occupation safety behavior in college].

    Science.gov (United States)

    Hongyan, Song; Yu, Wang; Rongrong, He; Ying, Xu

    2015-04-01

    This study aims to determine the awareness oral medical interns about occupation safety protection of knowledge and to present a scientific basis for perfecting the occupation safety education system and standard protection behavior. A self-designed questionnaire that used a retrospective questionnaire survey on 425 stomatological interns, scoring, and statistical analysis of the survey were performed. The questionnaire included occupation safety prevention knowledge, behavior cognitive, and protective behavior, among others. The questionnaire recovery rate was 100%, and the average scores of the prevention knowledge and behavior cognitive were 4.55 ± 0.91 and 4.40 ± 1.05, respectively. More than 90% interns can conduct the conventional protection, and less than 40% can perform special protection. For the item "occupation safety protection knowledge", the scores of three grade III hospitals were higher than that of stomatological hospitals and second level of first-class hospitals; the difference was statistically significant (P safety protection knowledge, behavioral cognitive, and protection behavior. The average score was higher for than for boys in the three contents, and the average score of interns accepting pre-job training was higher than those rejected; the difference was statistically significant (P safety knowledge of oral medical interns is not sufficient, and the protective behavior is poor. Schools and hospitals should strengthen the intern occupation safety and protection education and improve the status of occupation safety behavior.

  20. International joint research of medical and walfare appliances; Iryo fukushi kiki kokusai kyodo kenkyu jigyo

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-03-01

    To further elevate the medical level and to actively enhance Japan`s contribution to the world in its effort to properly meet the task of advancing longevity of men common to all the advanced countries, investigations were made to study how international joint research should be conducted in the field of medical and welfare appliances. Candidate projects in international joint research and investigations up to fiscal 1993 were arranged, and explanation was made about the strategic and long-term research and development projects (started in fiscal 1995) about medical and welfare appliances undertaken by the Ministry of Trade and Industry of Japan. The two are quite similar to each other, the Ministry of Trade and Industry program comprising six projects that are micropores collection of blood/microdose analysis, high precision three dimensional image assisted diagnosis, less invasive surgery, artificial organs, care assisting intelligent equipment, and welfare equipment for care at home, centering about which international joint research should be propelled. Visits were made to the scenes of research and development of advanced medical and welfare appliances in the U.S. and Canada and their actual state was studied in search for possible joint researches. Further, research and development institutions in Europe were visited and information was exchanged. 25 figs., 15 tabs.

  1. Determinants of career choices among women and men medical students and interns.

    Science.gov (United States)

    Redman, S; Saltman, D; Straton, J; Young, B; Paul, C

    1994-09-01

    Women continue to be poorly represented in medical specialties other than general practice. A cross-sectional design was used to explore the development of career plans as medical training progressed; men and women students were compared in their first (n = 316), final (n = 295) and intern (n = 292) years. Women at each stage of training were significantly more likely to choose general practice as the field in which they were most likely to practise. There was little evidence that these differences were influenced by experience during training: women were as likely to choose general practice in first year as in the intern year. The most important determinant of career choice appeared to be the flexibility of training and of practice of medicine: variables such as the opportunity for part-time training, flexible working hours and part-time practice were important determinants of career choice and were of more importance to women than to men. The study also found high rates of discrimination or harassment reported by women medical students and interns. The results indicate the need for continued debate about these issues within medicine and the development of more flexible styles of medical training and practice.

  2. Perceptions of growth monitoring and promotion among an international panel of district medical officers.

    Science.gov (United States)

    Roberfroid, Dominique; Lefèvre, Pierre; Hoerée, Tom; Kolsteren, Patrick

    2005-09-01

    The growth chart has been proposed as an educational tool to make the child's growth visible to both health workers and caregivers and to enhance communication between them. In the case of growth faltering, this would trigger timely corrective measures. Although the relevance of growth monitoring and promotion (GMP) has often been questioned in the literature, opinions of District Medical Officers responsible for local implementation of GMP are unknown. The aim of this qualitative research was to explore the perceptions and difficulties of an international panel of District Medical Officers regarding GMP. As an exploratory study, in-depth interviews of an international panel of District Medical Officers (n=19) were conducted. Data were coded using the QSR Nudist 5.0 software. A discrepancy between intended purposes and practice of GMP was detected at two levels. First, lack of participation of care-givers was reported. Second, the District Medical Officers expressed a restrictive interpretation of the concept of growth monitoring. The communication with parents was never reported as a means or a result of GMP, neither as an evaluation criterion of programme efficiency. The growth chart was mainly considered a tool intended to be used by health services for the purpose of diagnosis. This two-fold discrepancy between the intention of international policy-planners and practice of local programme implementers could be a crucial factor affecting the performance of GMP. More emphasis should be put on social communication and involvement of caregivers.

  3. Reasons for medical evacuations of soldiers serving in International Security Assistance Force (ISAF) operation in Afghanistan.

    Science.gov (United States)

    Korzeniewski, Krzysztof; Gregulski, Robert

    2014-01-01

    The article presents the results of a research study into the reasons for medical evacuations of Polish military personnel taking part in the International Security Assistance Force (ISAF) operation in Afghanistan from 2007 to 2013. The authors have analysed medical records of 485 soldiers who were medically evacuated out of a combat zone in Afghanistan for battle injuries, non-battle injuries and diseases. Each medically evacuated Polish soldier was subjected to statistical analysis. The study population comprised 25,974 soldiers assigned to the Polish Military Contingent Afghanistan in the given period. From 2007 to 2013, 1.9% of the Polish military personnel (n = 485) participating in the ISAF operation in Afghanistan were evacuated for medical reasons before the scheduled termination of their contract. 40.6% of all medical evacuations were due to battle injuries, 32.4% due to non-battle injuries, and 27.0% due to diseases. ISAF is an example of a combat operation, in which battle injuries remain the leading health problem in mission participants. 3 of 4 Polish soldiers who were medically evacuated from Afghanistan were no longer fit for military service in the area of operations due to the traumas they had suffered.

  4. To what extent is clinical and laboratory information used to perform medication reviews in the nursing home setting? the CLEAR study

    Directory of Open Access Journals (Sweden)

    Mestres Gonzalvo C

    2015-05-01

    Full Text Available Carlota Mestres Gonzalvo,1 Kim PGM Hurkens,2 Hugo AJM de Wit,3 Brigit PC van Oijen,1 Rob Janknegt,1 Jos MGA Schols,4 Wubbo J Mulder,5 Frans R Verhey,6 Bjorn Winkens,7 Paul-Hugo M van der Kuy1 1Department of Clinical Pharmacology and Toxicology, Orbis Medical Centre, Sittard, 2Department of Internal Medicine, Section of Geriatric Medicine, Academic Medical Centre, Amsterdam, 3Department of Clinical Pharmacy and Toxicology, Atrium Medical Centre, Heerlen, 4Department of Family Medicine and Department of Health Services Research, School for Public Health and Primary Care, Maastricht University, 5Department of Internal Medicine, Maastricht University Medical Centre, 6Department of Psychiatry and Neuropsychology, Alzheimer Centre Limburg/School for Mental Health and Neurosciences, 7Department of Methodology and Statistics, School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands Background: The aim of this study was to evaluate to what extent laboratory data, actual medication, medical history, and/or drug indication influence the quality of medication reviews for nursing home patients. Methods: Forty-six health care professionals from different fields were requested to perform medication reviews for three different cases. Per case, the amount of information provided varied in three subsequent stages: stage 1, medication list only; stage 2, adding laboratory data and reason for hospital admission; and stage 3, adding medical history/drug indication. Following a slightly modified Delphi method, a multidisciplinary team performed the medication review for each case and stage. The results of these medication reviews were used as reference reviews (gold standard. The remarks from the participants were scored, according to their potential clinical impact, from relevant to harmful on a scale of 3 to -1. A total score per case and stage was calculated and expressed as a percentage of the total score from the expert

  5. [Publication rates of Turkish medical specialty and doctorate theses on Medical Microbiology, Clinical Microbiology and Infectious Diseases disciplines in international journals].

    Science.gov (United States)

    Sipahi, Oğuz Reşat; Caglayan Serin, Derya; Pullukcu, Hüsnü; Tasbakan, Meltem; Köseli Ulu, Demet; Yamazhan, Tansu; Arda, Bilgin; Sipahi, Hilal; Ulusoy, Sercan

    2014-04-01

    Writing a thesis is mandatory for getting a postgraduate medical degree in Turkey. Publication of the results of the thesis in an indexed journal makes the results available to researchers, however publication rate is usually low. The aim of this retrospective observational study was to investigate the publication rate of Turkish Infectious Diseases and Clinical Microbiology, Medical Microbiology specialty theses and Microbiology doctorate theses in international peer-review journals. On August 17th 2007, the thesis database of the Council of Higher Education of the Republic of Turkey (YOK) where all specialization and doctorate theses are recorded obligatorily, was searched for Infectious Diseases and Clinical Microbiology and Medical Microbiology specialty and Microbiology doctorate theses. Assuming that publication of a thesis would last at least six months, theses dated to February 2007 and after were excluded. The publication rate of those theses was found out by searching Science Citation Index-Expanded database for thesis author and supervisor between August 17-September 12, 2007. Chi-square test was used for statistical analysis. Our search yielded a total of 834 theses dated from 1997 to 2007, however 10 of them were excluded, since they were dated to February 2007 or after. It was found that the overall publication rate was 11.4% (94/824). The publication rates for Microbiology doctorate, Medical Microbiology and Infectious Diseases and Clinical Microbiology specialty theses were 13.7% (34/249), 10.7% (33/309) and 10.2% (27/266), respectively, with no statistical significance (p> 0.05). It was determined that nine (9.6%) of the 94 published theses belonged to 1997-2001 period, whereas 85 (80.4%) were in 2002-2007 period (p< 0.05). The probable reason for this increase was thought to be related with the updated criteria of YOK carried out in 2000 for academic promotions, nevertheless the publication rate of the investigated theses in international peer-review

  6. 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.

  7. 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.

  8. 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.

  9. Prevalence and pattern of misconceptions about semen loss and sexual prowess among male medical interns

    Directory of Open Access Journals (Sweden)

    Ajish G Mangot

    2017-01-01

    Full Text Available Introduction: Sexual misconceptions have been around in India for a very long time. Growing liberal attitudes toward sex and sexual permissiveness can be expected to occur in the context of improved sexual knowledge among people. However, sexual myths continue to remain rampant. Therefore, the present study was planned with the aim to assess the level of sexual misconceptions regarding semen loss prevalent among male medical interns. Participants and Methods: This was a cross-sectional study among unmarried male medical students doing an internship. Eighty-one interns were recruited after fulfilling predecided inclusion/exclusion criteria and were asked to complete a specially made questionnaire to assess their sexual beliefs anonymously in complete privacy. Responses were analyzed using frequency distribution. Results: Seventy-nine percent of the participants believed that loss of semen can lead to reduction in the size of the penis, while 44.44% (n = 36 believed that it leads to sexual weakness, 56.8% (n = 46 believed it can lead to physical weakness, and 56.8% (n = 46 believed that excess masturbation can decrease sexual prowess. Discussion: This study helps bring to light the prevalence of sexual misconceptions among medical interns in spite of reaching a stage where they are expected to have sound conceptual, theoretical, and practical knowledge about sexual health and wellbeing. There is a dearth of national and international studies exploring the sociocultural aspects of sexuality specifically among medical students. The findings from this study are expected to stimulate researchers and academicians into further exploring the aspect of sexuality among the young medical fraternity.

  10. "They Will Come to Understand": Supervisor Reflections on International Medical Electives.

    Science.gov (United States)

    Roebbelen, Erica; Dorman, Katie; Hunter, Andrea; Kraeker, Christian; O'Shea, Tim; Bozinoff, Nikki

    2018-03-22

    Phenomenon: Increasing numbers of medical students from high-income countries are undertaking international medical electives (IMEs) during their training. Much has been written about the benefits of these experiences for the student, and concerns have been raised regarding the burden of IMEs on host communities. The voices of physicians from low- and middle-income countries who supervise IMEs have not been explored in depth. The current study sought to investigate host-physician perspectives on IMEs. Host supervisors were recruited by convenience sampling through students travelling abroad for IMEs during the summer of 2012. From 2012 through 2014, 11 semistructured interviews were conducted by telephone with host supervisors from Nepal, Uganda, Ghana, Guyana, and Kenya. Participants were invited to describe their motivations for hosting IMEs and their experiences of the benefits and harms of IMEs. Interviews were transcribed verbatim and checked for accuracy. An initial coding framework was developed and underwent multiple revisions, after which analytic categories were derived using conventional qualitative content analysis. For host supervisors, visits from international medical students provided a window into the resource-rich medical practice of high-income countries, and supervisors positioned themselves, their education, and clinical expertise against perceived standards of the international students' context. Hosting IMEs also contributed to supervisors' identities as educators connected to a global community. Supervisors described the challenge of helping students navigate their distress when confronting global health inequity. Finally, the desire for increasingly reciprocal relationships was expressed as a hope for the future. Insights: IMEs can be formative for host supervisors' identities and are used to benchmark host institutions compared with international medical standards. Reciprocity was articulated as essential for IMEs moving forward.

  11. Use of the concept mapping in teaching during a medical rotation of interns: an exploratory study.

    Science.gov (United States)

    Kwas, Hamida; Ghédira, Habib

    2017-12-01

    Concept mapping is an excellent learning toolallowing to stimulate active learning.For this reason, the concept mapping is currently used increasingly in the medical and paramedical field. The aim of our study is to determine the contribution of teaching of medical interns by the concept mapping. Fourteen students enrolled at the same time in a medical rotation in Pulmonology were recruited for this exploratory study. Interns are divided into two groups (A and B).Both groups are taught by the clinical case method, illustrated by a concept mapping for group A interns. The evolution of the knowledge accuracy at post-testing has been greater in the group taught by the method of concept mapping: the number of correct responses increased in all participants of group A versus only 4 of group B. All students taught by concept mapping had at the post-test a note higher than or equal to 10/20 versus only three of the group taught by the method without concept map. The average score was 13 (11-15) in group A versus 10.28 (6-14) in group B. We emphasize the use of concept mapping in teaching especially in the faculty of medicine and we encourage clinicians to use this method in teaching interns in the hospital.

  12. Knowledge of palliative care among medical interns in a tertiary health institution in Northwestern Nigeria

    Directory of Open Access Journals (Sweden)

    Daniel Chukwunyere Nnadi

    2016-01-01

    Full Text Available Background: Palliative care is the proactive care which seeks to maximize quality of life for people and families facing life-threatening illnesses. Objectives: To ascertain the existing knowledge of palliative care among medical interns and determine the effect of a structured educational intervention on improvement of their knowledge levels. Subjects and Methods: This is a quasi-experimental, interventional study with a one group pre- and post-test design involving medical interns rotating through the various departments of the Usmanu Danfodiyo University Teaching Hospital, Sokoto. The study population was chosen by convenience sampling method. The interns completed a pre- and a post-test assessment following a structured educational intervention for the evaluation of knowledge of palliative care. Knowledge was evaluated by a self-administered structured questionnaire. Results: A total number of 49 medical interns were recruited, among whom were 41 males and 8 females. Their ages ranged from 21 to 36 years with a mean of 27.7 (standard deviation 2.14 years. In the pretest, 11/49 (22.5% of the respondents had poor knowledge level of palliative care; however, in the postintervention, only 2/49 (4.1% of the respondents had poor knowledge. Similarly, good knowledge levels appreciated from 9/49 (18.4% to 14/49 (28.6% while very good knowledge increased from 10/49 (20.4% to 19/49 (38.8%. This effect was statistically significant (Chi-square test 11.655 df = 3, P = 0.009. Conclusion: There is poor knowledge of palliative care among the interns due to ignorance. Following an educational intervention, the knowledge levels appreciated significantly. Palliative care should be part of the medical curriculum.

  13. 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

  14. SU-F-E-12: Elective International Rotations in Medical Physics Residency Programs

    International Nuclear Information System (INIS)

    Brown, D; Mundt, A; Einck, J; Pawlicki, T

    2016-01-01

    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

  15. The medical contribution to assessing allegations of torture in international fact-finding missions.

    Science.gov (United States)

    Pounder, Derrick J

    2011-05-20

    International fact-finding missions directed towards the exposure of possible ill-treatment of persons deprived of their liberty have become increasingly common within the framework of international treaties. Such country visits occur with the consent and co-operation of government, provide unfettered access to all places of detention and allow private interviews with detainees. The Committee for the Prevention of Torture of the Council of Europe, the United Nations Special Rapporteur on Torture, and the United Nations Subcommittee on Prevention of Torture all engage in such missions, and make use of a medical professional as part of the investigative team. The medical contribution to fact finding missions assessing ill-treatment of detainees includes an assessment of the conditions of detention, the regime and the medical services. Custody doctors and their records can be a rich source of information about physical ill-treatment. The interview and examination of detainees often occurs in circumstances which are far from ideal. The safety and wellbeing of the detainees, including protection from reprisals, is always paramount. A medical examination may disclose injuries corroborative of specific allegations. More often, a medical history of the effects of ill treatment and the description of resolved transient injuries provides corroboration, and also forms part of assessing the overall credibility of the detainee. Equally important is the consistency of the allegation with other evidence obtained from a wide variety of sources including the inspection of the place of alleged ill-treatment. The evolved working methods draw on the basic principles underlying police criminal investigations and crime scene examinations as well as forensic medicine. A forensic medical expert can be a useful part of the team in such international fact finding missions. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  16. Factors associated with dropout in medical education: a literature review

    DEFF Research Database (Denmark)

    O'Neill, Lotte; 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....

  17. Clarifying changes in student empathy throughout medical school: a scoping review.

    Science.gov (United States)

    Ferreira-Valente, Alexandra; Monteiro, Joana S; Barbosa, Rita M; Salgueira, Ana; Costa, Patrício; Costa, Manuel J

    2017-12-01

    Despite the increasing awareness of the relevance of empathy in patient care, some findings suggest that medical schools may be contributing to the deterioration of students' empathy. Therefore, it is important to clarify the magnitude and direction of changes in empathy during medical school. We employed a scoping review to elucidate trends in students' empathy changes/differences throughout medical school and examine potential bias associated with research design. The literature published in English, Spanish, Portuguese and French from 2009 to 2016 was searched. Two-hundred and nine potentially relevant citations were identified. Twenty articles met the inclusion criteria. Effect sizes of empathy scores variations were calculated to assess the practical significance of results. Our results demonstrate that scoped studies differed considerably in their design, measures used, sample sizes and results. Most studies (12 out of 20 studies) reported either positive or non-statistically significant changes/differences in empathy regardless of the measure used. The predominant trend in cross-sectional studies (ten out of 13 studies) was of significantly higher empathy scores in later years or of similar empathy scores across years, while most longitudinal studies presented either mixed-results or empathy declines. There was not a generalized international trend in changes in students' empathy throughout medical school. Although statistically significant changes/differences were detected in 13 out of 20 studies, the calculated effect sizes were small in all but two studies, suggesting little practical significance. At the present moment, the literature does not offer clear conclusions relative to changes in student empathy throughout medical school.

  18. Recommended standardized terminology of the anterior female pelvis based on a structured medical literature review.

    Science.gov (United States)

    Jeppson, Peter C; Balgobin, Sunil; Washington, Blair B; Hill, Audra Jolyn; Lewicky-Gaupp, Christina; Wheeler, Thomas; Ridgeway, Beri; Mazloomdoost, Donna; Balk, Ethan M; Corton, Marlene M; DeLancey, John

    2018-07-01

    The use of imprecise and inaccurate terms leads to confusion amongst anatomists and medical professionals. We sought to create recommended standardized terminology to describe anatomic structures of the anterior female pelvis based on a structured review of published literature and selected text books. We searched MEDLINE from its inception until May 2, 2016, using 11 medical subject heading terms to identify studies reporting on anterior female pelvic anatomy; any study type published in English was accepted. Nine textbooks were also included. We screened 12,264 abstracts, identifying 200 eligible studies along with 13 textbook chapters from which we extracted all pertinent anatomic terms. In all, 67 unique structures in the anterior female pelvis were identified. A total of 59 of these have been previously recognized with accepted terms in Terminologia Anatomica, the international standard on anatomical terminology. We also identified and propose the adoption of 4 anatomic regional terms (lateral vaginal wall, pelvic sidewall, pelvic bones, and anterior compartment), and 2 structural terms not included in Terminologia Anatomica (vaginal sulcus and levator hiatus). In addition, we identified 2 controversial terms (pubourethral ligament and Grafenberg spot) that require additional research and consensus from the greater medical and scientific community prior to adoption or rejection of these terms. We propose standardized terminology that should be used when discussing anatomic structures in the anterior female pelvis to help improve communication among researchers, clinicians, and surgeons. Copyright © 2018 Elsevier Inc. All rights reserved.

  19. [Delegation of medico-administrative tasks : what do medical interns and secretaries think?

    Science.gov (United States)

    Castioni, Julien; Hagenbuch, Angélique; Tâche, Johann; Cappai, Milva; Jovanovic, Milica; Sartori, Claudio

    2017-11-22

    The hospital activity of physicians in training mainly consists in direct contacts with patients, tasks indirectly linked to patients such as administration, as well as clinical and theoretical training. In our era of digitalization, an important administrative work load without any added medical value fills their daily chores. In parallel activities of medical secretaries are getting more partitioned, with their desks situated far from physicians' and tasks often limited to finalizing discharge letters. Added to multiple overtime, this reduces physicians' and secretaries' work satisfaction. This article describes the context and development of delegating medico-administrative tasks to secretaries in our department of internal medicine.

  20. [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.

  1. Evaluation of "Office-based" Course of Intern Students at Shahid Beheshti University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Behrokh Mahmoudzadeh

    2016-06-01

    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

  2. Pharmacist medication reviews to improve safety monitoring in primary care patients.

    Science.gov (United States)

    Gallimore, Casey E; Sokhal, Dimmy; Zeidler Schreiter, Elizabeth; Margolis, Amanda R

    2016-06-01

    Patients prescribed psychotropic medications within primary care are at risk of suboptimal monitoring. It is unknown whether pharmacists can improve medication safety through targeted monitoring of at risk populations. Access Community Health Centers implemented a quality improvement pilot project that included pharmacists on an integrated care team to provide medication reviews for patients. Aims were to determine whether inclusion of a pharmacist performing medication reviews within a primary care behavioral health (PCBH) practice is feasible and facilitates safe medication use. Pharmacists performed medication reviews of the electronic health record for patients referred for psychiatry consultation. Reviews were performed 1-3 months following consultation and focused on medications with known suboptimal monitoring rates. Reviews were documented within the EHR and routed to the primary care provider. Primary outcome measures were change in percentage up-to-date on monitoring and AIMS assessment, and at risk of experiencing drug interaction(s) between baseline and 3 months postreview. Secondary outcome was provider opinion of medication reviews collected via electronic survey. Reviews were performed for 144 patients. Three months postreview, percentage up-to-date on recommended monitoring increased 18% (p = .0001), at risk for drug interaction decreased 20% (p improved safety monitoring of psychotropic medications. Results identify key areas for improvement that other clinics considering integration of similar pharmacy services should consider. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  3. Job stress, satisfaction, and coping strategies among medical interns in a South Indian tertiary hospital.

    Science.gov (United States)

    Chandramouleeswaran, Susmita; Edwin, Natasha C; Braganza, Deepa

    2014-07-01

    It has previously been demonstrated that there is a significant drop in all domains of quality of life among interns during internship. 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. 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. After completion of 6 months of internship, the modified version of the HCJSSQ was administered to all participants. 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. 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. More people found internship satisfying than stressful. However, a high proportion found it stressful, and many reported unhealthy coping mechanisms.

  4. 10 CFR 707.13 - Medical review of results of tests for illegal drug use.

    Science.gov (United States)

    2010-01-01

    ... another test, performed by the gas chromatography/mass spectrometry method (GC/MS). This procedure is... 10 Energy 4 2010-01-01 2010-01-01 false Medical review of results of tests for illegal drug use... Procedures § 707.13 Medical review of results of tests for illegal drug use. (a) All test results shall be...

  5. Usually Available Clinical and Laboratory Data Are Insufficient for a Valid Medication Review: A Crossover Study

    NARCIS (Netherlands)

    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

  6. Medication effects on the rate of orthodontic tooth movement: a systematic literature review.

    NARCIS (Netherlands)

    Bartzela, T.N.; 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

  7. Tools for the direct observation and assessment of psychomotor skills in medical trainees: a systematic review.

    Science.gov (United States)

    Jelovsek, J Eric; Kow, Nathan; Diwadkar, Gouri B

    2013-07-01

    The Accreditation Council for Graduate Medical Education (ACGME) Milestone Project mandates programmes to assess the attainment of training outcomes, including the psychomotor (surgical or procedural) skills of medical trainees. The objectives of this study were to determine which tools exist to directly assess psychomotor skills in medical trainees on live patients and to identify the data indicating their psychometric and edumetric properties. An electronic search was conducted for papers published from January 1948 to May 2011 using the PubMed, Education Resource Information Center (ERIC), Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Web of Science electronic databases and the review of references in article bibliographies. A study was included if it described a tool or instrument designed for the direct observation of psychomotor skills in patient care settings by supervisors. Studies were excluded if they referred to tools that assessed only clinical or non-technical skills, involved non-medical health professionals, or assessed skills performed on a simulator. Overall, 4114 citations were screened, 168 (4.1%) articles were reviewed for eligibility and 51 (1.2%) manuscripts were identified as meeting the study inclusion criteria. Three authors abstracted and reviewed studies using a standardised form for the presence of key psychometric and edumetric elements as per ACGME and American Psychological Association (APA) recommendations, and also assigned an overall grade based on the ACGME Committee on Educational Outcome Assessment grading system. A total of 30 tools were identified. Construct validity based on associations between scores and training level was identified in 24 tools, internal consistency in 14, test-retest reliability in five and inter-rater reliability in 20. The modification of attitudes, knowledge or skills was reported using five tools. The seven-item Global Rating Scale and the Procedure-Based Assessment received an

  8. Humanities in undergraduate medical education: a literature review.

    Science.gov (United States)

    Ousager, Jakob; Johannessen, Helle

    2010-06-01

    Humanities form an integral part of undergraduate medical curricula at numerous medical schools all over the world, and medical journals publish a considerable quantity of articles in this field. The aim of this study was to determine the extent to which the literature on humanities in undergraduate medical education seeks to provide evidence of a long-term impact of this integration of humanities in undergraduate medical education. Medline was searched for publications concerning the humanities in undergraduate medical education appearing from January 2000 to December 2008. All articles were manually sorted by the authors. Two hundred forty-five articles were included in the study. Following a qualitative analysis, the references included were categorized as "pleading the case," "course descriptions and evaluations," "seeking evidence of long-term impact," or "holding the horses." Two hundred twenty-four articles out of 245 either praised the (potential) effects of humanities on medical education or described existing or planned courses without offering substantial evidence of any long-term impact of these curricular activities on medical proficiency. Only 9 articles provided evidence of attempts to document long-term impacts using diverse test tools, and 10 articles presented relatively reserved attitudes toward humanities in undergraduate medical education. Evidence on the positive long-term impacts of integrating humanities into undergraduate medical education is sparse. This may pose a threat to the continued development of humanities-related activities in undergraduate medical education in the context of current demands for evidence to demonstrate educational effectiveness.

  9. How are medication errors defined? A systematic literature review of definitions and characteristics

    DEFF Research Database (Denmark)

    Lisby, Marianne; Nielsen, L P; Brock, Birgitte

    2010-01-01

    Multiplicity in terminology has been suggested as a possible explanation for the variation in the prevalence of medication errors. So far, few empirical studies have challenged this assertion. The objective of this review was, therefore, to describe the extent and characteristics of medication er...... error definitions in hospitals and to consider the consequences for measuring the prevalence of medication errors....

  10. 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:…

  11. 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 provide...

  12. Methodological review of UK and international low carbon scenarios

    International Nuclear Information System (INIS)

    Hughes, Nick; Strachan, Neil

    2010-01-01

    Scenarios have a long history in business, politics and military planning, as a tool for strategic planning to inform protective, proactive or consensus-based decision making in the face of uncertain futures. Recent years have seen a growth in scenarios for assessing the implications of low carbon futures, but relatively little work has linked these energy scenarios to the broader literature on scenario development. This paper undertakes a methodological review of a selection of UK and international low carbon scenario studies, using a typology of 'trend based', 'technical feasibility' and 'modelling' studies. Dominant methodologies in such studies have been the 2x2 axis and the 'back-casting' approach. Strengths of the studies reviewed include technological detail, and identification of key economic and social constraints. Weaknesses include the over-reliance on constructs such as exogenous emissions constraints, and high level trends, which diminish the ability to understand how the various future scenarios could be brought about or avoided. This is compounded by the lack of depiction of specific system actors; the tendency to abstract policy from the scenarios; and the resulting failure to consider policy, technology and behaviour in an iterative, 'co-evolving' fashion.

  13. Medication reconciliation and prescribing reviews by pharmacy technicians in a geriatric ward

    DEFF Research Database (Denmark)

    Buck, Thomas Croft; Gronkjaer, Louise Smed; Duckert, Marie-Louise

    2013-01-01

    OBJECTIVE: Incomplete medication histories obtained on hospital admission are responsible for more than 25% of prescribing errors. This study aimed to evaluate whether pharmacy technicians can assist hospital physicians' in obtaining medication histories by performing medication reconciliation an...... reconciliation and focused medication reviews. Further randomized, controlled studies including a larger number of patients are required to elucidate whether these observations are of significance and of importance for securing patient safety....... and prescribing reviews. A secondary aim was to evaluate whether the interventions made by pharmacy technicians could reduce the time spent by the nurses on administration of medications to the patients. METHODS: This observational study was conducted over a 7 week period in the geriatric ward at Odense...... University Hospital, Denmark. Two pharmacy technicians conducted medication reconciliation and prescribing reviews at the time of patients' admission to the ward. The reviews were conducted according to standard operating procedures developed by a clinical pharmacist and approved by the Head of the Geriatric...

  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. 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.

  16. Review of the Proceedings of the European Society for Medical Oncology (ESMO 2017 Congress

    Directory of Open Access Journals (Sweden)

    A. A. Kirichek

    2017-01-01

    Full Text Available The European Society for Medical Oncology (ESMO Congress in partnership with the European Association for Cancer Research took place between September 8th and 12th of 2017 in Madrid. In 42 years of its existence, the forum has grown from a regional educational meeting in Europe to the main international event in oncology. The key topic of this Congress was integration of molecular biology knowledge with clinical specialties. The ESMO 2017 Congress united almost 24,000 professionals of various fields from 131 countries who submitted 1736 abstracts. More than 50 scientific abstracts which were deemed worthy of special discussion and capable of changing current clinical practice, were separated into a category of late-breaking abstract (LBA. This review highlights some important topics of oncological urology that were discussed at the ESMO 2017 Congress.

  17. Literature review on the tele medical advice for ships (TMAS) 2005-2015

    DEFF Research Database (Denmark)

    Canals, M. Luisa; Jensen, Olaf Chresten; Eliseo Prisno-III, Don

    Background: The presentation will provide a review of the international scientific literature on telemedical assistance for ships (TMAS) during the latest 10 years. Materials and Methods: The literature search was done in collaboration in the three geographical IMHA-research groups by using Pub......Med and the respective national scientific journals. The search terms used: "telemedicine AND maritime, seafarers, ships, shipping, fishermen, fisherman, fishing, passengers". Results: All the abstracts (n= 54) were entered in the Zotero database and distributed in 5 categories: TMAS cross-sectional studies, n=14...... interesting articles can be found. Conclusions: The cross-sectional studies show that cardio-vascular disease and injuries form the main parts of the radio medical advice in the merchant, the fishing and the passenger/cruise ships segments. Even if the national TMAS centres have highly technical developed...

  18. 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.

  19. [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.

  20. Technology-assisted education in graduate medical education: a review of the literature

    OpenAIRE

    Jwayyed, Sharhabeel; Stiffler, Kirk A; Wilber, Scott T; Southern, Alison; Weigand, John; Bare, Rudd; Gerson, Lowell W

    2011-01-01

    Studies on computer-aided instruction and web-based learning have left many questions unanswered about the most effective use of technology-assisted education in graduate medical education. Objective We conducted a review of the current medical literature to report the techniques, methods, frequency and effectiveness of technology-assisted education in graduate medical education. Methods A structured review of MEDLINE articles dealing with "Computer-Assisted Instruction," "Internet or World W...

  1. Atomic bomb suffering and Chernobyl accident lessons learnt from international medical aid programs

    International Nuclear Information System (INIS)

    Yamashita, Shunichi

    2005-01-01

    The cooperative medical projects between Nagasaki University and countries of the former USSR have had being performed in mainly two regions: Chernobyl and Semipalatinsk since 1990 and 1995, respectively. The 21 st Center of Excellence (COE) program of ''International Consortium for Medical Care of Hibakusha and Radiation Life Science'' recently established in Nagasaki University can now serve our knowledge and experience much more directly. Its activity can be further extended to the radiocontaminated areas around the world, and based on the lessons of the past, it can indeed contribute to the future planning of the Network of Excellence (NOE) for Radiation Education Program as well as Radiation Emergency Medical Preparedness and Assistance under the auspices of the WHO-REMPAN. Within the frame of International Consortium of Radiation Research, a molecular epidemiology of thyroid diseases are now conducted in our departments in addition to international medical assistance. The clue of radiation-associated thyroid carcinogenesis may give us a new concept on experimental and epidemiological approaches to low dose radiation effects on human health, including those of internal radiation exposure. Concerning the role and responsibility of our work to the public, to avoid unnecessary radiophobia and to correctly understand radiation hazard and safety, we must build a bridge between basic research and widely open public education. Therefore, it is of high necessity to continuously work on clarification of the effects of ionizing radiation on human beings worldwide and to contribute the development of general guideline of radiation safety and radiation hazard, and to strive for the creation of substantiated radiation protection programs. (author)

  2. Atomic bomb suffering and Chernobyl accident lessons learnt from international medical aid programs

    Energy Technology Data Exchange (ETDEWEB)

    Yamashita, Shunichi [Nagasaki Univ. Graduate School of Biomedical Sciences, Atomic Bomb Disease Inst., Dept. of Molecular Medicine, Nagasaki (Japan)

    2005-03-01

    The cooperative medical projects between Nagasaki University and countries of the former USSR have had being performed in mainly two regions: Chernobyl and Semipalatinsk since 1990 and 1995, respectively. The 21{sup st} Center of Excellence (COE) program of ''International Consortium for Medical Care of Hibakusha and Radiation Life Science'' recently established in Nagasaki University can now serve our knowledge and experience much more directly. Its activity can be further extended to the radiocontaminated areas around the world, and based on the lessons of the past, it can indeed contribute to the future planning of the Network of Excellence (NOE) for Radiation Education Program as well as Radiation Emergency Medical Preparedness and Assistance under the auspices of the WHO-REMPAN. Within the frame of International Consortium of Radiation Research, a molecular epidemiology of thyroid diseases are now conducted in our departments in addition to international medical assistance. The clue of radiation-associated thyroid carcinogenesis may give us a new concept on experimental and epidemiological approaches to low dose radiation effects on human health, including those of internal radiation exposure. Concerning the role and responsibility of our work to the public, to avoid unnecessary radiophobia and to correctly understand radiation hazard and safety, we must build a bridge between basic research and widely open public education. Therefore, it is of high necessity to continuously work on clarification of the effects of ionizing radiation on human beings worldwide and to contribute the development of general guideline of radiation safety and radiation hazard, and to strive for the creation of substantiated radiation protection programs. (author)

  3. Integrating topics of sex and gender into medical curricula-lessons from the international community.

    Science.gov (United States)

    Miller, Virginia M; Kararigas, Georgios; Seeland, Ute; Regitz-Zagrosek, Vera; Kublickiene, Karolina; Einstein, Gillian; Casanova, Robert; Legato, Marianne J

    2016-01-01

    In the era of individualized medicine, training future scientists and health-care providers in the principles of sex- and gender-based differences in health and disease is critical in order to optimize patient care. International successes to incorporate these concepts into medical curricula can provide a template for others to follow. Methodologies and resources are provided that can be adopted and adapted to specific needs of other institutions and learning situations.

  4. 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

  5. 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

  6. 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

  7. Systematic reviews in context: highlighting systematic reviews relevant to Africa in the Pan African Medical Journal.

    Science.gov (United States)

    Wiysonge, Charles Shey; Kamadjeu, Raoul; Tsague, Landry

    2016-01-01

    contribute in enhancing the value of research in Africa, the Pan African Medical Journal will start a new regular column that will highlight priority systematic reviews relevant to the continent.

  8. [The confrontation of sexuality in the professional practice of future physicians: the viewpoint of medical interns].

    Science.gov (United States)

    Salinas Urbina, Addis Abeba; Jarillo Soto, Edgar Carlos

    2013-03-01

    The subject of sexuality in academic and service institutions is perceived through predominantly biological conceptual perspectives, blurring the subjective component that is imbued in social and cultural processes. The meanings that medical staff construct around sexuality have implications in their professional development and practice. This work presents results from a qualitative study into the meaning of sexuality among medical interns from the Universidad Autónoma Metropolitana-Xochimilco. In-depth interviews were conducted with students during their community service. This group was selected because they had finished their studies and were performing an independent and autonomous professional practice. The results, which were analyzed based on Grounded Theory, revealed three dichotomies: biology vs. social construction, individual vs. professional and theoretical learning vs. experiences in the community. The most relevant aspect revealed was the antagonism found between a medical intern's biology-centered academic knowledge and the challenge posed by their patients' reproductive and sexual health needs. The interns recognize that they lack the necessary skills to face issues of sexuality in their professional practice.

  9. Structural barriers in access to medical marijuana in the USA-a systematic review protocol.

    Science.gov (United States)

    Valencia, Celina I; Asaolu, Ibitola O; Ehiri, John E; Rosales, Cecilia

    2017-08-07

    There are 43 state medical marijuana programs in the USA, yet limited evidence is available on the demographic characteristics of the patient population accessing these programs. Moreover, insights into the social and structural barriers that inform patients' success in accessing medical marijuana are limited. A current gap in the scientific literature exists regarding generalizable data on the social, cultural, and structural mechanisms that hinder access to medical marijuana among qualifying patients. The goal of this systematic review, therefore, is to identify the aforementioned mechanisms that inform disparities in access to medical marijuana in the USA. This scoping review protocol outlines the proposed study design for the systematic review and evaluation of peer-reviewed scientific literature on structural barriers to medical marijuana access. The protocol follows the guidelines set forth by the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) checklist. The overarching goal of this study is to rigorously evaluate the existing peer-reviewed data on access to medical marijuana in the USA. Income, ethnic background, stigma, and physician preferences have been posited as the primary structural barriers influencing medical marijuana patient population demographics in the USA. Identification of structural barriers to accessing medical marijuana provides a framework for future policies and programs. Evidence-based policies and programs for increasing medical marijuana access help minimize the disparity of access among qualifying patients.

  10. Islamic medical jurisprudence syllabus: A Review in Saudi Arabia.

    Science.gov (United States)

    Chamsi-Pasha, H; Albar, M A

    2017-10-01

    The ever-increasing technological advances of Western medicine have created new ethical issues awaiting answers and response. The use of genetic therapy, organ transplant, milk-banking, end-of-life care and euthanasia are of paramount importance to the medical students and need to be addressed. A series of searches were conducted of Medline databases published in English between January 2000 and January 2017 with the following keywords: medical ethics, syllabus, Islam, jurisprudence. Islamic medical jurisprudence is gaining more attention in some medical schools. However, there is still lack of an organised syllabus in many medical colleges. The outlines of a syllabus in Islamic medical jurisprudence including Islamic values and moral principles related to both the practice and research of medicine are explored.

  11. A review of medical terminology standards and structured reporting.

    Science.gov (United States)

    Awaysheh, Abdullah; Wilcke, Jeffrey; Elvinger, François; Rees, Loren; Fan, Weiguo; Zimmerman, Kurt

    2018-01-01

    Much effort has been invested in standardizing medical terminology for representation of medical knowledge, storage in electronic medical records, retrieval, reuse for evidence-based decision making, and for efficient messaging between users. We only focus on those efforts related to the representation of clinical medical knowledge required for capturing diagnoses and findings from a wide range of general to specialty clinical perspectives (e.g., internists to pathologists). Standardized medical terminology and the usage of structured reporting have been shown to improve the usage of medical information in secondary activities, such as research, public health, and case studies. The impact of standardization and structured reporting is not limited to secondary activities; standardization has been shown to have a direct impact on patient healthcare.

  12. 78 FR 70598 - Submission for Review: Request for External Review (3206-NEW); Model Notice of Final Internal...

    Science.gov (United States)

    2013-11-26

    ... notice to enrollees about the result of any final internal adverse benefit determination, their external... OFFICE OF PERSONNEL MANAGEMENT Submission for Review: Request for External Review (3206-NEW); Model Notice of Final Internal Adverse Benefit Determination and Case Intake Form AGENCY: U.S. Office of...

  13. Lessons Learned from PISA: A Systematic Review of Peer-Reviewed Articles on the Programme for International Student Assessment

    Science.gov (United States)

    Hopfenbeck, Therese N.; Lenkeit, Jenny; El Masri, Yasmine; Cantrell, Kate; Ryan, Jeanne; Baird, Jo-Anne

    2018-01-01

    International large-scale assessments are on the rise, with the Programme for International Student Assessment (PISA) seen by many as having strategic prominence in education policy debates. The present article reviews PISA-related English-language peer-reviewed articles from the programme's first cycle in 2000 to its most current in 2015. Five…

  14. 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.

  15. The scholar role in the National Competence Based Catalogues of Learning Objectives for Undergraduate Medical Education (NKLM) compared to other international frameworks.

    Science.gov (United States)

    Hautz, Stefanie C; Hautz, Wolf E; Keller, Niklas; Feufel, Markus A; Spies, Claudia

    2015-01-01

    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? 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. Extracted contents of all frameworks may be summarized into the components Common Basics, Clinical Application, Research, Teaching and Education, and Lifelong Learning. Compared to the included frameworks the NKLM emphasises competencies necessary for research and teaching while clinical application is less prominently mentioned. 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.

  16. 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.

  17. A systematic review of factors influencing student ratings in undergraduate medical education course evaluations

    OpenAIRE

    Schiekirka, Sarah; Raupach, Tobias

    2015-01-01

    Background Student ratings are a popular source of course evaluations in undergraduate medical education. Data on the reliability and validity of such ratings have mostly been derived from studies unrelated to medical education. Since medical education differs considerably from other higher education settings, an analysis of factors influencing overall student ratings with a specific focus on medical education was needed. Methods For the purpose of this systematic review, online databases (Pu...

  18. Health Information Technology Continues to Show Positive Effect on Medical Outcomes: Systematic Review

    OpenAIRE

    Kruse, Clemens Scott; Beane, Amanda

    2018-01-01

    Background Health information technology (HIT) has been introduced into the health care industry since the 1960s when mainframes assisted with financial transactions, but questions remained about HIT’s contribution to medical outcomes. Several systematic reviews since the 1990s have focused on this relationship. This review updates the literature. Objective The purpose of this review was to analyze the current literature for the impact of HIT on medical outcomes. We hypothesized that there is...

  19. 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…

  20. A systematic review of the effectiveness of videoconference-based tele-education for medical and nursing education.

    Science.gov (United States)

    Chipps, Jennifer; Brysiewicz, Petra; Mars, Maurice

    2012-04-01

    Rural nurses and doctors typically have little opportunity to further their education and training. Studies have shown high participant satisfaction with the use of educational technology, such as videoconferencing, for education. A review of effectiveness of videoconference-based tele-education for medical and nursing education was conducted. The aims of this study were to: (1) systematically review the literature and critique the research methods on studies addressing the review question: "How effective is videoconference-based education for the education of doctors and nurses?" (2) summarize the existing evidence on the effectiveness of videoconference education for medical and nursing staff; and (3) apply the findings to South Africa and other countries across the globe. Research citations from 1990 to 2011 from cumulative index of nursing and allied health literature, Medline, Pubmed, PsycInfo, EBSCOhost, SABINET, Cochrane Database of Systematic Reviews, the Cochrane Controlled Trial Registry, Database of Abstracts of Reviews of Effectiveness, unpublished abstracts through NEXUS and Internet search engines (Google/Google scholar) were searched. Review methods included searching, sifting, abstraction, and quality assessment of relevant studies by two reviewers. Studies were evaluated for sample, design, intervention, threats to validity, and outcomes. No meta-analysis was conducted as the studies provided heterogeneous outcome data. Five studies were reviewed. Videoconference and face-to-face education is at least equivalent and one study reported an increase in knowledge and knowledge integration. Despite the methodological limitations and heterogeneity of the reviewed studies, there appears to be sufficient evidence of effectiveness to provide a rigorous Grade B evidence-based recommendation of moderate support. The use of videoconferencing for nursing and medical education should be encouraged along with guidelines for the use of videoconferencing. The

  1. Quarantine after an international biological weapons attack: medical and public health requirements for containment.

    Science.gov (United States)

    Oren, Meir

    2004-11-01

    The world now faces the dreadful possibility of biological weapons attacks by terrorists. Healthcare systems would have to cope with such emergencies should all preemptive measures fail. Information gained from the Global Mercury exercise and the SARS outbreak has shown that containing an outbreak at the start is more effective than reacting to it once it has spread and that containment should be treated both nationally and internationally. On the national level this entails developing rapid and effective methods to detect and identify infected cases, and implementing isolation and control measures to lower the risk of further transmission of the disease while assuring the safety of medical teams and laboratory workers. Strategic contingency plans should incorporate well-defined procedures for hospitalization and isolation of patients, providing regional backup of medical personnel and equipment and maintaining close cooperation between the various bodies in the healthcare system. Quarantine is an effective containment measure, especially if voluntarily imposed. Modern communication systems can help by sending professional teams timely instructions and providing the public with information to reduce panic and stress during quarantine procedures. Informing the public poses a dilemma: finding a balance between giving advance warning of an imminent epidemic outbreak and ascertaining the likelihood of its occurrence. Containment of international bioterrorist attacks depends entirely on close international cooperation to implement national and international strategic contingency plans with free exchange of information and recognition of procedures.

  2. An integrative review of the literature on registered nurses' medication competence.

    Science.gov (United States)

    Sulosaari, Virpi; Suhonen, Riitta; Leino-Kilpi, Helena

    2011-02-01

    The aim of this integrative literature review was to describe registered nurses' medication competence. The objectives of the literature review were to chart the need for future studies and use the results for instrument development. Nurses play a vital role in different phases of a patient's medication process and thus need adequate competence to fulfil their role. Research on nurses' level of medication competence in different competency areas has been published. However, previous studies have lacked a comprehensive or integrated definition or description of medication competence in nursing. Integrative literature review. The integrative literature review followed five stages: (1) problem identification, (2) literature search, (3) data evaluation, (4) data analysis and (5) presentation. Eligible articles were identified via systematic literature search of research and evidence-based--databases. Twenty-one studies met the selection criteria. Eleven competency areas that constitute nurses' medication competence were identified: (1) anatomy and physiology, (2) pharmacology, (3) communication, (4) interdisciplinary collaboration, (5) information seeking, (6) mathematical and medication calculation, (7) medication administration, (8) medication education, (9) assessment and evaluation, (10) documentation and (11) promoting medication safety as part of patient safety. The analysis revealed three major categories which integrate these competency areas: (1) decision making competence, (2) theoretical competence and (3) practical competence. Medication competence requires a solid knowledge base and the ability to apply that knowledge in real-life situations during often complex and dynamic patient medication processes. Decision making competence was found to be an important and integral part of a nurses' theoretical and practical competence. These main competence categories integrated all of the 11 competency areas identified in this review. It is important to determine

  3. Waste management assessment and technical review programme. WATRP. An international peer review service for radioactive waste management activities

    International Nuclear Information System (INIS)

    1994-09-01

    International Atomic Energy Agency provides international peer review services in radioactive waste management to those Member States that have established radioactive waste management programmes. Such services are provided within Waste Management Assessment and Technical Review Programme (WATRP). The main objective of WATRP is to provide international expertise and information on a requested subject in the field of radioactive waste management and to validate that programmes and activities are sound and performing well. Refs, figs and tabs

  4. 78 FR 5558 - Medical Review Board Public Meeting

    Science.gov (United States)

    2013-01-25

    ... fatigue-related research concerning bus and motorcoach drivers to identify relevant scientific and medical... ``medical standards for operators of commercial motor vehicles that will ensure that the physical condition... of the MRB is open to the public. Oral comments on the topic from the public will be heard during the...

  5. Review of determinants of national medical leadership development

    NARCIS (Netherlands)

    Keijser, Wouter Alexander; Poorthuis, Max Bastiaan; Tweedie, Judith; Wilderom, Celeste P.M.

    2017-01-01

    Increasingly, physician engagement in management, quality and innovation is being recognised as vital, requiring ’medical leadership’ (ML) competencies. Besides numerous local institutional efforts and despite the high level of autonomy of the medical profession and the education of its members, in

  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. Workplace-based assessment for vocational registration of international medical graduates.

    Science.gov (United States)

    Lillis, Steven; Van Dyk, Valencia

    2014-01-01

    Medical regulatory authorities need efficient and effective methods of ensuring the competence of immigrating international medical graduates (IMGs). Not all IMGs who apply for specialist vocational registration will have directly comparable qualifications to those usually accepted. As general licensure examinations are inappropriate for these doctors, workplace-based assessment (WBA) techniques would appear to provide a solution. However, there is little published data on such outcomes. All cases of WBA (n = 81) used for vocational registration of IMGs in New Zealand between 2008 and 2013 were collated and analyzed. The successful completion rate of IMGs through the pathway was 87%. The majority (64%) undertook the year of supervised practice and the final assessment in a provincial center. For those unsuccessful in the pathway, inadequate clinical knowledge was the most common deficit found, followed by poor clinical reasoning. A WBA approach for assessing readiness of IMGs for vocational registration is feasible. The constructivist theoretical perspective of WBA has particular advantages in assessing the standard of practice for experienced practitioners working in narrow scopes than traditional methods of assessment. The majority of IMGs undertook both the clinical year and the assessment in provincial hospitals, thus providing a workforce for underserved areas. © 2014 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital Medical Education.

  8. Brain abscess: a review | Magoha | East African Medical Journal

    African Journals Online (AJOL)

    Objective: To carry out a current review of brain abscess data source: review of all the published literature on the brain abscess until august 2016 was carried out through internet, google, pubmed and medline searches. Data selection: Published data on brain abscess were included in the review. Data extraction: Abstracts ...

  9. World Workshop on Oral Medicine VI : a systematic review of medication-induced salivary gland dysfunction

    NARCIS (Netherlands)

    Villa, Alessandro; Wolff, A.; Narayana, N.; Dawes, C.; Aframian, D. J.; Pedersen, A. M. Lynge; Vissink, A.; Aliko, A.; Sia, Y. W.; Joshi, R. K.; McGowan, R.; Jensen, S. B.; Kerr, A. R.; Ekstrom, J.; Proctor, G.

    The aim of this paper was to perform a systematic review of the pathogenesis of medication-induced salivary gland dysfunction (MISGD). Review of the identified papers was based on the standards regarding the methodology for systematic reviews set forth by the World Workshop on Oral Medicine IV and

  10. Literature review on recent international activity in cooperative vehicle-highway automation systems.

    Science.gov (United States)

    2012-12-01

    This literature review supports the report, Recent International Activity in Cooperative VehicleHighway Automation Systems. It : reviews the published literature in English dating from 2007 or later about non-U.S.-based work on cooperative vehicle...

  11. Drug-related problems identified in medication reviews by Australian pharmacists

    DEFF Research Database (Denmark)

    Stafford, Andrew C; Tenni, Peter C; Peterson, Gregory M

    2009-01-01

    OBJECTIVE: In Australia, accredited pharmacists perform medication reviews for patients to identify and resolve drug-related problems. We analysed the drug-related problems identified in reviews for both home-dwelling and residential care-facility patients. The objective of this study was to exam......OBJECTIVE: In Australia, accredited pharmacists perform medication reviews for patients to identify and resolve drug-related problems. We analysed the drug-related problems identified in reviews for both home-dwelling and residential care-facility patients. The objective of this study....... These reviews had been self-selected by pharmacists and submitte