WorldWideScience

Sample records for kaiser-permanente medical groups

  1. Something is amiss in Denmark: A comparison of preventable hospitalisations and readmissions for chronic medical conditions in the Danish Healthcare system and Kaiser Permanente

    DEFF Research Database (Denmark)

    Schiøtz, Michaela Louise; Price, Mary; Frølich, Anne

    2011-01-01

    As many other European healthcare systems the Danish healthcare system (DHS) has targeted chronic condition care in its reform efforts. Benchmarking is a valuable tool to identify areas for improvement. Prior work indicates that chronic care coordination is poor in the DHS, especially in comparison...... with care in Kaiser Permanente (KP), an integrated delivery system based in the United States. We investigated population rates of hospitalisation and readmission rates for ambulatory care sensitive, chronic medical conditions in the two systems....

  2. Kaiser Permanente's performance improvement system, Part 1: From benchmarking to executing on strategic priorities.

    Science.gov (United States)

    Schilling, Lisa; Chase, Alide; Kehrli, Sommer; Liu, Amy Y; Stiefel, Matt; Brentari, Ruth

    2010-11-01

    By 2004, senior leaders at Kaiser Permanente, the largest not-for-profit health plan in the United States, recognizing variations across service areas in quality, safety, service, and efficiency, began developing a performance improvement (PI) system to realizing best-in-class quality performance across all 35 medical centers. MEASURING SYSTEMWIDE PERFORMANCE: In 2005, a Web-based data dashboard, "Big Q," which tracks the performance of each medical center and service area against external benchmarks and internal goals, was created. PLANNING FOR PI AND BENCHMARKING PERFORMANCE: In 2006, Kaiser Permanente national and regional continued planning the PI system, and in 2007, quality, medical group, operations, and information technology leaders benchmarked five high-performing organizations to identify capabilities required to achieve consistent best-in-class organizational performance. THE PI SYSTEM: The PI system addresses the six capabilities: leadership priority setting, a systems approach to improvement, measurement capability, a learning organization, improvement capacity, and a culture of improvement. PI "deep experts" (mentors) consult with national, regional, and local leaders, and more than 500 improvement advisors are trained to manage portfolios of 90-120 day improvement initiatives at medical centers. Between the second quarter of 2008 and the first quarter of 2009, performance across all Kaiser Permanente medical centers improved on the Big Q metrics. The lessons learned in implementing and sustaining PI as it becomes fully integrated into all levels of Kaiser Permanente can be generalized to other health care systems, hospitals, and other health care organizations.

  3. The impact of removing financial incentives from clinical quality indicators : longitudinal analysis of four Kaiser Permanente indicators

    NARCIS (Netherlands)

    Lester, H.; Schmittdiel, J.; Selby, J.; Fireman, B.; Campbell, S.M.; Lee, J.; Whippy, A.; Madvig, P.

    2010-01-01

    OBJECTIVE: To evaluate the effect of financial incentives on four clinical quality indicators common to pay for performance plans in the United Kingdom and at Kaiser Permanente in California. DESIGN: Longitudinal analysis. SETTING: 35 medical facilities of Kaiser Permanente Northern California, 1997

  4. Investing in Obesity Treatment: Kaiser Permanente's Approach to Chronic Disease Management.

    Science.gov (United States)

    Tsai, Adam G; Histon, Trina; Donahoo, W Troy; Hashmi, Shahid; Murali, Sameer; Latare, Peggy; Oliver, Lajune; Slovis, Jennifer; Grall, Sarah; Fisher, David; Solomon, Loel

    2016-09-01

    Kaiser Permanente, an integrated health care delivery system in the USA, takes a "whole systems" approach to the chronic disease of obesity that begins with efforts to prevent it by modifying the environment in communities and schools. Aggressive case-finding and substantial investment in intensive lifestyle modification programs target individuals at high risk of diabetes and other weight-related conditions. Kaiser Permanente regions are increasingly standardizing their approach when patients with obesity require treatment intensification using medically supervised diets, prescription medication to treat obesity, or weight loss surgery.

  5. Systemic implementation strategies to improve hypertension: the Kaiser Permanente Southern California experience.

    Science.gov (United States)

    Sim, John J; Handler, Joel; Jacobsen, Steven J; Kanter, Michael H

    2014-05-01

    The past decade has seen hypertension improving in the United States where control is approximately 50%. Kaiser Permanente has mirrored and exceeded these national advances in control. Integrated models of care such as Kaiser Permanente and the Veterans Administration health systems have demonstrated the greatest hypertension outcomes. We detail the story of Kaiser Permanente Southern California (KPSC) to illustrate the success that can be achieved with an integrated health system model that uses implementation, dissemination, and performance feedback approaches to chronic disease care. KPSC, with a large ethnically diverse population of more than 3.6 million, has used a stepwise approach to achieve control rates greater than 85% in those recognized with hypertension. This was accomplished through systemic implementations of specific strategies: (1) capturing hypertensive members into a hypertension registry; (2) standardization of blood pressure measurements; (3) drafting and disseminating an internal treatment algorithm that is evidence-based and is advocating of combination therapy; and (4) a multidisciplinary approach using medical assistants, nurses, and pharmacists as key stakeholders. The infrastructure, support, and involvement across all levels of the health system with rapid and continuous performance feedback have been pivotal in ensuring the follow-through and maintenance of these strategies. The KPSC hypertension program is continually evolving in these areas. With these high control rates and established infrastructure, they are positioned to take on different innovations and study models. Such potential projects are drafting strategies on resistant hypertension or addressing the concerns about overtreatment of hypertension.

  6. Breaching the security of the Kaiser Permanente Internet patient portal: the organizational foundations of information security.

    Science.gov (United States)

    Collmann, Jeff; Cooper, Ted

    2007-01-01

    This case study describes and analyzes a breach of the confidentiality and integrity of personally identified health information (e.g. appointment details, answers to patients' questions, medical advice) for over 800 Kaiser Permanente (KP) members through KP Online, a web-enabled health care portal. The authors obtained and analyzed multiple types of qualitative data about this incident including interviews with KP staff, incident reports, root cause analyses, and media reports. Reasons at multiple levels account for the breach, including the architecture of the information system, the motivations of individual staff members, and differences among the subcultures of individual groups within as well as technical and social relations across the Kaiser IT program. None of these reasons could be classified, strictly speaking, as "security violations." This case study, thus, suggests that, to protect sensitive patient information, health care organizations should build safe organizational contexts for complex health information systems in addition to complying with good information security practice and regulations such as the Health Insurance Portability and Accountability Act (HIPAA) of 1996.

  7. Kaiser Permanente's "metadata-driven" national clinical intranet.

    Science.gov (United States)

    Dolin, R H; Boles, M; Dolin, R; Green, S; Hanifin, S; Hochhalter, B; Inglesis, R; Ivory, M; Levy, D; Nadspal, K; Rae, M A; Rucks, C J; Snyder, A; Stibolt, T; Stiefel, M; Travis, V

    2001-01-01

    This paper describes the approach taken to build Kaiser Permanente's national clinical intranet. A primary objective for the site is to facilitate resource discovery, which is enabled by the use of "metadata", or data (fields and field values) that describe the various resources available. Users can perform full text queries and/or fielded searching against the metadata. Metadata serves as the organizing principle of the site--it is used to index documents, sort search results, and structure the site's table of contents. The site's use of metadata--what it is, how it is created, how it is applied to documents, how it is indexed, how it is presented to the user in the search and the search results interface, and how it is used to construct the table of contents for the web site--will be discussed in detail. The result is that KP's national clinical intranet has coupled the power of Internet-like full text search engines with the power of MedLine-like fielded searching in order to maximize search precision and recall. Organizing content on the site in accordance with the metadata promotes overall consistency. Issues currently under investigation include how to better exploit the power of the controlled terminology within the metadata; whether the value gained is worth the cost of collecting metadata; and how automatic classification algorithms might obviate the need for manual document indexing.

  8. How Kaiser Permanente uses video ethnography of patients for quality improvement, such as in shaping better care transitions.

    Science.gov (United States)

    Neuwirth, Esther B; Bellows, Jim; Jackson, Ana H; Price, Patricia M

    2012-06-01

    Keeping patients and caregivers at the center of quality improvement is critical. Kaiser Permanente's Care Management Institute adapted video ethnography to achieve this aim, using video to capture interviews with-and observations of-patients and caregivers, identify patient-centered improvement opportunities, and communicate them effectively to clinical and administrative leaders and front-line staff. This method is particularly effective for helping understand the needs of frail elders, patients nearing the end of life, those with multiple chronic conditions, and other vulnerable people who are not well represented in focus groups and patient advisory councils. As part of an initiative to improve care transitions for elders with heart failure, video ethnography contributed to greatly reduced thirty-day hospital readmission rates, helping reduce readmissions at one medical center from 13.6 percent to 9 percent in six months. It also helped improve the reliability of the readmissions reduction program. When embedded within an established quality improvement framework, video ethnography can be an effective tool for innovating new solutions, improving existing processes, and spreading knowledge about how best to meet patient needs.

  9. Complete care at Kaiser Permanente: transforming chronic and preventive care.

    Science.gov (United States)

    Kanter, Michael H; Lindsay, Gail; Bellows, Jim; Chase, Alide

    2013-11-01

    In 2004 Kaiser Permanente Southern California (KPSC) recognized the potential to improve the quality of care. Healthcare Effectiveness Data and Information Set (HEDIS) performance was below what regional leadership aspired to achieve, exceeding the 90th national percentile on only 15 of 34 measures. Beginning in 2005 regional leadership identified several system opportunities to enhance evidence-based, person-focused care. DEVELOPMENT OF COMPLETE CARE: KPSC developed and implemented a comprehensive delivery system redesign and expanded and integrated existing clinical information systems, decision support, work flows, and self-management support-collectively referred to as Complete Care. The goal of Complete Care is to transform care for healthy members, those with chronic conditions, and those with multiple comorbidities. To date, KPSC has applied Complete Care to 26 chronic conditions and areas of preventive and wellness care. Implemented in all care settings and optimizing the roles of all health care team members to maximal scope of practice, Complete Care provides evidence-based, person-focused care addressing a large set of protocol-based health needs for every individual during every encounter within the health care system. On 51 HEDIS metrics, KPSC improvement using Complete Care averaged 13.0%, compared with 5.5% improvement in the national HEDIS 50th percentile. Implementation of Complete Care at KPSC was followed by six-year quality gains that outpaced changes in the HEDIS national percentiles for many measures. Additional care gaps have been included in proactive office encounter checklists; these relate to elder care, advance directives, posthospital care, immunizations, health maintenance, and pregnancy care.

  10. Kaiser Permanente's performance improvement system, part 3: multisite improvements in care for patients with sepsis.

    Science.gov (United States)

    Whippy, Alan; Skeath, Melinda; Crawford, Barbara; Adams, Carmen; Marelich, Gregory; Alamshahi, Mezhgan; Borbon, Josefina

    2011-11-01

    In 2008, Kaiser Permanente Northern California implemented an initiative to improve sepsis care. Early detection and expedited implementation of sepsis treatment bundles that include early goal-directed therapy (EGDT) for patients with severe sepsis were implemented. In a top-down, bottom-up approach to performance improvement, teams at 21 medical centers independently decided how to implement treatment bundles, using a "playbook" developed by rapid cycle pilot testing at two sites and endorsed by a sepsis steering committee of regional and medical center clinical leaders. The playbook contained treatment algorithms, standardized order sets and flow charts, best practice alerts, and chart abstraction tools. Regional mentors and improvement advisers within the medical centers supported team-building and rapid implementation. Timely and actionable data allowed ongoing identification of improvement opportunities. A consistent approach to performance improvement propelled local rapid improvement cycles and joint problem solving across facilities. The number of sepsis diagnoses per 1,000 admissions increased from a baseline value of 35.7 in July 2009 to 119.4 in May 2011. The percent of admitted patients who have blood cultures drawn who also have a serum lactate level drawn increased from a baseline of 27% to 97% in May 2011. The percent of patients receiving EGDT who had a second and lower lactate level within six hours increased from 52% at baseline to 92% in May 2011. Twenty-one cross-functional frontline teams redesigned processes of care to provide regionally standardized, evidence-based treatment algorithms for sepsis, substantially increasing the identification and risk stratification of patients with suspected sepsis and the provision of a sepsis care bundle that included EGDT.

  11. Kaiser Permanente Northern California pregnancy database: Description and proof of concept study.

    Science.gov (United States)

    Zerbo, Ousseny; Chan, Berwick; Goddard, Kristin; Lewis, Ned; Bok, Karin; Klein, Nicola P; Baxter, Roger

    2016-11-04

    We describe the establishment of a dynamic database linking mothers to newborns with the goal of studying vaccine safety in both pregnant women and their children and provide results of a study utilizing this database as a proof of concept. All Kaiser Permanente Northern California (KPNC) live births and their mothers were eligible for inclusion in the pregnancy database. We used the medical record number (MRN), a unique identifier, to retrieve information about events that occurred during the pregnancy and at delivery and linked this same MRN to newborns for post-partum follow up. We conducted a retrospective cohort study to evaluate the association between receipt of tetanus, diphtheria and acellular pertussis (Tdap) vaccine during pregnancy and fever 0-3days after the first dose of diphtheria tetanus and acellular pertussis (DTaP) vaccine in the infant. The study included infants who were born at ⩾37weeks gestation from January 1, 2009 - October 1, 2015 and who received their first DTaP vaccine between 6 and 10weeks of age. We utilized diagnostic codes from inpatient, emergency department, outpatient clinics, and telephone calls. We identified fever using ICD 9 code 780.6, recorded temperature ⩾101 degree Fahrenheit, or parental report. The database contained the starting and ending date of each pregnancy and basic demographic characteristics of mothers and infants. There were 859,699 women and 873,753 children in the database as of January 2016. The proof of concept study included 148,699 infants. In a multivariable logistic regression analysis, Tdap vaccination during pregnancy was not associated with infant fever 0-3daysafter first dose of DTaP (adjusted odds ratio=0.92, 95% CI 0.82-1.04). The KPNC pregnancy database can be used for studies investigating exposure during pregnancy and outcomes in mothers and/or infants, particularly monitoring vaccine safety and effectiveness. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. A quarter century of hospice care: the southern california kaiser permanente experience.

    Science.gov (United States)

    Milch, Mario; Brumley, Richard D

    2005-01-01

    Kaiser Permanente (KP) has been a pioneer in the development of hospice services in the United States. Since 1978, when hospice services were introduced in the KP Southern California Region, they have been gradually expanded to benefit thousands of patients and their families. However, important barriers to timely, appropriate utilization of hospice care remain. A pilot project conducted in our TriCentral Service Area has shown that palliative care-a newer development in end-of-life care-can be cost-effective in addition to being beneficial for patients and their families. Efforts are underway to emulate this model of care at other KP facilities. Availability of both home-based and inpatient palliative care services can expand the number and type of patients who, as they near the end of life, can benefit from effective symptom control and other support.

  13. Promoting policy and environmental change using photovoice in the Kaiser Permanente Community Health Initiative.

    Science.gov (United States)

    Kramer, Leila; Schwartz, Pamela; Cheadle, Allen; Borton, J Elaine; Wright, Merrick; Chase, Charlie; Lindley, Corina

    2010-05-01

    Creative ways must be found to engage both community residents and political leaders around policy and environmental solutions to public health issues. Photovoice is a community-based, participatory approach to documentary photography that provides people with training on photography, ethics, critical discussion, and policy advocacy. Photovoice projects have been implemented across the nation as part of Kaiser Permanente's Community Health Initiative-a community-based obesity prevention effort. This article focuses on the first Photovoice project implemented in three communities in Colorado. Photovoice themes related to healthy eating and active living include a lack of access to healthy food choices in stores and schools, unsafe street crossings and sidewalks, and the need to redevelop certain areas to encourage safe recreation. The involvement of policy leaders in the project combined with several dissemination activities has contributed to healthier food offerings in schools and neighborhoods and city planning efforts that emphasize walkability and access to healthy food, and park revitalization.

  14. A retrospective analysis of health systems in Denmark and Kaiser Permanente

    DEFF Research Database (Denmark)

    Frølich, Anne; Schiøtz, Michaela L; Strandberg-Larsen, Martin;

    2008-01-01

    ABSTRACT: BACKGROUND: To inform Danish health care reform efforts, we compared health care system inputs and performance and assessed the usefulness of these comparisons for informing policy. METHODS: Retrospective analysis of secondary data in the Danish Health Care System (DHS) with 5.3 million...... citizens and the Kaiser Permanente integrated delivery system (KP) with 6.1 million members in California. We used secondary data to compare population characteristics, professional staff, delivery structure, utilisation and quality measures, and direct costs. We adjusted the cost data to increase...... comparability. RESULTS: A higher percentage of KP patients had chronic conditions than did patients in the DHS: 6.3% vs. 2.8% (diabetes) and 19% vs. 8.5% (hypertension), respectively. KP had fewer total physicians and staff compared to DHS, with134 physicians/100,000 individuals versus 311 physicians/100...

  15. Kaiser Permanente-Sandia National Health Care Model: Phase 1 prototype final report. Part 2 -- Domain analysis

    Energy Technology Data Exchange (ETDEWEB)

    Edwards, D.; Yoshimura, A.; Butler, D.; Judson, R.; Mason, W.; Napolitano, L.; Mariano, R. [Sandia National Labs., Livermore, CA (United States); Eddy, D.; Schlessinger, L. [Kaiser Permanente, Pasadena, CA (United States)

    1996-11-01

    This report describes the results of a Cooperative Research and Development Agreement between Sandia National Laboratories and Kaiser Permanente Southern California to develop a prototype computer model of Kaiser Permanente`s health care delivery system. As a discrete event simulation, SimHCO models for each of 100,000 patients the progression of disease, individual resource usage, and patient choices in a competitive environment. SimHCO is implemented in the object-oriented programming language C{sup 2}, stressing reusable knowledge and reusable software components. The versioned implementation of SimHCO showed that the object-oriented framework allows the program to grow in complexity in an incremental way. Furthermore, timing calculations showed that SimHCO runs in a reasonable time on typical workstations, and that a second phase model will scale proportionally and run within the system constraints of contemporary computer technology.

  16. Kaiser Permanente Northern California: current experiences with internet, mobile, and video technologies.

    Science.gov (United States)

    Pearl, Robert

    2014-02-01

    The US health care system has been slow to adopt Internet, mobile, and video technologies, which have the capability to engage patients in their own care, increase patients' access to providers, and possibly improve the quality of care while reducing costs. Nevertheless, there are some pockets of progress, including Kaiser Permanente Northern California (KPNC). In 2008 KPNC implemented an inpatient and ambulatory care electronic health record system for its 3.4 million members and developed a suite of patient-friendly Internet, mobile, and video tools. KPNC has achieved many successes. For example, the number of virtual "visits" grew from 4.1 million in 2008 to an estimated 10.5 million in 2013. This article describes KPNC's experience with Internet, mobile, and video technologies and the obstacles faced by other health care providers interested in embracing them. The obstacles include the predominant fee-for-service payment model, which does not reimburse for virtual visits; the considerable investment needed to deploy these technologies; and physician buy-in.

  17. Kaiser Permanente/Sandia National health care model. Phase I prototype final report. Part 1 - model overview

    Energy Technology Data Exchange (ETDEWEB)

    Edwards, D.; Yoshimura, A.; Butler, D.; Judson, R. [and others

    1996-11-01

    This report describes the results of a Cooperative Research and Development Agreement between Sandia National Laboratories and Kaiser Permanente Southern California to develop a prototype computer model of Kaiser Permanente`s health care delivery system. As a discrete event simulation, SimHCO models for each of 100,000 patients the progression of disease, individual resource usage, and patient choices in a competitive environment. SimHCO is implemented in the object-oriented programming language C++, stressing reusable knowledge and reusable software components. The versioned implementation of SimHCO showed that the object-oriented framework allows the program to grow in complexity in an incremental way. Furthermore, timing calculations showed that SimHCO runs in a reasonable time on typical workstations, and that a second phase model will scale proportionally and run within the system constraints of contemporary computer technology. This report is published as two documents: Model Overview and Domain Analysis. A separate Kaiser-proprietary report contains the Disease and Health Care Organization Selection Models.

  18. Development of a Computerized Intravenous Insulin Application (AutoCal) at Kaiser Permanente Northwest, Integrated into Kaiser Permanente HealthConnect: Impact on Safety and Nursing Workload

    OpenAIRE

    Olinghouse, Christine

    2012-01-01

    Context: The electronic medical record, HealthConnect, at the Kaiser Sunnyside Medical Center in the Northwest used scanned paper protocols for intravenous insulin administration. A chart review of 15 patients on intravenous insulin therapy using state-of-the-art paper-based column protocols revealed 40% deviation from the protocol. A time study of experienced nurses computing the insulin dose revealed an average of 2 minutes per calculation per hour to complete.

  19. Risk of cancer in Asian Americans: a Kaiser Permanente cohort study.

    Science.gov (United States)

    Tran, H Nicole; Li, Yan; Udaltsova, Natalia; Armstrong, Mary Anne; Friedman, Gary D; Klatsky, Arthur L

    2016-10-01

    To supplement published cohort data about incident cancer in Asian Americans (Asians) including risk of specific Asian ethnic groups. A cohort study in 124,193 persons (13,344 Asians) with baseline examination data in 1978-1985 used Cox proportional hazards models with seven covariates to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs). Through 2012 cancer was diagnosed in 18,687 persons including 1,522 Asians. Compared to Whites, the HR (CIs) for any cancer in Asians was 0.8 (0.7-0.9, p risk was stronger for men (HR = 0.7, p risks with p risk, especially in women. HRs for specific Asian groups versus Whites follow: Chinese = 0.9 (p risk than Whites, and South Asians had lower risk than any other racial/ethnic group. Asians had lower cancer risk than Whites, due to lower risk of several cancer types. Each Asian ethnic group had lower risk than Whites with South Asians at the lowest risk.

  20. Incidence of Norovirus and Other Viral Pathogens That Cause Acute Gastroenteritis (AGE among Kaiser Permanente Member Populations in the United States, 2012-2013.

    Directory of Open Access Journals (Sweden)

    Scott P Grytdal

    Full Text Available Noroviruses and other viral pathogens are increasingly recognized as frequent causes of acute gastroenteritis (AGE. However, few laboratory-based data are available on the incidence of AGE caused by viral pathogens in the U.S. This study examined stool specimens submitted for routine clinical diagnostics from patients enrolled in Kaiser Permanente (KP health plans in metro Portland, OR, and the Maryland, District of Columbia, and northern Virginia geographic areas to estimate the incidence of viral enteropathogens in these populations. Over a one-year study period, participating laboratories randomly selected stools submitted for routine clinical diagnostics for inclusion in the study along with accompanying demographic and clinical data. Selected stools were tested for norovirus, rotavirus, sapovirus, and astrovirus using standardized real-time RT-PCR protocols. Each KP site provided administrative data which were used in conjunction with previously published data on healthcare utilization to extrapolate pathogen detection rates into population-based incidence rates. A total of 1,099 specimens collected during August 2012 to September 2013 were included. Mean age of patients providing stool specimens was 46 years (range: 0-98 years. Noroviruses were the most common viral pathogen identified among patients with AGE (n = 63 specimens, 6% of specimens tested. In addition, 22 (2% of specimens were positive for rotavirus; 19 (2% were positive for sapovirus; and 7 (1% were positive for astrovirus. Incidence of norovirus-associated outpatient visits was 5.6 per 1,000 person-years; incidence of norovirus disease in the community was estimated to be 69.5 per 1,000 person-years. Norovirus incidence was highest among children 65 years (outpatient incidence = 7.8 per 1,000 person-years; community incidence = 75.8 per 1,000 person-years. Outpatient incidence rates of rotavirus, sapovirus, and astrovirus were 2.0, 1.6, 0.6 per 1,000 person

  1. Incidence of Norovirus and Other Viral Pathogens That Cause Acute Gastroenteritis (AGE) among Kaiser Permanente Member Populations in the United States, 2012-2013.

    Science.gov (United States)

    Grytdal, Scott P; DeBess, Emilio; Lee, Lore E; Blythe, David; Ryan, Patricia; Biggs, Christianne; Cameron, Miriam; Schmidt, Mark; Parashar, Umesh D; Hall, Aron J

    2016-01-01

    Noroviruses and other viral pathogens are increasingly recognized as frequent causes of acute gastroenteritis (AGE). However, few laboratory-based data are available on the incidence of AGE caused by viral pathogens in the U.S. This study examined stool specimens submitted for routine clinical diagnostics from patients enrolled in Kaiser Permanente (KP) health plans in metro Portland, OR, and the Maryland, District of Columbia, and northern Virginia geographic areas to estimate the incidence of viral enteropathogens in these populations. Over a one-year study period, participating laboratories randomly selected stools submitted for routine clinical diagnostics for inclusion in the study along with accompanying demographic and clinical data. Selected stools were tested for norovirus, rotavirus, sapovirus, and astrovirus using standardized real-time RT-PCR protocols. Each KP site provided administrative data which were used in conjunction with previously published data on healthcare utilization to extrapolate pathogen detection rates into population-based incidence rates. A total of 1,099 specimens collected during August 2012 to September 2013 were included. Mean age of patients providing stool specimens was 46 years (range: 0-98 years). Noroviruses were the most common viral pathogen identified among patients with AGE (n = 63 specimens, 6% of specimens tested). In addition, 22 (2%) of specimens were positive for rotavirus; 19 (2%) were positive for sapovirus; and 7 (1%) were positive for astrovirus. Incidence of norovirus-associated outpatient visits was 5.6 per 1,000 person-years; incidence of norovirus disease in the community was estimated to be 69.5 per 1,000 person-years. Norovirus incidence was highest among children 65 years (outpatient incidence = 7.8 per 1,000 person-years; community incidence = 75.8 per 1,000 person-years). Outpatient incidence rates of rotavirus, sapovirus, and astrovirus were 2.0, 1.6, 0.6 per 1,000 person-years, respectively; community

  2. Facilitating Physician Access to Medical Reference Information

    OpenAIRE

    2005-01-01

    Context: Computer-based medical reference information is augmenting—and in some cases, replacing—many traditional sources. For Kaiser Permanente (KP) physicians, this change presents both advantages and obstacles to finding medical reference information.

  3. The fetal heart rate collaborative practice project: situational awareness in electronic fetal monitoring-a Kaiser Permanente Perinatal Patient Safety Program Initiative.

    Science.gov (United States)

    MacEachin, S Rachel; Lopez, Connie M; Powell, Kimberly J; Corbett, Nancy L

    2009-01-01

    Electronic fetal monitoring has historically been interpreted with wide variation between and within disciplines on the obstetric healthcare team. This leads to inconsistent decision making in response to tracing interpretation. To implement a multidisciplinary electronic fetal monitoring training program, utilizing the best evidence available, enabling standardization of fetal heart rate interpretation to promote patient safety. Local multidisciplinary expertise along with an outside consultant collaborated over a series of meetings to create a multimedia instructional electronic fetal monitoring training program. After production was complete, a series of conferences attended by nurses, certified nurse midwives, and physician champions, from each hospital, attended to learn how to facilitate training at their own perinatal units. All healthcare personnel across the Kaiser Permanente perinatal program were trained in NICHD nomenclature, emergency response, interpretation guidelines, and how to create local collaborative practice agreements. Metrics for program effectiveness were measured through program evaluations from attendees, the Safety Attitudes Questionnaire. Program evaluations rendered very positive scores from both physicians and clinicians. Comparing baseline to 4 years later, the perception of safety from the staff has increased over 10% in 5 out of the 6 factors analyzed. Active participation from all disciplines in this training series has highlighted the importance of teamwork and communication. The Fetal Heart Rate Collaborative Practice Project continues to evolve utilizing other educational modalities, such as online EFM education and unit-based interdisciplinary tracing reviews.

  4. Risk of Cardiovascular Disease Associated with a Restless Legs Syndrome Diagnosis in a Retrospective Cohort Study from Kaiser Permanente Northern California.

    Science.gov (United States)

    Van Den Eeden, Stephen K; Albers, Kathleen B; Davidson, Julie E; Kushida, Clete A; Leimpeter, Amethyst D; Nelson, Lorene M; Popat, Rita; Tanner, Caroline M; Bibeau, Kristen; Quesenberry, Charles P

    2015-07-01

    Recent cross-sectional studies suggest that restless legs syndrome (RLS) may be associated with an increased prevalence of cardiovascular disease (CVD) comorbidity or risk factors. We evaluated whether primary or secondary RLS was associated with an increased risk of incident cardiovascular disease in a retrospective cohort study within Kaiser Permanente Northern California (KPNC). We identified members of KPNC with primary RLS and secondary RLS between 1999 and 2008 by an algorithm that incorporated longitudinal clinical records related to the diagnosis and treatment of RLS and comorbidities. We then matched each RLS case with up to 50 individuals with no clinical records of RLS by age, sex, race/ethnicity, zip code, and membership duration. For the analyses we excluded any individual with coronary artery disease (CAD: angina, acute myocardial infarction, coronary revascularization procedure, CAD death), CVD (CAD plus stroke), and hypertension at baseline. New cardiovascular events were determined from clinical records. Follow-up ended at an outcome event, disenrollment from KPNC, or death, whichever occurred earliest. There were over 473,358 person-y of follow-up in this cohort analysis with a mean follow-up time of 3.91 y and range from 6 mo to 12 y. Survival analysis techniques, including survival curves and proportional hazard regression models, were used to assess the association between RLS status and CVD. There were 7,621 primary RLS and 4,507 secondary RLS cases identified and included in the study. In general, primary RLS cases were younger and had less comorbidity than secondary RLS cases. During the follow-up period, CVD was diagnosed in 478 primary RLS cohort members, CAD was diagnosed in 310, and hypertension events were identified in 1,466. Diagnosis in secondary RLS cohort members was made during the follow-up period with 451, 338, and 598 CVD, CAD, and hypertension events, respectively. Subjects with primary RLS had a similar risk of incident CVD

  5. Moderately premature infants at Kaiser Permanente Medical Care Program in California are discharged home earlier than their peers in Massachusetts and the United Kingdom

    Science.gov (United States)

    Profit, J; Zupancic, J A F; McCormick, M C; Richardson, D K; Escobar, G J; Tucker, J; Tarnow‐Mordi, W; Parry, G

    2006-01-01

    Objective To compare gestational age at discharge between infants born at 30–34+6 weeks gestational age who were admitted to neonatal intensive care units (NICUs) in California, Massachusetts, and the United Kingdom. Design Prospective observational cohort study. Setting Fifty four United Kingdom, five California, and five Massachusetts NICUs. Subjects A total of 4359 infants who survived to discharge home after admission to an NICU. Main outcome measures Gestational age at discharge home. Results The mean (SD) postmenstrual age at discharge of the infants in California, Massachusetts, and the United Kingdom were 35.9 (1.3), 36.3 (1.3), and 36.3 (1.9) weeks respectively (p  =  0.001). Compared with the United Kingdom, adjusted discharge of infants occurred 3.9 (95% confidence interval (CI) 1.4 to 6.5) days earlier in California, and 0.9 (95% CI −1.2 to 3.0) days earlier in Massachusetts. Conclusions Infants of 30–34+6 weeks gestation at birth admitted and cared for in hospitals in California have a shorter length of stay than those in the United Kingdom. Certain characteristics of the integrated healthcare approach pursued by the health maintenance organisation of the NICUs in California may foster earlier discharge. The California system may provide opportunities for identifying practices for reducing the length of stay of moderately premature infants. PMID:16449257

  6. Implementing the Electronic Medical Record in the Exam Room: The Effect on Physician-Patient Communication and Patient Satisfaction

    OpenAIRE

    Nagy, Vivian Tong; Kanter, Michael H

    2007-01-01

    With the implementation of the electronic medical record—called HealthConnect—in all exam rooms throughout the Kaiser Permanente health care delivery system, how computers in the exam room affects physician-patient communication is a new concern. Patient satisfaction scores were obtained for all primary and specialty care physicians in a large medical center in Southern California to determine how scores changed as physicians started using HealthConnect in the exam room. Results show no signi...

  7. Suzanne F. Delbanco on the Leapfrog Group and employer purchasing power. Interview by Pamela K. Scarrow.

    Science.gov (United States)

    Delbanco, Suzanne F

    2004-01-01

    Suzanne F. Delbanco, PhD MPH, is the first executive director of The Leapfrog Group, founded by the Business Roundtable. The Leapfrog Group's goal is to mobilize employer purchasing power to initiate breakthrough improvements in the safety, quality, and overall value of healthcare for American consumers. The group's growing consortium of more than 155 Fortune 500 companies and other large private and public healthcare purchasers provides health benefits to more than 34 million Americans; these companies spend more than 62 billion dollars on healthcare annually. Dr. Delbanco is a member of the National Committee for Quality Assurance Purchaser Advisory Council and a board member of Bridges to Excellence. Before joining The Leapfrog Group, she was a senior manager at the Pacific Business Group on Health (PBGH), where she worked on the quality team. Prior to joining PBGH, she worked on reproductive health policy and the changing healthcare marketplace initiative at the Henry J. Kaiser Family Foundation. She has also consulted on health insurance coverage in the temporary employment industry and on the first statewide survey in California of MediCal beneficiaries, and worked as a community Liaison for Kaiser Permanente during the establishment of one of California's first County Organized Health Systems. She holds a PhD in public policy from the Goldman School of Public PoLicy and a MPH from the School of Public Health at the University of California, Berkeley.

  8. Understanding Faculty and Trainee Needs Related to Scholarly Activity in a Large, Nonuniversity Graduate Medical Education Program

    Science.gov (United States)

    Becker, Davida; Garth, Hanna; Hollander, Rachel; Klein, Felice; Klau, Marc

    2017-01-01

    Context: Graduate medical education (GME) programs must develop curriculum to ensure scholarly activity among trainees and faculty to meet accreditation requirements and to support evidence-based medicine. Objective: Test whether research-related needs and interests varied across four groups: primary care trainees, specialty trainees, primary care faculty, and specialty faculty. Design: We surveyed a random sample of trainees and faculty in Kaiser Permanente Southern California’s GME programs. We investigated group differences in outcomes using Fisher exact and Kruskal-Wallis tests. Main Outcome Measures: Research experiences, skills, barriers, motivators, and interests in specific research skills development. Results: Participants included 47 trainees and 26 faculty (response rate = 30%). Among primary care faculty, 12 (71%) reported little or no research experience vs 1 (11%) for specialty faculty, 14 (41%) for primary care trainees, and 1 (8%) for specialty trainees (p skills also differed across groups (p skill level. Research barriers that differed across groups included other work roles taking priority; desire for work-life balance; and lack of managerial support, research equipment, administrative support, and funding. Conclusion: Faculty and trainees in primary care and specialties have differing research-related needs that GME programs should consider when designing curricula to support scholarly activity. Developing research skills of primary care faculty is a priority to support trainees’ scholarly activity. PMID:28333607

  9. Improving Blood Pressure Control through a Clinical Pharmacist Outreach Program in Diabetes Patients in Two-High Performing Health Systems: The Adherence and Intensification of Medications (AIM) Cluster Randomized Controlled Pragmatic Trial

    Science.gov (United States)

    Heisler, Michele; Hofer, Timothy P.; Schmittdiel, Julie A.; Selby, Joe V.; Klamerus, Mandi L.; Bosworth, Hayden B.; Bermann, Martin; Kerr, Eve A.

    2013-01-01

    Background Even in high performing health systems, some hypertensive patients with diabetes have persistent poor blood pressure (BP) control. Medication nonadherence and lack of medication intensification contribute to this poor control. We examined whether the Adherence and Intensification of Medications (AIM) intervention, a targeted pharmacist-led intervention that combined state-of-the-art elements found in efficacy studies to lower BP, could improve BP among diabetes patients with persistent hypertension and poor refill adherence or insufficient medication intensification. Methods and Results We conducted a prospective, multi-site cluster randomized pragmatic trial with randomization of 16 primary care teams at five medical centers (3 Veterans Affairs [VA] and 2 Kaiser Permanente [KP]) to the AIM intervention or usual care. The primary outcome was the relative change in systolic blood pressure (SBP) measurements, comparing 1,797 eligible intervention team patients to 2,303 eligible control team patients, between the 6-months preceding and the 6-months following the 14-month intervention period. We examined shorter-term changes in SBP as a secondary outcome. In our primary analysis, the intervention group SBP change from 6-months prior to 6-months after the 14-month intervention period was approximately the same as the control group, declining approximately 9 mm Hg in both groups. SBP lowering occurred more rapidly among eligible intervention team patients, with mean SBPs 2.4 mm Hg lower (95% CI: −3.4 to −1.5; p<.001) immediately after the intervention than those achieved by eligible control patients. Conclusions The AIM program more rapidly lowered SBPs among eligible intervention patients, but there was no significant difference in blood pressure between intervention and control patients 6 months following the intervention period. These findings show the importance of rigorously evaluating in different real-life clinical settings programs found in

  10. OBAYA (obesity and adverse health outcomes in young adults: feasibility of a population-based multiethnic cohort study using electronic medical records

    Directory of Open Access Journals (Sweden)

    Koebnick Corinna

    2012-08-01

    Full Text Available Abstract Background Although obesity is a risk factor for many chronic diseases, we have only limited knowledge of the magnitude of these associations in young adults. A multiethnic cohort of young adults was established to close current knowledge gaps; cohort demographics, cohort retention, and the potential influence of migration bias were investigated. Methods For this population-based cross-sectional study, demographics, and measured weight and height were extracted from electronic medical records of 1,929,470 patients aged 20 to 39 years enrolled in two integrated health plans in California from 2007 to 2009. Results The cohort included about 84.4% of Kaiser Permanente California members in this age group who had a medical encounter during the study period and represented about 18.2% of the underlying population in the same age group in California. The age distribution of the cohort was relatively comparable to the underlying population in California Census 2010 population, but the proportion of women and ethnic/racial minorities was slightly higher. The three-year retention rate was 68.4%. Conclusion These data suggest the feasibility of our study for medium-term follow-up based on sufficient membership retention rates. While nationwide 6% of young adults are extremely obese, we know little to adequately quantify the health burden attributable to obesity, especially extreme obesity, in this age group. This cohort of young adults provides a unique opportunity to investigate associations of obesity-related factors and risk of cancer in a large multiethnic population.

  11. The effect of patient satisfaction with pharmacist consultation on medication adherence: an instrumental variable approach

    Directory of Open Access Journals (Sweden)

    Gu NY

    2008-12-01

    Full Text Available There are limited studies on quantifying the impact of patient satisfaction with pharmacist consultation on patient medication adherence. Objectives: The objective of this study is to evaluate the effect of patient satisfaction with pharmacist consultation services on medication adherence in a large managed care organization. Methods: We analyzed data from a patient satisfaction survey of 6,916 patients who had used pharmacist consultation services in Kaiser Permanente Southern California from 1993 to 1996. We compared treating patient satisfaction as exogenous, in a single-equation probit model, with a bivariate probit model where patient satisfaction was treated as endogenous. Different sets of instrumental variables were employed, including measures of patients' emotional well-being and patients' propensity to fill their prescriptions at a non-Kaiser Permanente (KP pharmacy. The Smith-Blundell test was used to test whether patient satisfaction was endogenous. Over-identification tests were used to test the validity of the instrumental variables. The Staiger-Stock weak instrument test was used to evaluate the explanatory power of the instrumental variables. Results: All tests indicated that the instrumental variables method was valid and the instrumental variables used have significant explanatory power. The single equation probit model indicated that the effect of patient satisfaction with pharmacist consultation was significant (p<0.010. However, the bivariate probit models revealed that the marginal effect of pharmacist consultation on medication adherence was significantly greater than the single equation probit. The effect increased from 7% to 30% (p<0.010 after controlling for endogeneity bias. Conclusion: After appropriate adjustment for endogeneity bias, patients satisfied with their pharmacy services are substantially more likely to adhere to their medication. The results have important policy implications given the increasing focus

  12. Undergraduate Rural Medical Education Program Development: Focus Group Consultation with the NRHA Rural Medical Educators Group

    Science.gov (United States)

    Downey, Laura H.; Wheat, John R.; Leeper, James D.; Florence, Joseph A.; Boulger, James G.; Hunsaker, Matt L.

    2011-01-01

    Context: Over a decade ago, leaders in rural medical education established the Rural Medical Educators (RME) Group, an interest group within the National Rural Health Association, to support faculty in rural medical education programs. This group has convened an annual RME conclave since 2006. In 2008, this conclave convened 15 national leaders in…

  13. Medline Plus

    Full Text Available ... Male Incontinence: The Male Sling (Kaiser Permanente San Diego Medical Center, San Diego, CA, 6/20/2014) Simultaneous Inflatable Penile Prosthesis ( ... Male Incontinence: The Male Sling (Kaiser Permanente San Diego Medical Center, San Diego, CA, 6/20/2014) ...

  14. The Medicaid Medically Improved Group, Losing Disability...

    Data.gov (United States)

    U.S. Department of Health & Human Services — According to findings reported in, The Medicaid Medically Improved Group, Losing Disability Status and Growing Earnings, published in Volume 4, Issue 1 of the...

  15. The Medicaid Medically Improved Group, Losing Disability...

    Data.gov (United States)

    U.S. Department of Health & Human Services — According to findings reported in, The Medicaid Medically Improved Group, Losing Disability Status and Growing Earnings, published in Volume 4, Issue 1 of the...

  16. Structuring group medical practices: tax planning aspects.

    Science.gov (United States)

    Gassman, A S; Conetta, T F

    1992-01-01

    This article is the first in a series addressing the structuring of group medical practice entities, shareholder relationships, and general representation factors. In this article, a general background in federal tax planning is provided, including strategies for minimization of income tax payment and the potential problems that may be encountered when a group practice is not carefully structured.

  17. Marketing the academic medical center group practice.

    Science.gov (United States)

    Eudes, J A; Divis, K L

    1992-01-01

    From a marketing perspective, there are many differences between private and academic medical center (AMC) group practices. Given the growing competition between the two, write John Eudes and Kathy Divis, it is important for the AMC group practice to understand and use these differences to develop a competitive market advantage.

  18. Medical group management: a marketing orientation.

    Science.gov (United States)

    Bopp, K D; Allcorn, S

    1986-09-01

    This article considers the pragmatic aspects of conducting a situation/marketing audit for group medical practices. This audit is a key component in the formulation of a competitive strategy and the development of a marketing program. Given are a series of questions that may be used by medical groups to guide assessment of the opportunities and threats present in the environment as well as the strengths and weaknesses of the organization in meeting the environmental challenges. Furthermore, the article provides a framework for thinking about strategy and the variables that should be considered and aligned to achieve effective implementation of strategy. Finally, the parameters are outlined for deciding on a marketing program: the mix of marketing tools (service design, distribution channels, pricing and promotion) that should be employed to offensively and/or defensively position the medical group in the competitive marketplace.

  19. Management by objectives in medical group practice.

    Science.gov (United States)

    Bozis, D E

    1986-01-01

    When the concept of management by objectives first emerged, it was heralded by many as the long-sought secret to employee motivation. The MBO technique, involving the three primary functions of objective setting, objective using, and employee involvement, is described here in terms of both theory and practice. Although it does have its pitfalls and is certainly not the "ultimate answer," MBO in medical group practice does have its merits when properly introduced. It is much more than a purely academic concept, and its major strength lies in its recognition of the importance of human resources in getting the job done.

  20. Hospital Contracts: Important Issues for Medical Groups.

    Science.gov (United States)

    Rosolio, Charles E

    2016-01-01

    Relationships with hospitals and outpatient medical facilities have always been an important part of the business model for private medical practices. As healthcare delivery to patients has evolved in the United States (much of it driven by the new government mandates, regulations, and the Affordable Care Act), the delivery of such services is becoming more and more centered on the hospital or institutional setting, thus making contractual relationships with hospitals even more important for medical practices. As a natural outgrowth of this relationship, attention to hospital contracts is becoming more important.

  1. Health literacy and antidepressant medication adherence among adults with diabetes: the diabetes study of Northern California (DISTANCE).

    Science.gov (United States)

    Bauer, Amy M; Schillinger, Dean; Parker, Melissa M; Katon, Wayne; Adler, Nancy; Adams, Alyce S; Moffet, Howard H; Karter, Andrew J

    2013-09-01

    Previous studies have reported that health literacy limitations are associated with poorer disease control for chronic conditions, but have not evaluated potential associations with medication adherence. To determine whether health literacy limitations are associated with poorer antidepressant medication adherence. Observational new prescription cohort follow-up study. Adults with type 2 diabetes who completed a survey in 2006 and received a new antidepressant prescription during 2006-2010 (N = 1,366) at Kaiser Permanente Northern California. Validated three-item self-report scale measured health literacy. Discrete indices of adherence based on pharmacy dispensing data according to validated methods: primary non-adherence (medication never dispensed); early non-persistence (dispensed once, never refilled); non-persistence at 180 and 365 days; and new prescription medication gap (NPMG; proportion of time that the person is without medication during 12 months after the prescription date). Seventy-two percent of patients were classified as having health literacy limitations. After adjusting for sociodemographic and clinical covariates, patients with health literacy limitations had significantly poorer adherence compared to patients with no limitations, whether measured as early non-persistence (46 % versus 38 %, p diabetes and health literacy limitations may jeopardize the continuation and maintenance phases of depression pharmacotherapy. Findings underscore the importance of national efforts to address health literacy, simplify health communications regarding treatment options, improve public understanding of depression treatment, and monitor antidepressant adherence.

  2. Efficacy of a lay health worker led group antiretroviral medication ...

    African Journals Online (AJOL)

    Efficacy of a lay health worker led group antiretroviral medication adherence ... SAHARA-J: Journal of Social Aspects of HIV/AIDS ... of care, while adherence motivation and skills did not significantly change among the conditions over time.

  3. Views on group simulation in an integrated medical curriculum

    OpenAIRE

    Salaria M; Oyewole T; Shah S

    2017-01-01

    Mariam Salaria, Tobi Oyewole, Sundes ShahUniversity of Liverpool, School of Medicine, Liverpool, UKWe read with great interest the article by Ginzburg et al,1 regarding small group simulation with debrief, for first and second year medical students. Having completed four years at Liverpool Medical School, we agree that small group simulation assists in consolidating the knowledge of basic sciences. The article states that the majority of students agree that simulation followed by a debrief, i...

  4. Financing and cash flow management for the medical group practice.

    Science.gov (United States)

    Bert, Andrew J

    2008-01-01

    The expansion of a medical group practice and the addition of ancillary services require a substantial cash outlay. Obtaining proper financing to complete a successful expansion is a process that takes time, and there are critical steps that must be followed. The group's business objectives must be presented properly by developing a business plan detailing the practice and goals associated with the desired expansion. This article discusses some of the key elements that are essential in creating an overall effective business plan for the group medical practice.

  5. Focus group discussion: a tool for health and medical research.

    Science.gov (United States)

    Wong, L P

    2008-03-01

    Focus group discussion is a research methodology in which a small group of participants gather to discuss a specified topic or an issue to generate data. The main characteristic of a focus group is the interaction between the moderator and the group, as well as the interaction between group members. The objective is to give the researcher an understanding of the participants' perspective on the topic in discussion. Focus groups are rapidly gaining popularity in health and medical research. This paper presents a general introduction of the use of focus groups as a research tool within the context of health research, with the intention of promoting its use among researchers in healthcare. A detailed methodology for the conduct of focus groups and analysis of focus group data are discussed. The potentials and limitations of this qualitative research technique are also highlighted.

  6. Group processes in medical education: learning from social identity theory.

    Science.gov (United States)

    Burford, Bryan

    2012-02-01

    The clinical workplace in which doctors learn involves many social groups, including representatives of different professions, clinical specialties and workplace teams. This paper suggests that medical education research does not currently take full account of the effects of group membership, and describes a theoretical approach from social psychology, the social identity approach, which allows those effects to be explored. The social identity approach has a long history in social psychology and provides an integrated account of group processes, from the adoption of group identity through a process of self-categorisation, to the biases and conflicts between groups. This paper outlines key elements of this theoretical approach and illustrates their relevance to medical education. The relevance of the social identity approach is illustrated with reference to a number of areas of medical education. The paper shows how research questions in medical education may be usefully reframed in terms of social identity in ways that allow a deeper exploration of the psychological processes involved. Professional identity and professionalism may be viewed in terms of self-categorisation rather than simply attainment; the salience of different identities may be considered as influences on teamwork and interprofessional learning, and issues in communication and assessment may be considered in terms of intergroup biases. Social identity theory provides a powerful framework with which to consider many areas of medical education. It allows disparate influences on, and consequences of, group membership to be considered as part of an integrated system, and allows assumptions, such as about the nature of professional identity and interprofessional tensions, to be made explicit in the design of research studies. This power to question assumptions and develop deeper and more meaningful research questions may be increasingly relevant as the nature and role of the medical profession change

  7. Study protocol: The Adherence and Intensification of Medications (AIM study - a cluster randomized controlled effectiveness study

    Directory of Open Access Journals (Sweden)

    Selby Joe

    2010-10-01

    Full Text Available Abstract Background Many patients with diabetes have poor blood pressure (BP control. Pharmacological therapy is the cornerstone of effective BP treatment, yet there are high rates both of poor medication adherence and failure to intensify medications. Successful medication management requires an effective partnership between providers who initiate and increase doses of effective medications and patients who adhere to the regimen. Methods In this cluster-randomized controlled effectiveness study, primary care teams within sites were randomized to a program led by a clinical pharmacist trained in motivational interviewing-based behavioral counseling approaches and authorized to make BP medication changes or to usual care. This study involved the collection of data during a 14-month intervention period in three Department of Veterans Affairs facilities and two Kaiser Permanente Northern California facilities. The clinical pharmacist was supported by clinical information systems that enabled proactive identification of, and outreach to, eligible patients identified on the basis of poor BP control and either medication refill gaps or lack of recent medication intensification. The primary outcome is the relative change in systolic blood pressure (SBP measurements over time. Secondary outcomes are changes in Hemoglobin A1c, low-density lipoprotein cholesterol (LDL, medication adherence determined from pharmacy refill data, and medication intensification rates. Discussion Integration of the three intervention elements - proactive identification, adherence counseling and medication intensification - is essential to achieve optimal levels of control for high-risk patients. Testing the effectiveness of this intervention at the team level allows us to study the program as it would typically be implemented within a clinic setting, including how it integrates with other elements of care. Trial Registration The ClinicalTrials.gov registration number is NCT

  8. 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.

  9. Views on group simulation in an integrated medical curriculum

    Directory of Open Access Journals (Sweden)

    Salaria M

    2017-03-01

    Full Text Available Mariam Salaria, Tobi Oyewole, Sundes ShahUniversity of Liverpool, School of Medicine, Liverpool, UKWe read with great interest the article by Ginzburg et al,1 regarding small group simulation with debrief, for first and second year medical students. Having completed four years at Liverpool Medical School, we agree that small group simulation assists in consolidating the knowledge of basic sciences. The article states that the majority of students agree that simulation followed by a debrief, illustrated the clinical relevance of basic sciences. What is more, students felt that these practices provided chances for direct application of scientific knowledge, as well as simulating real world experience. The development of clinical reasoning was also noted, and as medical students ourselves, we agree that this aspect is cemented by simulation scenarios.View the original paper by Ginzburg and colleagues.

  10. Medical Student Perspectives of Active Learning: A Focus Group Study.

    Science.gov (United States)

    Walling, Anne; Istas, Kathryn; Bonaminio, Giulia A; Paolo, Anthony M; Fontes, Joseph D; Davis, Nancy; Berardo, Benito A

    2017-01-01

    Phenomenon: Medical student perspectives were sought about active learning, including concerns, challenges, perceived advantages and disadvantages, and appropriate role in the educational process. Focus groups were conducted with students from all years and campuses of a large U.S. state medical school. Students had considerable experience with active learning prior to medical school and conveyed accurate understanding of the concept and its major strategies. They appreciated the potential of active learning to deepen and broaden learning and its value for long-term professional development but had significant concerns about the efficiency of the process, the clarity of expectations provided, and the importance of receiving preparatory materials. Most significantly, active learning experiences were perceived as disconnected from grading and even as impeding preparation for school and national examinations. Insights: Medical students understand the concepts of active learning and have considerable experience in several formats prior to medical school. They are generally supportive of active learning concepts but frustrated by perceived inefficiencies and lack of contribution to the urgencies of achieving optimal grades and passing United States Medical Licensing Examinations, especially Step 1.

  11. Group counseling for medical students with drop-out experiences.

    Science.gov (United States)

    Kim, Eun Kyung; Baek, Sunyong; Woo, Jae Seok; Im, Sun Ju; Lee, Sun Hee; Kam, Beesung; Lee, Sang Yeoup; Yun, So Jung

    2013-03-01

    The purpose of this research was to describe our group counseling methods for medical students with drop-out experiences. Group counseling was offered to 11 medical students with drop-out experiences in their previous second semester. All subjects provided written informed consent before participating and completed a 2-day group counseling program using the Gestalt approach. The self-assertiveness training group counseling program consisted of 6 sessions, each of which lasted 90 minutes. Experience reports by participants after the program and data from semi-structured qualitative interviews were qualitatively analyzed. Program participants reported that they were moderately satisfied with the program regarding its usefulness and helpfulness on self-awareness, understanding, and reminding them of attempts to change behavior. Most students showed heightened levels of sincerity perceptions and positive attitudes in every session. The results demonstrated significant changes in experience in self-esteem, self-recognition, and interpersonal relationships. A group counseling program using the Gestalt approach could help medical students with drop-out experiences to adjust with 1 year their juniors, enhance their self-esteem, contribute to their psychological well-being, and prevent student re-failure through effective stress management and improved interpersonal relationships.

  12. A suicide prevention advisory group at an academic medical center.

    Science.gov (United States)

    Hough, David; Lewis, Philip

    2010-05-01

    During a 15-month period, there were seven suicides among patients who were in active treatment or who had been seen recently by providers in the Department of Psychiatry of Tripler Army Medical Center, Honolulu, Hawaii. As a result, a Suicide Prevention Advisory Group (SPAG) was formed to identify possible causes and make recommendations aimed at improving the identification and treatment of suicidal patients. The group made 11 specific recommendations. No known suicides occurred during the 22 months after the implementation of the Suicide Prevention Advisory Group's recommendations.

  13. Why employees resist change in medical group practice acquisitions.

    Science.gov (United States)

    Fabrizio, N

    1999-01-01

    Understanding employees' values and considerations is important in undergoing major organizational change. This research provides an insight of the business and financial aspects vs. the human relations aspects of acquiring a medical group practice. The five employees interviewed in this analysis provide insight as to the factors that employees consider in resisting change. Considering how employees feel through communicating will have a significant impact on efficiency, effectiveness and turnover.

  14. Biomimetic Adhesive Materials Containing Cyanoacryl Group for Medical Application

    Directory of Open Access Journals (Sweden)

    Sueng Hwan Jo

    2014-10-01

    Full Text Available For underwater adhesives with biocompatible and more flexible bonds using biomimetic adhesive groups, DOPA-like adhesive molecules were modified with cyanoacrylates to obtain different repeating units and chain length copolymers. The goal of this work is to copy the mechanisms of underwater bonding to create synthetic water-borne underwater medical adhesives through blending of the modified DOPA and a triblock copolymer (PEO-PPO-PEO for practical application to repair wet living tissues and bones, and in turn, to use the synthetic adhesives to test mechanistic hypotheses about the natural adhesive. The highest values in stress and modulus of the biomimetic adhesives prepared in wet state were 165 kPa and 33 MPa, respectively.

  15. Biomimetic adhesive materials containing cyanoacryl group for medical application.

    Science.gov (United States)

    Jo, Sueng Hwan; Sohn, Jeong Sun

    2014-10-17

    For underwater adhesives with biocompatible and more flexible bonds using biomimetic adhesive groups, DOPA-like adhesive molecules were modified with cyanoacrylates to obtain different repeating units and chain length copolymers. The goal of this work is to copy the mechanisms of underwater bonding to create synthetic water-borne underwater medical adhesives through blending of the modified DOPA and a triblock copolymer (PEO-PPO-PEO) for practical application to repair wet living tissues and bones, and in turn, to use the synthetic adhesives to test mechanistic hypotheses about the natural adhesive. The highest values in stress and modulus of the biomimetic adhesives prepared in wet state were 165 kPa and 33 MPa, respectively.

  16. Educational Strategies of Diabetes Group Medical Visits: A Review.

    Science.gov (United States)

    Kirk, Julienne K; Devoid, Hannah Marie; Strickland, Carmen

    2017-02-03

    Diabetes is a demanding disease that is growing in prevalence. Improved outcomes for patients with diabetes are highly dependent on self-management skills and the ability to make lifestyle changes. Innovative healthcare approaches are necessary to meet these specific patient needs. A group care medical visit (GMV) combines diabetes check-ups with diabetes education in a supportive and patient centered environment that promotes effective self-management. GMVs are associated with improved diabetes outcomes including hemoglobin A1C, weight, and self-efficacy; however details of the methods by which content is delivered to achieve these outcomes remain vague. Improved GMV diabetes outcomes may be the result of specific processes used in group care models. We seek to describe educational strategies, content, and qualities of facilitators that contribute to successful outcomes associated with diabetes GMVs . A review of the literature was conducted focusing on GMVs, specifically the educational strategies implemented, topics discussed, and facilitator qualities that contribute to successful outcomes. We identified 260 studies containing information about GMVs in patients with diabetes. A total of 7 citations met inclusion criteria and additional 5 were found through reference lists and relevant papers. Diabetes GMV educational topics comprise standard themes of disease process, medication, nutrition, and exercise. Several programs, however, target the development and realization of individualized patient goals, giving the patient more involvement in the session. Methods for facilitation may hold the key to successfully activating patients to reach meaningful behavior change goals. In addition to using expert clinical skills in diabetes care, effective facilitators provide support, and empower patients to take ownership of their diabetes. Rigorous evaluation of best practices for both the type and methods of delivering content in GMVs is lacking. Translational research to

  17. Psychotropic Medication Management in a Residential Group Care Program

    Science.gov (United States)

    Spellman, Douglas F.; Griffith, Annette K.; Huefner, Jonathan C.; Wise, Neil, III; McElderry, Ellen; Leslie, Laurel K.

    2010-01-01

    This article presents a psychotropic medication management approach that is used within a residential care program. The approach is used to assess medications at youths' times of entry and to facilitate decision making during care. Data from a typical case study have indicated that by making medication management decisions slowly, systematically,…

  18. Accreditation Council for Graduate Medical Education Core Competencies at a Community Teaching Hospital: Is There a Gap in Awareness?

    Science.gov (United States)

    Al-Temimi, Mohammed; Kidon, Michael; Johna, Samir

    2016-01-01

    Reports evaluating faculty knowledge of the Accreditation Council for Graduate Medical Education (ACGME) core competencies in community hospitals without a dedicated residency program are uncommon. Faculty evaluation regarding knowledge of ACGME core competencies before a residency program is started. Physicians at the Kaiser Permanente Fontana Medical Center (N = 480) were surveyed for their knowledge of ACGME core competencies before starting new residency programs. Knowledge of ACGME core competencies. Fifty percent of physicians responded to the survey, and 172 (71%) of respondents were involved in teaching residents. Of physicians who taught residents and had complete responses (N = 164), 65 (39.7%) were unsure of their knowledge of the core competencies. However, most stated that they provided direct teaching to residents related to the knowledge, skills, and attitudes stated in each of the 6 competencies as follows: medical knowledge (96.3%), patient care (95.7%), professionalism (90.7%), interpersonal and communication skills (86.3%), practice-based learning (85.9%), and system-based practice (79.6%). Physician specialty, years in practice (1-10 vs > 10), and number of rotations taught per year (1-6 vs 7-12) were not associated with knowledge of the competencies (p > 0.05); however, full-time faculty (teaching 10-12 rotations per year) were more likely to provide competency-based teaching. Objective assessment of faculty awareness of ACGME core competencies is essential when starting a residency program. Discrepancy between knowledge of the competencies and acclaimed provision of competency-based teaching emphasizes the need for standardized teaching methods that incorporate the values of these competencies.

  19. Self-Management Support to People with Type 2 Diabetes - A comparative study of Kaiser Permanente and the Danish Healthcare System

    DEFF Research Database (Denmark)

    Schiøtz, Michaela Louise; Strandberg-Larsen, Martin; Frølich, Anne

    2012-01-01

    En væsentlig del af kronikeromsorgen i et sundhedsvæsen er også at understøtte egenomsorgen. Egenomsorg omfatter fx, at patienten kender til, hvad der kan optimere behandlingsindsatsen, herunder ændring af livsstil, kendskab til sundhedsvæsenets tilbud, og at deltage aktivt i at koordinere og sik...

  20. Computer-assisted group study for learning/teaching medical entomology to medical students

    Directory of Open Access Journals (Sweden)

    Sudharsanam Manni Balasubramaniam

    2012-01-01

    Full Text Available Objectives: The objective of this study was to describe an innovative method used for teaching entomology. Setting : It was performed at Department of Preventive and Social Medicine, JIPMER, Puducherry. Materials and Methods: Fifty-five second year medical students were divided into two batches. Each batch had two sessions on entomology. In each session students were divided into small groups and assigned to prepare on the various insects of medical entomological importance and present on the prepared topic. The topics included vector characteristics, vector habits, diseases transmitted and modes of transmission of diseases, control of vectors. The corresponding photographs of the insects were projected at the end of each presentation. The modes of transmission, diseases transmitted, and control measures were learnt through the oral presentations. After each session students were shown the slides under microscopes to reinforce the features. Pretest and posttest were used to find the gain in knowledge and feedback was taken at the end of each session. Results: Comparison of pretest and posttest scores showed a statistically significant gain in the knowledge. Feedback from students revealed that objectives were clear for 42 of the 55 students. Facilitating factors included interactive session (14, group discussion (31, PowerPoint presentation (24, good moderator (14. Factors which hindered learning were lack of time for preparation (13 and afternoon sessions (2. Students suggested that more of this type of classes should be taken for them in near future (28. Conclusion: This method served as an effective alternative method as judged by students′ performance and feedback.

  1. Medical Team Training: Using Simulation as a Teaching Strategy for Group Work

    Science.gov (United States)

    Moyer, Michael R.; Brown, Rhonda Douglas

    2011-01-01

    Described is an innovative approach currently being used to inspire group work, specifically a medical team training model, referred to as The Simulation Model, which includes as its major components: (1) Prior Training in Group Work of Medical Team Members; (2) Simulation in Teams or Groups; (3) Multidisciplinary Teamwork; (4) Team Leader…

  2. Medical Team Training: Using Simulation as a Teaching Strategy for Group Work

    Science.gov (United States)

    Moyer, Michael R.; Brown, Rhonda Douglas

    2011-01-01

    Described is an innovative approach currently being used to inspire group work, specifically a medical team training model, referred to as The Simulation Model, which includes as its major components: (1) Prior Training in Group Work of Medical Team Members; (2) Simulation in Teams or Groups; (3) Multidisciplinary Teamwork; (4) Team Leader…

  3. Group concept mapping: An approach to explore group knowledge organization and collaborative learning in senior medical students.

    Science.gov (United States)

    Torre, Dario; Daley, Barbara J; Picho, Katherine; Durning, Steven J

    2017-10-01

    Group concept mapping may be used as a learning strategy that can potentially foster collaborative learning and assist instructors to assess the development of knowledge organization in medical students. Group concept maps were created by 39 medical students rotating through a fourth year medicine rotation. The group maps were developed based on a clinical vignette. Descriptive statistics and thematic analysis of students' evaluations were performed. Evaluations indicated that students enjoyed the collaborative nature of the exercise and the knowledge sharing activities associated with it. Group maps can demonstrate different knowledge organization Discussion: Group concept mapping can be used to explore students' organization and integration of knowledge structures in a collaborative setting. Additional research should focus on how group mapping and learning progresses over time and, whether group mapping can help identify curricular strengths and needs.

  4. Managing medical groups: 21st century challenges and the impact of physician leadership styles.

    Science.gov (United States)

    Martin, William E; Keogh, Timothy J

    2004-01-01

    Physician group managers and administrators charged with leading medical groups in the 21st century face a set of old and new challenges and opportunities. Leadership is assumed to make the difference between a successful and not-so-successful medical group. Yet, there is little research about how physician manager leadership styles contribute to the success of medical group practices. This article is a study of physician leadership styles using the DiSC, based upon a sample of 232 physician managers. Dominance (D) and conscientiousness (C) were the two dominant styles found in this study. Moreover, the two dominant combination leadership styles fall under the categories of the "creative" and the 'perfectionist." The article formulates practical recommendations for both physician managers and administrators for leading medical groups to respond more effectively to the challenges and opportunities facing medical groups in the 21st century.

  5. Secure Group Formation Protocol for a Medical Sensor Network Prototype

    DEFF Research Database (Denmark)

    Andersen, Jacob

    2009-01-01

    Designing security mechanisms such as privacy and access control for medical sensor networks is a challenging task; as such systems may be operated very frequently, at a quick pace, and at times in emergency situations. Understandably, clinicians hold extra unproductive tasks in low regard......, and experience from user workshops and observations of clinicians at work on a hospital ward show that if the security mechanisms are not well designed, the technology is either rejected altogether, or they are circumvented leaving the system wide open to attacks. Our work targets the problem of designing...... wireless sensors to be both secure and usable by exploring different solutions on a fully functional prototype platform. In this paper, we present an Elliptic Curve Cryptography (ECC) based protocol, which offers fully secure sensor set-up in a few seconds on standard (Telos) hardware. We evaluate...

  6. Psychotropic medication from an object relations theory perspective: an analysis of vignettes from group psychotherapy.

    Science.gov (United States)

    Fain, Dana Shindel; Sharon, Amos; Moscovici, Lucian; Schreiber, Shaul

    2008-07-01

    In this article we explore the content and dynamics of patients' verbalizations within a "living with medications" group. Patients' perceptions of their psychotropic medications are interpreted and classified within the framework of object relations theory. One's perception of the role of medication in one's life can serve as a gateway to one's inner world and the way that he or she perceives authority figures, peers, and oneself. We suggest that working through patients' relationships with their medications can help them to achieve better integration of internal object relations. Discussing patients' views about medications should therefore be seen as an important part of psychotherapy with many individuals. Such a discussion may enhance and improve efficacy of both psychotherapy and pharmacotherapy. It is of particular importance in group therapy, within milieu environments and with individuals reluctant to explicitly discuss interpersonal matters. Vignettes from the group sessions illustrate the way in which discussing medication advances group process.

  7. [Use of medication in combination with a modern group programme for smoking cessation].

    Science.gov (United States)

    Erfurt, L; Kröger, C B

    2015-02-01

    This study examined the acceptance, use and -adherence with regard to stop-smoking medication in addition to a smoking cessation programme. In a multi-centre field study with quasi-experimental control group design, the participants of a smoking cessation programme were asked about their smoking behaviour at the beginning and at the end of the course. A sample of 1 319 participants was contacted via telephone one year after the end of the course. Among the 1 052 participants, who could be interviewed, 312 subjects (29.7%) reported to have used stop-smoking medication while 85.2% of the medication users preferred nicotine replacement therapy. The objective medication adherence was 13.2%. 79.3% of the medication users believed that they had used the medication adherently. There were no significant differences between participants who started use of medication and non-users (long-term abstinence rate: no medication 34.6% vs. medication 31.7%; p=0.34). The outcome of a modern smoking cessation group programme could not be improved by providing additional stop-smoking medication. This finding and the lack of medication adherence raise doubts about the effectiveness of offering stop-smoking medication in addition to an intensive cognitive-behavioural-based smoking cessation programme that focusses on behavioural changes.

  8. The effects of capitation payment on the organizational structure of medical group practices.

    Science.gov (United States)

    Kralewski, J E; Wingert, T D; Knutson, D J; Johnson, C E; Veazie, P J

    1996-01-01

    This study explores the effects of capitation payment on the structural elements used by medical group practices to control physician-directed use of resources and the quality of patient care. Forty-five medical groups located in the highly competitive Minneapolis/St. Paul metropolitan area were studied. The range of capitation payment in these medical group practices is from 2% to 87%. Although the practices vary considerably in the extent to which they have developed these control mechanisms, it does not appear that capitation payment is a major factor influencing that pattern. It appears that many of these medical group practices either use less formal mechanisms than those included in this study to control resource use and the quality of care or use none at all. In either event, the data suggest that the effects of capitation payment on the structure of medical practices may be overestimated.

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

    Science.gov (United States)

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

    2016-01-28

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

  10. Development and Operation of a Modern Information Portal for the ISS Medical Groups

    Science.gov (United States)

    Damann, V.; Johnson, MaGee; Sargsyan, Ashot; McDonald, P. Vernon; Armstrong, C.; Scheer, M.; Duncan, J. Michael

    2007-01-01

    This viewgraph presentation begins with a review of some of the problems inherent in running medical services for the International Space Station. Part of the solution for the problems is the development of the information portal for the ISS medical groups. The presentation shows the tools that have been developed to assist in collaboration for the medical services, the security system and the capabilities of the portal.

  11. Differential impact of student behaviours on group interaction and collaborative learning: medical students' and tutors' perspectives.

    Science.gov (United States)

    Iqbal, Maha; Velan, Gary M; O'Sullivan, Anthony J; Balasooriya, Chinthaka

    2016-08-22

    Collaboration is of increasing importance in medical education and medical practice. Students' and tutors' perceptions about small group learning are valuable to inform the development of strategies to promote group dynamics and collaborative learning. This study investigated medical students' and tutors' views on competencies and behaviours which promote effective learning and interaction in small group settings. This study was conducted at UNSW Australia. Five focus group discussions were conducted with first and second year medical students and eight small group tutors were interviewed. Data were transcribed verbatim and thematic analysis was conducted. Students and tutors identified a range of behaviours that influenced collaborative learning. The main themes that emerged included: respectfulness; dominance, strong opinions and openness; constructiveness of feedback; active listening and contribution; goal orientation; acceptance of roles and responsibilities; engagement and enthusiasm; preparedness; self- awareness and positive personal attributes. An important finding was that some of these student behaviours were found to have a differential impact on group interaction compared with collaborative learning. This information could be used to promote higher quality learning in small groups. This study has identified medical students' and tutors' perceptions regarding interactional behaviours in small groups, as well as behaviours which lead to more effective learning in those settings. This information could be used to promote learning in small groups.

  12. Adapting to change: the advantage of modular clinic design.

    Science.gov (United States)

    Arsenault, Bruce

    2004-01-01

    Architects have applied modular design concepts for years. Projects benefiting most are those where a few room types are repeated often. Ambulatory care facilities are excellent candidates because this project type typically consists of a large number of rooms that can be standardized. The new Kaiser Permanente Santa Clara Medical Office Building illustrates the benefits and flexibility of modular design.

  13. Medical students perceive better group learning processes when large classes are made to seem small.

    Directory of Open Access Journals (Sweden)

    Juliette Hommes

    Full Text Available OBJECTIVE: Medical schools struggle with large classes, which might interfere with the effectiveness of learning within small groups due to students being unfamiliar to fellow students. The aim of this study was to assess the effects of making a large class seem small on the students' collaborative learning processes. DESIGN: A randomised controlled intervention study was undertaken to make a large class seem small, without the need to reduce the number of students enrolling in the medical programme. The class was divided into subsets: two small subsets (n=50 as the intervention groups; a control group (n=102 was mixed with the remaining students (the non-randomised group n∼100 to create one large subset. SETTING: The undergraduate curriculum of the Maastricht Medical School, applying the Problem-Based Learning principles. In this learning context, students learn mainly in tutorial groups, composed randomly from a large class every 6-10 weeks. INTERVENTION: The formal group learning activities were organised within the subsets. Students from the intervention groups met frequently within the formal groups, in contrast to the students from the large subset who hardly enrolled with the same students in formal activities. MAIN OUTCOME MEASURES: Three outcome measures assessed students' group learning processes over time: learning within formally organised small groups, learning with other students in the informal context and perceptions of the intervention. RESULTS: Formal group learning processes were perceived more positive in the intervention groups from the second study year on, with a mean increase of β=0.48. Informal group learning activities occurred almost exclusively within the subsets as defined by the intervention from the first week involved in the medical curriculum (E-I indexes>-0.69. Interviews tapped mainly positive effects and negligible negative side effects of the intervention. CONCLUSION: Better group learning processes can be

  14. A Selective Group Authentication Scheme for IoT-Based Medical Information System.

    Science.gov (United States)

    Park, YoHan; Park, YoungHo

    2017-04-01

    The technology of IoT combined with medical systems is expected to support advanced medical services. However, unsolved security problems, such as misuse of medical devices, illegal access to the medical server and so on, make IoT-based medical systems not be applied widely. In addition, users have a high burden of computation to access Things for the explosive growth of IoT devices. Because medical information is critical and important, but users have a restricted computing power, IoT-based medical systems are required to provide secure and efficient authentication for users. In this paper, we propose a selective group authentication scheme using Shamir's threshold technique. The property of selectivity gives the right of choice to users to form a group which consists of things users select and access. And users can get an access authority for those Things at a time. Thus, our scheme provides an efficient user authentication for multiple Things and conditional access authority for safe IoT-based medical information system. To the best of our knowledge, our proposed scheme is the first in which selectivity is combined with group authentication in IoT environments.

  15. Improving aquaaerobics as means of hydrorehabilitation of students of special medical groups.

    Directory of Open Access Journals (Sweden)

    Balamutova N.M.

    2011-02-01

    Full Text Available The questions which concern with estimate of implementation of aquaaerobics in an educational process of physical culture of students with weakened health were examined. In experiment took place 76 students of Law Academy. The data that were used in this research were taken from a questionnaire survey that was made among students, analysis of methodological literature and own practical experience. The experimental program of aquaaerobical studies with students of special medical group was developed .The analysis of students quantity of special medical groups which attended physical training studies showed that aquaaerobisc appeared no less attractive then medical swimming.

  16. The benefits of pass-fail grading on stress, mood, and group cohesion in medical students.

    Science.gov (United States)

    Rohe, Daniel E; Barrier, Patricia A; Clark, Matthew M; Cook, David A; Vickers, Kristin S; Decker, Paul A

    2006-11-01

    To objectively measure the effect of a pass-fail grading system on stress, mood, group cohesion, and test anxiety in medical students. Beginning with the class of 2006, the Mayo Medical School, Rochester, Minn, changed the grading system for first-year courses from a 5-interval grading system to a pass-fail grading system. Students in the previous class of 2005, who were graded using a 5-interval system during their first year of medical school, were compared with students in the class of 2006. Using a prospective study design, the 2 groups were compared at the end of both the first year and the second year of medical school on the Perceived Stress Scale, Profile of Mood States, Perceived Cohesion Scale, Test Anxiety Inventory, and (after year 2) the United States Medical Licensing Examination Step 1. Data collection occurred in 2002 and 2003 with the class of 2005 and in 2003 and 2004 with the class of 2006. Students graded with the pass-fail system had less perceived stress (median, 15.0 vs 21.0; P-.01) and greater group cohesion (median, 34.5 vs 30.0; P=.02) at the end of their second year of coursework than their 5-interval graded peers. The pass-fail group had better mood (median, 46.5) than the graded group (median, 64.0), but this difference was not statistically significant (P=.07). No significant differences were found between the 2 groups in test-taking anxiety or in United States Medical Licensing Examination Step 1 board scores. Pass-fail grading may reduce stress and increase group cohesion in medical students compared with traditional 5-interval grading.

  17. Medical Groups Raise Blood Pressure Rx Threshold for Healthy Adults Over 60

    Science.gov (United States)

    ... https://medlineplus.gov/news/fullstory_163063.html Medical Groups Raise Blood Pressure Rx Threshold for Healthy Adults Over 60 Guidelines ... benefit from more aggressive treatment is small, the groups say. Doctors ... control of blood pressure in healthy older adults may produce more harm ...

  18. Training Groups and Foreign-Born Psychiatric Medical Residents in the United States.

    Science.gov (United States)

    Greenberg, Andrea; Juthani, Nalini

    1991-01-01

    About two-thirds of all psychiatry residents are foreign-born medical graduates. Discusses the operation, content, focus, challenges, and benefits of a training group experience for the psychiatry residents at Bronx Lebanon Hospital. The goals are to aid acculturation, improve group psychotherapeutic skills, encourage self-awareness, and promote…

  19. The Use of Small Group Tutorials as an Educational Strategy in Medical Education

    Science.gov (United States)

    Ferris, Helena

    2015-01-01

    Small group tutorials are an educational strategy that is growing in popularity in medical education. This is indicative of the movement from a traditional teacher centred approach to more student-centred learning, which is characterised by active participation and autonomous learning (Hedge et al, 2011). However, small group teaching is one of…

  20. 75 FR 43557 - TA-W-73,682, Hartford Financial Services Group, Incorporated, Medical Bill Processing and...

    Science.gov (United States)

    2010-07-26

    ... Employment and Training Administration TA-W-73,682, Hartford Financial Services Group, Incorporated, Medical...; TA-W-73,682A, Hartford Financial Services Group, Incorporated Medical Bill Processing and Production... Financial Services Group, Incorporated, Medical Bill Processing and Production Center Support,...

  1. Performance anxiety at English PBL groups among Taiwanese medical students: a preliminary study.

    Science.gov (United States)

    Chen, Cheng-Sheng; Lai, Chung-Sheng; Lu, Peih-Ying; Tsai, Jer-Chia; Chiang, Hung-Che; Huang, In-Ting; Yu, Hsin-Su

    2008-03-01

    Students' performance anxiety can impact negatively on the effectiveness of medical education reform, including performance in problem-based learning (PBL) and in using English in discussion. This study aimed to investigate the nature of performance anxiety among Taiwanese medical students in an English-language PBL group. Eighteen Taiwanese, one American and four Asian medical students who were attending an international PBL workshop were enrolled. A questionnaire seeking demographic data and experience in use of PBL and eight questions evaluating performance anxiety were administered. The performance anxiety of Taiwanese medical students was compared to that of the Asians and the one American. Frequencies of each performance anxiety were calculated. The results suggested that the Taiwanese students showed more anxiety than the one student from the United States, but less than other Asian students. The acts of giving a report, being the center of attention, and talking in the PBL group were the most common situations related to anxiety in PBL groups. Using English and working in a new PBL environment are possible sources of anxiety. The presence of anxiety among the Taiwanese medical students in English PBL groups implies the necessity for developing an effective strategy to deal with students' performance anxiety.

  2. Self-development groups reduce medical school stress: a controlled intervention study

    Directory of Open Access Journals (Sweden)

    Stordal Kirsten I

    2010-03-01

    Full Text Available Abstract Background High stress levels and mental health problems are common among medical students and there is a lack of studies on group interventions that aim to reduce such distress during medical school. Methods A full class of students (n = 129 participated in group sessions during their third year of medical school in Bergen, Norway. The subsequent third-year class (n = 152 acted as control group, in order to create a quasi-experimental design. Two types of group intervention sessions were offered to the first class. One option was self-development groups led by trained group psychotherapists. Alternatively, students could choose discussion groups that focused on themes of special relevance to doctors, led by experienced general practitioners. The intervention comprised of 12 weekly group sessions each lasting 90 minutes. Data were gathered before the intervention (T1, and three months post intervention (T2. Distress was measured using the Perceived Medical School Stress (PMSS and Symptom Check List-5 (SCL-5 assessments. Results The intervention group showed a significant reduction in PMSS over the observation period. The subsequent year control group stayed on the same PMSS levels over the similar period. The intervention was a significant predictor of PMSS reduction in a multiple regression analysis adjusted for age and sex, β = -1.93 (-3.47 to -0.38, P = 0.02. When we analysed the effects of self-development and discussion groups with the control group as reference, self-development group was the only significant predictor of PMSS reduction, β = -2.18 (-4.03 to -0.33, P = 0.02. There was no interaction with gender in our analysis. This implicates no significant difference between men and women concerning the effect of the self-development group. There was no reduction in general mental distress (SCL-5 over this period. Conclusion A three-month follow-up showed that the intervention had a positive effect on perceived medical school

  3. Comparison of pain control medication in three age groups of elderly patients.

    Science.gov (United States)

    Honari, S; Patterson, D R; Gibbons, J; Martin-Herz, S P; Mann, R; Gibran, N S; Heimbach, D M

    1997-01-01

    There are no published reports of burn pain management in the elderly population. To assess the range of requirement and use of opioids among elderly patients with burns of different age categories, a retrospective review of 89 consecutive admissions of patients over 55 years of age (January 1995 through July 1996) was conducted. Complete data were available on 44 patients with a burn mean total body surface area of 17.2%. Patient ages ranged from 55 to 92 years. Individuals were divided into three age categories: Group I (55 to 65) n = 20; Group II (66 to 75) n = 14; and Group III (76 to 92) n = 10. Use of commonly prescribed opioids for procedural pain and breakthrough pain were evaluated. We compared the opioid equivalents of medications prescribed versus the actual amount administered. Paired t tests comparing minimum amount of medication ordered with that given revealed Group I patients received significantly more procedural medication than the minimum prescribed (t = 3.88, p = 0.001), and that Group III patients were given significantly less as needed medication than the minimum prescribed (t = 2.58, p < 0.05).

  4. Benchmarking medical group practices using claims data: methodological and practical problems.

    Science.gov (United States)

    Dove, H G; Greene, B R

    2000-10-01

    As claims data for physicians and groups of physicians has improved in quality and quantity, health information vendors have begun marketing information about medical groups' productivity, utilization, and quality. Based on interviews with product developers and our understanding of the evolution of their products, several methodological and practical issues remain. For now and the immediate future, health information vendors will continue to face the limitations of physicians' claims data. Vendors and purchasers should be aware of common data shortcomings such as inadequate monthly enrollment figures, possible physician upcoding to circumvent utilization management restrictions, and incorrect coding when a test is used to rule out a disease. In the longer term, several avenues seem likely to make medical groups' data better and richer because of computer-based medical records and efficiencies possible from the Internet. The field of benchmarking products for group practices is still an immature market. However, several trends suggest such products are highly desirable. Provider organizations which bear medical risk need benchmarking data to help improve their efficiency. There are many important nonprovider organizations that need good information on group practices' utilization patterns and outcomes to help them plan new products and negotiate with physicians.

  5. Impact of a Social Media Group Page on Undergraduate Medical Physiology Learning.

    Science.gov (United States)

    Shakoori, Tania Ahmed; Mahboob, Usman; Strivens, Janet; Willis, Ian

    2017-07-01

    To investigate the impact of associating classroom learning of medical physiology with a Facebook group page in an all-women medical college of a conservative small city in Pakistan. Qualitative interpretivist study using semi-structured interviews. Women Medical College Abbottabad, Pakistan, from March to December 2014. Aclosed Facebook study group was established at a local medical college in Pakistan. It was used to upload learning resources and initiate discussions, coordinated with classroom lectures of physiology. Thirteen semistructured interviews were conducted with volunteer students according to a standard protocol. Five major themes were identified. Facebook group is something new and exciting; it motivated self-study, research, collaborative learning and improved class attendance. Convenience of easily accessible resources allowed the students to concentrate on the lecture rather than note taking. It was easier to communicate with the instructor through Facebook than face to face. Lurkers were also learning. High achievers who had adapted to the current didactic system of teaching were less receptive of the collaborative learning and favored teaching geared towards exam preparation. Using social media for e-learning in undergraduate medical education can enhance the student learning experience, especially in resource-limited regions where Information and communication technology is not an integrated part of the teaching process.

  6. Modifying the ECC-based grouping-proof RFID system to increase inpatient medication safety.

    Science.gov (United States)

    Ko, Wen-Tsai; Chiou, Shin-Yan; Lu, Erl-Huei; Chang, Henry Ker-Chang

    2014-09-01

    RFID technology is increasingly used in applications that require tracking, identification, and authentication. It attaches RFID-readable tags to objects for identification and execution of specific RFID-enabled applications. Recently, research has focused on the use of grouping-proofs for preserving privacy in RFID applications, wherein a proof of two or more tags must be simultaneously scanned. In 2010, a privacy-preserving grouping proof protocol for RFID based on ECC in public-key cryptosystem was proposed but was shown to be vulnerable to tracking attacks. A proposed enhancement protocol was also shown to have defects which prevented proper execution. In 2012, Lin et al. proposed a more efficient RFID ECC-based grouping proof protocol to promote inpatient medication safety. However, we found this protocol is also vulnerable to tracking and impersonation attacks. We then propose a secure privacy-preserving RFID grouping proof protocol for inpatient medication safety and demonstrate its resistance to such attacks.

  7. Student Perceptions of Independent versus Facilitated Small Group Learning Approaches to Compressed Medical Anatomy Education

    Science.gov (United States)

    Whelan, Alexander; Leddy, John J.; Mindra, Sean; Matthew Hughes, J. D.; El-Bialy, Safaa; Ramnanan, Christopher J.

    2016-01-01

    The purpose of this study was to compare student perceptions regarding two, small group learning approaches to compressed (46.5 prosection-based laboratory hours), integrated anatomy education at the University of Ottawa medical program. In the facilitated active learning (FAL) approach, tutors engage students and are expected to enable and…

  8. Comparing Two Cooperative Small Group Formats Used with Physical Therapy and Medical Students

    Science.gov (United States)

    D'Eon, Marcel; Proctor, Peggy; Reeder, Bruce

    2007-01-01

    This study compared "Structured Controversy" (a semi-formal debate like small group activity) with a traditional open discussion format for medical and physical therapy students. We found that those students who had participated in Structured Controversy changed their personal opinion on the topic more than those who were in the Open Discussion…

  9. Conceptual foundations of classes with the disciples of special medical group in secondary schools

    Directory of Open Access Journals (Sweden)

    Vaskov Y.V.

    2014-05-01

    Full Text Available Purpose: study and scientific rationale for new approaches to the organization of educational work with students of special medical group in secondary schools. Material : analyzed 15 scientific sources regarding the approaches of different authors to develop educational programs for students of special medical group. Results : focuses on the outstanding issues in a substantive, logistical and human aspects. Found that the selection of the content of educational material for special medical groups is an empirical question. Selection is carried out by copying the existing curriculum of physical culture for healthy children with an indication of the load reduction and exemption of complex elements. Established a complete absence of evaluation of educational achievements of pupils. Based on modern approaches to teaching students based on biomedical and didactic aspects: Leading defined function of each stage of training, fleshed main goals and objectives of the educational process, substantiated various kinds of sports activity, taking into account the diagnosis of diseases and the needs of students of different ages and gender. Conclusions : the main controversy in the decision of the designated problem. Substantiated leading features of each stage of training in special medical groups. A system of assessment of students' achievements.

  10. [Comparison between two caller groups of a medical call centre in Switzerland].

    Science.gov (United States)

    Ackermann Rau, S; Zwahlen, M

    2008-05-01

    The incidence distribution of triage advice in the medical call centre Medi24 and the pattern of service utilisation were analysed with respect to two groups of callers with different insurance schemes. Individuals having contracted insurance of the Medi24 model could use the telephone consultation service of the medical call centre Medi24 (mainly part of the mandatory basic health insurance) voluntarily and free of charge whereas individuals holding an insurance policy of the Telmed model (special contract within the mandatory basic health insurance with a premium discount ranging from 8% to 12%) were obliged to have a telephone consultation before arranging an appointment with a medical doctor. A cross-sectional study was carried out in the medical call centre Medi24 based on all triage datasets of the Medi24 and Telmed groups collected during the one year period from July 1st 2005 to June 30th 2006. The distribution of the six different urgency levels within the two groups and their respective pattern of service utilisation was determined. In a multivariable logistic regression model the Odds Ratio for every enquiry originating from the Telmed group versus those originating from the Medi24 group was calculated. During a one-year period 48 388 triage requests reached the medical call centre Medi24, 56% derived from the Telmed group and 44% from the Medi24 group. Within the Medi24 group more than 25% of the individuals received self-care advice, within the Telmed group, on the other hand, only about 18% received such advice. In contrast, 27% of the Telmed triage requests but only 18% of the Medi24 triage requests resulted in the advice to make a routine appointment with a medical doctor. The probability that an individual of the Telmed group obtained the advice to go to the accident and emergency department was lower than for an individual of the Medi24 group (OR 0.77, 95% CI 0.60-0.99). Likewise, the probability of self-care advice was decreased in regard to the

  11. Group-sparse representation with dictionary learning for medical image denoising and fusion.

    Science.gov (United States)

    Li, Shutao; Yin, Haitao; Fang, Leyuan

    2012-12-01

    Recently, sparse representation has attracted a lot of interest in various areas. However, the standard sparse representation does not consider the intrinsic structure, i.e., the nonzero elements occur in clusters, called group sparsity. Furthermore, there is no dictionary learning method for group sparse representation considering the geometrical structure of space spanned by atoms. In this paper, we propose a novel dictionary learning method, called Dictionary Learning with Group Sparsity and Graph Regularization (DL-GSGR). First, the geometrical structure of atoms is modeled as the graph regularization. Then, combining group sparsity and graph regularization, the DL-GSGR is presented, which is solved by alternating the group sparse coding and dictionary updating. In this way, the group coherence of learned dictionary can be enforced small enough such that any signal can be group sparse coded effectively. Finally, group sparse representation with DL-GSGR is applied to 3-D medical image denoising and image fusion. Specifically, in 3-D medical image denoising, a 3-D processing mechanism (using the similarity among nearby slices) and temporal regularization (to perverse the correlations across nearby slices) are exploited. The experimental results on 3-D image denoising and image fusion demonstrate the superiority of our proposed denoising and fusion approaches.

  12. Small group effectiveness during pharmacology learning sessions in a Nepalese medical school

    Directory of Open Access Journals (Sweden)

    Shankar PR

    2011-06-01

    Full Text Available BackgroundSmall group learning sessions are used in pharmacology atthe KIST Medical College, Lalitpur, Nepal. Feedback aboutstudent behaviours that enhance and hinder small groupeffectiveness was obtained. This will help us improve thesmall group sessions and will also be useful to educatorsusing small groups in other medical schools.MethodThe small groups were self-managing with a group leader,time-keeper, recorder and presenter. Small groupeffectiveness was measured using the Tutorial GroupEffectiveness Instrument (TGEI developed by Singaram andco-authors. The instrument was administered in June 2010and key findings obtained were shared with students andfacilitators. The instrument was administered again inAugust. The mean cognitive, motivational, demotivationaland overall scores were compared among differentcategories of respondents in June and August. Scores werealso compared between June and August 2010.ResultsA total of 89 students participated in the study in June and88 in August 2010. In June, females rated overall groupproductivity higher compared to males. The cognitive andmotivational scores were higher in August 2010 while thedemotivational score was lower.ConclusionThe small group effectiveness was higher in August after theeducational intervention which utilised feedback aboutproblems observed, theoretical considerations of effectivesmall groups and how this information can be applied inpractice.

  13. Perceptions and efficiency of short-term medical aid missions among key groups of health professionals.

    Science.gov (United States)

    Chiu, Ya-Wen; Weng, Yi-Hao; Chen, Chih-Fu; Yang, Chun-Yuh; Lee, Ming-Liang

    2014-09-01

    This study investigated the perceptions of short-term assignments of medical services among participating health care professionals dispatched from Taiwan to underdeveloped areas. Structured questionnaires were mailed to four groups of professionals (physicians, pharmacists, nurses, and public health personnel) who had participated in any of 88 medical missions dispatched to 24 allied nations. A total of 278 returns were valid for analysis. Among them, 222 respondents reported that they had participated in just one overseas medical mission (79.9%). The majority of physicians, pharmacists, and nurses listed humanitarianism as their foremost incentive for participation. In contrast, public health personnel most frequently reported that they had been assigned to the mission abroad. Pharmacists, nurses, and public health personnel most commonly stated that their top goal was health care; but physicians said that aiding Taiwan's diplomatic relations was their main motive. While all groups generally recognized language proficiency and cultural awareness as important for conducting successful short-term medical aid missions (STMMs), many members of groups did not rate their own capabilities in those area as sufficient, especially pharmacists (p help inform efforts to integrate evidence into the deployment of STMMs.

  14. Experiences of sickness absence, marginality and Medically Unexplained Physical Symptoms - A focus group study

    DEFF Research Database (Denmark)

    E.L., Werner; A, Aamland; Malterud, Kirsti

    2013-01-01

    with a purposive sample of 12 participants, six men and six women, aged 24-59 years. Their average duration of sickness absence was 10.5 months. Participants were invited to share stories about experiences from the process leading to the ongoing sickness absence, with a focus on the causes being medically......PURPOSE: Medically unexplained physical symptoms (MUPS) form a major cause of sickness absence. The purpose of this study was to explore factors which may influence further marginalization among patients with MUPS on long-term sickness absence. METHODS: Two focus-group discussions were conducted...

  15. Student satisfaction and self-assessment after small group discussion in a medical ethics education program.

    Science.gov (United States)

    Joh, Hee-Kyung; Shin, Jwa-Seop

    2009-09-01

    Small group discussions are useful tools in medical ethics education. We aimed to assess student satisfaction with specific components of a small group discussion and to evaluate student self-assessment of the objectives of education. A structured questionnaire was developed after a literature review and a focus group interview. Components of the small group discussion were categorized by discussion case (self, other), individual activities (self-study, making materials, presentation experience), and group activities (preclass/in-class/postclass/plenary discussion, instructor's comments). The items for student self-assessment were: "To specify ethical issue in actual practice", "To get new knowledge", "To consider doctor's entity", "Empathy to others", "To get multidimensional viewpoint", "Viewpoint change", "To deliver my thought clearly", and "Ability to confront the medical ethics dilemma in the future". After the survey, an in-depth interview was performed to determine the reason behind the students' answers. A total of 121 students responded, for whom overall satisfaction and self-assessment were high. Students reported greater satisfaction with self-case, presentation experience, in-class discussion, and instructor's comments but less satisfaction with self-study before class and postclass discussion. Student self-assessment was highest in the ability to specify an ethical issue and lowest for viewpoint change and self-confidence. After multivariate analysis, higher student self-assessment was associated with greater satisfaction with the small group discussion. To improve the quality of medical ethics education, close investigation and monitoring of each component of the small group discussion and student achievement are essential, as is continuous feedback.

  16. Quality of life, treatment adherence, and locus of control: multiple family groups for chronic medical illnesses.

    Science.gov (United States)

    López-Larrosa, Silvia

    2013-12-01

    The Multiple Family Groups (MFGs) approach for patients with a chronic medical illness and their families is a structured psychoeducational program that unfolds in six weekly 90-minute sessions. In the MFGs, patients and family members explore new ways to balance illness and nonillness priorities in family life (Steinglass, 1998; Steinglass, 2000 Cuadernos de Terapia Familiar, 44-45, 11; Steinglass, Ostroff, & Steinglass, 2011 Family Process, 50, 393). © FPI, Inc.

  17. Teaching medical ethics: problem-based learning or small group discussion?

    Science.gov (United States)

    Heidari, Akram; Adeli, Seyyed-Hassan; Taziki, Sadegh-Ali; Akbari, Valliollahe; Ghadir, Mohammad-Reza; Moosavi-Movahhed, Seyyed-Majid; Ahangari, Roghayyeh; Sadeghi-Moghaddam, Parvaneh; Mirzaee, Mohammad-Rahim; Damanpak-Moghaddam, Vahid

    2013-01-01

    Lecture is the most common teaching method used in ethics education, while problem-based learning (PBL) and small group discussion (SGD) have been introduced as more useful methods. This study compared these methods in teaching medical ethics. Twenty students (12 female and 8 male) were randomly assigned into two groups. The PBL method was used in one group, and the other group was taught using the SGD method. Twenty-five open-ended questions were used for assessment and at the end of the course, a course evaluation sheet was used to obtain the students' views about the advantages and disadvantages of each teaching method, their level of satisfaction with the course, their interest in attending the sessions, and their opinions regarding the effect of teaching ethics on students' behaviors. The mean score in the PBL group (16.04 ± 1.84) was higher than the SGD group (15.48 ± 2.01). The satisfaction rates in the two groups were 3.00 ± 0.47 and 2.78 ± 0.83 respectively. These differences were not statistically significant. Since the mean score and satisfaction rate in the PBL group were higher than the SGD group, the PBL method is recommended for ethics education whenever possible.

  18. Group Medical Visits to Provide Gynecologic Care for Women Affected by Breast Cancer

    Directory of Open Access Journals (Sweden)

    Sally R. Greenwald

    2017-01-01

    Full Text Available Purpose: Women with breast cancer have complex and unique gynecologic needs that are challenging to effectively and comprehensively meet in a traditional gynecology visit format. Group medical visits are an effective and well-received model of care in other disease settings and can provide comprehensive health education as an adjunct to one-on-one evaluation and treatment. There are limited data regarding the use of this type of health care delivery in providing gynecology-focused care to women affected by breast cancer. Methods: A group medical visit model was created for gynecology providers to see new breast cancer patient consults. From May 2012 to February 2014, 148 patients (3–6 per group participated in a 1-hour informational session followed by a 15- to 30-minute individual visit with a physician that included history, physical examination and evaluation. We surveyed 101 women who attended these visits to evaluate a group model for providing gynecologic care and educational support to women with breast cancer. Results: Of those who responded to the survey question, 100% agreed or somewhat agreed that their expectations for an initial intake visit were met during the group visit; 81% agreed or somewhat agreed that they felt a group visit was preferable to an individual introductory visit. More than 95% agreed or somewhat agreed that the information was understandable and their questions were answered during the visit. Only 5 respondents expressed dissatisfaction with the additional time commitment for this type of visit. Conclusions: The majority of women surveyed expressed satisfaction with their experience with a group visit format. The women who participated preferred this format compared to an individual intake appointment when establishing gynecology care after breast cancer diagnosis/treatment, regardless of age, menopausal status, cancer stage or hormone receptor status. While further studies are warranted to directly compare and

  19. Role modelling of clinical tutors: a focus group study among medical students.

    Science.gov (United States)

    Burgess, Annette; Goulston, Kerry; Oates, Kim

    2015-02-14

    Role modelling by clinicians assists in development of medical students' professional competencies, values and attitudes. Three core characteristics of a positive role model include 1) clinical attributes, 2) teaching skills, and 3) personal qualities. This study was designed to explore medical students' perceptions of their bedside clinical tutors as role models during the first year of a medical program. The study was conducted with one cohort (n = 301) of students who had completed Year 1 of the Sydney Medical Program in 2013. A total of nine focus groups (n = 59) were conducted with medical students following completion of Year 1. Data were transcribed verbatim. Thematic analysis was used to code and categorise data into themes. Students identified both positive and negative characteristics and behaviour displayed by their clinical tutors. Characteristics and behaviour that students would like to emulate as medical practitioners in the future included: 1) Clinical attributes: a good knowledge base; articulate history taking skills; the ability to explain and demonstrate skills at the appropriate level for students; and empathy, respect and genuine compassion for patients. 2) Teaching skills: development of a rapport with students; provision of time towards the growth of students academically and professionally; provision of a positive learning environment; an understanding of the student curriculum and assessment requirements; immediate and useful feedback; and provision of patient interaction. 3) Personal qualities: respectful interprofessional staff interactions; preparedness for tutorials; demonstration of a passion for teaching; and demonstration of a passion for their career choice. Excellence in role modelling entails demonstration of excellent clinical care, teaching skills and personal characteristics. Our findings reinforce the important function of clinical bedside tutors as role models, which has implications for faculty development and

  20. The success of medical nutrition therapy in both genders and in different age groups

    Directory of Open Access Journals (Sweden)

    Ralević Slađana

    2013-01-01

    Full Text Available More than half of the adult population of the Republic of Serbia is overweight or obese. Obesity carries various risks and general health complications, which can significantly impair one's functioning and well-being. On the other hand, beneficial effects of body mass reduction are clearly confirmed. The therapeutic approach to obesity involves the use of various measures Treatment may include: medical nutrition therapy, programmed physical activity, medicaments and surgical treatment. The aim of this study was to examine if the effectiveness of medical nutrition therapy depends on the sex and age structure. This investigation was conducted as a retrospective study for the period from January 2008. until July 2009. During this time, 990 people came to the Counceling center. Only patients who came regularly to the controls and had BMI higher than 25 kg/m2 were included in this study. The average BMI in men was 31.55 kg/m2 and 32.66 kg/m2 in women. Compared to the first examination, majority of females (n = 35, 24.56% and males (n = 23, 25.27% reduced their BMI from 0 to 0.5 kg/m2 after medical nutrition therapy. Based on the results of X2 test, we concluded that there were statistically significant differences between men and women in effectiveness of medical nutrition therapy, while differences in the effectiveness of treatment in different age groups do not exist, neither in men nor in women.

  1. Parental illness perceptions and medication perceptions in childhood asthma, a focus group study.

    Science.gov (United States)

    Klok, Ted; Brand, Paul L; Bomhof-Roordink, Hanna; Duiverman, Eric J; Kaptein, Adrian A

    2011-02-01

    Asthma treatment according to guidelines fails frequently, through patients' nonadherence to doctors' advice. This study aimed to explore how differences in asthma care influence parents' perceptions to inhaled corticosteroids (ICS). We conducted six semistructured focus groups, including 44 parents of asthmatic children (2-12 years of age, treated in primary or specialist care). Verbatim transcripts were analysed with standard qualitative research methods. Parents decided deliberately whether ongoing ICS use was useful for their child. This decision was based on their perceptions about illness and medication. In primary care, this issue was hardly ever discussed with the health care provider because regular scheduled follow-up was unusual. In specialist care, regular scheduled follow-up was usual, and parental perceptions about illness and medication were discussed and modified when needed. Parent-reported adherence was lower in primary care than in specialist care. This focus group study illustrates how strongly parental perceptions of illness and medication influence adherence to health care providers' advice and that such perceptions can be modified within a strong doctor-patient partnership, improving adherence. © 2010 The Author(s)/Acta Paediatrica © 2010 Foundation Acta Paediatrica.

  2. Strategies to optimize medication use in the physician group practice: the role of the clinical pharmacist.

    Science.gov (United States)

    Devine, Emily Beth; Hoang, Susan; Fisk, Albert W; Wilson-Norton, Jennifer L; Lawless, Nathan M; Louie, Clifton

    2009-01-01

    To (1) describe the role of clinical pharmacists in providing population-based pharmaceutical care as employees of a physician group practice, (2) describe the strategies used by pharmacists to optimize medication use, (3) quantify improvements in care, and (4) illustrate the calculations used to quantify cost savings. Community-based, multispecialty, physician group practice located in the north Puget Sound area between 2003 and 2007. Using four cornerstones (evidence-based medicine, therapeutic interchange, academic detailing, and a local pharmacy and therapeutics committee), the pharmacists provided population-based pharmaceutical care, leading generic switches, target drug programs, and prescription to over-the-counter medication switches. They also led disease management programs, managed drug recalls, implemented electronic health records, negotiated budgets with health plans, and led patient assistance programs and prior authorization programs to improve patient satisfaction. Implementing these strategies from the vantage point of a physician group presents a seldom-realized employment opportunity for pharmacists. The impact of these strategies is measured by process, use, and clinical outcomes metrics. These, in turn, are linked to incentive payments in the pay-for-performance environment or to a lowered per member, per month cost in the capitated environment. In 2006-2007, 71% of our hypertensive patients received generic agents compared with a network average for receiving generic agents of 43%, while the proportion of patients with controlled blood pressure increased from 45% to 60%. We saved $450,000 in inpatient costs for deep venous thrombosis. Clinical pharmacists employed in a physician group practice can optimize medication use, improve care, and reduce costs.

  3. An Audit of the Effectiveness of Large Group Neurology Tutorials for Irish Undergraduate Medical Students

    LENUS (Irish Health Repository)

    Kearney, H

    2016-07-01

    The aim of this audit was to determine the effectiveness of large group tutorials for teaching neurology to medical students. Students were asked to complete a questionnaire rating their confidence on a ten point Likert scale in a number of domains in the undergraduate education guidelines from the Association of British Neurologists (ABN). We then arranged a series of interactive large group tutorials for the class and repeated the questionnaire one month after teaching. In the three core domains of neurological: history taking, examination and differential diagnosis, none of the students rated their confidence as nine or ten out of ten prior to teaching. This increased to 6% for history taking, 12 % in examination and 25% for differential diagnosis after eight weeks of tutorials. This audit demonstrates that in our centre, large group tutorials were an effective means of teaching, as measured by the ABN guidelines in undergraduate neurology.

  4. Group-based differences in anti-aging bias among medical students.

    Science.gov (United States)

    Ruiz, Jorge G; Andrade, Allen D; Anam, Ramanakumar; Taldone, Sabrina; Karanam, Chandana; Hogue, Christie; Mintzer, Michael J

    2015-01-01

    Medical students (MS) may develop ageist attitudes early in their training that may predict their future avoidance of caring for the elderly. This study sought to determine MS' patterns of explicit and implicit anti-aging bias, intent to practice with older people and using the quad model, the role of gender, race, and motivation-based differences. One hundred and three MS completed an online survey that included explicit and implicit measures. Explicit measures revealed a moderately positive perception of older people. Female medical students and those high in internal motivation showed lower anti-aging bias, and both were more likely to intend to practice with older people. Although the implicit measure revealed more negativity toward the elderly than the explicit measures, there were no group differences. However, using the quad model the authors identified gender, race, and motivation-based differences in controlled and automatic processes involved in anti-aging bias.

  5. Effectiveness of a group-based intervention to change medication beliefs and improve medication adherence in patients with rheumatoid arthritis: a randomized controlled trial.

    NARCIS (Netherlands)

    Zwikker, H.E.; Ende, C.H. van den; Lankveld, W.G. van; Broeder, A.A. den; Hoogen, F.H. van den; Mosselaar, B. van de; Dulmen, S. van; Bemt, B.J. van den

    2014-01-01

    Objective: To assess the effect of a group-based intervention on the balance between necessity beliefs and concern beliefs about medication and on medication non-adherence in patients with rheumatoid arthritis (RA). Methods: Non-adherent RA patients using disease-modifying anti-rheumatic drugs (DMAR

  6. Consumption of recommended food groups among children from medically underserved communities.

    Science.gov (United States)

    Kranz, Sibylle; Mitchell, Diane C; Smiciklas-Wright, Helen; Huang, Shirley H; Kumanyika, Shiriki K; Stettler, Nicolas

    2009-04-01

    This cross-sectional study of 2- to 12-year-olds living in medically underserved areas examined the proportion of children meeting the food group intake recommendations for fruits, vegetables, total grains, dairy, and meat/meat alternatives by age group and body weight status. Based on 24-hour recalls collected between July 2004 and March of 2005, mean food group intake and deviation from the recommended intake amounts were determined (actual intake minus recommended intake). Measured weight and height were used to calculate body mass index z scores using the Centers for Disease Control and Prevention growth charts. Data analyses were done for two age groups (2- to 5-year-olds and 6- to 12-year-olds) (n=214), by weight status categories (underweight or healthy weight [ or = 95th percentile]), and were repeated for the subset of children with biologically plausible reports. The majority of children lived in low-income households. More 2- to 5-year-olds met intake recommendations compared with 6- to 12-year-olds. Overall, the proportion of children meeting the food group intake recommendations was low with the exception of the meat group, which was met by 52% and 93% of the 2- to 5- and 6- to 12-year-old children, respectively. There was a positive association between the proportion of younger children meeting the fruits or total grains recommendation and increasing body weight. The data support the importance of community-level nutrition intervention programs to improve children's diet quality in low-income, medically underserved areas and suggest that such interventions may help reduce the risk of obesity.

  7. Gauging the feasibility of cost-sharing and medical student interest groups to reduce interview costs.

    Science.gov (United States)

    Lieber, Bryan A; Wilson, Taylor A; Bell, Randy S; Ashley, William W; Barrow, Daniel L; Wolfe, Stacey Quintero

    2014-11-01

    Indirect costs of the interview tour can be prohibitive. The authors sought to assess the desire of interviewees to mitigate these costs through ideas such as sharing hotel rooms and transportation, willingness to stay with local students, and the preferred modality to coordinate this collaboration. A survey link was posted on the Uncle Harvey website and the Facebook profile page of fourth-year medical students from 6 different medical schools shortly after the 2014 match day. There were a total of 156 respondents to the survey. The majority of the respondents were postinterview medical students (65.4%), but preinterview medical students (28.2%) and current residents (6.4%) also responded to the survey. Most respondents were pursuing a field other than neurosurgery (75.0%) and expressed a desire to share a hotel room and/or transportation (77.4%) as well as stay in the dorm room of a medical student at the program in which they are interviewing (70.0%). Students going into neurosurgery were significantly more likely to be interested in sharing hotel/transportation (89.2% neurosurgery vs 72.8% nonneurosurgery; p = 0.040) and in staying in the dorm room of a local student when on interviews (85.0% neurosurgery vs 57.1% nonneurosurgery; p = 0.040) than those going into other specialties. Among postinterview students, communication was preferred to be by private, email identification-only chat room. Given neurosurgery resident candidates' interest in collaborating to reduce interview costs, consideration should be given to creating a system that could allow students to coordinate cost sharing between interviewees. Moreover, interviewees should be connected to local students from neurosurgery interest groups as a resource.

  8. Understanding Medical Students' Experience with Stress and Its Related Constructs: A Focus Group Study from Singapore.

    Science.gov (United States)

    Farquhar, Julia; Lie, Desiree; Chan, Angelique; Ow, Mandy; Vidyarthi, Arpana

    2017-04-18

    In order to protect medical students from burnout and its untoward psychiatric effects, it is imperative to understand their stress, burnout, coping, and resilience experiences. This study aimed to derive collective definitions from the medical student perspective, to identify common themes of students' experiences, and to distinguish pre-clinical and clinical year students' experiences relating to these four constructs. The authors conducted focus groups of medical students in Singapore across 4 years using a semi-structured question guide. Participants shared their understanding, experiences, and the relationships between stress, burnout, coping, and resilience. Coders independently evaluated construct definitions and derived common themes through an iterative process, and compared transcripts of pre-clinical and clinical year students to determine differences in experience over time. Nine focus groups (54 students, 28 females, mean age 24.3) were conducted. Students identified common definitions for each construct. Nine themes emerged within three domains: (1) relating constructs to personal experience, (2) interrelating stress, burnout, coping, and resilience, and (3) understanding the necessity of stress. Compared to clinical students, pre-clinical students reported theory-based rather than reality-based experiences and exam-induced stress, defined constructs using present rather than future situations, and described constructs as independent rather than interrelated. This sample of medical students in Singapore shares a common understanding of stress, burnout, coping, and resilience, but experiences these uniquely. They perceive a positive role for stress. These findings build upon prior literature, suggesting an interrelationship between stress and its related constructs and adding the novel perspective of students from an Asian country.

  9. Enhancing medical students' reflectivity in mentoring groups for professional development - a qualitative analysis.

    Science.gov (United States)

    Lutz, Gabriele; Pankoke, Nina; Goldblatt, Hadass; Hofmann, Marzellus; Zupanic, Michaela

    2017-07-14

    Professional competence is important in delivering high quality patient care, and it can be enhanced by reflection and reflective discourse e.g. in mentoring groups. However, students are often reluctant though to engage in this discourse. A group mentoring program involving all preclinical students as well as faculty members and co-mentoring clinical students was initiated at Witten-Herdecke University. This study explores both the attitudes of those students towards such a program and factors that might hinder or enhance how students engage in reflective discourse. A qualitative design was applied using semi-structured focus group interviews with preclinical students and semi-structured individual interviews with mentors and co-mentors. The interview data were analyzed using thematic content analysis. Students' attitudes towards reflective discourse on professional challenges were diverse. Some students valued the new program and named positive outcomes regarding several features of professional development. Enriching experiences were described. Others expressed aversive attitudes. Three reasons for these were given: unclear goals and benefits, interpersonal problems within the groups hindering development and intrapersonal issues such as insecurity and traditional views of medical education. Participants mentioned several program setup factors that could enhance how students engage in such groups: explaining the program thoroughly, setting expectations and integrating the reflective discourse in a meaningful way into the curriculum, obliging participation without coercion, developing a sense of security, trust and interest in each other within the groups, randomizing group composition and facilitating group moderators as positive peer and faculty role models and as learning group members. A well-designed and empathetic setup of group mentoring programs can help raise openness towards engaging in meaningful reflective discourse. Reflection on and communication of

  10. Gender differences and similarities in medical students' experiences of mistreatment by various groups of perpetrators.

    Science.gov (United States)

    Siller, Heidi; Tauber, Gloria; Komlenac, Nikola; Hochleitner, Margarethe

    2017-08-14

    Mistreatment of medical students during medical education is a widespread concern. Studies have shown that medical students report the most mistreatment compared to students of other study programs and that the prevalence of mistreatment peaks during clinical training. For this reason, a study was conducted to assess prevalence of mistreatment among medical students committed by various groups of people. The focus was to identify whether gender was associated with the experience of mistreatment. Additionally, students' perception of university climate for reporting sexual harassment was assessed. In the study 88 medical students (45 women, 43 men) participated. A modified version of the Questionnaire on Student Abuse was used to assess students' experience of various types of mistreatment and associated distress during medical education. To explore factors that could be associated with this experience the organizational climate for reporting sexual harassment was assessed with the Psychological Climate for Sexual Harassment. The most often cited perpetrators of mistreatment were strangers (79.5%), friends (75.0%) and university staff (68.2%). Strangers mostly committed psychological mistreatment and sexual harassment, whereas friends additionally engaged in physical mistreatment of medical students. The most common form of mistreatment conducted by university staff was humiliation of students. These kinds of psychological mistreatment were reported to be distressing (43%). Gender differences were found in the prevalence of mistreatment. Women experienced more sexual harassment and humiliation than did men. On the other hand, men experienced more physical mistreatment than did women. Women reported experiencing more distress from mistreatment experiences than did men and also more often reported being mistreated by university staff than did men. Women perceived a greater risk in reporting sexual harassment to the organization than did men. Mistreatment of female and

  11. The Effect of Group Psychoeducation Program on Medication Adherence in Patients with Bipolar Mood Disorders: a Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Farnaz Rahmani

    2016-12-01

    Full Text Available Introduction: Medication nonadherence is highly prevalent in patients with bipolar disorders and often results in worsening disease prognosis. The purpose of this study was to investigate the effect of group psychoeducation on medication adherence in female patients with bipolar mood disorder type I. Methods: This randomized controlled trial was conducted on 76 patients with bipolar mood disorder admitted in female psychiatric wards of Razi teaching hospital, Tabriz, Iran. The participants were selected by convenience sampling method and were randomly assigned to experimental and control groups. Patients in experimental group received 10 continuous 90 minutes sessions of psychoeducation, two times a week. Medication adherence was measured using the medicine check list and medication adherence rating scale (MARS before and after intervention. Data analysis was performed with SPSS ver.13. Results: There was no significant difference between two groups regarding medication adherence before the intervention. After the study intervention, the mean scores of medication adherence check list and medication adherence rating scale in the experimental group were significantly higher than the control group. Conclusion: Since group psychoeducation was effective in improving patients' medication adherence, it could be recommended for psychiatric nurses to apply this intervention in the clinical setting.

  12. Patient confidentiality within the context of group medical visits: is there cause for concern?

    Science.gov (United States)

    Wong, Sabrina T; Lavoie, Josee G; Browne, Annette J; MacLeod, Martha L P; Chongo, Meck

    2015-10-01

    Group medical visits (GMVs), clinical encounters with a medical component delivered to groups of patients, have emerged as an innovative approach to potentially increasing efficiency while enhancing the quality of primary health care (PHC). GMVs have created the need to pay explicit attention to patient confidentiality. What strategies are used by providers and patients to address issues of confidentiality within GMVs? In-depth interviews were conducted with 34 PHC providers and 29 patients living in nine rural communities in British Columbia, Canada. Data were analysed using interpretive thematic analysis and a relational autonomy approach. We found three main themes: (i) choosing to disclose: balancing benefits and drawbacks of GMVs, (ii) maintaining confidentiality in GMVs and (iii) gaining strength from interdependent relationships: patients learning from each other. Confidentiality can be addressed and was not a major concern for patients attending or providers facilitating GMVs in these rural communities. Patients adopted strategies to address their own and others' concerns related to confidential health information. Providers used multiple strategies to maintain confidentiality within the group, including renegotiating what information is shared and providing examples of what information ought to be kept confidential. Although GMVs are not for all patients, a relational autonomy approach is useful in drawing attention to the context and structures which may influence their patients' ability to act autonomously. Successful delivery of GMVs requires both patients and providers to negotiate between maintaining confidentiality and an appropriate level of disclosure. © 2013 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

  13. Evolution of Facebook groups: Informal e-learning among medical laboratory scientists in Nigeria

    Directory of Open Access Journals (Sweden)

    Jarret Cassaniti

    2014-09-01

    Full Text Available Most people think of online courses when they talk about e-learning, but aspects of social media can also be considered e-learning. In 2011 the Knowledge for Health Project (K4Health began work with local partners to implement an e-learning and professional development policy for Medical Laboratory Scientists based on the needs identified by United States Agency for International Development (USAID/Nigeria. Six e-learning courses were developed and promoted through several channels including social media. A Facebook Group was created to share information about accessing and navigating the courses and attracted 8,500 members in 18 months. As the Group grew, the topics discussed evolved to include trade union news, employment opportunities and technical resources. Another Facebook Group provided insights that Facebook Groups could be used to facilitate interactions focused on continuing professional development. The findings show that Facebook Groups accommodate an informal learning style, allowing individuals to learn through peer support in flexible ways. It has also shown that the use of Facebook Groups is associated with high levels of engagement with e-learning courses.

  14. The Effect of Student Working Group Establishment on Teaching General Embryology Course to Medical Students

    Directory of Open Access Journals (Sweden)

    Mozafar Khazaei

    2012-11-01

    Full Text Available Introduction: Quantitative and qualitative enhancement of educational activities is an essential issue. Learners’ cooperation in the teaching process in order to increase teaching effectiveness and promotion is considered significant. The aim of the present study was to determine the effect of establishment of student working group on the teaching general embryology course to medical students.Methods: Ten students (1% of medical embryology course were selected to analyze the topics to be taught before each session according to lesson plan, and observe the whole teaching process during lesson presentation. Then, having asked the other students’ viewpoints and discussing with one another, they provided the teacher with a written report on the strengths and weaknesses of the teaching and its problems. The teacher analyzed the problems proposed by the working group to improve teaching process in the next session. At the end of the semester, a questionnaire was administered to all the participants. Data were analyzed using descriptive statistics.Results: The mean of students’ scores was 74.26%. The most important findings obtained in this study included positive role of film projection in teaching the materials (95.34%, significance of presentation of various pictures from different books (88.4%, changing students’ attitude toward application of embryology in different diseases (86%, and repetition of previous session’s pictures (83.75%. The weak points mentioned, however, were physical problems of the classroom and deficiency of audio visual equipment.Conclusion: Student working group has a positive impact on the teaching medical general embryology.

  15. Are medical treatments for individuals and groups like single-play and multiple-play gambles?

    Directory of Open Access Journals (Sweden)

    Michael L. DeKay

    2006-11-01

    Full Text Available People are often more likely to accept risky monetary gambles with positive expected values when the gambles will be played more than once. We investigated whether this distinction between single-play and multiple-play gambles extends to medical treatments for individual patients and groups of patients. Resident physicians and medical students (extit{n} = 69 and undergraduates (extit{n} = 99 ranked 9 different flu shots and a no-flu-shot option in 1 of 4 combinations of perspective (individual patient vs. group of 1000 patients and uncertainty frame (probability vs. frequency. The rank of the no-flu-shot option (a measure of preference for treatment vs. no treatment was not significantly related to perspective or participant population. The main effect of uncertainty frame and the interaction between perspective and uncertainty frame approached significance (0.1 {extgreater} extit{p} {extgreater} 0.05, with the no-flu-shot option faring particularly poorly (treatment faring particularly well when decisions about many patients were based on frequency information. Undergraduate participants believed that the no-flu-shot option would be less attractive (treatment would be more attractive in decisions about many patients, but these intuitions were inconsistent with the actual ranks. These results and those of other studies suggest that medical treatments for individuals and groups are not analogous to single-play and multiple-play monetary gambles, perhaps because many people are unwilling to aggregate treatment outcomes over patients in the same way that they would compute net gains or losses over monetary gambles.

  16. PBL curriculum improves medical students' participation in small-group tutorials.

    Science.gov (United States)

    Wun, Y T; Tse, Eileen Y Y; Lam, T P; Lam, Cindy L K

    2007-09-01

    Group learning is the core of problem-based learning (PBL) but has not been extensively studied, especially in Asian students. This study compared students of PBL and non-PBL curricula in students' talking time and participation in small-group tutorials in a medical school in Asia. The proportions of student talking of 46 tutorials in three teaching rotations of the PBL curriculum and those of 43 corresponding tutorials in the non-PBL curriculum were counted. Twelve videotapes of tutorials (six from each curriculum), stratified for tutor, case scenario and students' learning stage, were randomly selected and transcribed. They were rated with the group-interaction (5 items) and active-participation (four items) tutorial assessment scales developed by Valle et al. These outcomes were compared between the students of PBL and non-PBL curricula. Students from the PBL curriculum talked significantly more. In only two (4.7%) of 43 tutorials in the non-PBL curriculum did the students talk more than the tutors; but students talked more than the tutors in 17 (37.0%) of 46 tutorials in the PBL curriculum. PBL students scored significantly higher than non-PBL students in all items except one item (respect to peers) of the tutorial assessment scales, and in the mean scores of both the group interaction scale (items 1-5) and the active participation scale (items 6-9). The results suggested that PBL starting from the early years of a medical curriculum was associated with more active student participation, interaction and collaboration in small-group tutorials.

  17. Basic steps in establishing effective small group teaching sessions in medical schools.

    Science.gov (United States)

    Meo, Sultan Ayoub

    2013-07-01

    Small-group teaching and learning has achieved an admirable position in medical education and has become more popular as a means of encouraging the students in their studies and enhance the process of deep learning. The main characteristics of small group teaching are active involvement of the learners in entire learning cycle and well defined task orientation with achievable specific aims and objectives in a given time period. The essential components in the development of an ideal small group teaching and learning sessions are preliminary considerations at departmental and institutional level including educational strategies, group composition, physical environment, existing resources, diagnosis of the needs, formulation of the objectives and suitable teaching outline. Small group teaching increases the student interest, teamwork ability, retention of knowledge and skills, enhance transfer of concepts to innovative issues, and improve the self-directed learning. It develops self-motivation, investigating the issues, allows the student to test their thinking and higher-order activities. It also facilitates an adult style of learning, acceptance of personal responsibility for own progress. Moreover, it enhances student-faculty and peer-peer interaction, improves communication skills and provides opportunity to share the responsibility and clarify the points of bafflement.

  18. The regulatory framework of special medical group students' physical education: identifying the problem.

    Directory of Open Access Journals (Sweden)

    Mazur Valerij Anatol'evich

    2011-09-01

    Full Text Available The question of regulatory framework for special medical group students' physical education, and their physical condition in particular is elaborated. It is found that in the current program the identified question is missing, although the assessment of individual performance standards for the physical condition of the students was envisaged in the programs of 1977 and 1982. The need for such an assessment is indicated by the large number of Ukrainian and foreign pediatricians and specialists in therapeutic physical culture. At the same time the standards for assessing these indicators are not developed. It complicates the formation of positive motivation of students to regular classes, and does not promote their self-confidence, capabilities and effectiveness of monitoring the effectiveness of exercise in various forms. The findings suggest the need to define the optimal composition of the bulk of tests and functional tests to assess the physical condition of special medical group students with various diseases and to develop appropriate indicators for their evaluation standards.

  19. An investigation into the factors that encourage learner participation in a large group medical classroom

    Directory of Open Access Journals (Sweden)

    Moffett J

    2014-03-01

    participate than female students. Female students in this study commonly identified aversion to public speaking as a factor which held them back from participating in the large group lecture setting. These are important findings for veterinary and medical educators aiming to improve learner participation in the classroom. Potential ways of addressing this challenge include addition of small group activities and audience response systems during lectures, and inclusion of training interventions in public speaking at an early stage of veterinary and medical curricula. Keywords: age, class size, interaction, lecture, public speaking, sex, veterinary

  20. Medical cost-offset following treatment referral for alcohol and other drug use disorders in a group model HMO.

    Science.gov (United States)

    Polen, Michael R; Freeborn, Donald K; Lynch, Frances L; Mullooly, John P; Dickinson, Daniel M

    2006-07-01

    The purpose of this study was to determine whether specialty alcohol and other drug (AOD) treatment is associated with reduced subsequent medical care costs. AOD treatment costs and medical costs in a group model health maintenance organization (HMO) were collected for up to 6 years on 1,472 HMO members who were recommended for specialty AOD treatment, and on 738 members without AOD diagnoses or treatment. Addiction Severity Index measures were also obtained from a sample of 293 of those recommended for treatment. Changes in medical costs did not differ between treatment and comparison groups. Nor did individuals with improved treatment outcomes have greater reductions in medical costs. AOD treatment costs were not inversely related to subsequent medical costs, except for a subgroup with recent AOD treatment. In the interviewed sample, better treatment outcomes did not predict lower subsequent medical costs. Multiple treatment episodes may hold promise for producing cost-offsets.

  1. An investigation into the factors that encourage learner participation in a large group medical classroom.

    Science.gov (United States)

    Moffett, Jennifer; Berezowski, John; Spencer, Dustine; Lanning, Shari

    2014-01-01

    Effective lectures often incorporate activities that encourage learner participation. A challenge for educators is how to facilitate this in the large group lecture setting. This study investigates the individual student characteristics involved in encouraging (or dissuading) learners to interact, ask questions, and make comments in class. Students enrolled in a Doctor of Veterinary Medicine program at Ross University School of Veterinary Medicine, St Kitts, were invited to complete a questionnaire canvassing their participation in the large group classroom. Data from the questionnaire were analyzed using Excel (Microsoft, Redmond, WA, USA) and the R software environment (http://www.r-project.org/). One hundred and ninety-two students completed the questionnaire (response rate, 85.7%). The results showed statistically significant differences between male and female students when asked to self-report their level of participation (P=0.011) and their confidence to participate (Pspeaking" acted as the main deterrent to participating during a lecture. Female participants were 3.56 times more likely to report a fear of public speaking than male participants (odds ratio 3.56, 95% confidence interval 1.28-12.33, P=0.01). Students also reported "smaller sizes of class and small group activities" and "other students participating" as factors that made it easier for them to participate during a lecture. In this study, sex likely played a role in learner participation in the large group veterinary classroom. Male students were more likely to participate in class and reported feeling more confident to participate than female students. Female students in this study commonly identified aversion to public speaking as a factor which held them back from participating in the large group lecture setting. These are important findings for veterinary and medical educators aiming to improve learner participation in the classroom. Potential ways of addressing this challenge include

  2. The application of heterogeneous cluster grouping to reflective writing for medical humanities literature study to enhance students' empathy, critical thinking, and reflective writing

    National Research Council Canada - National Science Library

    Liao, Hung-Chang; Wang, Ya-Huei

    2016-01-01

    ... grouping in reflective writing for medical humanities literature acquisition could have positive effects on medical university students in terms of empathy, critical thinking, and reflective writing...

  3. Analysis of the Characteristics of Discussion Materials that Promote Group Discussion in the Medical Humanities.

    Science.gov (United States)

    Ahn, Jae Hee; Jeon, Woo Taek

    2011-12-01

    This study aims to analyze the characteristics of discussion materials that promote student participation in discussions, satisfaction with student instruction, and tutor intervention in the medical humanities. We surveyed 117 premedical students and 7 tutors who attended 4-week group discussions in the medical humanities in 2010. We described the discussion materials using the following 4 characteristics as independent variables: material type, level of understanding, interest, and quantity. Dependent variables were: student participation in the discussion, student instruction satisfaction, and tutor intervention. Correlation analysis, multiple regression analysis, and crosstab were performed using SPSS 15.0. The correlation between the characteristics of the discussion materials differed by grade. When the books were chosen as the discussion material in the instruction of first-year premedical students, the correlation between level of understanding, interest, and quantity was negative. Higher levels of understanding of the material and interest in the material led to an increase in discussion participation among both first- and second-year premedical students. Higher levels of understanding and interest of the discussion material also increased student satisfaction with the instruction, regardless of grade. Finally, levels of understanding of the material affected the degree of tutor intervention. Tutors intervened more often in discussions with first-year premedical students than with second-year premedical students. Differences in grades and the understanding of the discussion material should be considered when choosing discussion materials. Further study is required to continue the development of the discussion model and improve methods of facilitate discussion among students in the medical humanities.

  4. Simulation Suggests that medical group mergers won't undermine the potential utility of health information exchanges.

    NARCIS (Netherlands)

    Rudin, R.S.; Schneider, E.C.; Volk, L.A.; Szolovits, P.; Salzberg, C.A.; Simon, S.R.; Bates, D.W.

    2012-01-01

    Federal and state agencies are investing substantial resources in the creation of community health information exchanges, which are consortia that enable independent health care organizations to exchange clinical data. However, under pressure to form accountable care organizations, medical groups ma

  5. The ways of teaching process optimization in physical education of the students’ special medical group

    Directory of Open Access Journals (Sweden)

    Bukov U.A.

    2013-06-01

    Full Text Available Purpose – to identify the effectiveness of the use of innovative approaches in physical education teaching process of special medical group students. The study involved 15 boys aged 13-14 years. The lesson include exercises consisting of the elements of Pilates, yoga and static body-oriented therapy. The proposed program of physical exercises performed by students in the main part of the lesson and took the volume to 80% of the time. Set to increase the functionality of the skeletal muscles, the adaptive capacity of cardio-respiratory system, the health and strength of the nervous system, optimization of anthropometric indices, improved spinal mobility. A high degree of efficiency in the learning process of innovation of general preventive and therapeutic intervention is identified. Proposed to use in the educational process modern methods of prevention and correction

  6. Aerobics health as means of increasing somatic health of students of special medical group

    Directory of Open Access Journals (Sweden)

    Pivneva M.M.

    2013-08-01

    Full Text Available We prove the feasibility of employment by improving aerobic low intensity (LowImpact - heart rate in the range 128-140 beats / min, or 60-74% of HR max with students of special medical groups with disabilities cardiovascular system. The choice of three varieties of improving aerobics - classical, dance, tap dance - and with the help of laboratory experiment investigated the specificity of their effects on the physical health of students. According to the results of laboratory studies developed two versions of the author's method of application for improving aerobic physical education classes with students with disabilities but cardiac-vascular system, the main difference between them lies in the relationship and the manner of the classical sequence of exercises, dance, step aerobics. By comparing the results of educational experiments proved that both variants techniques contribute significantly improved key indicators of physical health subjects and thus are fairly equal in the nature of exposure.

  7. Utility of a dermatology interest group blog: the impact of medical student interest groups and Web 2.0 tools as educational resources

    Directory of Open Access Journals (Sweden)

    Jalalat SZ

    2014-09-01

    Full Text Available Sheila Z Jalalat, Richard F Wagner Jr Department of Dermatology, University of Texas Medical Branch, Galveston, TX, USA Abstract: The open access University of Texas Dermatology Interest Group blog was established in 2004 for the purposes of increasing communication and collaboration between medical students and dermatology faculty, residents, and alumni, as well as to promote educational opportunities and the missions for which the interest group was created. This blog is unique because of its longevity and continuous postings directed toward the educational and professional needs of medical students and residents. A blog user survey was performed to assess viewers' thoughts, purpose of viewing, demographic profile, subscriber status, usage of the blog and other Web 2.0 tools (forums, Facebook, blogs, Twitter, podcasts, and perceived usefulness. Sixty-one anonymous online surveys were completed during a 1-month period. Statistical analyses of the responses demonstrated that the utilization of web-based tools and the blog were valuable resources for students, especially for blog subscribers, those more involved in an interest group, and those reading the blog for a longer period of time. The usefulness and impact of this method of communication and dissemination of information in medical education may encourage other student groups, faculty advisors, and educators to implement similar educational tools at their institutions. Keywords: education, medical student, dermatology, blog

  8. Dental Students' Perceptions of Learning Value in PBL Groups with Medical and Dental Students Together versus Dental Students Alone.

    Science.gov (United States)

    Amin, Maryam; Zulla, Rosslynn; Gaudet-Amigo, Gisele; Patterson, Steven; Murphy, Natalie; Ross, Shelley

    2017-01-01

    At a dental school in Canada, problem-based learning (PBL) sessions were restructured from an integrated dental-medical model to a separate dental model, resulting in three groups of students available for study: those who had participated in the two-year dental and medical combined, the one-year dental and medical combined, the one-year dental alone, and the two-year dental alone. The aim of this qualitative study was to examine the extent to which the PBL structure affected the dental students' perceptions of the learning value of PBL in the different models. A total of 34 first-, second-, and third-year dental students participated in six focus groups in May and June 2011 (34% of students in those total classes). Semistructured questions explored their experiences in the different PBL structures. The interviews were recorded and transcribed verbatim, and thematic analysis was employed. The results showed positive and negative perceptions for both the combined dental and medical settings and the settings with dental students alone. For students in the combined PBL groups, positive perceptions included gaining information from medical peers, motivation to learn, and interdisciplinary collaborations. The negative perceptions mainly related to irrelevant content, dominating medical students, and ineffective preceptors. Members of the separate dental groups were more positive about the content and felt a sense of belonging. They appreciated the dental preceptors but were concerned about the inadequacy of their medical knowledge. Overall, the dental students valued the combined PBL experience and appreciated the opportunity to learn with their medical colleagues. Close attention, however, must be paid to PBL content and the preceptor's role to optimize dental students' experience in combined medical and dental groups.

  9. Active games in physical education students of special medical group with limited capacity of cardiovascular system

    Directory of Open Access Journals (Sweden)

    Kovaleva M.V.

    2013-08-01

    Full Text Available It is considered the directions of the development an effective methods of usage moving elements of sports and games in exercises. The experiment involved students of special medical groups that have various abnormalities of the cardiovascular system. The study was conducted in four stages: a search, the first experimental, the second experimental, final. We used questioning and education registry books of academic work. Found that the use of sports and outdoor games is students' interest, and increasing motivation for physical activity. Justified by the possibility of using games and exercises performed their adaptation by changing the pulse value. The resulting modification of gaming exercises are divided into three groups: the game in the area of heart rate to 110, 110-130 and 130-150 beats per minute. The first version of the experimental procedure at a heart rate of 110 and 110-130 beats per minute was ineffective for the emergence of significant positive changes in the functional state of the cardiovascular system students. Recommended experimental procedure based on the alternation and equivalence ratio of mobile elements and sports games and increases the heart rate to 130-150 beats per minute. Application of the method increases the overall level of physical health, improves the functional state of the cardiovascular system, health, activity and mood of the students.

  10. Features of effective medical knowledge resources to support point of care learning: a focus group study.

    Directory of Open Access Journals (Sweden)

    David A Cook

    Full Text Available OBJECTIVE: Health care professionals access various information sources to quickly answer questions that arise in clinical practice. The features that favorably influence the selection and use of knowledge resources remain unclear. We sought to better understand how clinicians select among the various knowledge resources available to them, and from this to derive a model for an effective knowledge resource. METHODS: We conducted 11 focus groups at an academic medical center and outlying community sites. We included a purposive sample of 50 primary care and subspecialist internal medicine and family medicine physicians. We transcribed focus group discussions and analyzed these using a constant comparative approach to inductively identify features that influence the selection of knowledge resources. RESULTS: We identified nine features that influence users' selection of knowledge resources, namely efficiency (with sub-features of comprehensiveness, searchability, and brevity, integration with clinical workflow, credibility, user familiarity, capacity to identify a human expert, reflection of local care processes, optimization for the clinical question (e.g., diagnosis, treatment options, drug side effect, currency, and ability to support patient education. No single existing resource exemplifies all of these features. CONCLUSION: The influential features identified in this study will inform the development of knowledge resources, and could serve as a framework for future research in this field.

  11. Perspective: a business school view of medical interprofessional rounds: transforming rounding groups into rounding teams.

    Science.gov (United States)

    Bharwani, Aleem M; Harris, G Chad; Southwick, Frederick S

    2012-12-01

    An effective interprofessional medical team can efficiently coordinate health care providers to achieve the collective outcome of improving each patient's health. To determine how current teams function, four groups of business students independently observed interprofessional work rounds on four different internal medicine services in a typical academic hospital and also interviewed the participants. In all instances, caregivers had formed working groups rather than working teams. Participants consistently exhibited parallel interdependence (individuals working alone and assuming their work would be coordinated with other caregivers) rather than reciprocal interdependence (individuals working together to actively coordinate patient care), the hallmark of effective teams. With one exception, the organization was hierarchical, with the senior attending physician possessing the authority. The interns exclusively communicated with the attending physician in one-on-one conversations that excluded all other members of the team. Although nurses and pharmacists were often present, they never contributed their ideas and rarely spoke.The authors draw on these observations to form recommendations for enhancing interprofessional rounding teams. These are to include the bedside nurse, pharmacist, and case manager as team members, begin with a formal team launch that encourages active participation by all team members, use succinct communication protocols, conduct work rounds in a quiet, distraction-free environment, have teams remain together for longer durations, and receive teamwork training and periodic coaching. High-performing businesses have effectively used teams for decades to achieve their goals, and health care professionals should follow this example.

  12. Investigating the Distribution of Medical Services among Socioeconomic Groups in Texas

    Science.gov (United States)

    Daniel, A.; Zhao, Ph D., S.; O'Keefe, Ph D., CRNP, RN, L.

    2016-12-01

    The Environmental Justice (EJ) literature generally focuses on negative environmental externalities and disamenities found around certain types of demographic conditions such as poor and ethnic groups. This study aims to identify any relationships among environmental risks, communities, and access to hospital services. Community demographic variables will be defined by census tracts and units based on a geographic information system, such as buffer tools. Empirical analyses of the relationships between demographics and environmental burdens take a prominent position in the large EJ literature. However, there is a dearth of research regarding exposed communities and access to hospitals for medical services. Leveraging a dataset that combines hospital locations, pollution sources, and demographic information, the authors will analyze whether different social groups (defined by gender, age, income, and education level) have equal access to hospitals. The research team consists of researchers from Earth system science, public policy, and nursing, and adopts an interdisciplinary approach including ArcGIS analysis and statistical modeling. This project also bridges the literature of health, air pollution, and environmental policy.

  13. Rates and predictors of referral for individual psychotherapy, group psychotherapy, and medications among Iraq and Afghanistan veterans with PTSD.

    Science.gov (United States)

    Mott, Juliette M; Barrera, Terri L; Hernandez, Caitlin; Graham, David P; Teng, Ellen J

    2014-04-01

    This study examined rates of referral for medication, individual psychotherapy, and group psychotherapy within a Veterans Affairs (VA) posttraumatic stress disorder (PTSD) specialty mental health clinic. Participants were 388 Iraq and Afghanistan veterans who were referred for PTSD treatment following a mental health evaluation required for all new VA enrollees. The majority of the sample was referred for medication (79 %), with comparatively fewer referrals for individual (39 %) or group psychotherapy (24 %). Forty percent of participants were referred for combined medication and psychotherapy. Patient demographic and clinical characteristics were examined to determine whether these variables predicted referral type. Female veterans and those with lower clinician ratings of overall functioning were more likely to be referred for individual therapy. Group psychotherapy referrals were more common in veterans who were older, unemployed, identified as an ethnic minority, and had a comorbid anxiety disorder. There were no significant predictors of medication referral.

  14. Assessing organisational development in primary medical care using a group based assessment: the Maturity Matrix.

    NARCIS (Netherlands)

    Elwyn, G.; Rhydderch, M.; Edwards, A.; Hutchings, H.; Marshall, M.; Myres, P.; Grol, R.P.T.M.

    2004-01-01

    OBJECTIVE: To design and develop an instrument to assess the degree of organisational development achieved in primary medical care organisations. DESIGN: An iterative development, feasibility and validation study of an organisational assessment instrument. SETTING: Primary medical care

  15. Model for Developing Educational Research Productivity: The Medical Education Research Group

    Science.gov (United States)

    Perry, Marcia; Hopson, Laura; House, Joseph B.; Fischer, Jonathan P.; Dooley-Hash, Suzanne; Hauff, Samantha; Wolff, Margaret S.; Sozener, Cemal; Nypaver, Michele; Moll, Joel; Losman, Eve D.; Carney, Michele; Santen, Sally A.

    2015-01-01

    Introduction Education research and scholarship are essential for promotion of faculty as well as dissemination of new educational practices. Educational faculty frequently spend the majority of their time on administrative and educational commitments and as a result educators often fall behind on scholarship and research. The objective of this educational advance is to promote scholarly productivity as a template for others to follow. Methods We formed the Medical Education Research Group (MERG) of education leaders from our emergency medicine residency, fellowship, and clerkship programs, as well as residents with a focus on education. First, we incorporated scholarship into the required activities of our education missions by evaluating the impact of programmatic changes and then submitting the curricula or process as peer-reviewed work. Second, we worked as a team, sharing projects that led to improved motivation, accountability, and work completion. Third, our monthly meetings served as brainstorming sessions for new projects, research skill building, and tracking work completion. Lastly, we incorporated a work-study graduate student to assist with basic but time-consuming tasks of completing manuscripts. Results The MERG group has been highly productive, achieving the following scholarship over a three-year period: 102 abstract presentations, 46 journal article publications, 13 MedEd Portal publications, 35 national didactic presentations and five faculty promotions to the next academic level. Conclusion An intentional focus on scholarship has led to a collaborative group of educators successfully improving their scholarship through team productivity, which ultimately leads to faculty promotions and dissemination of innovations in education. PMID:26594297

  16. Model for Developing Educational Research Productivity: The Medical Education Research Group

    Directory of Open Access Journals (Sweden)

    Marcia Perry

    2015-11-01

    Full Text Available Introduction: Education research and scholarship are essential for promotion of faculty as well as dissemination of new educational practices. Educational faculty frequently spend the majority of their time on administrative and educational commitments and as a result educators often fall behind on scholarship and research. The objective of this educational advance is to promote scholarly productivity as a template for others to follow. Methods: We formed the Medical Education Research Group (MERG of education leaders from our emergency medicine residency, fellowship, and clerkship programs, as well as residents with a focus on education. First, we incorporated scholarship into the required activities of our education missions by evaluating the impact of programmatic changes and then submitting the curricula or process as peer-reviewed work. Second, we worked as a team, sharing projects that led to improved motivation, accountability, and work completion. Third, our monthly meetings served as brainstorming sessions for new projects, research skill building, and tracking work completion. Lastly, we incorporated a workstudy graduate student to assist with basic but time-consuming tasks of completing manuscripts. Results: The MERG group has been highly productive, achieving the following scholarship over a three-year period: 102 abstract presentations, 46 journal article publications, 13 MedEd Portal publications, 35 national didactic presentations and five faculty promotions to the next academic level. Conclusion: An intentional focus on scholarship has led to a collaborative group of educators successfully improving their scholarship through team productivity, which ultimately leads to faculty promotions and dissemination of innovations in education.

  17. Evaluation of receptivity of the medical students in a lecture of a large group

    Directory of Open Access Journals (Sweden)

    Vidyarthi SurendraK, Nayak RoopaP, GuptaSandeep K

    2014-04-01

    Full Text Available Background: Lecturing is widely used teaching method in higher education. Instructors of large classes may have only option to deliver lecture to convey informations to large group students.Aims and Objectives: The present study was to evaluate the effectiveness/receptivity of interactive lecturing in a large group of MBBS second year students. Material and Methods: The present study was conducted in the well-equipped lecture theater of Dhanalakshmi Srinivasan Medical College and Hospital (DSMCH, Tamil Nadu. A fully prepared interactive lecture on the specific topic was delivered by using power point presentation for second year MBBS students. Before start to deliver the lecture, instructor distributed multiple choice 10 questionnaires to attempt within 10 minutes. After 30 minutes of delivering lecture, again instructor distributed same 10 sets of multiple choice questionnaires to attempt in 10 minutes. The topic was never disclosed to the students before to deliver the lecture. Statistics: We analyzed the pre-lecture & post-lecture questions of each student by applying the paired t-test formula by using www.openepi.com version 3.01 online/offline software and by using Microsoft Excel Sheet Windows 2010. Results: The 31 male, 80 female including 111 students of average age 18.58 years baseline (pre-lecture receptivity mean % was 30.99 ± 14.64 and post-lecture receptivity mean % was increased upto 53.51± 19.52. The only 12 students out of 111 post-lecture receptivity values was less (mean % 25.8± 10.84 than the baseline (mean % 45± 9.05 receptive value and this reduction of receptivity was more towards negative side. Conclusion: In interactive lecture session with power point presentation students/learners can learn, even in large-class environments, but it should be active-learner centered.

  18. Personal resources and negative and positive effects of traumatic events in a group of medical rescuers

    Directory of Open Access Journals (Sweden)

    Nina Ogińska-Bulik

    2016-10-01

    Full Text Available Background: The purpose of the research was to investigate the role of personal resources, such as optimism and sense of selfefficacy in both negative (posttraumatic stress disorder (PTSD symptoms and positive (posttraumatic growth – PTG effects of experienced trauma in a group of emergency service representatives. Material and Methods: Data of 100 medical rescue workers, mostly men (59% who have experienced traumatic events in their worksite were analyzed. The age of the participants ranged from 24 to 60 years (mean = 37.43; standard deviation = 8.73. Polish versions of the Impact of Event Scale – Revised and the Posttraumatic Growth Inventory were used to assess the negative and positive effects of experienced events. Optimism was assessed by the Life Orientation Test and sense of self-efficacy by the Generalized Self-Efficacy Scale. Results: The obtained results revealed that optimism is negatively associated with symptoms of PTSD in men, and sense of self-efficacy – positively with the severity of growth after trauma in women. Conclusions: The analyzed personal resources play a diverse role in the emergence of negative and positive effects of experienced traumatic events, depending on the gender of the respondents. Med Pr 2016;67(5:635–644

  19. Internet addiction in a group of medical students: a cross sectional study.

    Science.gov (United States)

    Pramanik, T; Sherpa, M T; Shrestha, R

    2012-03-01

    The use of Internet for education, recreation and communication is increasing day by day. Nevertheless, the possibility of exploitation and addiction leading to impairment in academic performance and emotional balance cannot be denied, especially among young population. The study was aimed to measure the degree of Internet addiction among a group of medical students. Internet addiction test questionnaire developed by Young was used to assess mild, moderate and severe addiction. Amongst the study population (n=130, age 19-23 years), 40% had mild addiction. Moderate and severe addiction was found in 41.53% and 3.07% of the participants respectively. The study revealed that 24% often and 19.2% always found themselves using Internet longer than they had planned or thought. Late night Internet surfing leading to sleep deprivation was found in 31.53% of the participants. Almost one fourth of them (25.38%) occasionally tried to cut down the time they spent on the Internet but failed and 31.53% sometimes experienced restlessness when deprived of Internet access. Results reflected that a significant number of participants suffered from mild to moderate addiction. The role of counseling and education should be emphasized for prevention of Internet addiction.

  20. Challenges and solutions in medically managed ACS in the Asia-Pacific region: expert recommendations from the Asia-Pacific ACS Medical Management Working Group.

    Science.gov (United States)

    Huo, Yong; Thompson, Peter; Buddhari, Wacin; Ge, Junbo; Harding, Scott; Ramanathan, Letchuman; Reyes, Eugenio; Santoso, Anwar; Tam, Li-Wah; Vijayaraghavan, Govindan; Yeh, Hung-I

    2015-03-15

    Acute coronary syndromes (ACS) remain a leading cause of mortality and morbidity in the Asia-Pacific (APAC) region. International guidelines advocate invasive procedures in all but low-risk ACS patients; however, a high proportion of ACS patients in the APAC region receive solely medical management due to a combination of unique geographical, socioeconomic, and population-specific barriers. The APAC ACS Medical Management Working Group recently convened to discuss the ACS medical management landscape in the APAC region. Local and international ACS guidelines and the global and APAC clinical evidence-base for medical management of ACS were reviewed. Challenges in the provision of optimal care for these patients were identified and broadly categorized into issues related to (1) accessibility/systems of care, (2) risk stratification, (3) education, (4) optimization of pharmacotherapy, and (5) cost/affordability. While ACS guidelines clearly represent a valuable standard of care, the group concluded that these challenges can be best met by establishing cardiac networks and individual hospital models/clinical pathways taking into account local risk factors (including socioeconomic status), affordability and availability of pharmacotherapies/invasive facilities, and the nature of local healthcare systems. Potential solutions central to the optimization of ACS medical management in the APAC region are outlined with specific recommendations.

  1. Utility of a dermatology interest group blog: the impact of medical student interest groups and Web 2.0 tools as educational resources.

    Science.gov (United States)

    Jalalat, Sheila Z; Wagner, Richard F

    2014-01-01

    The open access University of Texas Dermatology Interest Group blog was established in 2004 for the purposes of increasing communication and collaboration between medical students and dermatology faculty, residents, and alumni, as well as to promote educational opportunities and the missions for which the interest group was created. This blog is unique because of its longevity and continuous postings directed toward the educational and professional needs of medical students and residents. A blog user survey was performed to assess viewers' thoughts, purpose of viewing, demographic profile, subscriber status, usage of the blog and other Web 2.0 tools (forums, Facebook, blogs, Twitter, podcasts), and perceived usefulness. Sixty-one anonymous online surveys were completed during a 1-month period. Statistical analyses of the responses demonstrated that the utilization of web-based tools and the blog were valuable resources for students, especially for blog subscribers, those more involved in an interest group, and those reading the blog for a longer period of time. The usefulness and impact of this method of communication and dissemination of information in medical education may encourage other student groups, faculty advisors, and educators to implement similar educational tools at their institutions.

  2. SUITABILITY OF MEDICATIONS USED BY THE ELDERLY PARTICIPANTS OF A SOCIAL GROUP, ACCORDING TO THE BEERS CRITERIA

    Directory of Open Access Journals (Sweden)

    Geysa Donária de Miranda Mascarenhas

    2014-09-01

    Full Text Available The dynamic process defined as aging progressively reduces the functional capacity of the elderly and added to the lifestyle, they can to testify to the high number of pathologies. Thus, pharmacotherapy for this age group requires special care, keeping in view its peculiarities. Given this need, a group of researchers has developed criteria that allowed the identification of inappropriate medications. Thus, the aim of this study was to investigate the suitability of medications used by the elderly participants of a social group, in Vitória da Conquista, BA, according to the Beers criteria. This research was an exploratory descriptive study and data collection conducted through semi - structured interviews. It was asked to bring all the elderly who were using medications and / or prescriptions. It was found that 12.7% of the drugs used by the elderly appeared in the list of inappropriate medicines and 42% of respondents make use of polypharmacy. Among the most prescribed inappropriate medications, there is acetylsalicylic acid, diclofenac, diazepam, piroxicam, ibuprofen and amitriptyline. The class of inappropriate drugs most used by seniors was anti - inflammatory drugs. Given this, all health professionals need to put into practice the criteria for selecting medications this age group as the reality of existing drugs in Brazil.

  3. Foods That Help You Lose Weight

    Institute of Scientific and Technical Information of China (English)

    刘伟业

    1995-01-01

    "There are no magic foods," says Kelly Streit,health-education instructor at Kaiser Permanente Medical Care Program in Portland,Ore. "But there are foods that, because of their taste, texture or density, can help you lose weight. " That’s the idea behind the following foods, which trick your body into feeling satisfied with far less fat and fewer calories than it’s used to.

  4. Race and Ethnic Group Differences in Comorbid Major Depressive Disorder, Generalized Anxiety Disorder, and Chronic Medical Conditions.

    Science.gov (United States)

    Watkins, Daphne C; Assari, Shervin; Johnson-Lawrence, Vicki

    2015-09-01

    This study tested whether race and ethnic group differences exist for lifetime major depressive disorder and/or general anxiety disorder with one or more chronic medical conditions. Data from the National Survey of American Life, which included 3570 African American, 1438 Caribbean Black, and 891 non-Hispanic White adults were analyzed. Outcomes included at least one and multiple chronic medical conditions, from a list of 14 medical conditions (e.g., arthritis, cancer, diabetes, kidney disease, stroke, heart disease, etc.). Logistic regressions were fitted to data to determine how the association between major depressive disorder, general anxiety disorder, and one or more chronic medical conditions vary across race and ethnicity. Lifetime major depressive disorder (but not lifetime general anxiety disorder) was associated with at least one chronic medical condition among African Americans and Caribbean Blacks, but not non-Hispanic Whites. Lifetime major depressive disorder was similarly associated with multiple chronic medical conditions among African Americans, Caribbean Blacks, and non-Hispanic Whites. For Caribbean Blacks, stronger associations were found between major depressive disorder and general anxiety disorder with one or more chronic medical conditions compared to African Americans and non-Hispanic Whites. Findings suggest that race and ethnicity may shape the links between comorbid psychiatric disorders and chronic medical conditions. Mental health screening of individuals with chronic medical conditions in primary health-care settings may benefit from tailoring based on race and ethnicity. More research is needed to understand why associations between physical and mental health vary among race and ethnic groups.

  5. Management of chest pain: exploring the views and experiences of chiropractors and medical practitioners in a focus group interview

    Directory of Open Access Journals (Sweden)

    Rowell Robert M

    2005-09-01

    Full Text Available Abstract Background We report on a multidisciplinary focus group project related to the appropriate care of chiropractic patients who present with chest pain. The prevalence and clinical management, both diagnosis and treatment, of musculoskeletal chest pain in ambulatory medical settings, was explored as the second dimension of the focus group project reported here. Methods This project collected observational data from a multidisciplinary focus group composed of both chiropractic and medical professionals. The goals of the focus group were to explore the attitudes and experiences of medical and chiropractic clinicians regarding their patients with chest pain who receive care from both medical and chiropractic providers, to identify important clinical or research questions that may inform the development of 'best practices' for coordinating or managing care of chest pain patients between medical and chiropractic providers, to identify important clinical or research questions regarding the diagnosis and treatment of chest pain of musculoskeletal origin, to explore various methods that might be used to answer those questions, and to discuss the feasibility of conducting or coordinating a multidisciplinary research effort along this line of inquiry. The convenience-sample of five focus group participants included two chiropractors, two medical cardiologists, and one dual-degreed chiropractor/medical physician. The focus group was audiotaped and transcripts were prepared of the focus group interaction. Content analysis of the focus group transcripts were performed to identify key themes and concepts, using categories of narratives. Results Six key themes emerged from the analysis of the focus group interaction, including issues surrounding (1 Diagnosis; (2 Treatment and prognosis; (3 Chest pain as a chronic, multifactorial, or comorbid condition; (4 Inter-professional coordination of care; (5 Best practices and standardization of care; and (6

  6. Exploratory study of the characteristics of feedback in the reflective dialogue group given to medical students in a clinical clerkship

    Directory of Open Access Journals (Sweden)

    Chin-Chen Wen

    2015-02-01

    Full Text Available Purpose: Structured narrative reflective writing combined with guided feedback is an efficient teaching method for enhancing medical students’ reflective capacity. However, what kinds of feedback offered and reflection presented in a reflective group remain unclear. The aim of this study was to investigate the characteristics of feedback in a reflective dialogue group. Methods: Fifth-year medical students on a monthly interval rotation at the pediatric department of a medical center in eastern Taiwan during the 2012 academic year completed their reflective writing regarding patient and family psychosocial issues, and were subsequently debriefed in a 2-h group discussion session to receive feedback from a clinical tutor and peers. Content analysis was conducted to explore the characteristics of feedback and reflection presented in the reflective dialogue. The evaluative questionnaire regarding the benefits of reflection with others was administrated following the group session. Results: Forty students participated in five reflective groups and 108 psychosocial issues were discussed and identified. The tutor played an initiating role in the group discussion by providing six equal feedback types involving exploring new knowledge, initiating advanced discussion, highlighting the issues, and encouraging the students. The students provided eight types of feedback that involved a substantial deep discussion on psychosocial issues and action plans based on the complex interactive ecological network of clinical encounters. Each student attained 1.25 times the depth or breadth of reflection after receiving feedback and experienced the benefits of reflection with others. Conclusion: Through structured narrative reflective writing combined with pluralistic group discussion with a tutor and peers, the medical students had time to think deeply and broadly about psychosocial issues among patients and their family members. Facilitative feedback providing new

  7. Exploratory study of the characteristics of feedback in the reflective dialogue group given to medical students in a clinical clerkship

    Science.gov (United States)

    Wen, Chin-Chen; Lin, Meei-Ju; Lin, Chi-Wei; Chu, Shao-Yin

    2015-01-01

    Purpose Structured narrative reflective writing combined with guided feedback is an efficient teaching method for enhancing medical students’ reflective capacity. However, what kinds of feedback offered and reflection presented in a reflective group remain unclear. The aim of this study was to investigate the characteristics of feedback in a reflective dialogue group. Methods Fifth-year medical students on a monthly interval rotation at the pediatric department of a medical center in eastern Taiwan during the 2012 academic year completed their reflective writing regarding patient and family psychosocial issues, and were subsequently debriefed in a 2-h group discussion session to receive feedback from a clinical tutor and peers. Content analysis was conducted to explore the characteristics of feedback and reflection presented in the reflective dialogue. The evaluative questionnaire regarding the benefits of reflection with others was administrated following the group session. Results Forty students participated in five reflective groups and 108 psychosocial issues were discussed and identified. The tutor played an initiating role in the group discussion by providing six equal feedback types involving exploring new knowledge, initiating advanced discussion, highlighting the issues, and encouraging the students. The students provided eight types of feedback that involved a substantial deep discussion on psychosocial issues and action plans based on the complex interactive ecological network of clinical encounters. Each student attained 1.25 times the depth or breadth of reflection after receiving feedback and experienced the benefits of reflection with others. Conclusion Through structured narrative reflective writing combined with pluralistic group discussion with a tutor and peers, the medical students had time to think deeply and broadly about psychosocial issues among patients and their family members. Facilitative feedback providing new knowledge, deeper

  8. Exploring the Halal Status of Cardiovascular, Endocrine, and Respiratory Group of Medications

    Science.gov (United States)

    Sarriff, Azmi; Abdul razzaq, Hadeer Akram

    2013-01-01

    Muslim consumers have special needs in medical treatment that differ from non-Muslim consumers. In particular, there is a growing demand among Muslim consumers for Halal medications. This descriptive exploratory study aims to determine the Halal status of selected cardiovascular, endocrine, and respiratory medications stored in an out-patient pharmacy in a Malaysian governmental hospital. Sources of active ingredients and excipients for each product were assessed for Halal status based on available information obtained from product leaflets, the Medical Information Management System (MIMS) website, or manufacturers. Halal status was based on the products’ sources and categorized into Halal, Mushbooh, or Haram. The proportions of Halal, Mushbooh, and Haram products were at 19.1%, 57.1%, and 23.8%, respectively. The percentage of active ingredients for cardiovascular/endocrine products that were assessed as Haram was 5.3%; for respiratory medications, it was only 1.1%. For excipients, 1.7% and 4.8% fall under the category of Haram for cardiovascular/endocrine products and respiratory products, respectively. Ethanol and magnesium stearate were found to be the common substances that were categorized as Haram and Mushbooh. PMID:23785257

  9. Exploring the halal status of cardiovascular, endocrine, and respiratory group of medications.

    Science.gov (United States)

    Sarriff, Azmi; Abdul Razzaq, Hadeer Akram

    2013-01-01

    Muslim consumers have special needs in medical treatment that differ from non-Muslim consumers. In particular, there is a growing demand among Muslim consumers for Halal medications. This descriptive exploratory study aims to determine the Halal status of selected cardiovascular, endocrine, and respiratory medications stored in an out-patient pharmacy in a Malaysian governmental hospital. Sources of active ingredients and excipients for each product were assessed for Halal status based on available information obtained from product leaflets, the Medical Information Management System (MIMS) website, or manufacturers. Halal status was based on the products' sources and categorized into Halal, Mushbooh, or Haram. The proportions of Halal, Mushbooh, and Haram products were at 19.1%, 57.1%, and 23.8%, respectively. The percentage of active ingredients for cardiovascular/endocrine products that were assessed as Haram was 5.3%; for respiratory medications, it was only 1.1%. For excipients, 1.7% and 4.8% fall under the category of Haram for cardiovascular/endocrine products and respiratory products, respectively. Ethanol and magnesium stearate were found to be the common substances that were categorized as Haram and Mushbooh.

  10. Psychotropic medication in a randomly selected group of citizens receiving residential or home care

    DEFF Research Database (Denmark)

    Futtrup, Tina Bergmann; Helnæs, Ann Kathrine; Schultz, Hanne

    2014-01-01

    INTRODUCTION: Treatment with one or more psychotropic medications (PMs), especially in the elderly, is associated with risk, and the effects of treatment are poorly validated. The aim of this article was to describe the use of PM in a population of citizens receiving either residential care or home...... care with focus on the prevalence of drug use, the combination of different PMs and doses in relation to current recommendations. METHODS: The medication lists of 214 citizens receiving residential care (122) and home care (92) were collected together with information on age, gender and residential...... number 2007-58-0015....

  11. The Case for Unit-Based Teams: A Model for Front-line Engagement and Performance Improvement

    OpenAIRE

    Cohen, Paul M; Ptaskiewicz, Mark; Mipos, Debra

    2010-01-01

    Unit-based teams (UBTs)—defined as natural work groups of physicians, managers, and frontline staff who work collaboratively to solve problems, improve performance, and enhance quality—were established by the 2005 national agreement between Kaiser Permanente (KP) and the Coalition of KP Unions. They use established performance-improvement techniques and employee-engagement principles (including social-movement theory) to achieve clinical and operational goals. UBT members identify performance...

  12. TOWARDS LEARNER-CENTRED MEDICAL CURRICULUM: QUALITATIVE FOCUS GROUP STUDY OF INDIVIDUAL PREFERENCES DEPENDING ON VERBAL ENVIRONMENT.

    Science.gov (United States)

    Bukeyeva, A; Riklefs, V; Riklefs, I; Tashkenbayeva, V; Kassatova, A

    2016-05-01

    There is a strong evidence in medical education literature that the learner-centred curriculum favouring the use of metacognition and self-learning is very proficient. However, ethnocultural and verbal environment may undermine learners' ability to utilise the learning strategies, leading to inefficient learning. This study aimed to investigate the personal preferences of learners in multilingual educational environment prompting the most efficient learning. The study uses qualitative focus group methodology to understand students' opinion on how educational environment influences the efficiency of medical school curriculum.

  13. 医院集团内部审计研究%Research About The Internal Audit of Medical Group

    Institute of Scientific and Technical Information of China (English)

    刘花兰

    2014-01-01

    随着医疗体制改革的深入和国内众多医院集团的形成和发展,对医院的经济体制运行和财务管理提出了更高的要求,也为医院内部审计的发展提供了新的机遇和挑战。本文针对医院集团内部审计体系的构建问题,站在战略定位的高度,从医院集团内部审计的组织架构、管理与运作设计等方面进行了一定的分析,以期为我国医院集团的内部审计体系构建研究做一些积极探索。%along with the formation and development of medical system reform and domestic large medical group, has put forward higher requirements to financial management and operation of the hospital economic system, but also provides a new opportunity and chal enge for the development of hospital internal audit. In order to do some exploring research on the construction of China's medical group's internal audit system, based on the construction of internal audit system of medical group, as standing in the height of the strategic positioning, we analyzed from the aspects of internal audit organization, management and design of operation of medical group.

  14. Attributes of an Ideal Continuing Medical Education Institution Identified through Nominal Group Technique

    Science.gov (United States)

    Kristofco, Robert; Shewchuk, Richard; Casebeer, Linda; Bellande, Bruce; Bennett, Nancy

    2005-01-01

    Introduction: Continuing medical education (CME) is an important resource physicians use to maintain their clinical competence. While many options for CME programs are available, there are few measures of their impact and few measures for physicians to use to systematically gauge their efforts in maintaining competence. This study initiates a…

  15. Interaktiver Kleingruppenunterricht für Medizinstudenten der Klinischen Semester in einer onkologischen Gemeinschaftspraxis [Interactive medical education for medical students in an oncology group practice

    Directory of Open Access Journals (Sweden)

    Weide, Rudolf

    2007-02-01

    Full Text Available [english] Background: The education of medical students to become qualified medical doctors should be improved in Germany. Reasons for this are medical teachers not properly trained in education, a lack of quality control and low esteem of medical education, too large groups, no intensive relationship between students and academic teachers and the triad for medical teachers at university hospitals to qualify in their discipline, to perform science and lecture medical students. At the same time experienced associate professors who left university are not integrated optimally in medical education programs. Pilotproject: Since 1998 we are performing weekend seminars for advanced medical students. 3 students are educated by 1 teacher. The topics of the training are differential diagnosis of anaemia, polyglobulinaemia, leukocytopenia, leukocytosis, thrombocytopenia, thrombocytosis, training in morphology, diagnosis and treatment of leukaemia and lymphoma and principles of communication skills. Patient cases are presented in a problem oriented learning manner using patient files, a video microscope and a computer based learning programme for interactive purposes.Results: So far 320 students have participated in our seminars. Systematic quality evaluation of the teaching reveals excellent marks for practical relevance, learning atmosphere, didactics and effectiveness. Impressions of the routine work in an oncology group practice widens the experience of the students.Conclusion: Academical training for medical students is feasable and successful in an oncology group practice. This teaching model enables external associate professors to give their education in the environment where they are working and may relieve the University personally and financially.[german] Hintergrund: Die Ausbildung von Medizinstudenten zu guten Ärzten ist in Deutschland verbesserungsbedürftig. Die Gründe für ein suboptimales Studium sind die häufig fehlende Vernetzung von

  16. Use of smokeless tobacco among groups of Pakistani medical students – a cross sectional study

    Directory of Open Access Journals (Sweden)

    Ilyas Mahwish

    2007-09-01

    Full Text Available Abstract Background Use of smokeless tobacco is common in South Asia. Tobacco is a major preventable cause of morbidity and mortality. Doctors make one of the best avenues to influence patients' tobacco use. However, medical students addicted to tobacco are likely to retain this habit as physicians and are unlikely to counsel patients against using tobacco. With this background, this study was conducted with the objective of determining the prevalence of smokeless tobacco among Pakistani medical students. Methods A cross sectional study was carried out in three medical colleges of Pakistan – one from the north and two from the southern region. 1025 students selected by convenient sampling completed a peer reviewed, pre-tested, self-administered questionnaire. Questions were asked regarding lifetime use (at least once or twice in their life, current use (at least once is the last 30 days, and established use (more than 100 times in their life of smokeless tobacco. Chi square and logistic regression analyses were used. Results Two hundred and twenty (21.5% students had used tobacco in some form (smoked or smokeless in their lifetime. Sixty six (6.4% students were lifetime users of smokeless tobacco. Thirteen (1.3% were daily users while 18 (1.8% fulfilled the criterion for established users. Niswar was the most commonly used form of smokeless tobacco followed by paan and nass. Most naswar users belonged to NWFP while most paan users studied in Karachi. On univariate analysis, lifetime use of smokeless tobacco showed significant associations with the use of cigarettes, student gender (M > F, student residence (boarders > day scholars and location of the College (NWFP > Karachi. Multivariate analysis showed independent association of lifetime use of smokeless tobacco with concomitant cigarette smoking, student gender and location of the medical college. Conclusion The use of smokeless tobacco among medical students cannot be ignored. The

  17. Variation in managing asthma: experience at the medical group level in California.

    Science.gov (United States)

    Legorreta, A P; Liu, X; Zaher, C A; Jatulis, D E

    2000-04-01

    To explore the degree of variation in the quality of asthma management among physician groups participating in a managed care network. Cross-sectional observation. The study population consisted of patients with moderate or severe asthma identified through a pharmacy database from a managed care plan in 1996. The patients were surveyed to obtain their assessments of asthma care, including components on quality of care, quality of service, and outcomes of care. We selected 47 physician groups that provided services for at least 35 asthma patients who responded to the survey. Variations in the outcome variables across physician groups were described by quartile, range, and histogram. Compliance with national guidelines varied among physician groups but was generally low. Physician group rates for patient use of steroid inhalers ranged from 10.7% to 45.5% and daily peak flow meter use ranged from 0% to 13.1%. Satisfaction ratings were higher, with overall satisfaction with the quality of asthma care ranging from 74.6% to 94.3%. Outcomes also showed considerable variation among groups. One-month absenteeism rates ranged from 32% to 61%, and 65.7% to 94.3% of respondents did not have an emergency room visit in the past year. The quality of asthma care and service varied significantly across physician groups. Such reports for different physician groups make evidence-based outcomes information directly available to patients and physician groups, help patients make informed healthcare decisions, and stimulate quality improvement efforts by physician groups.

  18. Evolution of Facebook groups: Informal e-learning among medical laboratory scientists in Nigeria

    OpenAIRE

    2014-01-01

    Most people think of online courses when they talk about e-learning, but aspects of social media can also be considered e-learning. In 2011 the Knowledge for Health Project (K4Health) began work with local partners to implement an e-learning and professional development policy for Medical Laboratory Scientists based on the needs identified by United States Agency for International Development (USAID)/Nigeria. Six e-learning courses were developed and promoted through several channels includin...

  19. Medication withdrawal may be an option for a select group of patients in relapsing-remitting multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Guilherme Sciascia do Olival

    2013-08-01

    Full Text Available This article describes the clinical and radiological evolution of a stable group of patients with relapsing-remitting multiple sclerosis that had their disease-modifying therapy (DMT withdrawn. Forty patients, which had made continuous use of one immunomodulator and had remained free of disease for at least 5 years, had their DMT withdrawn and were observed from 13 to 86 months. Out of the followed patients, 4 (10% patients presented with new attacks. In addition to these patients, 2 (5% patients had new lesions revealed by magnetic resonance imaging that did not correspond to clinical attacks. Despite these results, the difficult decision to withdraw medication requires careful analysis. Withdrawal, however, should not be viewed as simply the suspension of treatment because these patients should be evaluated periodically, and the immunomodulators should be readily reintroduced if new attacks occur. Nonetheless, medication withdrawal is an option for a select group of patients.

  20. Team-Based Learning for Nursing and Medical Students: Focus Group Results From an Interprofessional Education Project.

    Science.gov (United States)

    Feather, Rebecca A; Carr, Doug E; Reising, Deanna L; Garletts, Derrick M

    2016-01-01

    Past research indicates that inadequacies in health care delivery create substantial preventable quality issues that can be addressed through improving relationships among clinicians to decrease the negative effects on patient outcomes. The purpose of this article is to describe the implementation of an interprofessional education project with senior nursing and third-year medical students working in teams in a clinical setting. Results include data from focus groups conducted at the conclusion of the project.

  1. Job Opening for Medical Officer in DCP’s Breast and Gynecologic Cancer Research Group | Division of Cancer Prevention

    Science.gov (United States)

    The Breast and Gynecologic Cancer Research Group (BGCRG), Division of Cancer Prevention (DCP), National Cancer Institute (NCI), has an opening for an experienced Medical Officer. BGCRG focuses on fostering the development and conduct of research on the prevention and early detection of breast cancer, cervix and human papillomavirus (HPV)-related cancers, endometrial cancers, ovarian cancers, and precursor conditions related to these cancers. Learn more about BGCRG. |

  2. Risk contracting and operational capabilities in large medical groups during national healthcare reform.

    Science.gov (United States)

    Mechanic, Robert E; Zinner, Darren

    2016-06-01

    Little is known about the scope of alternative payment models outside of Medicare. This study measures the full complement of public and private payment arrangements in large, multi-specialty group practices as a barometer of payment reform among advanced organizations. We collected information from 33 large, multi-specialty group practices about the proportion of their total revenue in 7 payment models, physician compensation strategies, and the implementation of selected performance management initiatives. We grouped respondents into 3 categories based on the proportion of their revenue in risk arrangements: risk-based (45%-100%), mixed (10%-35%), and fee-for-service (FFS) (0%-10%). We analyzed changes in contracting and operating characteristics between 2011 and 2013. In 2013, 68% of groups' total patient revenue was from FFS payments and 32% was from risk arrangements (unweighted average). Risk-based groups had 26% FFS revenue, whereas mixed-payment and FFS groups had 75% and 98%, respectively. Between 2011 and 2013, 9 groups increased risk contract revenue by about 15 percentage points and 22 reported few changes. Risk-based groups reported more advanced implementation of performance management strategies and were more likely to have physician financial incentives for quality and patient experience. The groups in this study are well positioned to manage risk-based contracts successfully, but less than one-third receive a majority of their revenue from risk arrangements. The experience of these relatively advanced groups suggests that expanding risk-based arrangements across the US health system will likely be slower and more challenging than many people assume.

  3. An Internal Evaluation of Educational Groups in Dentistry Faculty of Tabriz Medical University Using CIPP model in 2015

    Directory of Open Access Journals (Sweden)

    Farnaz Limouei

    2016-11-01

    Full Text Available The present study was carried out with the purpose of internal evaluation of educational groups in dentistry faculty of Tabriz Medical University using CIPP model. Statistical population of this descriptive- cross sectional study consists of faculty members (n=106 and specialized assistants (n=108, conducted as whole counting. Questionnaires in four aspects of context, input, process and product were used to collect data. Reliability coefficient was obtained by Cronbach’s Alpha method. It was 0.886 for faculty members and 0.916 for assistants. Descriptive statistical methods were used for data analysis. In the context aspect, it was assessed fairly favorable and favorable by professors and assistants, respectively, for Endodontics, dental Prosthodontics, Pathology and Pediatric dentistry groups; it was evaluated fairly favorable for the other groups according to both perspectives. Professors of Periodontics group evaluated the input aspect fairly favorable and the assistants evaluated it favorable; Radiology professors assessed the input favorable and assistants recognized it fairly favorable and in other groups, professors and assistants assessed the input aspect fairly favorable. The process aspect was evaluated fairly favorable in Orthodontics, Pediatric and Radiology groups, favorable in Pathology group, and fairly favorable according to the professors and favorable according to the assistants in other groups. The product aspect was favorable in operative and Pathology groups from professors' viewpoints and fairly favorable according to the assistants' opinions.

  4. The Impact of a Group Communication Course on Veterinary Medical Students' Perceptions of Communication Competence and Communication Apprehension.

    Science.gov (United States)

    Kedrowicz, April A

    2016-01-01

    This paper explores the impact of a group communication course on veterinary medical students' perceptions of communication competence and communication anxiety. Students enrolled in the Group Communication in Veterinary Medicine course completed the Personal Report of Communication Apprehension and the Communicative Competence Scale at the beginning (Time 1) and end (Time 2) of the semester. Results show that first-year veterinary students' self-perceptions of communication competence increased and their self-reported levels of communication apprehension decreased across multiple contexts from Time 1 to Time 2. This research provides support for experiential communication training fostering skill development and confidence.

  5. Shaping beside student of the special medical group of the culture sound lifestyle by means of computer technology

    Directory of Open Access Journals (Sweden)

    Vovk L.V.

    2010-07-01

    Full Text Available Considered results of the pedagogical experiment with use computer information-diagnostic system "Passport of health" on shaping the culture sound lifestyle beside student of the special medical group. Two groups student have took part in experiment in amount 151 persons. It is proved that pedagogical experiment has positively influenced upon fortification of health, life activity, high level of the knowledges and practical skills during education in high school. It is installed that one of the main of the conditions to efficiency of the physical education, are a knowledges, which allow effective to solve the delivered problems of the physical education to personalities.

  6. Parental illness perceptions and medication perceptions in childhood asthma, a focus group study

    NARCIS (Netherlands)

    Klok, Ted; Brand, Paul L.; Bomhof-Roordink, Hanna; Duiverman, Eric J.; Kaptein, Adrian A.

    Aim: Asthma treatment according to guidelines fails frequently, through patients' nonadherence to doctors' advice. This study aimed to explore how differences in asthma care influence parents' perceptions to inhaled corticosteroids (ICS). Methods: We conducted six semistructured focus groups,

  7. Group medical visits in the follow-up of women with a BRCA mutation: design of a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Hoogerbrugge Nicoline

    2011-08-01

    Full Text Available Abstract Background BRCA mutation carriers have a 40-80% life-time risk of developing breast cancer. They may opt for yearly breast cancer surveillance or for prophylactic mastectomy. Both options show increased survival rates. It is a complex choice to be made between these two options. As a result most women experience high levels of distress and high needs for information. To fulfill the needs for psychosocial support and information we have introduced group medical consultations (GMCs. A GMC provides individual medical visits conducted within a group. This 90 minute group-visit with 8-12 patients gives patients the opportunity to spend more time with their clinician and a behavioral health professional and learn from other patients experiencing similar topics. However, it should be noted that group sessions may increase fear in some patients or influence their decision making. Methods/design In this randomized controlled trial, 160 BRCA mutation carriers diagnosed maximally 2 years ago are recruited from the Radboud University Nijmegen Medical Centre. Participants are randomized in a 1:1 ratio to either the GMC intervention group (onetime participation in a GMC instead of a standard individual visit or to a usual care control group. Primary outcome measures are empowerment and psychological distress (SCL 90. Secondary outcome measures are fear of cancer, information needs before the consultation and the received information, self-examination of the breasts, patient satisfaction, quality of life and cost-effectiveness. Data are collected via self-reported questionnaires 1 week before the visit, and at 1 week and at 3 months follow-up. A pilot study was conducted to test all procedures and questionnaires. Discussion The possibility for interaction with other BRCA mutation carriers within a medical visit is unique. This study will assess the effectiveness of GMCs for BRCA mutation carriers to improve empowerment and decrease distress compared

  8. Association Between Thyroid Disease and Uveitis: Results From the Pacific Ocular Inflammation Study.

    Science.gov (United States)

    Borkar, Durga S; Homayounfar, Gelareh; Tham, Vivien M; Ray, Kathryn J; Vinoya, Aleli C; Uchida, Aileen; Acharya, Nisha R

    2017-06-01

    Common pathophysiological mechanisms may be responsible for immune dysregulation in both thyroid disease and uveitis. Studies investigating a possible association are limited. To determine the association between thyroid disease and uveitis. A retrospective, population-based case-control study was conducted from January 1, 2006, to December 31, 2007, among 217 061 members of the Kaiser Permanente Hawaii health system during the study period. A clinical diagnosis of uveitis was determined through a query of the electronic medical record followed by individual medical record review for confirmation by a uveitis specialist. Thyroid disease was determined based on International Classification of Diseases, Ninth Revision, coding. Two control groups were chosen at a 4:1 ratio for comparison with patients with uveitis. A logistic regression analysis was performed with uveitis as the main outcome variable and thyroid disease as the main predictor variable, while adjusting for age, sex, race, smoking status, and history of autoimmune disease. Data analysis was conducted between 2014 and 2016. A diagnosis of thyroid disease among patients with uveitis and respective controls. Of the 224 patients with uveitis (127 women and 97 men; mean [SD] age, 54.1 [17.8] years) identified during the study period, 29 (12.9%) had a diagnosis of thyroid disease, compared with 62 of 896 patients (6.9%) in the control group (P = .01) and 78 of 896 patients (8.7%) in the ophthalmology clinic control group (P = .06). Using the general Kaiser Permanente Hawaii population control group, patients who had thyroid disease had a 1.7-fold (95% CI, 1.03-2.80; P = .04) higher odds of having uveitis compared with patients who did not have thyroid disease when controlling for age, sex, race, smoking status, and autoimmune disease. A similar association was found using the ophthalmology clinic control group (odds ratio, 1.8; 95% CI, 1.1-2.9; P = .02) while adjusting for these factors

  9. Compliance and persistence of antidepressants versus anticonvulsants in patients with neuropathic pain during the first year of therapy.

    Science.gov (United States)

    Gharibian, Derenik; Polzin, Jennifer K; Rho, Jay P

    2013-05-01

    Neuropathic pain (NP) is a chronic condition that has human, social, and economic consequences. A variety of agents can be used for treatment; however, antidepressants and anticonvulsants are the 2 classes most widely studied and represent first-line agents in the management of NP. Little information is known about the adherence patterns of these medications during the first year of therapy in patients with NP. To examine the compliance and persistence of antidepressants versus anticonvulsants in patients with NP during the first year of therapy. Using electronic medical and pharmacy data for the Kaiser Permanente Southern California region, the adherence patterns for patients with a NP diagnosis prescribed an antidepressant or an anticonvulsant were studied. Compliance and persistence were measured using the medication possession ratio and the Refill-Sequence model, respectively. The study included 1817 patients with NP diagnosis taking either an antidepressant or an anticonvulsant. Within the antidepressant group, 42.9% were considered compliant, compared with 43.7% in the anticonvulsant group. Subanalysis of the 2 cohorts revealed that patients on venlafaxine were the most compliant (69.4%) compared with patients taking gabapentin (44.4%) and tricyclic antidepressants (41.8%) (Panticonvulsant group were considered persistent with their medication refills. Compliance and persistence rates were similar for patients with NP diagnosis taking antidepressants and anticonvulsants. Higher compliance was observed among patients taking venlafaxine; however, this population did have a small sample size.

  10. A focus group on cognition-enhancing medications in Alzheimer disease: disparities between professionals and consumers.

    Science.gov (United States)

    Post, S G; Stuckey, J C; Whitehouse, P J; Ollerton, S; Durkin, C; Robbins, D; Fallcreek, S J

    2001-01-01

    The emergence of cognition-enhancing drugs in the treatment of Alzheimer disease raises questions about quality of lives for those with dementia and for their caregivers, and about the perceptions of health care professionals. This pilot study analyzes a limited data from a series of three focus groups on the experience of treatment. These groups engaged both Alzheimer disease-affected persons, their caregivers, and a multidisciplinary professional core. We conclude that therapeutic goals need to be better addressed with patients and families, as well as better monitored, with the possibility of withdrawing therapy as appropriate. We also detected, as hypothesized, considerable disparity between the perspectives of professionals and consumers regarding the benefits of therapy.

  11. Wireless Sensors Grouping Proofs for Medical Care and Ambient Assisted-Living Deployment.

    Science.gov (United States)

    Trček, Denis

    2016-01-02

    Internet of Things (IoT) devices are rapidly penetrating e-health and assisted living domains, and an increasing proportion among them goes on the account of computationally-weak devices, where security and privacy provisioning alone are demanding tasks, not to mention grouping proofs. This paper, therefore, gives an extensive analysis of such proofs and states lessons learnt to avoid possible pitfalls in future designs. It sticks with prudent engineering techniques in this field and deploys in a novel way the so called non-deterministic principle to provide not only grouping proofs, but (among other) also privacy. The developed solution is analyzed by means of a tangible metric and it is shown to be lightweight, and formally for security.

  12. Wireless Sensors Grouping Proofs for Medical Care and Ambient Assisted-Living Deployment

    Directory of Open Access Journals (Sweden)

    Denis Trček

    2016-01-01

    Full Text Available Internet of Things (IoT devices are rapidly penetrating e-health and assisted living domains, and an increasing proportion among them goes on the account of computationally-weak devices, where security and privacy provisioning alone are demanding tasks, not to mention grouping proofs. This paper, therefore, gives an extensive analysis of such proofs and states lessons learnt to avoid possible pitfalls in future designs. It sticks with prudent engineering techniques in this field and deploys in a novel way the so called non-deterministic principle to provide not only grouping proofs, but (among other also privacy. The developed solution is analyzed by means of a tangible metric and it is shown to be lightweight, and formally for security.

  13. Knowledge of different medical and dental professional groups in Switzerland about halitosis.

    Science.gov (United States)

    Roth, Barbara; Oppliger, Nathalie; Filippi, Andreas

    2014-01-01

    Although halitosis is a widespread condition, it is still seen as too personal or embarrassing to talk about. The cause of real halitosis can be intraoral or extraoral. In order to determine the level of knowledge of health care providers in Switzerland, a survey was conducted over a period of three years in which 150 family physicians, 150 ear, nose and throat specialists, 154 dentists and 151 dental hygienists were personally interviewed. The survey shows that only 46.7% of the dentists and only 47.0% of the dental hygienists are consulted by patients for their halitosis, whereas 58.0% of the family physicians and 50.7% of the ENT specialists reported treating 1-10 patients for halitosis per year, while 46.7% of the ENT doctors even reported treating 11-100 patients for halitosis per year. 81.5% of all interviewed doctors and dental hygienists were of the opinion that halitosis mainly originates intraorally. 76.0% of the dentists and 72.8% of the dental hygienists as well as 33.3% of the family physicians recommend periodontitis therapy as halitosis treatment. This proves that a large percentage of medical professionals thinks that marginal periodontitis is the most common cause of halitosis. This study also shows that patients seek first consultations with dentists and dental hygienists less often than with family physicians and ENT specialists, despite the fact that the cause of halitosis is primarily intraoral.

  14. Identification and rates of delirium in elderly medical inpatients from diverse language groups.

    Science.gov (United States)

    Wand, Anne Pf; Thoo, William; Ting, Vicky; Baker, Janett; Sciuriaga, Hayley; Hunt, Glenn E

    2013-01-01

    A linguistically diverse cohort of 126 medical inpatients 65 y and over was recruited to determine rates of delirium after admission, associated outcomes, and staff detection of delirium. A clinical interview and cognitive and functional questionnaires were completed with the patient and their carer, and files were reviewed. The incidence of delirium at comprehensive assessment early after admission was 10.3% and the overall incidence 19.1% over the whole admission. Cognitive impairment was common (n = 80, 63.5%), including 61 patients (48.4%) who had dementia. Most patients (83%) with delirium had dementia. Staff recognized less than 21% of patients with delirium, 33% of patients with dementia, and 36% of cognitively impaired patients. There was no difference in outcomes between English and non-English speaking patients. Given the high prevalence and poor recognition of cognitive disorders in older people, routine cognitive screening should occur. Staff education should focus upon improving delirium detection and addressing the needs of cognitively impaired older inpatients.

  15. An online app platform enhances collaborative medical student group learning and classroom management.

    Science.gov (United States)

    Peacock, Justin G; Grande, Joseph P

    2016-01-01

    The authors presented their results in effectively using a free and widely-accessible online app platform to manage and teach a first-year pathology course at Mayo Medical School. The authors utilized the Google "Blogger", "Forms", "Flubaroo", "Sheets", "Docs", and "Slides" apps to effectively build a collaborative classroom teaching and management system. Students were surveyed on the use of the app platform in the classroom, and 44 (94%) students responded. Thirty-two (73%) of the students reported that "Blogger" was an effective place for online discussion of pathology topics and questions. 43 (98%) of the students reported that the "Forms/Flubaroo" grade-reporting system was helpful. 40 (91%) of the students used the remote, collaborative features of "Slides" to create team-based learning presentations, and 39 (89%) of the students found those collaborative features helpful. "Docs" helped teaching assistants to collaboratively create study guides or grading rubrics. Overall, 41 (93%) of the students found that the app platform was helpful in establishing a collaborative, online classroom environment. The online app platform allowed faculty to build an efficient and effective classroom teaching and management system. The ease of accessibility and opportunity for collaboration allowed for collaborative learning, grading, and teaching.

  16. Economic burden related to chemotherapy-related adverse events in patients with metastatic breast cancer in an integrated health care system

    Directory of Open Access Journals (Sweden)

    Rashid N

    2016-10-01

    Full Text Available Nazia Rashid,1 Han A Koh,2 Hilda C Baca,3 Kathy J Lin,1 Susan E Malecha,4 Anthony Masaquel5 1Drug Information Services, Kaiser Permanente, Downey, 2Southern California Permanente Medical Group, Kaiser Permanente, Bellflower, 3Pharmacy Analytical Services, Kaiser Permanente, Downey, 4US Medical Affairs, Genetech Inc., San Francisco, 5Health Economics and Outcomes, Genentech Inc., San Francisco, CA, USA Background: Breast cancer is treated with many different modalities, including chemotherapy that can be given as a single agent or in combination. Patients often experience adverse events from chemotherapy during the cycles of treatment which can lead to economic burden.Objective: The objective of this study was to evaluate costs related to chemotherapy-related adverse events in patients with metastatic breast cancer (mBC in an integrated health care delivery system.Methods: Patients with mBC newly initiated on chemotherapy were identified and the first infusion was defined as the index date. Patients were ≥18 years old at time of index date, had at least 6 months of health plan membership and drug eligibility prior to their index date. The chemotherapy adverse events were identified after the index date and during first line of chemotherapy. Episodes of care (EOC were created using healthcare visits. Chart review was conducted to establish whether the adverse events were related to chemotherapy. Costs were calculated for each visit, including medications related to the adverse events, and aggregated to calculate the total EOC cost.Results: A total of 1,682 patients with mBC were identified after applying study criteria; 54% of these patients had one or more adverse events related to chemotherapy. After applying the EOC method, there were a total of 5,475 episodes (4,185 single episodes [76.4%] and 1,290 multiple episodes [23.6%] related to chemotherapy-related adverse events. Within single episodes, hematological (1,387 EOC, 33

  17. Importance of support groups for intersex (disorders of sex development) patients, families and the medical profession.

    Science.gov (United States)

    Cull, M L; Simmonds, M

    2010-09-01

    Taboo still surrounds intersex/disorders of sex development, in spite of more openness in society regarding sex. Peer support is valuable in providing information and emotional support to those affected. Support groups also work with clinicians to promote better care, to assist with research studies and to increase clinical awareness and expertise by helping to stage symposia. They also foster greater public understanding via media involvement and training videos; and play an advocacy role, providing one voice to channel the concerns of a scattered population with these rare conditions.

  18. General guidelines for medically screening mixed population groups potentially exposed to nerve or vesicant agents

    Energy Technology Data Exchange (ETDEWEB)

    Watson, A.P.; Munro, N.B. (Oak Ridge National Lab., TN (United States)); Sidell, F.R. (Army Medical Research Inst. of Chemical Defense, Aberdeen Proving Ground, MD (United States)); Leffingwell, S.S. (Centers for Disease Control, Atlanta, GA (United States). Center for Environmental Health and Injury Control)

    1992-01-01

    A number of state and local planners have requested guidance on screening protocols and have expressed interest in sampling body fluids from exposed or potentially exposed individuals as a means of estimating agent dose. These guidelines have been developed to provide a clear statement that could be used by state and local emergency response personnel in the event of a nerve or vesicant agent incident resulting in off-post contamination; maximum protection from harm is the goal. The assumption is that any population group so exposed would be heterogeneous for age, gender, reproductive status, and state of health.

  19. General guidelines for medically screening mixed population groups potentially exposed to nerve or vesicant agents

    Energy Technology Data Exchange (ETDEWEB)

    Watson, A.P.; Munro, N.B. [Oak Ridge National Lab., TN (United States); Sidell, F.R. [Army Medical Research Inst. of Chemical Defense, Aberdeen Proving Ground, MD (United States); Leffingwell, S.S. [Centers for Disease Control, Atlanta, GA (United States). Center for Environmental Health and Injury Control

    1992-01-01

    A number of state and local planners have requested guidance on screening protocols and have expressed interest in sampling body fluids from exposed or potentially exposed individuals as a means of estimating agent dose. These guidelines have been developed to provide a clear statement that could be used by state and local emergency response personnel in the event of a nerve or vesicant agent incident resulting in off-post contamination; maximum protection from harm is the goal. The assumption is that any population group so exposed would be heterogeneous for age, gender, reproductive status, and state of health.

  20. Consensus Statement on medication use in multiple sclerosis by the Spanish Society of Neurology's study group for demyelinating diseases.

    Science.gov (United States)

    García-Merino, A; Fernández, O; Montalbán, X; de Andrés, C; Oreja-Guevara, C; Rodríguez-Antigüedad, A; Arbizu, T

    2013-01-01

    Treatments for multiple sclerosis therapy are rapidly evolving. It is believed that new drugs will be approved in the near future, thereby changing current indications for treatment. In this context, the Spanish Society of Neurology's study group on demyelinating diseases, which evaluates medication use in MS, has decided to draw up a consensus statement on the current indications and guidelines for multiple sclerosis treatment. Copyright © 2013 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

  1. Quality assurance in radiotherapy: the importance of medical physics staffing levels. Recommendations from an ESTRO/EFOMP joint task group.

    Science.gov (United States)

    Belletti, S; Dutreix, A; Garavaglia, G; Gfirtner, H; Haywood, J; Jessen, K A; Lamm, I L; Mijnheer, B; Noël, A; Nüsslin, F; Rosenow, U; Schneider, P; Seelentag, W; Sheriff, S; Svensson, H; Thwaites, D

    1996-10-01

    The safe application of ionising radiation for diagnosis and therapy requires a high level of knowledge of the underlying processes and of quality assurance. Sophisticated modern equipment can be used effectively for complicated diagnostic and therapeutic techniques only with adequate physics support. In the light of recent analyses and recommendations by national and international societies a joint working group of representatives from ESTRO (European Society for Therapeutic Radiology and Oncology) and from EFOMP (European Federation of Organisations for Medical Physics) was set up to assess the necessary staffing levels for physics support to radiotherapy. The method used to assess the staffing levels, the resulting recommendations and examples of their practical application are described.

  2. Nutritional care of Danish medical inpatients: Effect on dietary intake and the occupational groups' perspectives of intervention

    Directory of Open Access Journals (Sweden)

    Jensen Lillian

    2004-09-01

    Full Text Available Abstract Background Many patients do not eat and drink sufficiently during hospitalisation. The clinical consequences of this under nutrition include lassitude, an increased risk of complications and prolonged convalescence. The aim of the study was 1 to introduce intervention targeting nutritional care for medical inpatients, 2 to investigate the effect of this intervention, and 3 to investigate the occupational groups' attitudes towards nutritional intervention and nutritional care in general. Methods The design was to determinate the extent to which the protein and energy requirements of medical inpatients were met before and after intervention. Dietary protein and energy intakes were assessed by 72-hour weighed food records. A total number of 108 medical patients at four bed sections and occupational groups in the two intervention bed sections, Aarhus University Hospital, Denmark participated. The intervention included introduction and implementation of nursing procedures targeting nutritional care during a five-month investigation period using standard food produced at the hospital. The effect of intervention for independent groups of patients were tested by one-way analysis of variance. After the intervention occupational groups were interviewed in focus groups. Results Before the intervention hospital food on average met 72% of the patients' protein requirement and 85% of their energy requirement. After intervention hospital food satisfied 85% of the protein and 103% of the energy requirements of 14 patients in one intervention section and 56% of the protein and 76% of the energy requirement of 17 patients in the other intervention section. Hospital food satisfied 61% of the protein and 75% of the energy requirement in a total of 29 controls. From the occupational groups' point of view lack of time, lack of access to food, and lack of knowledge of nutritional care for patients were identified as barriers to better integration of

  3. PS1-18: A Feasibility Pilot to Determine the Practicality of Using the HMO Research Network to Research the Genetics of Drug-Induced Serious Adverse Events

    Science.gov (United States)

    Hemmes, Mia; Arterburn, David; Gerhard, Glen; McCarty, Catherine; Nakasato, Cynthia; Pawloski, Pamala; Rukstalis, Margaret; Schmelzer, John; Yale, Steven; Davis, Robert

    2011-01-01

    Background/Aims The International Serious Adverse Events Consortium (iSAEC) is a pharmaceutical industry and FDA-led consortium focused on identifying DNA variants useful for predicting risk of drug-induced rare serious adverse events (SAEs). We assessed the feasibility of using electronic medical databases at six HMORN sites to identify provisional cases of three SAEs: drug-induced liver injury (DILI), serious skin rashes (SSR), including Stevens-Johnson syndrome, toxic epidermal necrolysis, and angioedema, and extreme weight gain (EWG) among adults on atypical antipsychotics. Methods Project work was divided among three teams. HealthPartners and Marshfield Clinic led the DILI team, Kaiser Permanente Hawaii and Kaiser Permanente Georgia led the SSR team and Group Health and Geisinger guided the EWG study. Teams met routinely via biweekly conference calls to coordinate their study efforts; monthly conference calls were conducted to coordinate the overall project, mark progress and discuss challenges and solutions. For each study, standardized case identification criteria were developed with input from iSAEC, expert panels, and medical literature. Potential cases were identified through electronic data searches using diagnoses, medication histories, laboratory test results, and other clinical data elements indicative of DILI and SSR during 2000–2009, or EWG from 2004–2009. Potential cases of DILI and SSR were abstracted to assess provisional case status and determine implicated drugs. Weight trajectories of suspected EWG cases were visually inspected to confirm EWG during atypical antipsychotic treatment period. Results A total of 99 provisional cases of DILI, 41 cases of SJS/TEN and 56 provisional cases of angioedema were identified from the electronic records of the participating HMOs. For EWG, 249 cases were confirmed and an additional 341 were categorized as “possible” cases, with additional chart review and patient interview required for confirmation

  4. Unrelated adult stem cell donor medical suitability: recommendations from the World Marrow Donor Association Clinical Working Group Committee.

    Science.gov (United States)

    Lown, R N; Philippe, J; Navarro, W; van Walraven, S M; Philips-Johnson, L; Fechter, M; Pawson, R; Bengtsson, M; Beksac, M; Field, S; Yang, H; Shaw, B E

    2014-07-01

    The World Marrow Donor Association (WMDA) fosters collaboration between international registries to facilitate the exchange of hematopoietic stem cell products for unrelated stem cell donor transplantation. As indications for hematopoietic SCT grow, the movement of products across the world will increase. Although competent authorities may regulate products within their country, there is a need to protect the best interests of donors and recipients by identifying universal donor medical suitability criteria. Within this report the WMDA provides a background to unrelated adult donor and recipient safety, recommends a common framework for assessing the health of unrelated adult donors at each stage of the donation pathway and presents a novel mechanism for sharing international consensus criteria for individual medical and lifestyle conditions. Wherever possible, these criteria are evidence-based. By establishing a donor medical suitability working group, the WMDA has developed a process through which donor centers and registries may request a consensus opinion on conditions not already listed, as well as challenge existing criteria. Guidance from the WMDA is intended to complement, not supersede, guidance from national competent authorities and international regulatory bodies.

  5. FREQUENCY AND DISTRIBUTION OF ABO & RH BLOOD GROUP IN BILASPUR DISTRICT OF CHHATTISGARH STATE : A STUDY FROM MEDICAL COLLEGE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Bhanu Pratap

    2015-07-01

    Full Text Available BACKGROUND : Approximate 30 blood group systems have discovered and more than 400 erythrocytes antigens are identified. Blood group ABO and Rh are most important among all other blood group systems in transfusion service practices. The frequency of four major blood gr oup s namely A, B, O, AB with Rh Positive and Negative varies in different population of the world and differ also in region and race wise. MATERIAL AND METHOD : This 5 years retrospective study was conducted at Blood Bank of a Medical college Hospital of Bi laspur in Northern Chhattisgarh, catering the 1/3 population of state. Data were collected from the Blood Bank Grouping record from the period of January 2010 to December 2014. Blood group of blood donors and patients were determined by Monoclonal Anti Ser a by slide agglutinations tests. Rare case and difficult case were examined by test tube agglutination method and Matrix Gel System of Tulip. RESULT AND CONCLUSIO N: 31973 subjects were examined for blood group during observation period, Out of these 31092( 97.25% were male and 881 (2.75% were female. The frequency of blood group B in these populations was 11007 (34.42% (33.36% Rh Positive and 1.06% Rh Negative Followed by O were 10864 (33.97% (33.33% Rh Positive and 0.64% Rh Negative, A was 9113 (28.50 % (27.99 % Rh Positive and 0.51% Rh Negative and AB was 989 (3.11% (3.01% Rh Positive and 0.1% Rh Negative. Rhesus group Rh Positive were 31242 (97.7 % and Rh Negative were 731 (2.3 %.

  6. Patient-perceived value of Medication Therapy Management (MTM services: a series of focus groups

    Directory of Open Access Journals (Sweden)

    Amanda Brummel, PharmD

    2012-01-01

    Full Text Available Objective: To determine the patient-perceived value of MTM services and non-financial barriers preventing patients with insurance coverage from receiving MTM services. Design: Focus groups. Setting: Fairview Pharmacy Services, Minneapolis, MN.Participants: Three focus groups, each with five to nine participants, consisting of different participant populations: (i patients who paid out-of-pocket to receive MTM services; (ii insurance beneficiaries, under which MTM is a covered benefit and participants may have received incentives for receiving MTM services; (iii patients with an insurance plan which covers MTM services who were recruited to receive MTM services but declined. Intervention: MTM services. Main Outcome Measure: Patient-perceived value of MTM services and non-financial barriers. Results: Seven themes were identified relating to the patient-perceived value of MTM services: collaboration of the health care team, MTM pharmacist as a supporter/advocate/confidant, MTM pharmacist as a resource for questions and education, accessibility to the MTM pharmacist, financial incentives for participation in MTM services, MTM pharmacy as a specialty field, and the MTM pharmacist as a coordinator. Three themes were identified regarding patient-perceived non-financial barriers to receiving MTM services, including: availability of the MTM pharmacist, patient/physician lack of knowledge of MTM services, patient’s belief that MTM services are not needed. Conclusion: MTM is a service which patients identify as valuable. Patients are able to identify non-financial barriers that may prevent some patients from receiving MTM services. This study provides preliminary evidence of both the value and barriers perceived by patients.

  7. Case Finding and Medical Treatment of Type 2 Diabetes among Different Ethnic Minority Groups: The HELIUS Study

    Directory of Open Access Journals (Sweden)

    Marieke B. Snijder

    2017-01-01

    Full Text Available Aims. Prevention of diabetes complications depends on the level of case finding and successful treatment of diabetes, which may differ between ethnicities. Therefore, we studied the prevalence by age, awareness, treatment, and control of type 2 diabetes, among a multiethnic population. Methods. We included 4,541 Dutch, 3,032 South-Asian Surinamese, 4,109 African Surinamese, 2,323 Ghanaian, 3,591 Turkish, and 3,887 Moroccan participants (aged 18–70 y from the HELIUS study. The prevalence of diabetes was analysed by sex, ethnicity, and 10-year age groups. Ethnic differences in the prevalence, awareness, treatment, and control of diabetes were studied by logistic regression. Results. From the age of 31–40 years and older, the prevalence of diabetes was 3 to 12 times higher among ethnic minority groups than that among the Dutch host population. Awareness and medical treatment of diabetes were 2 to 5 times higher among ethnic minorities than that among Dutch. Among those medically treated, only 37–53% had HbA1c levels on target (≤7.0%; only Dutch men had HbA1c levels on target more often (67%. Conclusions. Our results suggest that the age limit for case finding among ethnic minority groups should be lower than that for the general population. Importantly, despite higher awareness and treatment among ethnic minorities, glycemic control was low, suggesting a need for increased efforts to improve the effectiveness of treatment in these groups.

  8. Group-based trajectory models: a new approach to classifying and predicting long-term medication adherence.

    Science.gov (United States)

    Franklin, Jessica M; Shrank, William H; Pakes, Juliana; Sanfélix-Gimeno, Gabriel; Matlin, Olga S; Brennan, Troyen A; Choudhry, Niteesh K

    2013-09-01

    Classifying medication adherence is important for efficiently targeting adherence improvement interventions. The purpose of this study was to evaluate the use of a novel method, group-based trajectory models, for classifying patients by their long-term adherence. We identified patients who initiated a statin between June 1, 2006 and May 30, 2007 in prescription claims from CVS Caremark and evaluated adherence over the subsequent 15 months. We compared several adherence summary measures, including proportion of days covered (PDC) and trajectory models with 2-6 groups, with the observed adherence pattern, defined by monthly indicators of full adherence (defined as having ≥24 d covered of 30). We also compared the accuracy of adherence prediction based on patient characteristics when adherence was defined by either a trajectory model or PDC. In 264,789 statin initiators, the 6-group trajectory model summarized long-term adherence best (C=0.938), whereas PDC summarized less well (C=0.881). The accuracy of adherence predictions was similar whether adherence was classified by PDC or by trajectory model. Trajectory models summarized adherence patterns better than traditional approaches and were similarly predicted by covariates. Group-based trajectory models may facilitate targeting of interventions and may be useful to adjust for confounding by health-seeking behavior.

  9. Evaluating direct-to-consumer marketing of race-based pharmacogenomics: a focus group study of public understandings of applied genomic medication.

    Science.gov (United States)

    Bates, Benjamin R; Poirot, Kristan; Harris, Tina M; Condit, Celeste M; Achter, Paul J

    2004-01-01

    Some medical providers have advocated applied genomics, including the use of genetically linked racial phenotypes in medical practice, raising fear that race-based medication will become justified. As with other emerging medical genetic technologies, pharmaceutical companies may advertise these treatments. Researchers fear that consumers will uncritically accept pharmaceutical messages and demand the product. In this exploratory study, we examined public reactions to advertisements for applied genomic medications. A focus group methodology was employed. Participants tended to resist the message and generated warrants for doing so, indicating critical reception of the messages. Message accepters also provided warrants. Warrants for resistance and acceptance differ between self-identified racial groups. Consumers, health care providers, and pharmaceutical corporations will benefit from a better understanding of direct-to-consumer advertisements as medical communication. Our study concludes that both advocates and opponents of direct-to-consumer advertisements should recognize that potential consumers of pharmacogenomics act as critical consumers of health advertising discourse.

  10. [Factors forming opnion on marijuana legalization in Poland among group of students from medical and technical college faculty].

    Science.gov (United States)

    Suwała, Małgorzata; Gerstenkorn, Andrzej; Szewczyk, Anna

    2015-01-01

    Marijuana is the most popular illegal drug in the world. In 2010 17.6% of polish adult population (age 15-64) and 37.3% of youth (age 17-18) declared use of marijuana at least once in their lifetime. Recent years in Poland brought back public discussion regarding decriminalization and legalization of marijuana. The main goal of the study was to reveal the opinion about legalization of marijuana in Poland among students of medical and technical faculty in correlation with chosen socio-demographic factors, college major, attitude to tobacco smoking, use of drugs and religious practice. Study included 230 students (110 from Medical University of Lodz and 120 from Technical University of Lodz). Women consisted on 56.1% of surveyed and men on 43.9%. Study used audit survey as a research method. Results. 40.4% of students considered marijuana as "soft" drug and in majority (65.7%) are convinced that it is not addictive. The main part of studied group (83%) claimed that marijuana is easily accessible in Poland. The majority of the group (38.75%) was against marijuana legalization, a little bit less (35.2%) approved its legalization in Poland and 26.1% had no opinion. Type of college faculty had not been detected as a factor influencing support for legalization. Important factors influencing positive opinion on legalization was: living in the city, tobacco smoking, socializing with legalization supporters, lack of regular religious practice, drug use. CONCLUSION. Young people's diversified opinion regarding legalization of marijuana in Poland should encourage further discussion. Educational and preventive activities within different social groups are necessary to form a conscious opinion on legalization of marijuana in Poland based on the knowledge of actual scientific facts.

  11. Impact of Participation in TimeSlips, a Creative Group-Based Storytelling Program, on Medical Student Attitudes toward Persons with Dementia: A Qualitative Study

    Science.gov (United States)

    George, Daniel R.; Stuckey, Heather L.; Dillon, Caroline F.; Whitehead, Megan M.

    2011-01-01

    Purpose: To evaluate whether medical student participation in TimeSlips (TS), a creative group-based storytelling program, with persons affected by dementia would improve student attitudes toward this patient population. Design and Methods: Fifteen fourth-year medical students from Penn State College of Medicine participated in a month-long…

  12. Zygomycosis in Europe: analysis of 230 cases accrued by the registry of the European Confederation of Medical Mycology (ECMM) Working Group on Zygomycosis between 2005 and 2007.

    NARCIS (Netherlands)

    Skiada, A.; Pagano, L.; Groll, A.; Zimmerli, S.; Dupont, B.; Lagrou, K.; Lass-Florl, C.; Bouza, E.; Klimko, N.; Gaustad, P.; Richardson, M.; Hamal, P.; Akova, M.; Meis, J.F.G.M.; Rodriguez-Tudela, J.L.; Roilides, E.; Mitrousia-Ziouva, A.; Petrikkos, G.

    2011-01-01

    Zygomycosis is an important emerging fungal infection, associated with high morbidity and mortality. The Working Group on Zygomycosis of the European Confederation of Medical Mycology (ECMM) prospectively collected cases of proven and probable zygomycosis in 13 European countries occurring between

  13. Principles of developing a well-rounded program of physical rehabilitation for female students in the special medical group with consideration of physical activity impairment

    Directory of Open Access Journals (Sweden)

    Golod N. R.

    2015-04-01

    Full Text Available Purpose : to highlight the main provisions of a comprehensive physical rehabilitation program for students of special medical group based on violations of the motor capacity. Material : testing 24 students of special medical group and the same number of their healthy peers on standardized tests of physical qualities. To reflect the movement disorders applied functional movement screen. Results : a program of rehabilitation of the students included: lifestyle modification; morning hygienic gymnastics; kinesitherapy (using yoga fitness, functional training; aerobic exercise (swimming, Nordic Walking, jogging, aerobics wellness; massage. First presented a unified approach to working with students of special medical groups - selection based on load capacity motor disorders according to the results of tests of functional movement screen. The complexity of the impact of the program involves the impact on the physical, social and mental health components. Conclusions : the author's program of physical rehabilitation of students of special medical group is complex.

  14. Survey on distributing situation in nursing group working in Tehran Medical Science University Emam Khomeinee Hospital During2013-14

    Directory of Open Access Journals (Sweden)

    Azari S

    2017-01-01

    Full Text Available Introduction: Nowadays justice in health and injustice elimination in health section turns out to a most important concern of health systems in the world, especially for developing countries. So current research happened with purpose to survey manner of distribution and dedication ofTehran Medical Science University Emam Khomeinee (may rest in peace Hospital nursing staff. Analysis method: The studying society of this descriptive analytical research in Tehran Medical Science University Emam Khomeinee Hospital During 2013-14 includes entire units nursing group personnel (Nurse, Paramedic and Nurse Aid. Information has been gathered by self-made forms and data analyzing has done by EXCEL Software, Descriptive statistical indexes and suggested standard guidance from Ministry of Health. Findings: Results of done estimation in 27 units of studying hospital and comparing that to current situation shows that based on suggested pattern of Health Ministry just one unit (3.7% from manpower staff matches this pattern, 18 units (66.67% were lower and 8 units (29.62% were far upon this pattern. Conclusion: Generally in studying hospital lack of nursing staff was obvious that combination and distribution of nursing forces in their different units was uneven and they didn’t match the current situation. Hereupon, intended hospitals require correct management and planning in this field, so that will cause increase in hospital performance and presenting service quality to patients.

  15. Principles of developing a well-rounded program of physical rehabilitation for female students in the special medical group with consideration of physical activity impairment

    OpenAIRE

    Golod N. R.

    2015-01-01

    Purpose : to highlight the main provisions of a comprehensive physical rehabilitation program for students of special medical group based on violations of the motor capacity. Material : testing 24 students of special medical group and the same number of their healthy peers on standardized tests of physical qualities. To reflect the movement disorders applied functional movement screen. Results : a program of rehabilitation of the students included: lifestyle modification; morning hygienic gym...

  16. What Is the Organizational Culture Regarding Use of Family Nurse Practitioners as Perceived by Selected Objective Medical Group Executives

    Science.gov (United States)

    1997-05-01

    efficiently maintained the household during my mental absences throughout the past year. They have surprised me with gourmet dinners of pasta , jell-o... Dental Corps (DC), Medical Service Corps (MSC), or Biomedical Service Corps (BSC) who is responsible for successful mission accomplishments through...team there may be any mix of medical corps specialties (i.e.. Medical Corps, Nurse Corps, Dental Corps, Biomedical Service Corps, and 20 Medical

  17. The well-being and personal wellness promotion strategies of medical oncologists in the North Central Cancer Treatment Group.

    Science.gov (United States)

    Shanafelt, Tait D; Novotny, Paul; Johnson, Mary E; Zhao, Xinghua; Steensma, David P; Lacy, Martha Q; Rubin, Joseph; Sloan, Jeff

    2005-01-01

    The well-being of oncologists is important to the well-being of their patients. While much is known about oncologist distress, little is known about oncologist well-being. We set out to evaluate oncologist well-being and the personal wellness promotion strategies used by oncologists. We performed a cross-sectional survey of medical oncologists in the North Central Cancer Treatment Group using a validated instrument to measure quality of life. Study-specific questions explored stressors, wellness promotion strategies and career satisfaction. Of 241 responding oncologists (response rate 61%), 121 (50%) reported high overall well-being. Being age 50 or younger (57 vs. 41%; p = 0.01), male (53 vs. 31%; p = 0.01) and working 60 h or less per week (50 vs. 33%; p = 0.005) were associated with increased overall well-being on bivariate analysis. Ratings of the importance of a number of personal wellness promotion strategies differed for oncologists with high well-being compared with those without high well-being. Developing an approach/philosophy to dealing with death and end-of-life care, using recreation/hobbies/exercise, taking a positive outlook and incorporating a philosophy of balance between personal and professional life were all rated as substantially more important wellness strategies by oncologists with high well-being (p values career satisfaction. Half of medical oncologists experience high overall well-being. Use of specific personal wellness promotion strategies appears to be associated with oncologist well-being. Further investigations of the prevalence, promotion, causes, inequities and clinical impact of physician well-being are needed. .

  18. Complications of NewColorIris implantation in phakic eyes: a review

    Directory of Open Access Journals (Sweden)

    Sikder S

    2011-04-01

    Full Text Available Shameema Sikder1, Scott W Davis2, Huck Holz3, Majid Moshirfar41The Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA; 2Drexel University College of Medicine, Philadelphia, PA, USA; 3Kaiser Permanente Medical Group, Santa Clara, CA, USA; 4The John A Moran Eye Center, Salt Lake City, UT, USAPurpose: To provide a literature review of implant related complications from bilateral NewColorIris implantation (Kahn Medical Devices, Panama City, Panama.Methods: A PubMed search of peer-reviewed ophthalmology journals for complications related to NewColorIris implants was performed.Results: Including a recent case published by the authors, a total of nine patients (18 eyes with management of complications such as endothelial cell loss, elevated intraocular pressure (IOP, corneal edema, anterior chamber inflammation, decreased visual acuity, and cataract formation were reviewed.Conclusions: Sight-threatening complications including corneal decompensation, IOP elevation, uveitis, and hyphema have been described after NewColorIris implantation.Keywords: intraocular pressure, footplates, elevated IOP

  19. A multicentre, double-blind, randomised, controlled, parallel-group study of the effectiveness of a pharmacist-acquired medication history in an emergency department

    Science.gov (United States)

    2013-01-01

    Background Admission to an emergency department (ED) is a key vulnerable moment when patients are at increased risk of medication discrepancies and medication histories are an effective way of ensuring that fewer errors are made. This study measured whether a pharmacist-acquired medication history in an ED focusing on a patient’s current home medication regimen, and available to be used by a doctor when consulting in the ED, would reduce the number of patients having at least 1 medication discrepancy related to home medication. Methods This multicentre, double-blind, randomised, controlled parallel-group study was conducted at 3 large teaching hospitals. Two hundred and seventy participants were randomly allocated to an intervention (n = 134) or a standard care (n = 136) arm. All consecutive patients >18 years old admitted through the ED were eligible. The intervention consisted of pharmacists conducting a standardised comprehensive medication history interview focusing on a patient’s current home medication regimen, prior to being seen by a doctor. Data recorded on the admission medication order form was available to be used by a doctor during consultation in the ED. The admission medication order form was given to doctors at a later stage in the control arm for them to amend prescriptions. The effect of the intervention was assessed primarily by comparing the number of patients having at least 1 admission medication discrepancy regarding medication being taken at home. Secondary outcomes concerned the characteristics and clinical severity of such medication discrepancies. Results The intervention reduced discrepancies occurring by 33% (p medication occurred most frequently (55.1%) and most discrepancies (42.7%) were judged to have the potential to cause moderate discomfort or clinical deterioration. Conclusions A pharmacist-acquired medication history in an ED focusing on a patient’s current home medication regimen available to be used by a doctor

  20. Contraceptive practices among reproductive age group of women in Justice K. S. Hegde Medical College Hospital, Mangalore

    Directory of Open Access Journals (Sweden)

    Lakshmi Manjeera M

    2013-02-01

    Full Text Available Background: India’s population as per 2011 census was 1.21 billion second only to china in the world, and is estimated to overtake china by 2050. India was the first country to launch National Family Planning Program in 1952. Even though various measures have been taken to encourage the usage of contraception but, the achievement in this field was not to the extent expected due to various social and cultural factors. Methods: It was a cross sectional study conducted in out patients and inpatients of department of obstetrics and gynecology, Justice K. S. Hegde medical college hospital, Mangalore. The study constituted 705 subjects. It was an interview based study. The study was aimed to know the awareness, acceptance and prevalence of temporary and permanent contraceptive methods among the study group and various factors affecting the contraceptive usage. Results: A total of 705 women in the age group between 18-45 years were studied. 671 (95.2% were aware of one or multiple methods of contraception, 615 (87.2 % accepted the contraceptive practices, and 495 (71.2% followed or are following contraception at the time of study. Of 705 women, 366 (51.9% followed or used temporary methods, 227 (32.2% followed permanent methods of contraception. Conclusions: Awareness about the contraception is not sufficient enough to use contraception in the community, also shows that more programs are required to combat the influence of various factors on contraception usage, and emphasizing on the positive effects of the use of contraception. [Int J Reprod Contracept Obstet Gynecol 2013; 2(1.000: 39-46

  1. Awareness of and Readiness for Medication Therapy Management Among Community Pharmacists in New York City: Results from a Focus Group

    Directory of Open Access Journals (Sweden)

    Sharrel Pinto, BS Pharm, DMM, MS, PhD

    2013-01-01

    Full Text Available For pharmacist-provided Medication Therapy Management (MTM services to operate effectively and efficiently, pharmacists must understand the process of MTM delivery, assess the barriers and challenges in creating a sustainable MTM program, and realize the willingness and readiness of their colleagues to deliver such services. In order to assess feasibility of such services among high-risk neighborhoods in New York City (NYC, a focus group design was used to qualitatively assess pharmacists’ perceptions of MTM. Findings showed that reimbursement and allocation of resources were the most discussed challenges/barriers to the provision of pharmacist-provided MTM services. Overall, pharmacists were willing, but not yet ready, to provide MTM services on a large scale. Lack of understanding of MTM structure/process, reimbursement challenges, and the need for collaboration between providers were key components to pharmacists’ willingness to provide services. Additional training opportunities were deemed necessary for them to feel confident to conduct clinical services. Although pharmacists discussed several issues regarding MTM, they were still interested in participating and seeing how MTM would impact their community practice settings. Understanding these perceptions of pharmacists on MTM allowed us to better understand and assess ways for continuous quality improvement of services that will enhance patient care.

  2. Management of systemic AL amyloidosis: recommendations of the Myeloma Foundation of Australia Medical and Scientific Advisory Group.

    Science.gov (United States)

    Weber, N; Mollee, P; Augustson, B; Brown, R; Catley, L; Gibson, J; Harrison, S; Ho, P J; Horvath, N; Jaksic, W; Joshua, D; Quach, H; Roberts, A W; Spencer, A; Szer, J; Talaulikar, D; To, B; Zannettino, A; Prince, H M

    2015-04-01

    Systemic AL amyloidosis is a plasma cell dyscrasia with a characteristic clinical phenotype caused by multi-organ deposition of an amyloidogenic monoclonal protein. This condition poses a unique management challenge due to the complexity of the clinical presentation and the narrow therapeutic window of available therapies. Improved appreciation of the need for risk stratification, standardised use of sensitive laboratory testing for monitoring disease response, vigilant supportive care and the availability of newer agents with more favourable toxicity profiles have contributed to the improvement in treatment-related mortality and overall survival seen over the past decade. Nonetheless, with respect to the optimal management approach, there is a paucity of high-level clinical evidence due to the rarity of the disease, and enrollment in clinical trials is still the preferred approach where available. This review will summarise the Clinical Practice Guidelines on the Management of Systemic Light Chain (AL) Amyloidosis recently prepared by the Medical Scientific Advisory Group of the Myeloma Foundation of Australia. It is hoped that these guidelines will assist clinicians in better understanding and optimising the management of this difficult disease.

  3. Determinants of negative preference for female fetuses amongst women of reproductive age group at rural medical college

    Directory of Open Access Journals (Sweden)

    Deepti Shrivastava

    2013-02-01

    Full Text Available Background: India is experiencing lowest child sex ratio of the world. The deficit of girl children has been progressively increasing, in spite of so many laws to favour them like Sharda act, act against dowry and law against female feticide, i.e. PC & PNDT. The present study attempted to explore the determinants of negative preference of female fetuses at rural setup and preferences for prevention of female foeticide. Methods: In a prospective, multicentric, cohort study, 2203 married women of reproductive age group were interviewed by pretested piloted structured questionnaire. SPSS software was used for statistical analysis. Results: Common causes for not preferring daughters were related to their marriages expenses, dowry along with exogamy and practices regarding death ceremonies of parents. Self deprived image of today’s woman by herself is mainly responsible for not allowing her to welcome another girl child in a family. Conclusions: Female foeticide is still in practice inspite of awareness programmes and existing law. Main reason for it is societal need due to marriage related customs and cultures along with unethical practices by service providers. To increase in self-esteem of women can only reduce the volume of service receiver along with upliftment of moral and ethical values of service providers from the beginning of their medical training can prevent it to happen. [Int J Reprod Contracept Obstet Gynecol 2013; 2(1.000: 67-73

  4. Risk of Delayed Intracerebral Hemorrhage in Anticoagulated Patients after Minor Head Trauma: The Role of Repeat Cranial Computed Tomography

    Science.gov (United States)

    Swap, Clifford; Sidell, Margo; Ogaz, Raquel; Sharp, Adam

    2016-01-01

    Context: Patients receiving anticoagulant medications who experience minor head injury are at increased risk of an intracerebral hemorrhage (ICH) developing, even after an initial computed tomography (CT) scan of the brain yields normal findings. Conflicting evidence exists regarding the frequency at which delayed bleeding occurs. Objective: To identify the frequency of delayed traumatic ICH in patients receiving warfarin or clopidogrel. Design: We performed a retrospective observational study of adult trauma encounters for anticoagulated patients undergoing head CT at 1 of 13 Kaiser Permanente Southern California Emergency Departments (EDs) between 2007 and 2011. Encounters were identified using structured data from electronic health and administrative records, and then records were individually reviewed for validation of results. Main Outcome Measures: The primary outcome measure was ICH within 60 days of an ED visit with a normal head CT result. Results: Our sample included 443 (260 clopidogrel and 183 warfarin) eligible ED encounters with normal findings of initial head CT. Overall, 11 patients (2.5%, 95% confidence interval [CI] = 1.4%–4.4%) had a delayed ICH, and events occurred at similar rates between the clopidogrel group (6/260, 2.3%, CI 1.1%–5.0%) and warfarin group (5/183, 2.7%, CI 1.2%–6.2%). Conclusion: Trauma patients in the ED who are receiving warfarin or clopidogrel have approximately a 2.5% risk of delayed ICH after an initial normal finding on a head CT. PMID:26901269

  5. Impact of Participation in TimeSlips, a Creative Group-Based Storytelling Program, on Medical Student Attitudes Toward Persons With Dementia: A Qualitative Study

    OpenAIRE

    George, Daniel R.; Stuckey, Heather L.; Dillon, Caroline F.; Whitehead, Megan M.

    2011-01-01

    Purpose: To evaluate whether medical student participation in TimeSlips (TS), a creative group-based storytelling program, with persons affected by dementia would improve student attitudes toward this patient population. Design and Methods: Fifteen fourth-year medical students from Penn State College of Medicine participated in a month-long regimen of TS sessions at a retirement community. Student course evaluations were analyzed at the conclusion of the program to examine perceived qualitati...

  6. Evaluation of large-group lectures in medicine - development of the SETMED-L (Student Evaluation of Teaching in MEDical Lectures) questionnaire.

    Science.gov (United States)

    Müller, Tjark; Montano, Diego; Poinstingl, Herbert; Dreiling, Katharina; Schiekirka-Schwake, Sarah; Anders, Sven; Raupach, Tobias; von Steinbüchel, Nicole

    2017-08-18

    The seven categories of the Stanford Faculty Development Program (SFDP) represent a framework for planning and assessing medical teaching. Nevertheless, so far there is no specific evaluation tool for large-group lectures that is based on these categories. This paper reports the development and psychometric validation of a short German evaluation tool for large-group lectures in medical education (SETMED-L: 'Student Evaluation of Teaching in MEDical Lectures') based on the SFDP-categories. Data were collected at two German medical schools. In Study 1, a full information factor analysis of the new 14-item questionnaire was performed. In Study 2, following cognitive debriefings and adjustments, a confirmatory factor analysis was performed. The model was tested for invariance across medical schools and student gender. Convergent validity was assessed by comparison with results of the FEVOR questionnaire. Study 1 (n = 922) yielded a three-factor solution with one major (10 items) and two minor factors (2 items each). In Study 2 (n = 2740), this factor structure was confirmed. Scale reliability ranged between α = 0.71 and α = 0.88. Measurement invariance was given across student gender but not across medical schools. Convergent validity in the subsample tested (n = 246) yielded acceptable results. The SETMED-L showed satisfactory to very good psychometric characteristics. The main advantages are its short yet comprehensive form, the integration of SFDP-categories and its focus on medical education.

  7. "Medical students" burn out – need of student mentor and support groups and emotional resilience skills training to be a part of medical school curriculum

    Directory of Open Access Journals (Sweden)

    Shoaib M

    2017-02-01

    Full Text Available Maria Shoaib,1 Anoshia Afzal,1 Muhammad Aadil,2 1Department of Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan; 2Department of Psychiatry, Rush University Medical Center, Chicago, IL, USA We would like to applaud the authors of the article “Potential predictors of psychological distress and well-being in medical students: a cross-sectional pilot study” for conducting a cross-sectional pilot study to understand the predictors of psychological distress and well-being and for assessing their extent using latest scales that have not been extensively used for this purpose before.1 We would like to add some views in its support. View the original paper by Bore and colleagues. 

  8. Cost and Impact of Voluntary Medical Male Circumcision in South Africa: Focusing the Program on Specific Age Groups and Provinces.

    Directory of Open Access Journals (Sweden)

    Katharine Kripke

    Full Text Available In 2012, South Africa set a goal of circumcising 4.3 million men ages 15-49 by 2016. By the end of March 2014, 1.9 million men had received voluntary medical male circumcision (VMMC. In an effort to accelerate progress, South Africa undertook a modeling exercise to determine whether circumcising specific client age groups or geographic locations would be particularly impactful or cost-effective. Results will inform South Africa's efforts to develop a national strategy and operational plan for VMMC.The study team populated the Decision Makers' Program Planning Tool, Version 2.0 (DMPPT 2.0 with HIV incidence projections from the Spectrum/AIDS Impact Module (AIM, as well as national and provincial population and HIV prevalence estimates. We derived baseline circumcision rates from the 2012 South African National HIV Prevalence, Incidence and Behaviour Survey. The model showed that circumcising men ages 20-34 offers the most immediate impact on HIV incidence and requires the fewest circumcisions per HIV infection averted. The greatest impact over a 15-year period is achieved by circumcising men ages 15-24. When the model assumes a unit cost increase with client age, men ages 15-29 emerge as the most cost-effective group. When we assume a constant cost for all ages, the most cost-effective age range is 15-34 years. Geographically, the program is cost saving in all provinces; differences in the VMMC program's cost-effectiveness across provinces were obscured by uncertainty in HIV incidence projections.The VMMC program's impact and cost-effectiveness vary by age-targeting strategy. A strategy focusing on men ages 15-34 will maximize program benefits. However, because clients older than 25 access VMMC services at low rates, South Africa could consider promoting demand among men ages 25-34, without denying services to those in other age groups. Uncertainty in the provincial estimates makes them insufficient to support geographic targeting.

  9. Cost and Impact of Voluntary Medical Male Circumcision in South Africa: Focusing the Program on Specific Age Groups and Provinces

    Science.gov (United States)

    Kripke, Katharine; Thambinayagam, Ananthy; Pillay, Yogan; Loykissoonlal, Dayanund; Bonnecwe, Collen; Barron, Peter; Kiwango, Eva; Castor, Delivette

    2016-01-01

    Background In 2012, South Africa set a goal of circumcising 4.3 million men ages 15–49 by 2016. By the end of March 2014, 1.9 million men had received voluntary medical male circumcision (VMMC). In an effort to accelerate progress, South Africa undertook a modeling exercise to determine whether circumcising specific client age groups or geographic locations would be particularly impactful or cost-effective. Results will inform South Africa’s efforts to develop a national strategy and operational plan for VMMC. Methods and Findings The study team populated the Decision Makers’ Program Planning Tool, Version 2.0 (DMPPT 2.0) with HIV incidence projections from the Spectrum/AIDS Impact Module (AIM), as well as national and provincial population and HIV prevalence estimates. We derived baseline circumcision rates from the 2012 South African National HIV Prevalence, Incidence and Behaviour Survey. The model showed that circumcising men ages 20–34 offers the most immediate impact on HIV incidence and requires the fewest circumcisions per HIV infection averted. The greatest impact over a 15-year period is achieved by circumcising men ages 15–24. When the model assumes a unit cost increase with client age, men ages 15–29 emerge as the most cost-effective group. When we assume a constant cost for all ages, the most cost-effective age range is 15–34 years. Geographically, the program is cost saving in all provinces; differences in the VMMC program’s cost-effectiveness across provinces were obscured by uncertainty in HIV incidence projections. Conclusion The VMMC program’s impact and cost-effectiveness vary by age-targeting strategy. A strategy focusing on men ages 15–34 will maximize program benefits. However, because clients older than 25 access VMMC services at low rates, South Africa could consider promoting demand among men ages 25–34, without denying services to those in other age groups. Uncertainty in the provincial estimates makes them

  10. Finding a Path to Entrustment in Undergraduate Medical Education: A Progress Report From the AAMC Core Entrustable Professional Activities for Entering Residency Entrustment Concept Group.

    Science.gov (United States)

    Brown, David R; Warren, Jamie B; Hyderi, Abbas; Drusin, Ronald E; Moeller, Jeremy; Rosenfeld, Melvin; Orlander, Philip R; Yingling, Sandra; Call, Stephanie; Terhune, Kyla; Bull, Janet; Englander, Robert; Wagner, Dianne P

    2017-06-01

    To better prepare graduating medical students to transition to the professional responsibilities of residency, 10 medical schools are participating in an Association of American Medical Colleges pilot to evaluate the feasibility of explicitly teaching and assessing 13 Core Entrustable Professional Activities for Entering Residency. The authors focused on operationalizing the concept of entrustment as part of this process. Starting in 2014, the Entrustment Concept Group, with representatives from each of the pilot schools, guided the development of the structures and processes necessary for formal entrustment decisions associated with students' increased responsibilities at the start of residency. Guiding principles developed by the group recommend that formal, summative entrustment decisions in undergraduate medical education be made by a trained group, be based on longitudinal performance assessments from multiple assessors, and incorporate day-to-day entrustment judgments by workplace supervisors. Key to entrustment decisions is evidence that students know their limits (discernment), can be relied on to follow through (conscientiousness), and are forthcoming despite potential personal costs (truthfulness), in addition to having the requisite knowledge and skills. The group constructed a developmental framework for discernment, conscientiousness, and truthfulness to pilot a model for transparent entrustment decision making. The pilot schools are studying a number of questions regarding the pathways to and decisions about entrustment. This work seeks to inform meaningful culture change in undergraduate medical education through a shared understanding of the assessment of trust and a shared trust in that assessment.

  11. Can health care teams improve primary care practice?

    Science.gov (United States)

    Grumbach, Kevin; Bodenheimer, Thomas

    2004-03-10

    In health care settings, individuals from different disciplines come together to care for patients. Although these groups of health care personnel are generally called teams, they need to earn true team status by demonstrating teamwork. Developing health care teams requires attention to 2 central questions: who is on the team and how do team members work together? This article chiefly focuses on the second question. Cohesive health care teams have 5 key characteristics: clear goals with measurable outcomes, clinical and administrative systems, division of labor, training of all team members, and effective communication. Two organizations are described that demonstrate these components: a private primary care practice in Bangor, Me, and Kaiser Permanente's Georgia region primary care sites. Research on patient care teams suggests that teams with greater cohesiveness are associated with better clinical outcome measures and higher patient satisfaction. In addition, medical settings in which physicians and nonphysician professionals work together as teams can demonstrate improved patient outcomes. A number of barriers to team formation exist, chiefly related to the challenges of human relationships and personalities. Taking small steps toward team development may improve the work environment in primary care practices.

  12. Effects of racial and ethnic group and health literacy on responses to genomic risk information in a medically underserved population.

    Science.gov (United States)

    Kaphingst, Kimberly A; Stafford, Jewel D; McGowan, Lucy D'Agostino; Seo, Joann; Lachance, Christina R; Goodman, Melody S

    2015-02-01

    Few studies have examined how individuals respond to genomic risk information for common, chronic diseases. This randomized study examined differences in responses by type of genomic information (genetic test/family history) and disease condition (diabetes/heart disease), and by race/ethnicity in a medically underserved population. 1,057 English-speaking adults completed a survey containing 1 of 4 vignettes (2-by-2 randomized design). Differences in dependent variables (i.e., interest in receiving genomic assessment, discussing with doctor or family, changing health habits) by experimental condition and race/ethnicity were examined using chi-squared tests and multivariable regression analysis. No significant differences were found in dependent variables by type of genomic information or disease condition. In multivariable models, Hispanics were more interested in receiving a genomic assessment than Whites (OR = 1.93; p literacy had greater interest than those with adequate health literacy. Blacks (OR = 1.78; p = .001) and Hispanics (OR = 1.85; p = .001) had greater interest in discussing information with family than Whites. Non-Hispanic Blacks (OR = 1.45; p = .04) had greater interest in discussing genomic information with a doctor than Whites. Blacks (β = -0.41; p literacy was negatively associated with number of health habits participants intended to change. Findings suggest that race/ethnicity may affect responses to genomic risk information. Additional research could examine how cognitive representations of this information differ across racial/ethnic groups. Health literacy is also critical to consider in developing approaches to communicating genomic information.

  13. Explanation and relations. How do general practitioners deal with patients with persistent medically unexplained symptoms: a focus group study

    Directory of Open Access Journals (Sweden)

    van Spaendonck Karel P

    2009-09-01

    Full Text Available Abstract Background Persistent presentation of medically unexplained symptoms (MUS is troublesome for general practitioners (GPs and causes pressure on the doctor-patient relationship. As a consequence, GPs face the problem of establishing an ongoing, preferably effective relationship with these patients. This study aims at exploring GPs' perceptions about explaining MUS to patients and about how relationships with these patients evolve over time in daily practice. Methods A qualitative approach, interviewing a purposive sample of twenty-two Dutch GPs within five focus groups. Data were analyzed according to the principles of constant comparative analysis. Results GPs recognise the importance of an adequate explanation of the diagnosis of MUS but often feel incapable of being able to explain it clearly to their patients. GPs therefore indicate that they try to reassure patients in non-specific ways, for example by telling patients that there is no disease, by using metaphors and by normalizing the symptoms. When patients keep returning with MUS, GPs report the importance of maintaining the doctor-patient relationship. GPs describe three different models to do this; mutual alliance characterized by ritual care (e.g. regular physical examination, regular doctor visits with approval of the patient and the doctor, ambivalent alliance characterized by ritual care without approval of the doctor and non-alliance characterized by cutting off all reasons for encounter in which symptoms are not of somatic origin. Conclusion GPs feel difficulties in explaining the symptoms. GPs report that, when patients keep presenting with MUS, they focus on maintaining the doctor-patient relationship by using ritual care. In this care they meticulously balance between maintaining a good doctor-patient relationship and the prevention of unintended consequences of unnecessary interventions.

  14. The application of heterogeneous cluster grouping to reflective writing for medical humanities literature study to enhance students' empathy, critical thinking, and reflective writing.

    Science.gov (United States)

    Liao, Hung-Chang; Wang, Ya-Huei

    2016-09-02

    To facilitate interdisciplinary collaboration and to make connections between patients' diseases and their social/cultural contexts, the study examined whether the use of heterogeneous cluster grouping in reflective writing for medical humanities literature acquisition could have positive effects on medical university students in terms of empathy, critical thinking, and reflective writing. A 15-week quasi-experimental design was conducted to investigate the learning outcomes. After conducting cluster algorithms, heterogeneous learning clusters (experimental group; n = 43) and non-heterogeneous learning clusters (control group; n = 43) were derived for a medical humanities literature study. Before and after the intervention, an Empathy Scale in Patient Care (ES-PC), a critical thinking disposition assessment (CTDA-R), and a reflective writing test were administered to both groups. The findings showed that on the empathy scale, significant differences in the "behavioral empathy," "affective empathy," and overall sections existed between the post-test mean scores of the experimental group and those of the control group, but such differences did not exist in "intelligent empathy." Regarding critical thinking, there were significant differences in "systematicity and analyticity," "skepticism and well-informed," "maturity and skepticism," and overall sections. As for reflective writing, significant differences existed in "ideas," "voice and point of view," "critical thinking and representation," "depth of reflection on personal growth," and overall sections, but not in "focus and context structure" and "language and conventions." This study outlined an alternative for using heterogeneous cluster grouping in reflective writing about medical humanities literature to facilitate interdisciplinary cooperation to provide more humanizing medical care.

  15. Exploration on Construction of the New Medical Equipment Management System for the Mobile Medical Service Sub-Group%构建机动卫勤分队卫生装备管理新体系探讨

    Institute of Scientific and Technical Information of China (English)

    莫群; 田君鹏

    2015-01-01

    This paper mainly introduced the practices of the Mobile Medical Service Sub-Group in medical equipment management in the hospital and discussed construction of a new medical equipment management system. The scientiifc and effectiveness management could ensure the steady work status of medical equipment, enhance its efifcacy and advance tactical efifciency.%本文主要介绍我院机动卫勤分队卫生装备管理的主要做法,探索构建一套卫生装备管理新体系,通过科学有效的管理,确保卫生装备状态可靠,充分发挥其效能,形成战斗力。

  16. Eight years’ experience with a Medical Education Journal Club in Mexico: a quasi-experimental one-group study

    OpenAIRE

    Sánchez-Mendiola, Melchor; Morales-Castillo, Daniel; Torruco-García, Uri; Varela-Ruiz, Margarita

    2015-01-01

    Background A time-honored strategy for keeping up to date in medicine and improving critical appraisal skills is the Journal Club (JC). There are several reports of its use in medicine and allied health sciences but almost no reports of JC focused on medical education. The purpose of the study is to describe and evaluate an eight years’ experience with a medical education Journal Club (MEJC). Methods We started a monthly medical education JC in 2006 at UNAM Faculty of Medicine in Mexico City....

  17. Off-label use of medical products in radiation therapy: summary of the report of AAPM Task Group No. 121.

    Science.gov (United States)

    Thomadsen, Bruce R; Heaton, H Thompson; Jani, Shirish K; Masten, Jeffery P; Napolitano, Mary E; Ouhib, Zoubir; Reft, Chester S; Rivard, Mark J; Robin, T Tydings; Subramanian, Manny; Suleiman, Orhan H

    2010-05-01

    Medical products (devices, drugs, or biologics) contain information in their labeling regarding the manner in which the manufacturer has determined that the products can be used in a safe and effective manner. The Food and Drug Administration (FDA) approves medical products for use for these specific indications which are part of the medical product's labeling. When medical products are used in a manner not specified in the labeling, it is commonly referred to as off-label use. The practice of medicine allows for this off-label use to treat individual patients, but the ethical and legal implications for such unapproved use can be confusing. Although the responsibility and, ultimately, the liability for off-label use often rests with the prescribing physician, medical physicists and others are also responsible for the safe and proper use of the medical products. When these products are used for purposes other than which they were approved, it is important for medical physicists to understand their responsibilities. In the United States, medical products can only be marketed if officially cleared, approved, or licensed by the FDA; they can be used if they are not subject to or specifically exempt from FDA regulations, or if they are being used in research with the appropriate regulatory safeguards. Medical devices are either cleared or approved by FDA's Center for Devices and Radiological Health. Drugs are approved by FDA's Center for Drug Evaluation and Research, and biological products such as vaccines or blood are licensed under a biologics license agreement by FDA's Center for Biologics Evaluation and Research. For the purpose of this report, the process by which the FDA eventually clears, approves, or licenses such products for marketing in the United States will be referred to as approval. This report summarizes the various ways medical products, primarily medical devices, can legally be brought to market in the United States, and includes a discussion of the

  18. Discussion on Human Resource Management of Medical Group%集团型医疗机构人力资源管理的探讨

    Institute of Scientific and Technical Information of China (English)

    林平平

    2016-01-01

    在现行医疗制度改革形势下,为使医疗资源被最大化利用,各医疗机构进行集团化的整合已成为新型的组织模式,随之医疗集团的人力资源管理也必须进行相应的改革创新。本文以台州恩泽医疗中心(集团)为例,介绍了医疗集团人力资源统一管理的实践探索,并由此带来的作用以及存在的一些难点问题。%Under the environment of current medical system reform, in order to maximize the use of medical resources, group integration of medical institutions has become a new organization model. Therefore, human resource management of the medical group should also have corresponding reform and innovation. This paper takes Taizhou Enze Medical Center (Group) as an example and introduces the exploration and practice of unified human resources management, the effect of management and some existing difficult problems.

  19. 医疗机构战略群组划分及其战略选择%Strategic Group Classification and Strategic Choice of Medical Institution

    Institute of Scientific and Technical Information of China (English)

    全晓明; 熊慧琴; 王馀祥; 骆芳; 熊巨洋; 张亮

    2011-01-01

    After the new healtb care reform launched the market competition among medical institutions has become increasingly fierce.Advisable strategic planning will play a critical role in the future for the medical insititutions which are in different level.The paper uses the clustering model to analyse the prospective of medical organization then the theory of strategy group is explored to classify medical institutions into A.B.C and D strategic group.Based on this theory, different development tactics are given for the different strategic group,thus it put forward some useful suggestion for the medical institurions to select appropriate strategy.%随着新一轮医药卫生体制改革的进一步深入,医疗行业的市场竞争日趋激烈.处于不同境况的医疗机构,适宜的发展战略将决定其未来命运.本文提出医疗机构战略群组概念,运用战略聚类模型,从医疗机构的竞争力和发展速度两个维度,把医疗机构分成A、B、C、D4个战略群组,并对每一种战略群组提出适宜的发展策略,为医疗机构合理选择战略提供参考.

  20. Guidelines for education and training of medical physicists in radiotherapy. Recommendations from an ESTRO/EFOMP working group.

    NARCIS (Netherlands)

    Eudaldo, T.; Huizenga, H.; Lamm, I.L.; McKenzie, A.; Milano, F.; Schlegel, W.; Thwaites, D.; Heeren, G.

    2004-01-01

    PURPOSE: To provide a guideline curriculum covering theoretical and practical aspects of education and training for medical physicists in radiotherapy within Europe. MATERIAL AND METHODS: Guidelines have been developed for the specialist theoretical knowledge and practical experience required to

  1. [Two woman medical doctors of the Meiji era who came from the "Preservative District of Johnai Suwakohji Important Traditional Buildings Group", Kanegasaki Town, Iwate Prefecture].

    Science.gov (United States)

    Fukushima, Masakazu

    2010-09-01

    There is a historical group of samurai buildings called the "Preservative District of Johnai Suwakohji Important Traditional Buildings Group" in Kanegasaki Town, Iwate Prefecture. Two woman medical doctors (Misaho Aizawa and Mie Shiga, came from this district at the end of the Meiji Era (1910-1911). Misaho Aizawa was born in a minister's family in 1885 and studied at the Women's School of Dohshisha. After graduation she studied abroad at the Women's Medical College of Philadelphia and graduated from the college in 1910. Immediately after graduation she came back to Japan and got a medical license in Japan. She married a minister and was employed by the Red Cross Clinic in Fukuoka Prefecture. Mie Shiga was born in a samurai-family in 1880 and worked her way through various medical schools in Tokyo. After three failures to pass the national medical examination she received a medical license in 1911. In 1913 she opened her clinic of internal medicine & pediatrics in Utsunomiya. She made an effort to diagnose correctly and won patients' confidence. These two women had neither communication nor common points due to the differences of their family environment and their age. However, they were brought up by fathers who were enthusiastic for education and they made an effort to become woman doctors. Although women's social situation and the female compulsory education rate were low, and women's medical education was poor in the Meiji Era, Misaho Aizawa was able to enter the medical route under the influence of Christianity, and Mie Shiga through the assistance of her family and her samurai spirit.

  2. Use of Modified SOAP Notes and Peer-Led Small-Group Discussion in a Medical Physiology Course: Addressing the Hidden Curriculum

    Science.gov (United States)

    Kibble, Jonathan; Hansen, Penelope A.; Nelson, Loren

    2006-01-01

    Peer leading of small-group discussion of cases; use of modified subjective, objective, assessment of physiology (SOAP) notes; and opportunities for self-assessment were introduced into a Medical Physiology course to increase students' awareness and practice of professional behaviors. These changes arose from faculty members' understanding of the…

  3. Eight years' experience with a Medical Education Journal Club in Mexico: a quasi-experimental one-group study.

    Science.gov (United States)

    Sánchez-Mendiola, Melchor; Morales-Castillo, Daniel; Torruco-García, Uri; Varela-Ruiz, Margarita

    2015-12-14

    A time-honored strategy for keeping up to date in medicine and improving critical appraisal skills is the Journal Club (JC). There are several reports of its use in medicine and allied health sciences but almost no reports of JC focused on medical education. The purpose of the study is to describe and evaluate an eight years' experience with a medical education Journal Club (MEJC). We started a monthly medical education JC in 2006 at UNAM Faculty of Medicine in Mexico City. Its goal is to provide faculty with continuing professional development in medical education. A discussion guide and a published paper were sent 2 weeks before sessions. We reviewed the themes and publication types of the papers used in the sessions, and in June-July 2014 administered a retrospective post-then-pre evaluation questionnaire to current participants that had been regular attendees to the JC for more than 2 years. The retrospective post-then-pre comparisons were analyzed with Wilcoxon signed-rank test. Effect sizes were calculated for the pre-post comparisons with Cohen's r. There have been 94 MEJC sessions until July 2014. Average attendance is 20 persons, a mix of clinicians, educators, psychologists and a sociologist. The articles were published in 32 different journals, and covered several medical education themes (curriculum, faculty development, educational research methodology, learning methods, assessment, residency education). 22 Attendees answered the evaluation instrument. The MEJC had a positive evaluation from good to excellent, and there was an improvement in self-reported competencies in medical education literature critical appraisal and behaviors related to the use of evidence in educational practice, with a median effect size higher than 0.5. The evaluation instrument had a Cronbach's alpha of 0.96. A periodic Medical Education Journal Club can improve critical appraisal of the literature, and be maintained long-term using evidence-based strategies. This activity

  4. Contextualizing the relevance of basic sciences: small-group simulation with debrief for first- and second-year medical students in an integrated curriculum.

    Science.gov (United States)

    Ginzburg, Samara B; Brenner, Judith; Cassara, Michael; Kwiatkowski, Thomas; Willey, Joanne M

    2017-01-01

    There has been a call for increased integration of basic and clinical sciences during preclinical years of undergraduate medical education. Despite the recognition that clinical simulation is an effective pedagogical tool, little has been reported on its use to demonstrate the relevance of basic science principles to the practice of clinical medicine. We hypothesized that simulation with an integrated science and clinical debrief used with early learners would illustrate the importance of basic science principles in clinical diagnosis and management of patients. Small groups of first- and second-year medical students were engaged in a high-fidelity simulation followed by a comprehensive debrief facilitated by a basic scientist and clinician. Surveys including anchored and open-ended questions were distributed at the conclusion of each experience. The majority of the students agreed that simulation followed by an integrated debrief illustrated the clinical relevance of basic sciences (mean ± standard deviation: 93.8% ± 2.9% of first-year medical students; 96.7% ± 3.5% of second-year medical students) and its importance in patient care (92.8% of first-year medical students; 90.4% of second-year medical students). In a thematic analysis of open-ended responses, students felt that these experiences provided opportunities for direct application of scientific knowledge to diagnosis and treatment, improving student knowledge, simulating real-world experience, and developing clinical reasoning, all of which specifically helped them understand the clinical relevance of basic sciences. Small-group simulation followed by a debrief that integrates basic and clinical sciences is an effective means of demonstrating the relationship between scientific fundamentals and patient care for early learners. As more medical schools embrace integrated curricula and seek opportunities for integration, our model is a novel approach that can be utilized.

  5. Contextualizing the relevance of basic sciences: small-group simulation with debrief for first- and second-year medical students in an integrated curriculum

    Science.gov (United States)

    Ginzburg, Samara B; Brenner, Judith; Cassara, Michael; Kwiatkowski, Thomas; Willey, Joanne M

    2017-01-01

    Aim There has been a call for increased integration of basic and clinical sciences during preclinical years of undergraduate medical education. Despite the recognition that clinical simulation is an effective pedagogical tool, little has been reported on its use to demonstrate the relevance of basic science principles to the practice of clinical medicine. We hypothesized that simulation with an integrated science and clinical debrief used with early learners would illustrate the importance of basic science principles in clinical diagnosis and management of patients. Methods Small groups of first- and second-year medical students were engaged in a high-fidelity simulation followed by a comprehensive debrief facilitated by a basic scientist and clinician. Surveys including anchored and open-ended questions were distributed at the conclusion of each experience. Results The majority of the students agreed that simulation followed by an integrated debrief illustrated the clinical relevance of basic sciences (mean ± standard deviation: 93.8% ± 2.9% of first-year medical students; 96.7% ± 3.5% of second-year medical students) and its importance in patient care (92.8% of first-year medical students; 90.4% of second-year medical students). In a thematic analysis of open-ended responses, students felt that these experiences provided opportunities for direct application of scientific knowledge to diagnosis and treatment, improving student knowledge, simulating real-world experience, and developing clinical reasoning, all of which specifically helped them understand the clinical relevance of basic sciences. Conclusion Small-group simulation followed by a debrief that integrates basic and clinical sciences is an effective means of demonstrating the relationship between scientific fundamentals and patient care for early learners. As more medical schools embrace integrated curricula and seek opportunities for integration, our model is a novel approach that can be utilized

  6. Diet and Exercise Adherence and Practices among Medically Underserved Patients with Chronic Disease: Variation across Four Ethnic Groups

    Science.gov (United States)

    Orzech, Kathryn M.; Vivian, James; Huebner Torres, Cristina; Armin, Julie; Shaw, Susan J.

    2013-01-01

    Many factors interact to create barriers to dietary and exercise plan adherence among medically underserved patients with chronic disease, but aspects related to culture and ethnicity are underexamined in the literature. Using both qualitative ("n" = 71) and quantitative ("n" = 297) data collected in a 4-year, multimethod study…

  7. Use of Alternative Medications for Menopause-Related Symptoms in Three Major Ethnic Groups of Ipoh, Perak, Malaysia.

    Science.gov (United States)

    Ohn Mar, Saw; Malhi, Fatehpal; Syed Rahim, Syed Hamid; Chua, Chin Tong; Sidhu, Sarjeet Singh; Sandheep, Sugathan

    2015-11-01

    This cross-sectional study investigated the use of alternative medications to alleviate menopause-related symptoms among Malay, Chinese, and Indian women of Ipoh city. The prevalence, types, effectiveness, and associated factors were determined. The prevalence of alternative medication use was 41.4%. Evening primrose oil (EPO) was the most popular medication used (18.1%), followed by soy-based products (12.3%), green tea (6.8%), and gingko (5.8%). The medication was reported to be highly effective by 58.3% of soya bean diet users and 41.1% of EPO users. Significant variables associated with the use were Chinese or Indian ethnicity (P < .001), age between 50 and 54 years (P < .01), lower self-health rating (P < .05), education level of diploma or professional degree (P < .05), employment as professionals or entrepreneurs (P < .05), and the use of hormone replacement therapy (P < .05). Regression analysis showed that Chinese and Indians had significantly higher odds for the use than Malays (Chinese: odds ratio [OR] = 4.33, 95% confidence interval [CI] = 2.392-7.837; Indians: OR = 3.248, 95% CI = 1.586-6.654).

  8. Predictive Value of the School-leaving Grade and Prognosis of Different Admission Groups for Academic Performance and Continuity in the Medical Course – a Longitudinal Study

    Science.gov (United States)

    Kadmon, Guni; Resch, Franz; Duelli, Roman; Kadmon, Martina

    2014-01-01

    Background: The school-leaving GPA and the time since completion of secondary education are the major criteria for admission to German medical schools. However, the predictive value of the school-leaving grade and the admission delay have not been thoroughly examined since the amendment of the Medical Licensing Regulations and the introduction of reformed curricula in 2002. Detailed information on the prognosis of the different admission groups is also missing. Aim: To examine the predictive values of the school-leaving grade and the age at enrolment for academic performance and continuity throughout the reformed medical course. Methods: The study includes the central admission groups “GPA-best” and “delayed admission” as well as the primary and secondary local admission groups of three consecutive cohorts. The relationship between the criteria academic performance and continuity and the predictors school-leaving GPA, enrolment age, and admission group affiliation were examined up to the beginning of the final clerkship year. Results: The academic performance and the prolongation of the pre-clinical part of undergraduate training were significantly related to the school-leaving GPA. Conversely, the dropout rate was related to age at enrolment. The students of the GPA-best group and the primary local admission group performed best and had the lowest dropout rates. The students of the delayed admission group and secondary local admission group performed significantly worse. More than 20% of these students dropped out within the pre-clinical course, half of them due to poor academic performance. However, the academic performance of all of the admission groups was highly variable and only about 35% of the students of each group reached the final clerkship year within the regular time. Discussion: The school-leaving grade and age appear to have different prognostic implications for academic performance and continuity. Both factors have consequences for the

  9. Impact of personality temperaments and characters on academic performance and specialty selection among a group of Egyptian medical graduates.

    Science.gov (United States)

    El Sheikh, Mona M; Shaker, Nermin M; Hussein, Hanan; Ramy, Hisham A

    2014-08-01

    The relationship between personality temperaments, academic achievement and specialty interest is important because of its implications in career counseling. To assess the effect of personality on academic performance and career selection and to study the impact of some sociodemographic factors on academic achievement and career choice of medical graduates. A total of 436 medical graduates of Ain Shams medical school were approached, out of which 331 participated. They were given a sociodemographic questionnaire, and the Temperament and Character Inventory-Revised (TCI-R; 240) for personality construct; they had to answer questions about academic achievement, ranking, scores and choice of medical specialty. Novelty seeking (NS1, NS2 and NS3) and self-transcendence (ST1 and ST2) were correlated with graduation ranking, (r = .2, p = .00; r = .15, p = .009; r = .16, p = .005; r = .12, p = .003; r = .14, p = .02; r = .17, p = .004; r = .13, p = .03, respectively), that is, lower NS and ST had better academic outcome. Only high school score was associated with better achievement (p = .00). In specialty selection, females were significantly overrepresented in pediatrics and clinical pathology, whereas males were significantly predominating surgical specialties except for obstetrics and gynecology (p = .00). Students choosing patient-centered specialties had higher reward dependence (RD), persistence (PS) and cooperativeness (C); those choosing clinical pathology had highest harm avoidance (HA), whereas those choosing radiology had lowest HA and those choosing surgery had significantly higher self-directedness (SD3). Personality impacts academic achievement and specialty choice with other factors as gender and previous scholastic performance. © The Author(s) 2013.

  10. Radiation protection dosimetry in medicine - Report of the working group n.9 of the European radiation dosimetry group (EURADOS) - coordinated network for radiation dosimetry (CONRAD - contract EC N) fp6-12684; Dosimetrie pour la radioprotection en milieu medical - rapport du groupe de travail n. 9 du European radiation dosimetry group (EURADOS) - coordinated netword for radiation dosimetry (CONRAD - contrat CE fp6-12684)

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2009-07-01

    This report present the results achieved within the frame of the work the WP 7 (Radiation Protection Dosimetry of Medical Staff) of the coordination action CONRAD (Coordinated Network for Radiation Dosimetry) funded through the 6. EU Framework Program. This action was coordinated by EURADOS (European Radiation Dosimetry Group). EURADOS is an organization founded in 1981 to advance the scientific understanding and the technical development of the dosimetry of ionising radiation in the fields of radiation protection, radiobiology, radiation therapy and medical diagnosis by promoting collaboration between European laboratories. WP7 coordinates and promotes European research for the assessment of occupational exposures to staff in therapeutic and diagnostic radiology workplaces. Research is coordinated through sub-groups covering three specific areas: 1. Extremity dosimetry in nuclear medicine and interventional radiology: this sub-group coordinates investigations in the specific fields of the hospitals and studies of doses to different parts of the hands, arms, legs and feet; 2. Practice of double dosimetry: this sub-group reviews and evaluates the different methods and algorithms for the use of dosemeters placed above and below lead aprons in large exposure during interventional radiology procedures, especially to determine effective doses to cardiologists during cardiac catheterization; and 3. Use of electronic personal dosemeters in interventional radiology: this sub-group coordinates investigations in laboratories and hospitals, and intercomparisons with passive dosemeters with the aim to enable the formulation of standards. (authors)

  11. Factorial Validity and Reliability of the Tamil Version of Multidimensional Scale of Perceived Social Support Among a Group of Participants in University Malaya Medical Centre, Malaysia

    OpenAIRE

    Ng Chong Guan; Abdul Rasyid Sulaiman; Loh Huai Seng; Anne Yee Hway Ann; Suzaily Wahab; Subash Kumar Pillai

    2013-01-01

    Background and Objectives: This study was done to validate the Tamil version of Multidimensional Scale of Perceived Social Support (MSPSS-TV) among a group of Indian participants in University Malaya. Materials and Methods: Ninety-four people who took part in this study were given MSPSS-TV, Medical Outcome Study (MOS) social support survey, Malay version of Beck Depression Inventory (BDI), Malay version of General Health Questionnaire (GHQ), and English version of MSPSS. After a week, these p...

  12. Learning global health: a pilot study of an online collaborative intercultural peer group activity involving medical students in Australia and Indonesia.

    Science.gov (United States)

    Ambrose, Mark; Murray, Linda; Handoyo, Nicholas E; Tunggal, Deif; Cooling, Nick

    2017-01-13

    There is limited research to inform effective pedagogies for teaching global health to undergraduate medical students. Theoretically, using a combination of teaching pedagogies typically used in 'international classrooms' may prove to be an effective way of learning global health. This pilot study aimed to explore the experiences of medical students in Australia and Indonesia who participated in a reciprocal intercultural participatory peer e-learning activity (RIPPLE) in global health. Seventy-one third year medical students (49 from Australia and 22 from Indonesia) from the University of Tasmania (Australia) and the University of Nusa Cendana (Indonesia) participated in the RIPPLE activity. Participants were randomly distributed into 11 intercultural 'virtual' groups. The groups collaborated online over two weeks to study a global health topic of their choice, and each group produced a structured research abstract. Pre- and post-RIPPLE questionnaires were used to capture students' experiences of the activity. Descriptive quantitative data were analysed with Microsoft Excel and qualitative data were thematically analysed. Students' motivation to volunteer for this activity included: curiosity about the innovative approach to learning; wanting to expand knowledge of global health; hoping to build personal and professional relationships; and a desire to be part of an intercultural experience. Afer completing the RIPPLE program, participants reported on global health knowledge acquisition, the development of peer relationships, and insight into another culture. Barriers to achieving the learning outcomes associated with RIPPLE included problems with establishing consistent online communication, and effectively managing time to simultaneously complete RIPPLE and other curricula activities. Medical students from both countries found benefits in working together in small virtual groups to complement existing teaching in global health. However, our pilot study

  13. Small Group Learning in Medical Education: A Second Look at the Springer, Stanne, and Donovan Meta-Analysis.

    Science.gov (United States)

    Colliver, Jerry A.; Feltovich, Paul J.; Verhulst, Steven J.

    2003-01-01

    Reviews the studies on which a meta-analysis by Springer, Stanne, and Donovan (1999) were based; the meta-analysis had concluded that small group learning in science, mathematics, engineering, and technology education is effective. Concludes that the meta-analysis' call for more widespread implementation of small group learning is not supported.…

  14. Small Group Learning in Medical Education: A Second Look at the Springer, Stanne, and Donovan Meta-Analysis.

    Science.gov (United States)

    Colliver, Jerry A.; Feltovich, Paul J.; Verhulst, Steven J.

    2003-01-01

    Reviews the studies on which a meta-analysis by Springer, Stanne, and Donovan (1999) were based; the meta-analysis had concluded that small group learning in science, mathematics, engineering, and technology education is effective. Concludes that the meta-analysis' call for more widespread implementation of small group learning is not supported.…

  15. Managing E-mail Interactions with Patients: A Discussion with Clinicians in Evaluating the Personal Health Link Project.

    Science.gov (United States)

    Serrato, Carl A; Retecki, Sally

    2004-01-01

    One software feature in the Personal Health Link (PHL) Project allows members of Kaiser Permanente to send secure e-mail messages to clinicians and staff. As an early step in the PHL evaluation process, a group of primary care physicians met to discuss their opinions and experiences with e-mail interactions with patients and to suggest strategies for effectively managing these e-mail interactions. Most clinicians spoke from their experience with e-mail interactions with patients in a conventional e-mail environment; only one clinician in the group was using PHL.

  16. Experience in the use of social media in medical and health education. Contribution of the IMIA Social Media Working Group.

    Science.gov (United States)

    Paton, C; Bamidis, P D; Eysenbach, G; Hansen, M; Cabrer, M

    2011-01-01

    Social media are online tools that allow collaboration and community building. Succinctly, they can be described as applications where "users add value". This paper aims to show how five educators have used social media tools in medical and health education to attempt to add value to the education they provide. We conducted a review of the literature about the use of social media tools in medical and health education. Each of the authors reported on their use of social media in their educational projects and collaborated on a discussion of the advantages and disadvantages of this approach to delivering educational projects. We found little empirical evidence to support the use of social media tools in medical and health education. Social media are, however, a rapidly evolving range of tools, websites and online experiences and it is likely that the topic is too broad to draw definitive conclusions from any particular study. As practitioners in the use of social media, we have recognised how difficult it is to create evidence of effectiveness and have therefore presented only our anecdotal opinions based on our personal experiences of using social media in our educational projects. The authors feel confident in recommending that other educators use social media in their educational projects. Social media appear to have unique advantages over non-social educational tools. The learning experience appears to be enhanced by the ability of students to virtually build connections, make friends and find mentors. Creating a scientific analysis of why these connections enhance learning is difficult, but anecdotal and preliminary survey evidence appears to be positive and our experience reflects the hypothesis that learning is, at heart, a social activity.

  17. Metabolic evaluation and medical management of upper urinary tract stone disease. Guidelines from the Scandinavian Cooperative Group for Urinary Stones

    DEFF Research Database (Denmark)

    Osther, P J; Grenabo, L; Haraldsson, G

    1999-01-01

    A set of simple guidelines for metabolic evaluation and medical/dietary management of patients with urolithiasis is presented. The evaluation scheme is based on the documented risk factors in the Nordic area and the results of controlled clinical trials, and takes its basis in the severity...... of the stone disease in the individual stone patient. The initial evaluation in all patients aims at diagnosing conditions with a definitive metabolic, infectious or anatomical/functional cause of stone formation (MIAF urolithiasis). Patients with MIAF urolithiasis are treated according to the nature...

  18. Exploring medical student learning in the large group teaching environment: examining current practice to inform curricular development

    OpenAIRE

    Luscombe, Ciara; Montgomery, Julia

    2016-01-01

    Background Lectures continue to be an efficient and standardised way to deliver information to large groups of students. It has been well documented that students prefer interactive lectures, based on active learning principles, to didactic teaching in the large group setting. Despite this, it is often the case than many students do not engage with active learning tasks and attempts at interaction. By exploring student experiences, expectations and how they use lectures in their learning we w...

  19. Contextualizing the relevance of basic sciences: small-group simulation with debrief for first- and second-year medical students in an integrated curriculum

    Directory of Open Access Journals (Sweden)

    Ginzburg SB

    2017-01-01

    Full Text Available Samara B Ginzburg,1 Judith Brenner,1 Michael Cassara,2 Thomas Kwiatkowski,1 Joanne M Willey,1 1Department of Science Education, Hofstra Northwell School of Medicine, Hempstead, 2Department of Emergency Medicine, Northwell Health, Great Neck, NY, USA Aim: There has been a call for increased integration of basic and clinical sciences during ­preclinical years of undergraduate medical education. Despite the recognition that clinical simulation is an effective pedagogical tool, little has been reported on its use to demonstrate the relevance of basic science principles to the practice of clinical medicine. We hypothesized that simulation with an integrated science and clinical debrief used with early learners would illustrate the importance of basic science principles in clinical diagnosis and management of patients.  Methods: Small groups of first -and second-year medical students were engaged in a high-fidelity simulation followed by a comprehensive debrief facilitated by a basic scientist and clinician. Surveys including anchored and open-ended questions were distributed at the conclusion of each experience.  Results: The majority of the students agreed that simulation followed by an integrated debrief illustrated the clinical relevance of basic sciences (mean ± standard deviation: 93.8% ± 2.9% of first-year medical students; 96.7% ± 3.5% of second-year medical students and its importance in patient care (92.8% of first-year medical students; 90.4% of second-year medical students. In a thematic analysis of open-ended responses, students felt that these experiences provided opportunities for direct application of scientific knowledge to diagnosis and treatment, improving student knowledge, simulating real-world experience, and developing clinical reasoning, all of which specifically helped them understand the clinical relevance of basic sciences.  Conclusion: Small-group simulation followed by a debrief that integrates basic and clinical

  20. High School Students Are a Target Group for Fight against Self-Medication with Antimalarial Drugs: A Pilot Study in University of Kinshasa, Democratic Republic of Congo

    Directory of Open Access Journals (Sweden)

    Ramsès Kabongo Kamitalu

    2016-01-01

    Full Text Available Aim. To assess the self-medication against malaria infection in population of Congolese students in Kinshasa, Democratic Republic of Congo (DRC. Methods. A cross-sectional study was carried out in University of Kinshasa, Kinshasa, Democratic Republic of Congo. Medical records of all students with malaria admitted to Centre de Santé Universitaire of University of Kinshasa from January 1, 2008, to April 30, 2008, were reviewed retrospectively. Results. The median age of the patients was 25.4 years (range: from 18 to 36 years. The majority of them were male (67.9%. Artemisinin-based combination treatments (ACTs was the most used self-prescribed antimalarial drugs. However, self-medication was associated with the ingestion of quinine in 19.9% of cases. No case of ingestion of artesunate/artemether in monotherapy was found. All the medicines taken were registered in DRC. In this series, self-prescribed antimalarial was very irrational in terms of dose and duration of treatment. Conclusion. This paper highlights self-medication by a group who should be aware of malaria treatment protocols. The level of self-prescribing quinine is relatively high among students and is disturbing for a molecule reserved for severe disease in Congolese health care policy in management of malaria.

  1. Validity of the Malay version of the Internet Addiction Test: a study on a group of medical students in Malaysia.

    Science.gov (United States)

    Guan, Ng Chong; Isa, Saramah Mohammed; Hashim, Aili Hanim; Pillai, Subash Kumar; Harbajan Singh, Manveen Kaur

    2015-03-01

    The use of the Internet has been increasing dramatically over the decade in Malaysia. Excessive usage of the Internet has lead to a phenomenon called Internet addiction. There is a need for a reliable, valid, and simple-to-use scale to measure Internet addiction in the Malaysian population for clinical practice and research purposes. The aim of this study was to validate the Malay version of the Internet Addiction Test, using a sample of 162 medical students. The instrument displayed good internal consistency (Cronbach's α = .91), parallel reliability (intraclass coefficient = .88, P Internet Use Scale (Pearson's correlation = .84, P Internet dependence. Principal component analysis with varimax rotation identified a 5-factor model. The Malay version of the Internet Addiction Test appeared to be a valid instrument for assessing Internet addiction in Malaysian university students. © 2012 APJPH.

  2. 76 FR 19174 - In the Matter of Circuit Systems, Inc., Global Energy Group, Inc., Integrated Medical Resources...

    Science.gov (United States)

    2011-04-06

    ... From the Federal Register Online via the Government Publishing Office SECURITIES AND EXCHANGE COMMISSION File No. 500-1 In the Matter of Circuit Systems, Inc., Global Energy Group, Inc., Integrated... information concerning the securities of Circuit Systems, Inc. because it has not filed any periodic...

  3. Evaluating effectiveness of small group information literacy instruction for Undergraduate Medical Education students using a pre- and post-survey study design.

    Science.gov (United States)

    McClurg, Caitlin; Powelson, Susan; Lang, Eddy; Aghajafari, Fariba; Edworthy, Steven

    2015-06-01

    The Undergraduate Medical Education (UME) programme at the University of Calgary is a three-year programme with a strong emphasis on small group learning. The purpose of our study was to determine whether librarian led small group information literacy instruction, closely integrated with course content and faculty participation, but without a hands on component, was an effective means to convey EBM literacy skills. Five 15-minute EBM information literacy sessions were delivered by three librarians to 12 practicing physician led small groups of 15 students. Students were asked to complete an online survey before and after the sessions. Data analysis was performed through simple descriptive statistics. A total of 144 of 160 students responded to the pre-survey, and 112 students answered the post-survey. Instruction in a small group environment without a mandatory hands on component had a positive impact on student's evidence-based information literacy skills. Students were more likely to consult a librarian and had increased confidence in their abilities to search and find relevant information. Our study demonstrates that student engagement and faculty involvement are effective tools for delivering information literacy skills when working with students in a small group setting outside of a computer classroom. © 2015 Health Libraries Group.

  4. EFFICIENCY OF IMMUNOCORRECTION WITH MEDICAL OZONE IN PROTRACTED PURULENT INFLAMMATORY DISEASES AFFECTING SOFT TISSUES IN THE PATIENTS OF SENIOR AGE GROUP

    Directory of Open Access Journals (Sweden)

    T. I. Vitkina

    2008-01-01

    Full Text Available Abstract. We performed a clinical and immunological study of patients from senior age group suffering with protracted purulent inflammation of soft tissues in maxillo-facial area. The patients underwent either common medication, or combined treatment including ozone therapy. Application of medicinal ozone, along with basic treatment schedule, resulted into more marked and rapid normalization of non-specific resistance markers, Т-cell immunity. This approach allows of reducing the terms of inpatient care and variety of possible complications. (Med. Immunol., 2008, vol. 10, N 2-3, pp 277-282.

  5. Determining of a role of the teacher of physical training in making up of consciousness of students of special medical groups of higher educational establishments.

    Directory of Open Access Journals (Sweden)

    Korjagin V.M.

    2010-08-01

    Full Text Available The state of health of students is construed. Students of 1 rate participated in experiment. The functional state of health of students is defined. Effect of the teacher on the relation of students of special medical groups to state of the health is defined. Possibilities of improving of health with the help of exercises on physical training are exhibited. Main routes of methodological correction of operation of the teacher with students are defined. The primal problem of the teacher is a making up at students of the realized relation of necessity of improving and conservation of health, education of crop of a healthy way of life.

  6. Developing Policy for Integrating Biomedicine and Traditional Chinese Medical Practice Using Focus Groups and the Delphi Technique

    Directory of Open Access Journals (Sweden)

    Vincent C. H. Chung

    2012-01-01

    Full Text Available In Hong Kong, statutory regulation for traditional Chinese medicine (TCM practitioners has been implemented in the past decade. Increasing use of TCM on top of biomedicine (BM services by the population has been followed; but corresponding policy development to integrate their practices has not yet been discussed. Using focus group methodology, we explore policy ideas for integration by collating views from frontline BM (n=50 and TCM clinicians (n=50. Qualitative data were analyzed under the guidance of structuration model of collaboration, a theoretical model for understanding interprofessional collaboration. From focus group findings we generated 28 possible approaches, and subsequently their acceptability was assessed by a two round Delphi survey amongst BM and TCM policy stakeholders (n=12. Consensus was reached only on 13 statements. Stakeholders agreed that clinicians from both paradigms should share common goals of providing patient-centered care, promoting the development of protocols for shared care and information exchange, as well as strengthening interprofessional connectivity and leadership for integration. On the other hand, attitudes amongst policy stakeholders were split on the possibility of fostering trust and mutual learning, as well as on enhancing innovation and governmental support. Future policy initiatives should focus on these controversial areas.

  7. EVALUATION OF LECTURE AS A LARGE GROUP TEACHING METHOD IN UNDERGRADUATE MEDICAL CURRICULUM: STUDENT’S PERSPECTIVE

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    Gitanjali Kailas

    2014-09-01

    Full Text Available To evaluate lecture as a large group teaching method from student’s perspective. METHODS: The present study was undertaken in the department of Microbiology, KIMS, Amalapuram. A total of 60 Second year MBBS students were taken as study subjects. A questionnaire was designed and students were asked to fill it and also give suggestions as a part of feedback about the lectures conducted in the department of Microbiology. RESULTS: A total of 83.4% students find Chalkboard method + Power point presentation as the best way of delivering a lecture. Nearly 56.6% students opined that ideal duration for class should be 40 - 50 minutes. Long duration of lecture was a major disadvantage according to 66.6% students. 90% students feel that some time period of lecture should be reserved for interactive session. Majority of students also preferred class on e-learning. 70% students feel that tutorials or seminars are needed along with theory class for better understanding of the subject. CONCLUSION: Lectures should be efficiently delivered by the instructor giving a conceptual understanding of the subject instead of mere reading the content. Lecture should be supplemented with tutorials and group discussion to improve learning. Duration of class should be restricted to 40-50 minutes as traditional long duration class makes it difficult to hold the attention of the students for an entire class period. Brief interaction with students will promote active learning. E-learning should be encouraged.

  8. Effect of Stress Caused by Academic Tests on Cortisol and ProlactineLevels in a Group of Medical Students

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    Alba Lucía Salamanca

    2006-06-01

    Full Text Available Introduction: The relationship betweenimmunological system and stress has been debatedin the last years. Neurohormonal changes produceimmunologic response variations with majorchanges in the cytokines levels, causing depressionof the cytolytic responses due to a decrease in theNK (Natural Killer cells population (1.Academic stress is a useful stress model to studyhormonal changes in the Hypotalamic-Pituitary–Adrenocortical (HPA axis (2, 3.Materials and Methods: The present studyevaluates th0e behavior of cortisol and prolactinehormones and their effect on the adaptativeresponses of Herpes Simplex Virus type I in apopulation of 26 medical students with agesbetween 14 and 27 years. Male students represented80.8% of the evaluated population. This is a threestage longitudinal intervention study whereantibodies, cortisol and prolactin levels weremeasured against Herpes Simplex Virus type I.The first measure was done 15 days previous tothe stressful event, the second during the stressfulevent (mid-academic period exams and the lastone, 15 days posterior to the stressful event. Allsamples were taken from 8:00 am to 10:00 am.Results and Discussion: Prolactine averagevalues were found to be significantly different (p< 0.001 when comparing the three stages.Cortisol values changes were near showingsignificant differences (p = 0.098, with an increaseduring the stressful event and a decrease after theexposure. Antibodies levels of Herpes SimplexVirus type I showed a significant difference (p =0.043 increasing tendency in the three stages.Adaptative responses to Herpes Simplex Virustype I augmented as a result of prolactineconcentration increase due to a stressor eventexposure. This explains an increment in thecytotoxic cell activity (NK cells which incrementcytokine concentration, such as INF-α, whichamplify humoral IgG antibody mediated response,according with obtained results. Even thoughcortisol levels do not significantly increased duringthe stressful

  9. User perspectives on an electronic decision-support tool performing comprehensive medication reviews - a focus group study with physicians and nurses.

    Science.gov (United States)

    Koskela, Tuomas; Sandström, Saana; Mäkinen, Joonas; Liira, Helena

    2016-01-22

    Although a number of studies have evaluated the effectiveness of computerized decision-support systems (CDSS), there is lack of data on user perspectives, barriers, and facilitators to the implementation of CDSSs in real-life surroundings. The aim of this study was to assess individually perceived barriers, facilitators and ideas influencing the CDSS implementation and usability. In this qualitative study, five focus groups were carried out with physicians and nurses separately at the Tampere City Health Center, Finland. The participants were end-users of the EBMeDS computerized decision support system. An explorative data content analysis was applied. The most important barrier to benefitting from CDSS was the lack of structured and coded diagnosis documentation and outdated medication information in the electronic health records. This led to false alerts and distrust towards the system. Among the major facilitators found were e.g. the beneficial reminders that helped practitioners take into account matters otherwise ignored; automatic glomerular filtration rate (GFR) calculations; medication safety checks; and the summaries in the single medication review at a glance. Physicians' and nurses' are keen to use the CDSS and it may enhance their inter-professional collaboration. Documenting patient information in a structured, uniform and easy manner is the essential starting point for electronic decision support. When implementing CDSS, managers need to focus on common practices in documenting structured data in their organizations in order to prevent undermining trust in the system.

  10. Feedback on video recorded consultations in medical teaching: why students loathe and love it – a focus-group based qualitative study

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    Baerheim Anders

    2005-07-01

    Full Text Available Abstract Background Feedback on videotaped consultations is a useful way to enhance consultation skills among medical students. The method is becoming increasingly common, but is still not widely implemented in medical education. One obstacle might be that many students seem to consider this educational approach a stressful experience and are reluctant to participate. In order to improve the process and make it more acceptable to the participants, we wanted to identify possible problems experienced by students when making and receiving feedback on their video taped consultations. Methods Nineteen of 75 students at the University of Bergen, Norway, participating in a consultation course in their final term of medical school underwent focus group interviews immediately following a video-based feedback session. The material was audio-taped, transcribed, and analysed by phenomenological qualitative analysis. Results The study uncovered that some students experienced emotional distress before the start of the course. They were apprehensive and lacking in confidence, expressing fear about exposing lack of skills and competence in front of each other. The video evaluation session and feedback process were evaluated positively however, and they found that their worries had been exaggerated. The video evaluation process also seemed to help strengthen the students' self esteem and self-confidence, and they welcomed this. Conclusion Our study provides insight regarding the vulnerability of students receiving feedback from videotaped consultations and their need for reassurance and support in the process, and demonstrates the importance of carefully considering the design and execution of such educational programs.

  11. The small group in problem-based learning: more than a cognitive 'learning' experience for first-year medical students in a diverse population.

    Science.gov (United States)

    McLean, Michelle; Van Wyk, Jacqueline M; Peters-Futre, Edith M; Higgins-Opitz, Susan B

    2006-06-01

    In problem-based learning (PBL) curricula, first-year students need to adapt to a new learning environment and an unfamiliar new pedagogy. The small-group tutorial potentially offers a learning environment where students can become self-directed learners, collaborating with other group members to achieve individual and group learning goals. At the end of the first six-week theme in a relatively new PBL curriculum, new medical students were canvassed about coping with PBL (self-directed learning; content; time management; resources) and the value of the small-group tutorial, the latter of which is currently being reported. Almost 84% of students (n = 178) responded. The benefits of participating in small groups were categorized into three domains-cognitive, affective and social-as identified from student responses. Results were analysed in terms of gender and prior educational experience (secondary school vs. prior tertiary educational experience). For almost 94% of students, the small-group tutorial provided a conducive learning environment that influenced their personal development (i.e. tolerance, patience) and socialization into the faculty. Significantly more males indicated that they had developed social skills, while more school-leavers (matriculants) than mature students felt more receptive to the views of others. More mature students claimed to have made friends. Irrespective of some conflicting opinions in the literature, the present results suggest that the PBL tutorial may be important in facilitating student socialization into a new and unfamiliar academic environment, particularly when the pedagogy differs markedly from their past educational experiences. Through interacting with fellow students from diverse origins who hold different views in the intimate setting of the small group, students felt that they had not only increased their knowledge but had also developed personally and socially. It is proposed that the small group may be useful for

  12. A focus Group Study of Medical Students’ Views of an Integrated Complementary and Alternative Medicine (CAM Curriculum: Students Teaching Teachers

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    Désirée Lie, M.D

    2008-01-01

    Full Text Available Background: Student views of new curricula can shape training outcomes. This qualitative study elicited student opinions of CAM instruction to examine and distill best strategies.Methods: 49 second, third and fourth year students participated in focus groups using a predefined question route. Interviews were audio taped and transcribed.Results: Students successfully differentiated CAM curricula from other academic content and were supportive of a longitudinal integrated approach. They had positive disposition toward CAM use for themselves but this did not necessarily translate into patient recommendations. They agreed that goals of the CAM curriculum should center on awareness of patient use and evidence and information relevant to clinical practice. They advocated a case-based, hands-on, experiential strategy vs lectures. Students proposed greater institutional commitment to strengthen curricular effectiveness. The majority did not intend to practice CAM modalities but valued skills to assess them. Patient-centeredness was recognized. As training progressed, students exhibited a growing tendency to evaluate CAM efficacy, and therefore value, exclusively according to evidence.Conclusions: In-depth student input allowed examination of the effectiveness of a CAM curriculum,permitting improvement and assessment of program effectiveness.

  13. An update on the use of Atripla® in the treatment of HIV in the United States

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    Michael A Horberg

    2010-06-01

    Full Text Available Michael A Horberg1, Daniel B Klein21HIV Interregional Initiative, Kaiser Permanente, Oakland, California, USA; 2Department of Infectious Diseases, Kaiser Permanente Hayward Medical Center, Hayward, California, USAAbstract: Atripla® (Gilead Sciences Inc, Foster City, CA, USA and Bristol-Myers Squibb, New York City, NY, USA is a coformulated single pill composed of efavirenz, emtricitabine, and tenofovir disoproxil, intended as a once-daily potent combination antiretroviral therapeutic agent. Its efficacy is equivalent to the 3 component drugs taken in a combination as single medications. The coformulated antiretroviral regimen can be quite effective in patients whose human immunodeficiency virus is sensitive to all 3 components of Atripla. However, women at risk of pregnancy, already pregnant, or nursing mothers should not take Atripla, due to the teratogenic potential of the efavirenz moiety. Adverse effects are similar to those seen with the constituent medications, including potential central nervous system effects and renal toxicity. Since its US Food and Drug administration approval, prescriptions for Atripla have increased steadily.Keywords: tenofovir, efavirenz, emtricitabine, antiretroviral therapy

  14. Reaching the hard-to-reach: a systematic review of strategies for improving health and medical research with socially disadvantaged groups

    Science.gov (United States)

    2014-01-01

    Background This study aims to review the literature regarding the barriers to sampling, recruitment, participation, and retention of members of socioeconomically disadvantaged groups in health research and strategies for increasing the amount of health research conducted with socially disadvantaged groups. Methods A systematic review with narrative synthesis was conducted. Searches of electronic databases Medline, PsychInfo, EMBASE, Social Science Index via Web of Knowledge and CINHAL were conducted for English language articles published up to May 2013. Qualitative and quantitative studies as well as literature reviews were included. Articles were included if they reported attempts to increase disadvantaged group participation in research, or the barriers to research with disadvantaged groups. Groups of interest were those described as socially, culturally or financially disadvantaged compared to the majority of society. Eligible articles were categorised according to five phases of research: 1) sampling, 2) recruitment and gaining consent, 3) data collection and measurement, 4) intervention delivery and uptake, and 5) retention and attrition. Results In total, 116 papers from 115 studies met inclusion criteria and 31 previous literature reviews were included. A comprehensive summation of the major barriers to working with various disadvantaged groups is provided, along with proposed strategies for addressing each of the identified types of barriers. Most studies of strategies to address the barriers were of a descriptive nature and only nine studies reported the results of randomised trials. Conclusions To tackle the challenges of research with socially disadvantaged groups, and increase their representation in health and medical research, researchers and research institutions need to acknowledge extended timeframes, plan for higher resourcing costs and operate via community partnerships. PMID:24669751

  15. Perfil dos médicos auditores no estado do Rio Grande do Sul Profile of a medical auditing group in the state of Rio Grande do Sul

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    Claus Michael Preger

    2005-04-01

    Full Text Available OBJETIVO: O presente artigo analisa o perfil do médico auditor no Estado do Rio Grande do Sul, tomando por base o grupo de médicos que participou dos cursos de pós-graduação em Auditoria em Saúde, Fundação Unimed, nas cidades de Porto Alegre e Caxias do Sul. MÉTODOS: Apresentamos uma revisão histórica, estudo das leis e normas que regem a função de médico auditor e uma revisão bibliográfica sobre a auditoria médica no Brasil. Foi aplicado um instrumento fechado, no qual constavam dados pessoais e de formação profissional, assim como relativos à satisfação pessoal, saúde e bem-estar do entrevistado. RESULTADOS: Responderam ao questionário 71 médicos auditores com um total de 85 funções de auditoria médica em locais diversos de trabalho: 83,8% do sexo masculino, com faixa de idade preponderante de 41 a 50 anos (38%, formados em média há 21,96 +/- 7,68 anos, com tempo de atuação em auditoria médica de 7,24 +/- 6,62 anos, e 88,7% possuem títulos universitários e/ou cursos de especialização médica nas mais diversas áreas de atuação. Do grupo pesquisado, 25,37% têm relação formal de emprego, 60% encontram-se satisfeitos como pessoa e como profissional, estando bem fisicamente. No grupo entrevistado, não existem médicos com menos de 33 anos de idade nem formados há menos de 7 anos. CONCLUSÕES: Fica evidente o alto grau de formação, especialização e de atualização dos médicos auditores entrevistados. O presente estudo contribuirá para que se possa estabelecer o perfil do médico auditor brasileiro.BACKGROUND: This paper aims to determine the profile of the medical auditor in the State of Rio Grande do Sul, Brazil, based upon a group of physicians who participated in the post-graduation courses of Unimed Foundation Health Auditing, in the cities of Porto Alegre and Caxias do Sul, together with other professionals performing the same activity in the State of Rio Grande do Sul. METHODS: A historical

  16. Are medical residents a "core group" for future improvement of influenza vaccination coverage in health-care workers? A study among medical residents at the University Hospital of Palermo (Sicily).

    Science.gov (United States)

    Amodio, Emanuele; Tramuto, Fabio; Maringhini, Guido; Asciutto, Rosario; Firenze, Alberto; Vitale, Francesco; Costantino, Claudio; Calamusa, Giuseppe

    2011-10-19

    Despite international recommendations, vaccination coverage among European healthcare workers, including physicians, is widely recognized as unsatisfactory. In order to plan tailored vaccination campaigns and increase future coverage, we investigated reasons for refusing vaccination and determinants associated with influenza vaccine uptake among young health care workers. A survey was carried out during September and October 2010 on medical residents attending post-graduate Schools of the Medical Faculty at the University of Palermo (Italy). Each participant completed an anonymous web-based questionnaire including items on demographic and occupational characteristics, knowledge, attitudes and behaviours with regard to influenza and influenza vaccination, and main sources of information. A total of 202 (66.9%) out of 302 medical residents participated in the survey. During the 2009-2010 influenza vaccine campaign, 44 residents (21.8%) were vaccinated against seasonal influenza and 84 (41.6%) against pandemic influenza A (H1N1) 2009. For the impending 2010-2011 influenza season, 45 (22.3%) stated their intention to get vaccinated against seasonal influenza, 40 (19.8%) were uncertain and 117 (57.9%) were opposed. Considering themselves to be a high risk group for developing influenza was significantly associated with vaccination against both 2009-2010 seasonal (adj-OR=1.46; 95% CI=1.05-2.04) and pandemic A (H1N1) influenza (adj-OR 1.38; 95% CI=1.08-1.75). Intention to get vaccinated against 2010-2011 seasonal influenza was significantly more frequent in participants who had a high perception of efficacy/safety (adj-OR=1.49; 95% CI=1.05-2.12). After adjusting for confounding, vaccinations against seasonal 2009-2010 influenza, pandemic influenza A (H1N1) 2009 and seasonal 2010-2011 influenza were significantly more frequent in residents who were vaccinated against influenza at least once in the previous five influenza seasons. Influenza vaccination among medical

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

    Science.gov (United States)

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

    2014-10-02

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

  18. Prevalence, awareness, medication, control, and risk factors associated with hypertension in Bai ethnic group in rural China: the Yunnan Minority Eye Study.

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    Jinman Zhang

    Full Text Available PURPOSE: This study aimed to assess the prevalence, awareness, treatment, and control of hypertension and their associated factors among Bai ethnic population in the rural China. METHODS: A population-based survey was conducted in 2010 with a randomly cluster sampling in rural communities in Dali, southwest China. A total of 2133 adults aged 50 or above were interviewed, and their blood pressure, height, weight and waist circumference were measured. Hypertension was defined as a mean SBP≥140 mmHg and/or DBP≥90 mmHg, and/or current use of antihypertensive medications. RESULTS: The prevalence of hypertension was 42.1% (899/2133, and the age- and gender-adjusted prevalence was 40.0%. Among the hypertensive participants, 28.4% (255/899were aware of their condition, while 24.6% (221/899 took antihypertensive medications, with only 7.5% (67/899 of those achieving blood pressure control (<140/90 mmHg. Risk factors for hypertension were older age, smoking, alcohol drinking, family history of HBP, overweight, and obesity, while protective factors included being lean, and having finished senior high school or above. CONCLUSIONS: Hypertension prevalence is high among the population of Bai ethnic group in China, while the associated risk factors of hypertension include overweight/obesity, cigarette smoking, history of hypertension, and older age. The percentages of hypertensive participants aware of their hypertension and those taking antihypertensive medications were low with an incredibly low proportion of hypertensive patients who kept their hypertension under control. It is suggested that health education and hypertension screening programs be carried out in the area for the high blood pressure prevention and control.

  19. First on-line survey of an international multidisciplinary working group (MightyMedic) on current practice in diagnosis, therapy and follow-up of dyslipidemias.

    Science.gov (United States)

    Stefanutti, C; D'Alessandri, G; Petta, A; Harada-Shiba, M; Julius, U; Soran, H; Moriarty, P M; Romeo, S; Drogari, E; Jaeger, B R

    2015-05-01

    The MightyMedic (Multidisciplinary International Group for Hemapheresis TherapY and MEtabolic DIsturbances Contrast) Working Group has been founded in 2013. The leading idea was to establish an international network of interdisciplinary nature aimed at working to cross national borders research projects, clinical trials, educational initiatives (meetings, workshops, summer schools) in the field of metabolic diseases, namely hyperlipidemias, and diabetes, preventive cardiology, and atherosclerosis. Therapeutic apheresis, its indications and techniques, is a parallel field of investigation. The first on-line survey of the Group has been completed in the first half of 2014. The survey included # 24 Centers in Italy, Germany, Greece, UK, Sweden, Japan and USA. Relevant data have been collected on current practice in diagnosis, therapy and follow-up of dyslipidemias. 240 subjects with hyperlipidemia and treated with lipoprotein apheresis have been reported in the survey, but a large percentage of patients (35%) who could benefit from this therapeutic option are still treated by conventional drug approach. Genetic molecular diagnosis is performed in only 33% of patients while Lipoprotein(a) (Lp(a)) is included in cardiovascular disease risk assessment in 71% of participating Centers. New detailed investigations and prospective multicenter studies are needed to evaluate changes induced by the impact of updated indications and strategies, as well as new treatment options, targeting standardization of therapeutic and diagnostic approaches.

  20. Description and student self-evaluation of a pilot integrated small group learning and simulation programme for medical students in the first clinical year.

    Science.gov (United States)

    Levinson, Michele; Kelly, Diane; Zahariou, Krisoula; Johnson, Matthew; Jackman, Christine; Mackenzie, Sara

    2017-02-01

    Contemporary education for medical students should be student-centred, integrated and contextualised. Small group learning promotes clinical reasoning and skills for lifelong learning. Simulation can provide experiential learning in a safe and controlled environment. We developed a weekly integrated problem-based learning and simulation programme (IPS) over two semesters in the first clinical year to augment clinical placement experience and contextualise theory into work-relevant practice. To evaluate the new programme at Kirkpatrick level 1. An anonymous survey of participating students. The programme was well liked. Students found the programme relevant and that they had a better understanding of patient safety and the assessment of the deteriorating patient. They felt it contributed to integration of theory and practice, clinical reasoning and the acquisition of non-technical skills, particularly affective and communication elements. This IPS programme in the first clinical year can deliver a student-centred curriculum to complement clinical placement that delivers the important requirements of contemporary medical student education. © 2016 Royal Australasian College of Physicians.

  1. Combination goserelin and tamoxifen therapy in premenopausal advanced breast cancer: a multicentre study by the ITMO group. Italian Trials in Medical Oncology.

    Science.gov (United States)

    Buzzoni, R.; Biganzoli, L.; Bajetta, E.; Celio, L.; Fornasiero, A.; Mariani, L.; Zilembo, N.; Di Bartolomeo, M.; Di Leo, A.; Arcangeli, G.

    1995-01-01

    It has been suggested that tamoxifen may improve the efficacy of medical castration with luteinising hormone-releasing hormone analogues, but very few data have so far been published concerning the clinical and endocrinological activity of this therapeutic modality. In this phase II multicentre trial conducted by the Italian Trials in Medical Oncology group (ITMO), 64 premenopausal patients with hormone receptor-positive or unknown breast cancer were treated with monthly s.c. injections of goserelin 3.6 mg, in association with a tamoxifen daily dose of 20 mg, as first-line therapy for their advanced disease. All of the patients were evaluable for efficacy and there was an overall response rate of 41% (95% confidence interval 28-52%), with 7 of the 26 responders achieving complete remission. The median time to response was 4 months (range 2-17), and the median response duration was 13 months (range 6-37 +). Better responses were observed in soft tissues (51%); the response in visceral and bone metastases was respectively 19% and 37%. Serum concentrations of gonadotrophins and oestradiol were significantly decreased by the treatment, oestrogen levels being constantly suppressed to within the range observed in post-menopausal women. No significant change was detected in serum testosterone levels. In our experience, although it was not associated with any increased clinical efficacy, the concurrent use of goserelin and tamoxifen proved to be a feasible approach in the management of premenopausal advanced breast cancer. PMID:7734310

  2. Combining a leadership course and multi-source feedback has no effect on leadership skills of leaders in postgraduate medical education. An intervention study with a control group

    DEFF Research Database (Denmark)

    Malling, Bente Vigh; Mortensen, Lene; Bonderup, Thomas

    2009-01-01

    BACKGROUND: Leadership courses and multi-source feedback are widely used developmental tools for leaders in health care. On this background we aimed to study the additional effect of a leadership course following a multi-source feedback procedure compared to multi-source feedback alone especially...... regarding development of leadership skills over time. METHODS: Study participants were consultants responsible for postgraduate medical education at clinical departments. STUDY DESIGN: pre-post measures with an intervention and control group. The intervention was participation in a seven-day leadership...... course. Scores of multi-source feedback from the consultants responsible for education and respondents (heads of department, consultants and doctors in specialist training) were collected before and one year after the intervention and analysed using Mann-Whitney's U-test and Multivariate analysis...

  3. Medical Students' Attitudes Toward Non-Adherent Patients Before and After a Simulated Patient-Role Activity and Small-Group Discussion: Revisited.

    Science.gov (United States)

    DelPrete, Angela; Giordano, Christin; Castiglioni, Analia; Hernandez, Caridad

    2016-01-01

    Introduction This study seeks to explore whether the documented decline in medical student empathy can be prevented or slowed using simulated patient-role activities and small-group discussions about the patient experience of living with a chronic illness. Methods First-year students (M1, n = 118) at the University of Central Florida College of Medicine (UCFCOM) participated in a simulated patient-role activity resembling the experience of a patient with Type 2 diabetes mellitus. The activity included taking daily "medication," participating in moderate exercise, and maintaining a low carbohydrate diet. At the end of the simulated patient-role activity, students took part in a small-group discussion about their experiences. Students completed the Jefferson Scale of Physician Empathy: Student Version (JSPE:S) before and after the activity. Additionally, fourth-year students (M4) at UCFCOM completed the JSPE:S to serve as the control, as this class completed the curriculum without any simulated patient-role activities. Results A total of 86 responses out of 118 possible M1 participants (73% response rate) were received. Of these, 62 surveys were completed and were therefore used for statistical analysis. A dependent sample t-test revealed no statistically significant increase on pre-activity (M = 111.15, SD = 8.56) and post-activity (M = 111.38, SD = 9.12) empathy scores (p = .78). A positive correlation was revealed to exist between pre- and post-activity empathy scores (r = 0.72, p students, our findings suggest that on a short-term scale, empathy levels were not affected by the activity.

  4. Specialty pharmaceuticals care management in an integrated health care delivery system with electronic health records.

    Science.gov (United States)

    Monroe, C Douglas; Chin, Karen Y

    2013-05-01

    The specialty pharmaceuticals market is expanding more rapidly than the traditional pharmaceuticals market. Specialty pharmacy operations have evolved to deliver selected medications and associated clinical services. The growing role of specialty drugs requires new approaches to managing the use of these drugs. The focus, expectations, and emphasis in specialty drug management in an integrated health care delivery system such as Kaiser Permanente (KP) can vary as compared with more conventional health care systems. The KP Specialty Pharmacy (KP-SP) serves KP members across the United States. This descriptive account addresses the impetus for specialty drug management within KP, the use of tools such as an electronic health record (EHR) system and process management software, the KP-SP approach for specialty pharmacy services, and the emphasis on quality measurement of services provided. Kaiser Permanente's integrated system enables KP-SP pharmacists to coordinate the provision of specialty drugs while monitoring laboratory values, physician visits, and most other relevant elements of the patient's therapy. Process management software facilitates the counseling of patients, promotion of adherence, and interventions to resolve clinical, logistic, or pharmacy benefit issues. The integrated EHR affords KP-SP pharmacists advantages for care management that should become available to more health care systems with broadened adoption of EHRs. The KP-SP experience may help to establish models for clinical pharmacy services as health care systems and information systems become more integrated.

  5. Preliminary Efficacy of Group Medical Nutrition Therapy and Motivational Interviewing among Obese African American Women with Type 2 Diabetes: A Pilot Study

    Science.gov (United States)

    Miller, Stephania T.; Oates, Veronica J.; Brooks, Malinda A.; Shintani, Ayumi; Jenkins, Darlene M.

    2014-01-01

    Objective. To assess the efficacy and acceptability of a group medical nutritional therapy (MNT) intervention, using motivational interviewing (MI). Research Design & Method. African American (AA) women with type 2 diabetes (T2D) participated in five, certified diabetes educator/dietitian-facilitated intervention sessions targeting carbohydrate, fat, and fruit/vegetable intake and management. Motivation-based activities centered on exploration of dietary ambivalence and the relationships between diet and personal strengths. Repeated pre- and post-intervention, psychosocial, dietary self-care, and clinical outcomes were collected and analyzed using generalized least squares regression. An acceptability assessment was administered after intervention. Results. Participants (n = 24) were mostly of middle age (mean age 50.8 ± 6.3) with an average BMI of 39 ± 6.5. Compared to a gradual pre-intervention loss of HbA1c control and confidence in choosing restaurant foods, a significant post-intervention improvement in HbA1c (P = 0.03) and a near significant (P = 0.06) increase in confidence in choosing restaurant foods were observed with both returning to pre-intervention levels. 100% reported that they would recommend the study to other AA women with type 2 diabetes. Conclusion. The results support the potential efficacy of a group MNT/MI intervention in improving glycemic control and dietary self-care-related confidence in overweight/obese AA women with type 2 diabetes. PMID:25243082

  6. Preliminary Efficacy of Group Medical Nutrition Therapy and Motivational Interviewing among Obese African American Women with Type 2 Diabetes: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Stephania T. Miller

    2014-01-01

    Full Text Available Objective. To assess the efficacy and acceptability of a group medical nutritional therapy (MNT intervention, using motivational interviewing (MI. Research Design & Method. African American (AA women with type 2 diabetes (T2D participated in five, certified diabetes educator/dietitian-facilitated intervention sessions targeting carbohydrate, fat, and fruit/vegetable intake and management. Motivation-based activities centered on exploration of dietary ambivalence and the relationships between diet and personal strengths. Repeated pre- and post-intervention, psychosocial, dietary self-care, and clinical outcomes were collected and analyzed using generalized least squares regression. An acceptability assessment was administered after intervention. Results. Participants (n = 24 were mostly of middle age (mean age 50.8 ± 6.3 with an average BMI of 39 ± 6.5. Compared to a gradual pre-intervention loss of HbA1c control and confidence in choosing restaurant foods, a significant post-intervention improvement in HbA1c (P = 0.03 and a near significant (P = 0.06 increase in confidence in choosing restaurant foods were observed with both returning to pre-intervention levels. 100% reported that they would recommend the study to other AA women with type 2 diabetes. Conclusion. The results support the potential efficacy of a group MNT/MI intervention in improving glycemic control and dietary self-care-related confidence in overweight/obese AA women with type 2 diabetes.

  7. Factorial validity and reliability of the tamil version of multidimensional scale of perceived social support among a group of participants in University Malaya Medical Centre, Malaysia

    Directory of Open Access Journals (Sweden)

    Ng Chong Guan

    2013-01-01

    Full Text Available Background and Objectives: This study was done to validate the Tamil version of Multidimensional Scale of Perceived Social Support (MSPSS-TV among a group of Indian participants in University Malaya. Materials and Methods: Ninety-four people who took part in this study were given MSPSS-TV, Medical Outcome Study (MOS social support survey, Malay version of Beck Depression Inventory (BDI, Malay version of General Health Questionnaire (GHQ, and English version of MSPSS. After a week, these participants were again required to complete the MSPSS-TV, but with the item sequences shuffled. Results: Internal consistency of this scale was excellent (Cronbach′s alpha = 0.924, and both test-retest reliability (0.71 and parallel form reliability (0.92 were high (Spearman′s rho, P<0.01. MSPSS-TV was negatively correlated with GHQ and BDI. Interpretation and Conclusions: The MSPSS-TV demonstrated sound psychometric properties in gauging the social support among a group of participants. It could therefore be used as a simple screening tool among the young educated Malaysians.

  8. 病案分组讨论教学法在临床心电图带教中的应用%Application of Medical Record Group Discussion Teaching Method in the Clinical Electrocardiogram Teaching

    Institute of Scientific and Technical Information of China (English)

    杨桂花

    2016-01-01

    Objective To study the application of medical record group discussion teaching method in the clinical electro-cardiogram teaching. Methods 200 cases of school students majoring in clinic in 2014 were selected as the research ob-jects, and divided into two groups with 100 cases in each according to the admission number, the traditional group adopted the teaching model mainly in analysis and explanation of class medical record, the discussion group adopted medical record group discussion teaching model, and the final grades and students' evaluation of teaching model of the two groups were observed. Results The operation ability and medical record analysis ability in the traditional group were lower than those in the discussion group and the comparison between groups had statistical significance, P0.05);100名学生对该病案讨论模式的平均肯定率为92.3%。结论在临床心电图教学中应用病案分组讨论方式可增加学生对该学科自主学习意识,提升对心电图的了解与掌握,减少该学科学生期末的挂科率,有效增加临床学生对心电图的全面掌握和对疾病判断思维的培养。

  9. Building a Privacy, Ethics, and Data Access Framework for Real World Computerised Medical Record System Data: A Delphi Study. Contribution of the Primary Health Care Informatics Working Group.

    Science.gov (United States)

    Liyanage, H; Liaw, S-T; Di Iorio, C T; Kuziemsky, C; Schreiber, R; Terry, A L; de Lusignan, S

    2016-11-10

    Privacy, ethics, and data access issues pose significant challenges to the timely delivery of health research. Whilst the fundamental drivers to ensure that data access is ethical and satisfies privacy requirements are similar, they are often dealt with in varying ways by different approval processes. To achieve a consensus across an international panel of health care and informatics professionals on an integrated set of privacy and ethics principles that could accelerate health data access in data-driven health research projects. A three-round consensus development process was used. In round one, we developed a baseline framework for privacy, ethics, and data access based on a review of existing literature in the health, informatics, and policy domains. This was further developed using a two-round Delphi consensus building process involving 20 experts who were members of the International Medical Informatics Association (IMIA) and European Federation of Medical Informatics (EFMI) Primary Health Care Informatics Working Groups. To achieve consensus we required an extended Delphi process. The first round involved feedback on and development of the baseline framework. This consisted of four components: (1) ethical principles, (2) ethical guidance questions, (3) privacy and data access principles, and (4) privacy and data access guidance questions. Round two developed consensus in key areas of the revised framework, allowing the building of a newly, more detailed and descriptive framework. In the final round panel experts expressed their opinions, either as agreements or disagreements, on the ethics and privacy statements of the framework finding some of the previous round disagreements to be surprising in view of established ethical principles. This study develops a framework for an integrated approach to ethics and privacy. Privacy breech risk should not be considered in isolation but instead balanced by potential ethical benefit.

  10. Frequency, duration and predictors of bronchiolitis episodes of care among infants ≥32 weeks gestation in a large integrated healthcare system: a retrospective cohort study

    Science.gov (United States)

    2012-01-01

    Background Bronchiolitis is common in the first two years of life and is the most frequent cause of hospitalization in this age group. No previous studies have used an episode-of-care analysis to describe the frequency, duration, and predictors of bronchiolitis episodes of care during the first two years. Methods We conducted a retrospective cohort study of 123,264 infants ≥32 weeks gestation born at 6 Northern California Kaiser Permanente hospitals between 1996 and 2002. We used electronic medical records to concatenate hospital, emergency department and outpatient health care encounters for bronchiolitis into discrete episodes of care. We used descriptive statistics to report frequency and duration of bronchiolitis episodes and used logistic regression to assess the effect of gestational age and other clinical and demographic predictors on the outcome of bronchiolitis episodes. Results Among all infants, the rate of bronchiolitis episodes was 162 per 1000 children during the first 2 years of life; approximately 40% required >1 day of medical attention with a mean duration of 7.0 ± 5.9 days. Prematurity was associated with increased risk of bronchiolitis episodes and longer duration. Bronchiolitis episodes rates per 1000 infants were 246 for 32–33 weeks gestational age, 204 for 34–36 weeks, and 148–178 for >36 weeks. Male gender, African-American and Hispanic race/ethnicity, and parental history of asthma were associated with an increased risk of having a bronchiolitis episode and/or longer duration. Conclusions Bronchiolitis episodes of care are frequent during the first two years of life and the duration ranges from 1 to 27 days. Prematurity was associated with more frequent and longer duration of bronchiolitis episodes of care, which may reflect illness severity and/or perceived vulnerability. PMID:22682080

  11. Telephone-Based Coaching.

    Science.gov (United States)

    Boccio, Mindy; Sanna, Rashel S; Adams, Sara R; Goler, Nancy C; Brown, Susan D; Neugebauer, Romain S; Ferrara, Assiamira; Wiley, Deanne M; Bellamy, David J; Schmittdiel, Julie A

    2017-03-01

    Many Americans continue to smoke, increasing their risk of disease and premature death. Both telephone-based counseling and in-person tobacco cessation classes may improve access for smokers seeking convenient support to quit. Little research has assessed whether such programs are effective in real-world clinical populations. Retrospective cohort study comparing wellness coaching participants with two groups of controls. Kaiser Permanente Northern California, a large integrated health care delivery system. Two hundred forty-one patients who participated in telephonic tobacco cessation coaching from January 1, 2011, to March 31, 2012, and two control groups: propensity-score-matched controls, and controls who participated in a tobacco cessation class during the same period. Wellness coaching participants received an average of two motivational interviewing-based coaching sessions that engaged the patient, evoked their reason to consider quitting, and helped them establish a quit plan. Self-reported quitting of tobacco and fills of tobacco cessation medications within 12 months of follow-up. Logistic regressions adjusting for age, gender, race/ethnicity, and primary language. After adjusting for confounders, tobacco quit rates were higher among coaching participants vs. matched controls (31% vs. 23%, p Coaching participants and class attendees filled tobacco-cessation prescriptions at a higher rate (47% for both) than matched controls (6%, p coaching was as effective as in-person classes and was associated with higher rates of quitting compared to no treatment. The telephonic modality may increase convenience and scalability for health care systems looking to reduce tobacco use and improve health.

  12. Prevalence, awareness, medication, control, and risk factors associated with hypertension in Yi ethnic group aged 50 years and over in rural China: the Yunnan minority eye study.

    Science.gov (United States)

    Chen, Lixing; Zong, Yuan; Wei, Tao; Sheng, Xun; Shen, Wei; Li, Jun; Niu, Zhiqiang; Zhou, Hua; Zhang, Yang; Yuan, Yuansheng; Chen, Qin; Zhong, Hua

    2015-04-15

    Hypertension is an important public health issue in China, but there are few studies examining hypertension in ethnic groups in Yunnan, China. This study, Yunnan Minority Eye Study (YMES), was initially designed to determine the prevalence and impact of eye diseases, including hypertension and diabetes mellitus. As a part of YMES, the prevalence, awareness, treatment, and control of hypertension and the associated risk factors among the Yi ethnic population in rural China are reported. A population-based survey was conducted in 2012 with adult participants over 50 from rural communities in Shilin Yi Autonomous County, Yunnan Province, located in southwest China. A random cluster sampling method was used to select a representative sample. The participants' blood pressure, height, weight, and waist circumference were measured. Hypertension was defined as mean systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg, and/or current use of antihypertensive medications. A total of 2208 adults were assessed. The prevalence of hypertension was 38.5%, and the age- and gender-adjusted prevalence was 37.0%. The proportion of patients who were aware of their hypertension among those diagnosed with hypertension was 24.8%. Of those aware of having hypertension, 23.6% took antihypertensive drugs. Among all hypertensive patients, only 7.2% had controlled their hypertension (ethnic group in China. The ratio of awareness, treatment, and control of hypertension were considerately low. Hypertension education and screening programs in rural China are recommended to improve the health status of this population.

  13. The Economic and Epidemiological Impact of Focusing Voluntary Medical Male Circumcision for HIV Prevention on Specific Age Groups and Regions in Tanzania

    Science.gov (United States)

    2016-01-01

    Background Since its launch in 2010, the Tanzania National Voluntary Medical Male Circumcision (VMMC) Program has focused efforts on males ages 10–34 in 11 priority regions. Implementers have noted that over 70% of VMMC clients are between the ages of 10 and 19, raising questions about whether additional efforts would be required to recruit men age 20 and above. This analysis uses mathematical modeling to examine the economic and epidemiological consequences of scaling up VMMC among specific age groups and priority regions in Tanzania. Methods and Findings Analyses were conducted using the Decision Makers’ Program Planning Tool Version 2.0 (DMPPT 2.0), a compartmental model implemented in Microsoft Excel 2010. The model was populated with population, mortality, and HIV incidence and prevalence projections from external sources, including outputs from Spectrum/AIDS Impact Module (AIM). A separate DMPPT 2.0 model was created for each of the 11 priority regions. Tanzania can achieve the most immediate impact on HIV incidence by circumcising males ages 20–34. This strategy would also require the fewest VMMCs for each HIV infection averted. Circumcising men ages 10–24 will have the greatest impact on HIV incidence over a 15-year period. The most cost-effective approach (lowest cost per HIV infection averted) targets men ages 15–34. The model shows the VMMC program is cost saving in all 11 priority regions. VMMC program cost-effectiveness varies across regions due to differences in projected HIV incidence, with the most cost-effective programs in Njombe and Iringa. Conclusions The DMPPT 2.0 results reinforce Tanzania’s current VMMC strategy, providing newfound confidence in investing in circumcising adolescents. Tanzanian policy makers and program implementers will continue to focus scale-up of VMMC on men ages 10–34 years, seeking to maximize program impact and cost-effectiveness while acknowledging trends in demand among the younger and older age groups

  14. Medication Use Before Your Operation

    Science.gov (United States)

    ... Surgical Support Groups Recursos en Español (Spanish Resources) Medication Use Before Your Operation Your medications may have ... restart taking these drugs. (See list.) List of medications that affect blood clotting:* Antiplatelet Medication: Anagrelide (Agrylin®), ...

  15. Initial persistence with antihypertensive therapies is associated with depression treatment persistence, but not depression.

    Science.gov (United States)

    Schmittdiel, Julie A; Dyer, Wendy; Uratsu, Connie; Magid, David J; O'Connor, Patrick J; Beck, Arne; Butler, Melissa; Ho, Michael P; Vazquez-Benitez, Gabriela; Adams, Alyce S

    2014-06-01

    The purpose of this study was to examine the relationship between the presence of clinical depression and persistence to drug therapy treatment for depression with early nonpersistence to antihypertensive therapies in a large, diverse cohort of newly treated hypertension patients. Using a hypertension registry at Kaiser Permanente Northern California, the authors conducted a retrospective cohort study of 44,167 adults (18 years and older) with hypertension who were new users of antihypertensive therapy in 2008. We used multivariate logistic regression analysis to model the relationships between the presence of clinical depression and early nonpersistence (defined as failing to refill the first prescription within 90 days after the end of the first fill days' supply) to antihypertensive therapies, controlling for sociodemographic and clinical risk factors. Within the group of 1484 patients who had evidence of clinical depression in the 12 months prior to the initiation of antihypertensive therapy, the authors examined the relationship between drug therapy treatment for depression and 6-month persistence with antidepressant therapy with early nonpersistence with antihypertensive therapies. No association was found between the presence of clinical depression and early nonpersistence to antihypertensive therapies after adjustment for individual demographic and clinical characteristics and neighborhood-level socioeconomic status. However, among the subset of 1484 patients with documented evidence of clinical depression in the 12 months prior to the initiation of antihypertensive therapy, being prescribed and persistence with antidepressant therapy was strongly associated with lower odds of early nonpersistence to antihypertensive medications (odds ratio, 0.64; confidence interval, 0.42-0.96). In an integrated delivery system, the authors found that treatment for depression was associated with higher levels of antihypertensive persistence. Improving quality of depression

  16. Zygomycosis in Europe: analysis of 230 cases accrued by the registry of the European Confederation of Medical Mycology (ECMM) Working Group on Zygomycosis between 2005 and 2007.

    Science.gov (United States)

    Skiada, A; Pagano, L; Groll, A; Zimmerli, S; Dupont, B; Lagrou, K; Lass-Florl, C; Bouza, E; Klimko, N; Gaustad, P; Richardson, M; Hamal, P; Akova, M; Meis, J F; Rodriguez-Tudela, J-L; Roilides, E; Mitrousia-Ziouva, A; Petrikkos, G

    2011-12-01

    Zygomycosis is an important emerging fungal infection, associated with high morbidity and mortality. The Working Group on Zygomycosis of the European Confederation of Medical Mycology (ECMM) prospectively collected cases of proven and probable zygomycosis in 13 European countries occurring between 2005 and 2007. Cases were recorded by a standardized case report form, entered into an electronic database and analysed descriptively and by logistic regression analysis. During the study period, 230 cases fulfilled pre-set criteria for eligibility. The median age of the patients was 50 years (range, 1 month to 87 years); 60% were men. Underlying conditions included haematological malignancies (44%), trauma (15%), haematopoietic stem cell transplantation (9%) and diabetes mellitus (9%). The most common manifestations of zygomycosis were pulmonary (30%), rhinocerebral (27%), soft tissue (26%) and disseminated disease (15%). Diagnosis was made by both histology and culture in 108 cases (44%). Among 172 cases with cultures, Rhizopus spp. (34%), Mucor spp. (19%) and Lichtheimia (formerly Absidia) spp. (19%) were most commonly identified. Thirty-nine per cent of patients received amphotericin B formulations, 7% posaconazole and 21% received both agents; 15% of patients received no antifungal therapy. Total mortality in the entire cohort was 47%. On multivariate analysis, factors associated with survival were trauma as an underlying condition (p 0.019), treatment with amphotericin B (p 0.006) and surgery (p <0.001); factors associated with death were higher age (p 0.005) and the administration of caspofungin prior to diagnosis (p 0.011). In conclusion, zygomycosis remains a highly lethal disease. Administration of amphotericin B and surgery, where feasible, significantly improve survival.

  17. Advanced airway management in combat casualties by medics at the point of injury: a sub-group analysis of the reach study.

    Science.gov (United States)

    Mabry, Robert L; Frankfurt, Alan

    2011-01-01

    background: Optimal airway management protocols for the prehospital battlefield setting have not been defined. Airway management strategies in this environment must take into account the injury patterns, the environment and training requirements of military prehospital providers. This is a post-hoc, sub-group analysis of the Registry of Emergency Airways Arriving at Combat Hospitals or REACH database. This study examines only those patients who had advanced airways placed for trauma by an enlisted military medic at the point of injury. results: Twenty (100%) of the patients had a traumatic injury, 19 (95%) were male, and 13 (65%) had a gun shot wounds (GSWs) as the mechanism of injury. The majority, 12 (60%) patients had an esophageal-tracheal airway device placed. Of the remaining patients, four (20%) underwent endotracheal intubation, three (15%) had a surgical cricothyroidotomy performed, and one (5%) had a Laryngeal Mask Airway (LMA) placed. Seventeen (85%) of the twenty patients were dead on arrival or died shortly after arrival at the Combat Support Hospital (CSH). All of the patients that died had a Glasgow Coma Scale (GCS) of three upon arrival. The Glasgow Coma Scale provides a score in the range 3-15; patients with scores of 3-8 are usually said to be in a coma. Three patients in this group survived to transfer from the CSH. Two of the transfers were lost to follow up, one with a GSW to the head and GCS of three, the other with a GCS of five from injuries sustained in an explosion. The third patient had a surgical cricothyroidotomy (SC) performed in the field for an expanding neck hematoma and recovered fully following surgery. conclusions: Casualties that tolerate invasive airway management without sedation in the context of trauma prognosticates a very high mortality. Airway management algorithms for military providers should reflect the casualties encountered on the battlefield not patients in cardiac arrest which predominate in the civilian EMS airway

  18. Ototoxic Medications (Medication Effects)

    Science.gov (United States)

    ... Information for the Public / Hearing and Balance Ototoxic Medications (Medication Effects) By Barbara Cone, Patricia Dorn, Dawn Konrad- ... Audiology Information Series [PDF]. What Is Ototoxicity? Certain medications can damage the ear, resulting in hearing loss, ...

  19. Papers on medical disputes-induced group events in 2006-2013:A bibliometric analysis%2006-2013年“医闹”类群体性事件研究论文的调查分析

    Institute of Scientific and Technical Information of China (English)

    李娜; 卢青; 戎文慧

    2014-01-01

    Objective To study the countermeasures for preventing medical disputes-induced group events by ana-lyzing the related papers.Methods Distributions of publication years, institutions of authors, and subjects in pa-pers on medical disputes-induced group events in 2006-2013 covered in Wanfang Data Knowledge Service Platform and CNKI were analyzed by bibliometrics.Results A total of 676 papers on medical disputes-induced group events were published in 2006-2013 .Their authors were mainly from medical educational institutions or medical and health institutions.The number of papers on medical tangles, relation between physicians and patients, legal con-struction, reasons for medical disputes was significantly larger than that of those on the "third party"mechanism and medical liability insurance .Conclusion Certain advances have been achieved in study on medical disputes-induced group events.However, there is a room for their improvement, further studies are thus needed.%目的:通过统计分析“医闹”类群体性事件研究论文,探讨“医闹”类群体性事件的防范对策。方法:选用万方数据知识服务平台和CNKI中国知网,采用文献计量方法,对2006-2013年“医闹”类群体性事件研究论文的年代分布、作者所属机构分布、研究主题等进行统计分析。结果:2006-2013年共发表相关研究论文676篇,作者所属机构以医学院校及医疗卫生机构居多,研究内容以医疗纠纷、医患关系、法律建设、“医闹”原因和防范对策居多,研究“第三方”机制和医疗责任保险的论文较少。结论:相关研究取得了一定进展,但尚存在待改进之处。

  20. Participant observation and change of perspectives: medical anthropology and the encounter with socially marginalised groups. First experiences with a new teaching concept.

    Science.gov (United States)

    Mohr, Berit; Hovermann, Peter; Roelcke, Volker

    2012-01-01

    This paper examines the new teaching concept "Providing medical care on the fringe of society: Participant observation and change in perspectives" in the context of the interdisciplinary field of Querschnittsbereich 2/Q 2 (the transdisciplinary section under AOÄ, the German Regulations for licensed physicians) that explores the history, theory and ethics of medicine. The disciplinary approach usually adopted in Q 2 is supplemented with concepts from medical anthropology; in addition students will be exposed to people in extreme social situations. The aim is to make students aware of and invite them to reflect upon: the importance of participant observation in the specific on-site setting of medical thinking and acting; the importance of the subjectivity of all those involved in doctor/patient interaction; and the fact that key medical terms (such as the "need" as seen by the physician vs. the need as seen by the patient) are essentially context-dependent in their interpretation. At a more general level students will learn how to put themselves in the position of different protagonists in a range of medical settings, and practice the skill of reflecting critically upon putative conceptual/theoretical and normative-ethical assumptions in medicine.

  1. An Application Study on the Cognitive-Behavioral Group Therapy in Medical Students with Social Anxiety%认知行为团体疗法在社交焦虑医学生中的应用研究

    Institute of Scientific and Technical Information of China (English)

    黄爱华; 张乃正; 李磊; 王娟丽

    2016-01-01

    目的:探讨认知行为团体疗法对改善医学生社交焦虑的效果,以期改善医学生社交沟通能力。方法根据纳入排除标准对某校三年制高职存在社交焦虑医学生随机分为实验组、对照组,对照组常规参加学校心理健康教育,实验组在此基础上采用认知行为团体疗法进行干预。运用交往焦虑量表( IAS)、惧怕否定量表( FNE)、社交回避与困扰量表( SAD)对干预前、后社交焦虑医学生认知、情绪、行为水平进行测量,评价干预效果。结果干预后实验组医学生社交焦虑认知、情绪、行为三方面水平均较对照组有显著改善(P<0.05)。结论认知行为团体疗法能够有效改善医学生社交焦虑水平。%Objective:To explore the effects of cognitive-behavioral group therapy on relieving social anxiety of medical students and thus improve the communication ability of medical students. Methods: The medical students with social anxiety in our school were randomly divided into two groups. The subjects in the control group and the experiment group were given with the routine mental health education and the cognitive-behavioral group therapy respectively. The cognitive, emotional, and behavioral levels were measured before and after intervention using Interaction Anxious-ness Scale ( IAS ) , Fear of Negative Evaluation Scale ( FNE ) , Social Avoidance and Distress Scale ( SAD) , and in order to evaluate the effects of cognitive-behavioral group therapy. Results:After the intervention of cognitive-behavioral group therapy in medical students, all the three levels of anxiety were im-proved significantly in the experimental group than those in the control group ( P<0 . 05 ) . Conclusion:Cognitive-behavioral group therapy could effectively decrease the level of social anxiety for medical students.

  2. Several Suggestions about the Construction of the Group of Medical Engineering%对医学工程技术队伍建设的几点建议

    Institute of Scientific and Technical Information of China (English)

    毛英军; 谢立旗; 王明刚

    2012-01-01

    本文通过对部队和地方12所三级甲等医院医学工程部门的人员编制、业务工作等情况的调研,就如何加强医学工程技术队伍建设、促进医疗设备质量安全控制工作、提高保障能力提出 几点建议.%After researching the circumstances of dept of medical equipment about the staff and the scope of business from 12 tertiary A class hospital in recent years. There are some suggestions about how to wind the level of the medical engineering team, promoting the control of medical equipment quality and safety and improving security ability.

  3. An adapted, four-week mind-body skills group for medical students: reducing stress, increasing mindfulness, and enhancing self-care.

    Science.gov (United States)

    Greeson, Jeffrey M; Toohey, Michael J; Pearce, Michelle J

    2015-01-01

    Despite the well-known stress of medical school, including adverse consequences for mental and behavioral health, there is little consensus about how to best intervene in a way that accommodates students׳ intense training demands, interest in science, and desire to avoid being stigmatized. The objective of this study, therefore, was to evaluate the feasibility, acceptability, and initial effectiveness of an adapted, four-week stress management and self-care workshop for medical students, which was based on the science and practice of mind-body medicine. The current study used a prospective, observational, and mixed methods design, with pretest and posttest evaluations. Participants (n = 44) included medical and physician-scientist (MD/PhD) students from a large, southeastern medical school. Feasibility was assessed by rates of workshop enrollment and completion. Acceptability was assessed using qualitative ratings and open-ended responses that queried perceived value of the workshop. Quantitative outcomes included students׳ ratings of stress and mindfulness using validated self-report surveys. Enrollment progressively increased from 6 to 15 to 23 students per workshop in 2007, 2009, and 2011, respectively. Of the 44 enrolled students, 36 (82%) completed the workshop, indicating that the four-session extracurricular format was feasible for most students. Students reported that the workshop was acceptable, stating that it helped them cope more skillfully with the stress and emotional challenges of medical school, and helped increase self-care behaviors, such as exercise, sleep, and engaging in social support. Students also reported a 32% decrease in perceived stress (P stress and mindfulness were significantly correlated (r = -0.42; P = .01). Together, these findings suggest that a brief, voluntary mind-body skills workshop specifically adapted for medical students is feasible, acceptable, and effective for reducing stress, increasing mindfulness, and enhancing

  4. Students' perceptions about the transition to the clinical phase of a medical curriculum with preclinical patient contacts; a focus group study

    NARCIS (Netherlands)

    Godefrooij, Merijn B; Diemers, Agnes D; Scherpbier, Albert J J A

    2010-01-01

    BACKGROUND: Studies have shown that medical students experience the transition between preclinical and clinical training as a stressful period. They are generally frustrated by their inability to apply their knowledge to solve clinical problems in practice. Preclinical patient contacts may offer a s

  5. Turkish Medical Information System and Medical Librarianship

    Directory of Open Access Journals (Sweden)

    Huriye Çolaklar

    2010-01-01

    Full Text Available In Turkey, medical information is supported at state level according to national policies. However, although the history of medical libraries in Turkey goes back to the 13th century in Anatolia, modern medical library applications adopted since the 1950s have not received much state support. In the past thirteen years a few medical libraries joined forces under ÜNAK (the Association of University and Research Librarians to contribute to the organization and development of Turkish Medical Information through the establishment of a "Medical Working Group" in 2000.

  6. Screening Tool for Older Persons' Appropriate Prescriptions for Japanese: Report of the Japan Geriatrics Society Working Group on "Guidelines for medical treatment and its safety in the elderly".

    Science.gov (United States)

    Kojima, Taro; Mizukami, Katsuyoshi; Tomita, Naoki; Arai, Hiroyuki; Ohrui, Takashi; Eto, Masato; Takeya, Yasushi; Isaka, Yoshitaka; Rakugi, Hiromi; Sudo, Noriko; Arai, Hidenori; Aoki, Hiroaki; Horie, Shigeo; Ishii, Shinya; Iwasaki, Koh; Takayama, Shin; Suzuki, Yusuke; Matsui, Toshifumi; Mizokami, Fumihiro; Furuta, Katsunori; Toba, Kenji; Akishita, Masahiro

    2016-09-01

    In 2005, the Japan Geriatrics Society published a list of potentially inappropriate medication that was an extract from the "Guidelines for medical treatment and its safety in the elderly 2005." The 2005 guidelines are due for a revision, and a new comprehensive list of potentially inappropriate medications is required. A total of 15 diseases, conditions and special areas related to their clinical care were selected. We originated clinical questions and keywords for these 15 areas, carried out a systematic review using these search criteria, and formulated guidelines applying the Grading of Recommendations Assessment, Development and Evaluation system advocated by Minds2014. If we did not find good evidence despite the drug being clinically important, we looked for evidence of efficacy and for disease-specific guidelines, and incorporated them into our guidelines. We selected 2098 articles (140 articles per area), and extracted another 186 articles through a manual search. We further added guidelines based on disease entity and made two lists, one of "drugs to be prescribed with special caution" and the other of "drugs to consider starting," primarily considering individuals aged 75 years or older or those who are frail or in need of special care. New lists of potentially inappropriate medications and potential prescribing omissions called "Screening Tool for Older Person's Appropriate Prescriptions for Japanese" were constructed. We anticipate that future studies will highlight more evidence regarding the safety of high-quality drugs, further improving the provision of appropriate medical care for the elderly. Geriatr Gerontol Int 2016: 16: 983-1001. © 2016 Japan Geriatrics Society.

  7. Experiences, attitudes and possibilities for improvement concerning the cooperation between occupational physicians, rehabilitation physicians and general practitioners in Germany from the perspectives of the medical groups and rehabilitation patients - a protocol for a qualitative study.

    Science.gov (United States)

    Voelter-Mahlknecht, Susanne; Stratil, Jan M; Kaluscha, Rainer; Krischak, Gert; Rieger, Monika A

    2017-04-26

    Rehabilitation measures for patients in the working age primarily aim at maintaining employability, restoring fitness for work or timely return to work (RTW). To facilitate RTW after long sick leave in Germany, both rehabilitation physicians' knowledge about the patients' workplace and communication between the rehabilitation physician and the occupational physician need to be improved. This research will record the experiences and attitudes of occupational physicians, rehabilitation physicians and general practitioners, as well as of rehabilitation patients, to indicate barriers and possibilities for improvement concerning the intersection between workplace and rehabilitation institution. As a previous literature review has shown, insufficient data on the experiences and attitudes of the stakeholders are available. Therefore, an exploratory qualitative approach was chosen. 8 focus group discussions will be conducted with occupational physicians, rehabilitation physicians, general practitioners and rehabilitation patients (2 focus groups with 6-8 interviewees per category). Qualitative content analysis will be used to evaluate the data, thus describing positive and negative experiences and attitudes, barriers and possibilities for improvement at the intersection of general and occupational medicine and rehabilitation with regard to the workplace. The data from the focus groups will be used to develop a standardised quantitative questionnaire for a survey of the medical groups and rehabilitation patients in a follow-up project. The research will be undertaken with the approval of the Ethics Committee of the Medical Faculty and University Hospital of Tuebingen. The study participants' consent will be documented in written form. The names of all study participants and all other confidential information data fall under medical confidentiality. The results will be published in a peer-reviewed medical journal independent of the nature of the results. Published by the BMJ

  8. “I Want to Keep the Personal Relationship With My Doctor”: Understanding Barriers to Portal Use among African Americans and Latinos

    Science.gov (United States)

    Allen, Jill Y; Poole, Dolly; Tieu, Lina; Kanter, Michael H; Garrido, Terhilda

    2016-01-01

    Background Despite the widespread implementation of electronic health records (EHRs), there is growing evidence that racial/ethnic minority patients do not use portals as frequently as non-Hispanic whites to access their EHR information online. This differential portal use could be problematic for health care disparities since early evidence links portal use to better outcomes. Objective We sought to understand specific barriers to portal use among African American and Latino patients at Kaiser Permanente, which has had a portal in place for over a decade, and broad uptake among the patient population at large. Methods We conducted 10 focus groups with 87 participants in 2012 and 2013 among African American and Latino Kaiser Permanente members in the mid-Atlantic, Georgia, and Southern California regions. Members were eligible to participate if they were not registered for portal access. Focus groups were conducted within each racial/ethnic group, and each included individuals who were older, had a chronic disease, or were parents (as these are the three biggest users of the portal at Kaiser Permanente overall). We videotaped each focus group and transcribed the discussion for analysis. We used general inductive coding to develop themes for major barriers to portal use, overall and separately by racial/ethnic group. Results We found that lack of support was a key barrier to initiating portal use in our sample—both in terms of technical assistance as well as the fear of the portal eroding existing personal relationships with health care providers. This held true across a range of focus groups representing a mix of age, income, health conditions, and geographic regions. Conclusions Our study was among the first qualitative explorations of barriers to portal use among racial/ethnic subgroups. Our findings suggest that uniform adoption of portal use across diverse patient groups requires more usable and personalized websites, which may be particularly important for

  9. Incidence of anemia in patients diagnosed with solid tumors receiving chemotherapy, 2010–2013

    Directory of Open Access Journals (Sweden)

    Xu H

    2016-04-01

    Full Text Available Hairong Xu,1 Lanfang Xu,2 John H Page,1 Kim Cannavale,2 Olivia Sattayapiwat,2 Roberto Rodriguez,3 Chun Chao2 1Center for Observational Research, Amgen Inc., Thousand Oaks, CA, USA; 2Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA; 3Department of Hematology Oncology, Los Angeles Medical Center, Kaiser Permanente Southern California, Psadena, CA, USA Purpose: The purpose of this study was to evaluate and characterize the risk of anemia during the course of chemotherapy among patients with five common types of solid tumors. Patients and methods: Patients diagnosed with incident cancers of breast, lung, colon/rectum, stomach, and ovary who received chemotherapy were identified from Kaiser Permanente Southern California Health Plan (2010–2012. All clinical data were collected from the health plan’s electronic medical records. Incidence proportions of patients developing anemia and 95% confidence intervals were calculated overall and by anemia severity and type, as well as by stage at cancer diagnosis, and by chemotherapy regimen and cycle. Results: A total of 4,426 patients who received chemotherapy were included. Across cancers, 3,962 (89.5% patients developed anemia during the course of chemotherapy (normocytic 85%, macrocytic 10%, microcytic 5%; normochromic 47%, hyperchromic 44%, hypochromic 9%. The anemia grades were distributed as follows: 58% were grade 1, 34% grade 2, 8% grade 3, and <1% grade 4. The incidence of grade 2+ anemia ranged from 26.3% in colorectal cancer patients to 59.2% in ovarian cancer patients. Incidence of grade 2+ anemia increased from 29% in stage I to 49% in stage IV. Incidence of grade 2+ anemia varied from 18.2% in breast cancer patients treated with cyclophosphamide + docetaxel regimen to 59.7% in patients with ovarian cancer receiving carboplatin + paclitaxel regimen. Conclusion: The incidence of moderate-to-severe anemia (hemoglobin <10 g/dL remained considerably

  10. Postcataract endophthalmitis prophylaxis using irrigation, incision hydration, and eye pressurization with vancomycin

    Directory of Open Access Journals (Sweden)

    Schelonka LP

    2015-07-01

    Full Text Available Lee P Schelonka,1 Margaret A SaBell2 1Department of Opthalmology, Kaiser Permanente Lone Tree Medical Offices, Lone Tree, 2Department of Infection Control, Kaiser Permanente Lone Tree Medical Offices, Lone Tree, Denver, CO, USA Purpose: This study aimed to determine whether switching from balanced salt solution (BSS to vancomycin 20 g/mL BSS for incision hydration and eye pressurization reduces the rate of postcataract endophthalmitis.Methods: This was a patient safety/quality improvement project, including all patients undergoing cataract surgery at the Kaiser Permanente Colorado Ophthalmology Department from January 2002 to December 2014. Throughout the study, patients received vancomycin 20 µg/mL in the irrigating solution. During the baseline period from 2002 to 2005, surgeons pressurized eyes and hydrated incisions with plain BSS. During the intervention period from 2006 through 2014, surgeons switched from BSS to the vancomycin/BSS irrigating solution for eye pressurization and incision hydration.Results: A total of 57,263 cataract operations were performed by 24 surgeons at seven surgical centers: 12,400 in the baseline period and 44,863 in the intervention period. The rate of postcataract endophthalmitis declined significantly from 5/12,400 (rate: 0.4/1,000 in the baseline period to 1/44,863 (rate: 0.022/1,000 during the intervention period (odds ratio [OR]: 18.1, 95% confidence interval [CI]: 2.11–154.9; χ2=13.5, P=0.00024. Accounting for an estimated 2.05-fold risk reduction due to confounding variables, the risk reduction attributed to the intervention remained significant: (adjusted OR: 8.78, 95% CI: 1.73–44.5; χ2=10.06, P=0.0015. Since 2009, we have not experienced any cases of postcataract endophthalmitis after 32,753 operations.Conclusion: We experienced a significant reduction in postcataract endophthalmitis when we switched from BSS to the vancomycin/BSS irrigating solution for incision hydration and eye pressurization

  11. Applied group theory applications in the engineering (physical, chemical, and medical), biological, social, and behavioral sciences and in the fine arts

    Science.gov (United States)

    Borg, S. F.

    1976-01-01

    A generalized applied group theory is developed, and it is shown that phenomena from a number of diverse disciplines may be included under the umbrella of a single theoretical formulation based upon the concept of a group consistent with the usual definition of this term.

  12. Classification of A Medically Important Group of Gamasid Mites by Numerical Taxonomy in Yunnan, China%云南医学革螨数值分类研究

    Institute of Scientific and Technical Information of China (English)

    罗礼溥; 郭宪国

    2007-01-01

    Objective To determine the taxonomic position of medically important gamasid mites and to compare numerical taxonomy with the traditional systematics in the classification of gamasid mites. Methods Based on hierarchical cluster analysis, numerical taxonomy was applied to study fifty-seven species of medically important gamasid mites. Results The results of cluster analysis based on squared euclidean distance showed that Hirstionyssus Fonseca and Echinonyssus Hirst should be separated from Laelapidae Berlese and formed an independent family. The taxonomic position of the remaining species remains the same as those in the traditional systematics. Conclusion Numerical taxonomy can objectively reflect the taxonomic position of the medically important gamasid mites. The result of classification by numerical taxonomy is consistent with traditional systematics for gamasid mites.%目的 以云南省57种医学革螨作为分类单元,以形态特征为主列出60项分类性状特征来探讨云南省医学革螨不同属和种的亲缘关系.方法 运用SPSS 11.5统计软件中的系统聚类分析,对57种医学革螨进行数值分类.结果 赫刺螨属和棘刺螨属单独从厉螨科中分离出来,其余种类的分类结果与传统的分类结果一致.结论 数值分类能比较客观地反映医学革螨各分类阶元的分类地位与亲缘关系,分类结果与传统形态分类结果基本一致.

  13. Contents and features of forming students' culture of health of special medical group in the process of theoretical preparation on physical education.

    Directory of Open Access Journals (Sweden)

    Gribok N.N.

    2010-12-01

    Full Text Available The problem of forming valued attitude is considered toward own health for students with the presence of diseases. New vision of maintenance of theoretical preparation is found on physical education of students at which rejections are marked in a state of health. An experimental on-line tutorial is offered, on the basis of analysis of the existent program, on physical education for the students of task medical force. It is set that the offered on-line tutorial is directed not only on liquidation of diseases but also on forming, strengthening and maintenance of own health in spiritual, psychical and physical aspects.

  14. The HIV Care Cascade Measured Over Time and by Age, Sex, and Race in a Large National Integrated Care System.

    Science.gov (United States)

    Horberg, Michael Alan; Hurley, Leo Bartemeier; Klein, Daniel Benjamin; Towner, William James; Kadlecik, Peter; Antoniskis, Diana; Mogyoros, Miguel; Brachman, Philip Sigmund; Remmers, Carol Louise; Gambatese, Rebecca Claire; Blank, Jackie; Ellis, Courtney Georgiana; Silverberg, Michael Jonah

    2015-11-01

    HIV care cascades can evaluate programmatic success over time. However, methodologies for estimating cascade stages vary, and few have evaluated differences by demographic subgroups. We examined cascade performance over time and by age, sex, and race/ethnicity in Kaiser Permanente, providing HIV care in eight US states and Washington, DC. We created cascades for HIV+ members' age ≥13 for 2010-2012. We measured "linkage" (a visit/CD4 within 90 days of being diagnosed for new patients; ≥1 medical visit/year if established); "retention" (≥2 medical visits ≥60 days apart); filled ART (filled ≥3 months of combination ART); and viral suppression (HIV RNA age, and race/ethnicity. We found men had statistically (p age was associated (p care results improved over time, but significant differences exist by patient demographics. Specifically, retention efforts should be targeted toward younger patients and blacks; women, blacks, and Latinos require greater ART prescribing.

  15. Analyse of the Medical Students, Coping Style Among anger - out Group and Anger - in Group%医学生愤怒、郁怒情绪与特质应对方式的相关性研究

    Institute of Scientific and Technical Information of China (English)

    张锡凤; 陶海燕; 乔明琦; 张惠云

    2011-01-01

    Objective:To supply the theory support of the psychological mechanism of anger in TCM, we carryed out the research about coping style of people which were anger - in or anger - out. Methods: The students were differentiated by STAXI - 2,and were assessed by Trait Coping Style Questionnaire(TCSQ). The data was analysed by SPSS 13.0. Results: There were significant difference on negative coping style among anger - out group and normal group ( P < 0. 001 ), and as well as both negative coping stycle and positive coping style among anger - in group and normal group, and anger - in group and anger - out group ( P <0.001 ). Conclusion :The anger - in group has more tendency than anger - out group in the negative coping stycle ,and we also researched the correlations about disease of anger on the side of coping style.%目的:分析愤怒、郁怒人群特质应对方式的相关性研究,为探讨怒产生及诱发情志病证的心理机制提供理论支持.方法:以状态一特质怒表达量表(STAXI-2)作为筛选工具,区分出愤怒、郁怒人群,使用特质应对方式问卷(TCSQ)对学生人群进行调查分析,采用SPSS 13.0对数据进行统计分析.结果:愤怒组与正常组在消极应对方面存在显著性差异(P<0.001),郁怒组与愤怒组、正常组在消极应对、积极应对方面均存在显著性差异(P<0.001).结论:愤怒、郁怒人群均倾向于采取消极应对方式处理问题,且郁怒人群的倾向性更大,进一步揭示了怒致病与应对方式的相关性,为中医情志病因学研究增添新的手段和方法.

  16. How does the quality of life and the underlying biochemical indicators correlate with the performance in academic examinations in a group of medical students of Sri Lanka?

    Directory of Open Access Journals (Sweden)

    Manjula Hettiarachchi

    2014-02-01

    Full Text Available Background: Individual variation of examination performance depends on many modifiable and non-modifiable factors, including pre-examination anxiety. Medical students’ quality of life (QoL and certain biochemical changes occurring while they are preparing for examinations has not been explored. Purpose: We hypothesize that these parameters would determine the examination performance among medical students. Methods: Fourth-year medical students (n=78 from the University of Ruhuna, Sri Lanka, were invited. Their pre- and post-exam status of QoL, using the World Health Organization Quality of Life (WHOQOL-BREF questionnaire, and the level of biochemical marker levels (i.e., serum levels of thyroid profile including thyroglobulin, cortisol and ferritin were assessed. Differences between the scores of QoL and serum parameters were compared with their performance at the examination. Results: The mean QoL score was significantly lower at pre-exam (56.19±8.1 when compared with post-exam (61.7±7.1 levels (p<0.001. The median serum TSH level prior to the exam (0.9 mIU/L; interquartile range 0.74–1.4 mIU/L was significantly lower (p=0.001 when compared with the level after the exam (median of 2.7 mIU/L; IQR 1.90–3.60. The mean±SD fT4 level was significantly higher before the exam (19.48±0.4 pmol/L at study entry vs. 17.43±0.3 pmol/L after the exam; p<0.001. Median serum ferritin (SF level prior to the exam (43.15 (23.5–63.3 µg/L was significantly lower (p≤0.001 when compared with after-exam status (72.36 (49.9–94.9 µg/L. However, there was no difference in mean serum cortisol levels (16.51±0.7 at pre-exam and 15.88±0.7 at post-exam, respectively; p=0.41. Conclusions: Students had higher fT4 and low ferritin levels on pre-exam biochemical assessment. It was evident that students who perform better at the examination had significantly higher QoL scores at each domain tested through the questionnaire (Physical health, Psychological

  17. Situation of young radiation oncologists, medical physicists and radiation biologists in German-speaking countries : Results from a web-based survey of the Young DEGRO working group.

    Science.gov (United States)

    Krug, David; Baumann, Rene; Rieckmann, Thorsten; Fokas, Emmanouil; Gauer, Tobias; Niyazi, Maximilian

    2016-08-01

    The working group "Young DEGRO" (yDEGRO) was established in 2014 by the German Society of Radiation Oncology (DEGRO). We aimed to assess the current situation of young radiation oncologists, medical physicists and radiation biologists. An online survey that included 52 questions or statements was designed to evaluate topics related to training, clinical duties and research opportunities. Using the electronic mailing list of the DEGRO and contact persons at university hospitals in Germany as well as at four hospitals in Switzerland and Austria, young professionals employed in the field of radiation oncology were invited to participate in the survey. A total of 260 responses were eligible for analysis. Of the respondents 69 % had a professional background in medicine, 23 % in medical physics and 9 % in radiation biology. Median age was 33 years. There was a strong interest in research among the participants; however a clear separation between research, teaching and routine clinical duties was rarely present for radiation oncologists and medical physicists. Likewise, allocated time for research and teaching during regular working hours was often not available. For radiation biologists, a lack of training in clinical and translational research was stated. This survey details the current state of education and research opportunities in young radiation oncologists, medical physicists and radiation biologists. These results will form the basis for the future working program of the yDEGRO.

  18. Epidemiologic assessment of mortality, building collapse pattern, and medical response after the 1992 earthquake in Turkey. Disaster Reanimatology Study Group (DRSG).

    Science.gov (United States)

    Angus, D C; Pretto, E A; Abrams, J I; Ceciliano, N; Watoh, Y; Kirimli, B; Certug, A; Comfort, L K

    1997-01-01

    Post-earthquake engineering and epidemiologic assessments are important for the development of injury prevention strategies. This paper describes mortality and its relationship to building collapse patterns and initial medical responses following the 1992 earthquake in Erzincan, Turkey. The study consisted of: 1) background data collection and review; 2) design and implementation of a field survey; and 3) site inspection of building collapse patterns. The survey included: 1) national (n = 11) and local (n = 17) officials; 2) medical and search and rescue (SAR) workers (n = 38); and 3) a geographically stratified random sample of lay survivors (n = 105). The survey instruments were designed to gather information regarding location, injuries, initial actions and prior training of survivors and responders, and the location, injuries, and management of dead and dying victims. A case-control design was constructed to assess the relationship between mortality, location, and building collapse pattern. There was extensive structural damage throughout the region, especially in the city where mid-rise, unreinforced masonry buildings (MUMBs) incorporating a "soft" first floor design (large store windows for commercial use) and one story adobe structures were most vulnerable to collapse. Of 526 people who died in the city, 87% (n = 456) were indoors at the time of the earthquake. Of these, 92% (n = 418) died in MUMBs. Of 54 witnessed deaths, 55% (n = 28) of victims died slowly, the majority of whom (n = 26) were pinned or trapped (p building type is inappropriate for areas of seismic risk. The vulnerability of MUMBs appears due to a lack of lateral force resistance as a result of the use of glass store front windows and the absence of shear walls. The prevalence of this building type in earthquake-prone regions needs to be investigated further. A large portion of victims dying in an earthquake die slowly at the scene of injury. Prior public first-aid and rescue training

  19. Medical Physics Data Book,

    Science.gov (United States)

    The Medical Physics Data Book is a collection of physical and chemical data useful in medical physics . The information has been extracted from other...ionizing Radiation. Carried out by the Medical Physics Data Group of the American Association of Physicists in Medicine, this compilation is meant to

  20. The feasibility of determining the effectiveness and cost-effectiveness of medication organisation devices compared with usual care for older people in a community setting: systematic review, stakeholder focus groups and feasibility randomised controlled trial.

    Science.gov (United States)

    Bhattacharya, Debi; Aldus, Clare F; Barton, Garry; Bond, Christine M; Boonyaprapa, Sathon; Charles, Ian S; Fleetcroft, Robert; Holland, Richard; Jerosch-Herold, Christina; Salter, Charlotte; Shepstone, Lee; Walton, Christine; Watson, Steve; Wright, David J

    2016-07-01

    Medication organisation devices (MODs) provide compartments for a patient's medication to be organised into the days of the week and the recommended times the medication should be taken. To define the optimal trial design for testing the clinical effectiveness and cost-effectiveness of MODs. The feasibility study comprised a systematic review and focus groups to inform a randomised controlled trial (RCT) design. The resulting features were tested on a small scale, using a 2 × 2 factorial design to compare MODs with usual packaging and to compare weekly with monthly supply. The study design was then evaluated. Potential participants were identified by medical practices. Aged over 75 years, prescribed at least three solid oral dosage form medications, unintentionally non-adherent and self-medicating. Participants were excluded if deemed by their health-care team to be unsuitable. One of three MODs widely used in routine clinical practice supplied either weekly or monthly. To identify the most effective method of participant recruitment, to estimate the prevalence of intentional and unintentional non-adherence in an older population, to provide a point estimate of the effect size of MODs relative to usual care and to determine the feasibility and acceptability of trial participation. The systematic review included MOD studies of any design reporting medication adherence, health and social outcomes, resource utilisation or dispensing or administration errors. Focus groups with patients, carers and health-care professionals supplemented the systematic review to inform the RCT design. The resulting design was implemented and then evaluated through questionnaires and group discussions with participants and health-care professionals involved in trial delivery. Studies on MODs are largely of poor quality. The relationship between adherence and health outcomes is unclear. Of the limited studies reporting health outcomes, some reported a positive relationship while some

  1. Research on the Balint groups to improve medical staff occupational stress and burnout aspects%巴林特小组改善医护人员职业压力与职业倦怠

    Institute of Scientific and Technical Information of China (English)

    高新义

    2016-01-01

    目的::探讨巴林特小组在改善医护人员职业压力和职业倦怠方面的效果,降低医护人员负性情绪体验,有效预防医护人员职业倦怠。方法:选取潍坊市某中医院124名医护人员,采用知觉压力量表(CPSS)、职业倦怠量表(MBI-HSS)、正性负性情绪量表(PANAS),选取量表高分端的27%中的20人为研究对象,随机划分成10人的实验组,进行为期3个月的巴林特小组干预,10人的对照组,无任何干预,在干预前后分别对实验组和对照组进行测量。结果:实验组被试在 CPSS 总分、紧张感、失控感、MBI- HSS 总分、情绪疲惫感、工作冷漠感、负性情绪水平维度上后测得分低于前测,差异有统计学意义(t =4.58,4.58,3.58,4.92,5.60,3.34,8.17;P 0.05)。结论:巴林特小组可以改善医护人员职业压力和职业倦怠。%Objective:To investigate the effect of Balint groups to improve of medical staff occupational stress and job burnout,and then to reduce the negative emotional experience and prevent the job burnout of medical staffs effec-tively.Methods:124 medical staffs from traditional Chinese medical hospital of Linqu were enrolled in this study,u-sing Perceived Stress Scale,Maslach Burnout Inventory,The Positive and Negative Affect Scale to investigate the status.20 people of high scores on PSS,MBI,NA were selected,divided 10 of them into Balint group in random ways and then trained for three months;10 medical staff were divided into control group without any intervention.Both ex-perimental group and control group were asked to complete all the scales before and after the intervention.Results:In scores on CPSS,sense of tension,sense of out of control,MBI- HSS,emotion exhaustion,job burnout,negative af-fect,the experimental group were significantly lower than before(t = 4.58,4.58,3.58,4.92,5.60,3.34,8.1 7;P 0.05).Conclusion:Balint groups can improve occupation-al stress and job burnout of medical staff.

  2. The Practice Exploration of Medical Quality Safety Management and Hospital Patient Relationship Academic Groups in the Prevention of Medical Disputes%医疗质量安全管理与医患关系学组在防范医疗纠纷中的实践探讨

    Institute of Scientific and Technical Information of China (English)

    杨丽娜; 濮永杰; 何剑

    2015-01-01

    To analyze the typical performance of medical institutions such as poor management,against rules,technology deficiency,insufficient condition and weak responsibility feeling according to the basic situation of medical accidents authentication in Sichuan province in 2014.Aimed at establishing a medical dispute and quality safety event reporting system,we focused on improving medical treatment quality,ensuring medical safety, preventing medical quality safety incidents,strengthening the doctor-patient communication both doctors and patients in accordance with the law,which would guide the orderly settlement of medical disputes platform work objectives as well as provide policy decision basis for administrative departments of health.We should strengthen the doctor-patient communication ability training in each grade of medical institutions,and explore the practice of medical quality hospital patient relationship academic groups in the prevention of medical disputes.%根据2014年度四川省医疗事故技术鉴定的基本情况,分析医疗机构存在管理不严、违反制度、技术欠缺、条件不够、责任心不强等典型表现,并从有利于搭建围绕提高医疗质量、保障医疗安全、防范医疗质量安全事件、加强医患沟通、引导医患双方依法有序解决医疗纠纷平台的工作目标和为卫生行政主管部门提供政策决策依据,建立医患纠纷和质量安全事件上报体系,加强各级医疗机构的医患沟通能力培训,探讨医疗质量安全管理与医患关系学组在防范医疗纠纷中的实践。

  3. Physical development and physical preparedness of students of special medical group with the disease of vegetative-vascular dystonia of mixed type

    Directory of Open Access Journals (Sweden)

    Olchovik A. V.

    2015-03-01

    Full Text Available Purpose : theoretically and experimentally substantiate the effect of the author's physical rehabilitation program to the level of physical development and physical fitness of students. Material : the study involved 40 students. Conducted teacher testing: sprinting, flexion and extension arms in emphasis lying on the floor, the rise in the saddle for 1 min., long jump from their seats, jump up from their seats, shuttle run (4 x 9 meters, torso forward from position sitting. Results : author's physical rehabilitation program includes physiotherapy, therapeutic massage, aqua gym, fitball gymnastics, acupressure and health food. The educational process is aimed at: the normalization of blood pressure and heart rate; balance of excitation and inhibition in the central nervous system; reducing the number of relapses; prevention of complications and hardening of the body; increase the level of physical fitness and health; acquire the necessary professional for students of applied skills. At the workshops, special attention is paid to the medical control, self-control and physical exercise techniques, taking into account contraindications. General and professionally applied physical preparation is carried out taking into account the features of students. Conclusions : It is recommended to attract students to self-realization of physical rehabilitation at home.

  4. Implantable electronic medical devices

    CERN Document Server

    Fitzpatrick, Dennis

    2014-01-01

    Implantable Electronic Medical Devices provides a thorough review of the application of implantable devices, illustrating the techniques currently being used together with overviews of the latest commercially available medical devices. This book provides an overview of the design of medical devices and is a reference on existing medical devices. The book groups devices with similar functionality into distinct chapters, looking at the latest design ideas and techniques in each area, including retinal implants, glucose biosensors, cochlear implants, pacemakers, electrical stimulation t

  5. Feasibility and short-term impact of the "case study in-house group training program for family nursing" at medical facilities.

    Science.gov (United States)

    Yamazaki, Akemi; Tsumura, Akemi; Mine, Hiroko; Kimura, Chisato; Soeda, Akemi; Odatsu, Kazumi; Kiwado, Wataru

    2017-02-01

    The aim of this study was to evaluate the feasibility and short-term impact of case study training in family nursing care targeting midlevel nursing professionals. The intervention group participated in four 90-minute case study training sessions over 6 months, while the control group participated in two 90-minute lectures. Using primary outcome variables as evaluation indexes, we measured the participants' total scores on the Family Importance in Nursing Care Scale and 4 subitems 3 times (before, immediately after and 1 month after training) from May 2014 to March 2015 and then conducted 2-way repeated-measure analysis of variance. We asked the participants and training planners/managers to provide feedback on their evaluation and then performed content analysis on their responses. Although the primary impact due to the different measurement times was significant, no significant difference was observed in the interaction between measurement time and training differences. Of the 4 subitems, significant interactions because of measurement time and training differences were observed only in Fam-B. Feedback data showed all participants felt that their understanding of the importance of family nursing care was strengthened, and participants in the intervention group specifically described how they were utilizing what they had learned from training in practice.

  6. Population Effects of Influenza A(H1N1) Pandemic among Health Plan Members, San Diego, California, USA, October-December 2009.

    Science.gov (United States)

    Bitar, Roger A

    2016-02-01

    Lacking population-specific data, activity of seasonal and pandemic influenza is usually tracked by counting the number of diagnoses and visits to medical facilities above a baseline. This type of data does not address the delivery of services in a specific population. To provide population-specific data, this retrospective study of patients with influenza-like illness, influenza, and pneumonia among members of a Kaiser Permanente health plan in San Diego, California, USA, during October-December 2009 was initiated. Population data included the number of outpatients accessing healthcare; the number of patients diagnosed with pneumonia; antimicrobial therapy administered; number of patients hospitalized with influenza, influenza-like illness, or pneumonia; level of care provided; and number of patients requiring specialized treatments (e.g., oxygen, ventilation, vasopressors). The rate of admissions specific to weeks and predictions of 2 epidemiologic models shows the strengths and weaknesses of those tools. Data collected in this study may improve planning for influenza pandemics.

  7. A Study to Identify Variables Contributing to Length of Stay for Selected Diagnosis Related Groups (DRG) at Madigan Army Medical Center

    Science.gov (United States)

    1989-06-07

    Margolis, and Wise 1986). A total of 215 patients 0 0in DRG 162 ( inguinal and femoral hernia repair, age 18 to 69 years C• C0 m without complications...the 0.05 level for one of the four DRGs. 0• " C 0m Additional analysis revealed that the diagnostic group, type of anesthesia , use of consultations...Allergy/Immunology I 1 Anesthesia I 1 Child Psychology 1 1 Dermatology I Developmental Peds I Emergency Medicine I Endocrinology 1 1 o Facul Devel

  8. [Consensus statement of an interdisciplinary group of French experts on modalities of diagnosis and medical treatment of Alzheimer's disease at a treatable stage].

    Science.gov (United States)

    Petit, H; Bakchine, S; Dubois, B; Laurent, B; Montagne, B; Touchon, J; Robert, P; Vellas, B; Vetel, J M; Cogneau, J; Marin La Meslée, R; Sorbé, G

    1998-06-01

    A group of French expert met on the 7th and 8th of February 1998 in order to establish a consensus attitude for Alzheimer's disease diagnosis and treatment. Members were drawn from primary care, geriatrics, neurology and psychiatry. They used the consensus statement of the American Association for Geriatrics, the Alzheimer's Association and the American Geriatrics Society published in JAMA, in October 1997 as a source of data for further consideration. Alzheimer's disease in the most common etiology of dementia. Main clinical features are cognitive impairment and psycho-behavioral disorders. Diagnosis must be one of inclusion and not exclusion. It is based on interviews of informants and family members and office-based clinical assessment. After a physical examination, cognitive function must be evaluated using the Mini-Mental State Examination. A laboratory evaluation should include a complete blood cell count, blood chemistry and determination of thyroid-stimulating hormone. In addition, noncontrast computed tomography head scans are adequate in most cases. Available pharmacologic treatments are not curative but are given to improve quality of life and enhance cognition and behavior. Two cholinesterases inhibitors, tacrine and donepezil, are the only agents officially authorized for treatment of the cognitive impairment in Alzheimer's disease. Mood and behaviour disorder also have to be treated by both pharmacologic and nonpharmacologic strategies. Only pharmacologic treatments will be detailed here. The consensus statements established by this group of experts will be reevaluated each year, considering the new available data on Alzheimer's disease.

  9. Medical marijuana

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000899.htm Medical marijuana To use the sharing features on this ... have legalized marijuana for medical use. How Does Medical Marijuana Work? Medical marijuana may be: Smoked Vaporized ...

  10. Nordic working group on x-ray diagnostics - Practical implementation of the directive on medical exposures in the Nordic EU countries

    Energy Technology Data Exchange (ETDEWEB)

    Waltenburg, H.N.; Groen, P. [National Institute of Radiation Hygiene, Herlev (Denmark); Leitz, W. [Swedish Radiation Protection Authority, Stockholm (Sweden); Servomaa, A. [Finnish Centre for Radiation and Nuclear Safety, Helsinki (Finland); Einarsson, G. [Icelandic Radiation Protection Institute, Reykjavik (Iceland); Olerud, H. [Norwegian Radiation Protection Authority, Oslo (Norway)

    2003-06-01

    The EU directive on medical exposure, 97/43/EURATOM (referred to in the following as MED) imposes new requirements on hospital departments using ionising radiation for either diagnostics or treatment of illnesses. The directive was approved on 30 June 1997, and the member states were obliged to implement the requirements into national legislation before 13 May 2000. The implementation of a directive of this kind is a complicated process requiring time as well as other resources. The Nordic EU countries (Sweden, Finland and Denmark) must comply with the rules in MED, while this is not the case for Norway and Iceland as EFTA (European Free Trade Association) members, since the agreements between EFTA and EU does not cover the EURATOM treaty. The issues that have to be addressed in the national legislation are justification, optimisation, responsibilities, procedures, training, equipment, special protection during pregnancy and breast-feeding, and potential exposure. A central aspect in MED is the requirement for quality assurance programmes to be established in radiological departments (and in other departments employing ionising radiation). A change of this magnitude in legislation requires adjustments in the routines of the individual departments. The staff in each department needs to prepare and follow procedures and instructions for daily work and also participate in day-to-day quality assurance. A considerable burden has also been laid on the radiation protection authorities in the member states, first in the process of transposing MED into national law or regulations, and secondly in guiding the process of practical implementation. Here we will describe how the individual Nordic EU countries have chosen to implement MED in national legislation and how far the process of complying with the requirements has come so far. Although Norway and Iceland are not required to follow MED, it is still interesting for comparison to include the situation in these countries

  11. Parental exposure to medications and hydrocarbons and ras mutations in children with acute lymphoblastic leukemia: A report from the Children's Oncology Group

    Energy Technology Data Exchange (ETDEWEB)

    Shu, X.O.; Perentesis, J.P.; Wen, W.Q.; Buckley, J.D.; Boyle, E.; Ross, J.A.; Robison, L.L. [Childrens Oncology Group, Arcadia, CA (United States)

    2004-07-01

    Using data from a large case-control study of childhood acute lymphoblastic leukemia (ALL; age < 15 years), we used a case-case comparison approach to examine whether reported parental exposure to hydrocarbons at work or use of specific medications are related to ras gene mutations in the leukemia cells of children with ALL. We examined mutations in K-ras and N-ras genes atcodons 12, 13, and 61 by PCR and allele-specific oligonucleotide hybridization and confirmed them by DNA sequencing. Odds ratios (ORs) and 95% confidence intervals (CIs) were derived from logistic regression to examine the association of parental exposures with ras mutations. A total of 127 (15.2%) cases had ras mutations (K-ras 4.7% and N-ras 10.68%). Both maternal (OR 3.2,95% CI 1.7-6.1) and paternal (OR 2.0, 95% CI 1.1-3.7) reported use of mind-altering drugs were associated with N-ras mutations. Paternal use of amphetamines or diet pills was associated with N-ras mutations (OR 4.1, 95% CI 1.1-15.0). Maternal exposure to solvents (OR 3.1, 95% CI 1.0-9.7) and plastic materials (OR 6.9, 95% CI 1.2-39.7) during pregnancy and plastic materials after pregnancy (OR 8.3, 95% CI 1.4-48.8) were related to K-ras mutation. Maternal over exposure to oil and coal products before case diagnosis (OR 2.3, 95% CI 1.1-4.8) and during the postnatal period (OR 2.2, 95% CI 1.0-5.5) and paternal exposure to plastic materials before index pregnancy (OR 2.4, 95% CI 1.1-5.1) and other hydrocarbons during the postnatal period (OR 1.8, 95% CI 1.0-1.3) were associated with N-ras mutations. This study suggests that parental exposure to specific chemicals may be associated with distinct ras mutations in children who develop ALL.

  12. Sucesso no tratamento do zumbido com terapia em grupo Group therapy for patients with tinnitus at the University of Brasilia Medical School

    Directory of Open Access Journals (Sweden)

    Lisiane Holdefer

    2010-02-01

    Full Text Available Embora os tratamentos em grupos para o zumbido sejam uma área bem documentada na literatura internacional, até onde sabemos nunca foram realizados no Brasil. Este estudo apresenta uma experiência bem-sucedida de um tratamento em grupo para zumbido baseado na terapia de retreinamento do zumbido aliada com as técnicas cognitivo-comportamentais. O objetivo deste estudo é avaliar pacientes com zumbido antes e depois do tratamento em grupo estruturado baseado da terapia de retreinamento do zumbido e na terapia cognitivo comportamental. MATERIAL E MÉTODO: Estudo coorte prospectivo: 27 sujeitos aplicaram-se para a pesquisa. Responderam ao inventário do Handicap do Zumbido (THI e à escala da Ansiedade e Depressão Hospitalar (HAD,antes e depois do tratamento. Foram realizadas 6 sessões estruturadas segundo os princípios da terapia de retreinamento do zumbido associada com técnicas cognitivo-comportamentais. RESULTADOS: 27 pacientes iniciaram e 19 terminaram o tratamento (8 excluídos. 47,4% homens, média das idades 47.6. O resultado do THI antes e depois do tratamento foi respectivamente: funcionais, 29 e 14; emocional, 24 e 10; e catastrófico, 12 e 5; a escala HAD: ansiedade, 12 e 9 e depressão, 10 e 6. CONCLUSÃO: O tratamento descrito é efetivo na melhora do zumbido.Although group therapy for tinnitus is a well documented field in the international literature, as far as we know it has never been held in Brazil. This study represents a successful experience of a group therapy for tinnitus based on the tinnitus retraining therapy associated with behavioral cognitive techniques. The goal of the present study is to assess patients with tinnitus before and after the group therapy based on the tinnitus retraining therapy and the behavioral cognitive therapy. MATERIALS AND METHODS: Prospective cohort study: 27 subjects signed in for the study, and answered the Tinnitus Handicap Inventory (THI and the Hospital Depression and Anxiety Scale (HAD

  13. Perceptions of an ideal point-of-care test for sexually transmitted infections--a qualitative study of focus group discussions with medical providers.

    Directory of Open Access Journals (Sweden)

    Yu-Hsiang Hsieh

    Full Text Available BACKGROUND: A point-of-care test (POCT for sexually transmitted infections (STIs, which offers immediate diagnosis resulting in patients receiving diagnosis and treatment in a single visit, has the ability to address some of the STI control needs. However, needs assessment from STI experts and end users about currently available STI POCTs and their future new development has not been evaluated since World Health Organization Sexually Transmitted Diseases Diagnostics Initiative was formed over 15 years ago. Therefore, our objective was to explore the perceptions of the ideal types of STI POCT for use in health care settings. METHODOLOGY/PRINCIPAL FINDINGS: A qualitative study, encompassing eight focus groups, was conducted from March 2008 through April 2009. Participants included 6 STD clinic directors, 63 clinicians, and 7 public health/laboratory/epidemiology professionals in the STI field. Discussion topics included currently available POCT, perceived barriers to using POCT in clinics, priority STI for the development of new POCT, and characteristics of the ideal POCT. All discussions were recorded and transcribed verbatim. Themes raised as barriers for current POCT included complexity, long time frames of the so-called "rapid" test, multiple time-driven steps, requiring laboratory technician, difficulty in reading result, interruption of workflow, unreliability, and invasiveness. Chlamydia trachomatis was identified as the priority organism for development of a new STI POCT. Themes indicated for the ideal POCT included rapid turnaround (up to 20 minutes, ease of use, non-invasive, accurate (preferred sensitivity and specificity in the range of high 90s, Clinical Laboratory Improvement Amendments (CLIA-waived, user-friendly (for both patients and staff, compact, durable, and sturdy. CONCLUSIONS/SIGNIFICANCE: Focus group discussions with STI experts and professionals highlighted chlamydia as the top priority pathogen for POCT development, and

  14. 标准化套装HRP软件在医疗集团的应用探索%Exploration of the Application of Standardized HRP Software Package in the Medical Group

    Institute of Scientific and Technical Information of China (English)

    尹东杰; 张蓓; 吴杰

    2015-01-01

    介绍了套装医院资源计划系统(HRP)在中国医院的实施现状,并对其在未来医疗集团的应用推行进行初步探究。首先简述目前国内医院信息化的发展需求,指出HRP是未来医院提升运营管理水平的一套信息管理系统。通过HRP在国内外医院部署的成功案例,总结出其成功实施的关键要素。随着医疗集团成为未来一种新的医院发展模式,标准化套装HRP软件的多组织系统体系架构,可拓展性与高集成性的特点正是满足医疗集团需求的产品,其在医疗行业将会有更加广阔的应用前景。%The current situation of the implementation of hospital resource planning system (HRP) package in hospitals in China is introduced, and its application and promotion in the future medical group is preliminarily studied. First the current informatization development of domestic hospitals is briefly described. It points out that HRP is a management information system for hospitals to improve the operation and management level in the future. Through successful cases of the deployment of HRP in hospitals at home and abroad, the key elements of it successful implementation are summarized. As the medical group will be a new hospital development mode in the future, with the multi-organization system architecture, expansibility and high integration, the standardized HRP software package is the product which can meet the demand of medical group. It will have broader application prospects in the medical industry.

  15. Working Methods and Experiences of Nursing Groups in Blast Injury External Aid Medical Team%爆炸伤外援医疗队护理组的工作方法与体会

    Institute of Scientific and Technical Information of China (English)

    柏素萍; 蒋玲

    2015-01-01

    目的 探讨爆炸伤外援医疗队护理组的工作方法.方法 迅速组成医疗队护理组,制定外援护理组工作职责和制度.根据患者的病情发展,实施烧伤专科的理论培训及技能训练.同时加强与各方信息沟通,及时做好反馈.严格执行患者安全管理制度,严防不良事件.结果 参与救治患者11例中,1例在48 h内死亡,其余10例危重患者经一个月护理,未发生与护理相关的并发症.结论 外援医疗队护理组能做好医疗点爆炸伤护理工作的支援帮带,对提高护理质量及救治成功率有积极作用.%Objective To explore the working methods and experiences of nursing groups in blast injury external aid medical team.Methods Formulate the working responsibilities and systems of foreign aid medical nursing groups rapidly. Based on patients' disease progression to implement training of burns specialist theory and skill. Meanwhile, reinforce the communication with all aspects and make feedback timely. Execute the system of patient safety management strictly and avoid adverse event. Results In the treatment of 11 patients, 1 patient died in 48 hours and others did not displayed related nursing complications within 1 months' nursing treatment.Conclusion External aid medical team nursing groups can provide blast injury nursing work in the medical post with effective support and help and exert positive role in improving nursing quality and treatment success rate.

  16. 打造塑造医学生高尚医德情操的优质课程群——中国医学伦理学与生命伦理学发展研究之四%Constructing High-quality Curriculum Group for Cultivating Noble Morality in Medical Students——Research on Medical Ethics and Bioethics Development in China (4th)

    Institute of Scientific and Technical Information of China (English)

    李恩昌; 程乐森; 王庆淼

    2012-01-01

    In order to strengthen the medical ethics education in medical students, it is necessary to create a " high - quality curriculum group for cultivating noble morality in medical students" , the curriculum group includes medical ethics, medical sociology, medical psychology, medical history, science of health law and other courses. In these courses, medical ethics lies in the core status, is also the core curriculum and plays a leading role. Meanwhile , curriculum of ideological and political theory course is foundational and leading for cultivating noble morality in medical students, curriculum of ideological and political theory course and medical humanities courses with medical ethics as a core have the same target of cultivating noble morality in medical students.%为加强医学生医德教育,有必要打造一个能够“塑造医学生高尚道德情操的优质课程群”,该课程群包括医学伦理学、医学社会学、医学心理学、医学史、卫生法学等课程,其中医学伦理学是塑造医学生高尚医德情操的核心课程,发挥主导作用.同时,思想政治理论课各门课程是塑造医学生高尚医德情操的基础性、导向性课程.思想政治理论课与以医学伦理学为核心的医学人文课程统一于“塑造医学生高尚医德情操”的目标,在当前具有重要的意义.

  17. Barriers and motivators to voluntary medical male circumcision uptake among different age groups of men in Zimbabwe: results from a mixed methods study.

    Directory of Open Access Journals (Sweden)

    Karin Hatzold

    Full Text Available BACKGROUND: We conducted quantitative and qualitative studies to explore barriers and motivating factors to VMMC for HIV prevention, and to assess utilization of existing VMMC communication channels. METHODS AND FINDINGS: A population-based survey was conducted with 2350 respondents aged 15-49. Analysis consisted of descriptive statistics and bivariate analysis between circumcision and selected demographics. Logistic regression was used to determine predictors of male circumcision uptake compared to intention to circumcise. Focus group discussions (FGDs were held with men purposively selected to represent a range of ethnicities. 68% and 53% of female/male respondents, respectively, had heard about VMMC for HIV prevention, mostly through the radio (71%. Among male respondents, 11.3% reported being circumcised and 49% reported willingness to undergo VMMC. Factors which men reported motivated them to undergo VMMC included HIV/STI prevention (44%, improved hygiene (26%, enhanced sexual performance (6% and cervical cancer prevention for partner (6%. Factors that deterred men from undergoing VMMC included fear of pain (40%, not believing that they were at risk of HIV (18%, lack of partner support (6%. Additionally, there were differences in motivators and barriers by age. FGDs suggested additional barriers including fear of HIV testing, partner refusal, reluctance to abstain from sex and myths and misconceptions. CONCLUSIONS: VMMC demand-creation messages need to be specifically tailored for different ages and should emphasize non-HIV prevention benefits, such as improved hygiene and sexual appeal, and need to address men's fear of pain. Promoting VMMC among women is crucial as they appear to have considerable influence over men's decision to get circumcised.

  18. 医学生就业指导团体辅导活动课程的设计与实施%Design and implementation of group counseling activity curriculum for the employment of medical students

    Institute of Scientific and Technical Information of China (English)

    张青; 钱奕; 孙婷; 朱炜; 赖婧; 杨智男

    2016-01-01

    [目的]设计医学生就业指导团体辅导活动课程并实施。[方法]选取选修大学生就业指导课程的62名一年级和二年级学生,随机分为试验组和对照组,试验组采用团体辅导活动课程,对照组采用传统课堂讲授法,辅导前后比较两组学生的职业决策自我效能得分。[结果]辅导后,两组学生的职业决策自我效能总分均提高,试验组学生团体辅导后社会支持和应对技能得分高于对照组(P <0.05)。[结论]将团体辅导应用于高校就业指导教学中有助于提高大学生的职业决策自我效能。%Objective:To design group counseling activiey curriculum medical students’career and to implement it.Method:A total of 62 freshmen and sophomeres in the second semester of the 2014—2015 academic year have college students career guidance program were selected and randomly divided into test group and control group.Students in test group received group counseling activity curriculum.And the control group recived tradi-tional classroom lectures.Career decision making self efficacy scores were compared before and after the counselling.Results:After counseling,the two groups of students career decision making self efficacy scores were increased.After the group counseling,social support and coping skills scores of the teat group students were higher than that of the control group(P <0.05).Conclusion:To apply group counseling career guidance courses in colleges and universities can help to improve college students’career decision making self efficacy.

  19. Renewing the models of process through digital design: the challenge launched by ADITAZZ with the “Small Hospital – Big Ideas” International competition

    Directory of Open Access Journals (Sweden)

    Romano Del Nord

    2013-10-01

    Full Text Available The critical issues facing the construction industry, can only be overcome with a policy of actions and strategies that should be shared and implemented by all stakeholders interested in fostering innovation, that is the driving force of growth. Our role is to envisage new forms of innovation that might affect the “way” we conceive and design buildings as well the “way” we manage processes, enhancing the methodology and the means that have always been at the core of technological culture. In this context, it is interesting to evaluate the multidisciplinary digital design that the American group ADITAZZ has developed for a recent International Competition, sponsored by Kaiser Permanente. Aditazz Realization Platform (ARP has allowed to produce multi-aggregation scenarios to meet the criteria of the Competition. This design, based on a digital and multidisciplinary culture is of great interest for the potentials of contemporary technology.

  20. [Shared web-based data center for multi-institutional clinical trials: evaluation of UMIN-INDICE (university hospital medical information network-internet data and information center for medical research)in clinical trials of JIVROSG (Japan interventional radiology in oncology study group)].

    Science.gov (United States)

    Sone, Miyuki; Arai, Yasuaki; Kiuchi, Takahiro; Ishikawa, Hirono; Aoki, Noriaki; Inaba, Yoshitaka; Yoshioka, Tetsuya; Aramaki, Takeshi; Kobayashi, Takeshi; Matsuoka, Toshiyuki; Anai, Hiroshi; Tanigawa, Noboru; Osuga, Keigo; Takeuchi, Yoshito; Okusaka, Takushi; Kanazawa, Susumu; Matsui, Osamu; Endo, Keigo

    2012-04-01

    A patient registration system is mandatory for establishing the scientific credibility of the multi-center clinical trials. The Japan Interventional Radiology in Oncology Study Group (JIVROSG) was organized in 2002 to establish evidence supporting the procedures used in interventional radiology. The Internet Data and Information Center for Medical Research (INDICE), provided by the University Hospital Medical Information Network(UMIN), has been utilized for patient registration in the clinical trials of JIVROSG. In this study, the safety and efficacy of UMIN-INDICE were evaluated. From 2002 to 2010, 18 clinical trials, including one international trial, were conducted. A total of 736 patients were enrolled from 51 institutions. No significant trouble was encountered during this period. A questionnaire survey demonstrated that 90% of participating researchers could use this system without difficulties. UMIN-INDICE may contribute to promoting clinical trials as an infrastructure of multicenter studies.

  1. The Risk of Dupuytren Surgery in Obese Individuals.

    Science.gov (United States)

    Hacquebord, Jacques H; Chiu, Vicki Y; Harness, Neil G

    2017-03-01

    Dupuytren disease is a common benign fibroproliferative disorder causing thickening and shortening of the palmar fascia of the hand. The exact etiology of the disease is unclear but known risk factors such as increased age, male sex, and northern European ethnicity have been established. A link between body mass index (BMI) and Dupuytren disease has not been established previously. The purpose of this study was to test the hypothesis that lower BMI is associated with increased risk for Dupuytren disease diagnosis. After we obtained institutional review board approval, we performed a retrospective review using an electronic medical record and an administrative database from Kaiser Permanente Southern California to identify all enrolled patients there between 2007 and 2014 who were diagnosed with Dupuytren disease. Basic demographic data including age, sex, ethnicity, and BMI were collected. Bivariate and multivariable logistical regression analyses were performed to evaluate for associations between Dupuytren disease and BMI. A total of 2,049,803 patients aged 18 years and older were enrolled in Kaiser Permanente Southern California from 2007 to 2014. During that period, 14,844 patients were identified as having Dupuytren disease. The data were consistent with well-defined demographic trends in Dupuytren disease, with increased rates seen in males, Caucasians, and patients aged 50 years and older. In the multivariable analysis, when controlling for age, race, and sex, the risk of Dupuytren disease was inversely proportional to BMI. The current study showed that higher BMI is associated with decreased odds of having Dupuytren disease. Further work will be required to determine the cause for the apparent relationship between Dupuytren disease and BMI and whether physiologic factors related to obesity may be protective against the development of Dupuytren disease. Prognostic II. Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All

  2. Bacteremia in Children 3 to 36 Months Old After Introduction of Conjugated Pneumococcal Vaccines.

    Science.gov (United States)

    Greenhow, Tara L; Hung, Yun-Yi; Herz, Arnd

    2017-04-01

    In June 2010, Kaiser Permanente Northern California replaced all 7-valent pneumococcal conjugate vaccine (PCV7) vaccines with the 13-valent pneumococcal conjugate vaccine (PCV13). Our objectives were to compare the incidence of bacteremia in children 3 to 36 months old by 3 time periods: pre-PCV7, post-PCV7/pre-PCV13, and post-PCV13. We designed a retrospective review of the electronic medical records of all blood cultures collected on children 3 to 36 months old at Kaiser Permanente Northern California from September 1, 1998 to August 31, 2014 in outpatient clinics, in emergency departments, and in the first 24 hours of hospitalization. During the study period, 57 733 blood cultures were collected in the population of children 3 to 36 months old. Implementation of routine immunization with the pneumococcal conjugate vaccine resulted in a 95.3% reduction of Streptococcus pneumoniae bacteremia, decreasing from 74.5 to 10 to 3.5 per 100 000 children per year by the post-PCV13 period. As pneumococcal rates decreased, Escherichia coli, Salmonella spp, and Staphylococcus aureus caused 77% of bacteremia. Seventy-six percent of all bacteremia in the post-PCV13 period occurred with a source. In the United States, routine immunizations have made bacteremia in the previously healthy toddler a rare event. As the incidence of pneumococcal bacteremia has decreased, E coli, Salmonella spp, and S aureus have increased in relative importance. New guidelines are needed to approach the previously healthy febrile toddler in the outpatient setting. Copyright © 2017 by the American Academy of Pediatrics.

  3. 浅析宋代法律对弱势群体的医疗保障%Medical Security for the Vulnerable Groups in the Law of the Song Dynasty

    Institute of Scientific and Technical Information of China (English)

    杜菁; 梁永宣; 孟永亮

    2016-01-01

    Song Dynasty is the peak period of social legal system development in ancient China and appeared a lot of legal systems for the civilization progress,including the very important medical security for the vulnerable groups especially for the aged,females,children,the sick and the disabled,servants and pris-oners. Due to the restriction of age,gender,physiological defects,social position and identity,the survival state of these groups were of the inferior. The protection was especially required when in sickness. In the paper,the representative code of Songxingtong(《宋刑统》)and the other relevant historic materials in the Song Dynasty were collected. It was found that in the protection of the vulnerable groups for their survival right and the right of medical treatment,a lot of relevant legal clauses and medical systems had been developed and implemen-ted. It played the positive role in protecting patients'rights,promoting the legal civilization,stabilizing social order,etc.%宋代是中国古代社会法制发展的高峰期,出现了许多文明进步的法律制度,其中对老年病者、妇女病者、儿童病者、残疾病者、奴婢病者、狱囚病者等弱势群体的医疗保障极为重视。这部分人由于年龄、性别、生理缺陷、地位、身份等限制,其生存状况处于劣势地位,患病时更加需要受到保护。文中主要通过梳理宋代代表性法典《宋刑统》及其他相关史料,发现宋代在保护弱势群体的生存权、就医权等方面,制定和实施了许多相关的法律条目和医事制度,在保护病者权益、促进法制文明、稳定社会秩序等方面起到了积极作用。

  4. 发挥高值耗材团购优势缓解“看病贵”难题%Take the Advantages of Group Purchasing for High-value Medical Consumptive Materials to Relieve the Problem of High Medical Costs

    Institute of Scientific and Technical Information of China (English)

    胡丹

    2015-01-01

    针对高值耗材价格虚高问题,长春市从付费方式改革入手,充分发挥“议价谈判”职能,实施高值耗材医保招标团购。两年多来,积极开展综合调控,创新采购模式,实施“结算漏”制度,保障了招标工作的良性循环。切实降低了采购成本,挤出了医疗费用虚高的水份,减轻群众医疗负担,节约了医保基金,使患者、医院、供应商和医保四方受益。%Because of the problem of false high-price in medical consumptive materials, starting from the payment method reform, and to make"negotiation"playing full roles, group purchasing of high-value medical consumable materials was implemented in Changchun. In more than two years, through comprehensive regulation and procurement mode innovating, a virtuous circle of group purchasing is ensured. After that, it reduces the purchasing cost, cuts off the grey profit chain in it, squeezes out the false high cost in health case, reduces peoples’ health care burden, and saves the medical insurance fund. As a result, it makes patients, hospitals, suppliers and health insurance all four aspects benefit from group buying.

  5. Abortion - medical

    Science.gov (United States)

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

  6. Oral Medication

    Science.gov (United States)

    ... Size: A A A Listen En Español Oral Medication The first treatment for type 2 diabetes blood ... new — even over-the-counter items. Explore: Oral Medication How Much Do Oral Medications Cost? Save money ...

  7. Lean Healthcare Treatment:Lean Revolution in Thedacare Medical Group of the United States%精益医疗:美国泰德康医疗集团的精益变革

    Institute of Scientific and Technical Information of China (English)

    邓婕

    2015-01-01

    After reading and studying the series books on lean healthcare treatment,especially the book On The Mend,the author introduces the general situation about the lean revolution in Thedacare Medical Group,key ideas and prac-tice of lean medical treatment,the main experience on lean revolution,analyze and summarize the revelation to domestic hospital management according to the practice of home hospital management.%笔者`研读精益医疗系列丛书及相关文献,特别是《精益医疗》一书,介绍了美国泰德康医疗集团精益变革的概况,以及该集团实施精益医疗的核心理念和具体实践、精益变革的主要经验体会,并结合国内医院管理实际,分析总结了泰德康精益变革对我国医院管理的启示。

  8. Correlation between relative rates of hospital treatment or death due to ischaemic heart disease (IHD) and of IHD-related medication among socio-occupational and economic activities groups in Denmark, 1996-2005

    DEFF Research Database (Denmark)

    Hannerz, Harald; Dalhoff, Kim; Burr, Hermann

    2014-01-01

    Standardised Hazard Ratios (SHR) for hospital treatment or death due to IHD and SHR for purchase of prescriptions for medicine that may prevent IHD from (re)occurring, among socio-occupational and economic activities groups in Denmark. The SHR were based on a 10-year prospective follow-up of 2 million people...... or death due to IHD (SHR = 0.80, 95% CI: 0.71-0.91). CONCLUSION: Apart from a few caveats, the strong correlations obtained in the present study signify that purchase of a prescription for IHD-related medication is a usable risk indicator for IHD in the working population of Denmark. The usage of medicine...... data in addition to or instead of the use of death or hospital data in epidemiological studies on work-related IHD risk will bring about a tremendous increase in statistical power....

  9. [Unravelling medical leadership].

    Science.gov (United States)

    Voogt, Judith J; van Rensen, Elizabeth L J; Noordegraaf, Mirko; Schneider, Margriet M E

    2015-01-01

    Medical leadership is a popular topic in the Netherlands, and several interest groups now incorporate medical leadership into postgraduate medical education. However, there is no consensus on what this concept entails. By conducting a discourse analysis, a qualitative method which uses language and text to reveal existing viewpoints, this article reveals three perspectives on medical leadership: administrative leadership, leadership within organisations and leadership within each doctor's daily practice. Text analysis shows that the first two perspectives refer to medical leadership mainly in a defensive manner: by demonstrating medical leadership doctors could 'take the lead' once again; patient care only seems to play a small part in the process. These perspectives are not free of consequences, they will determine how the medical profession is constructed. For this reason, it is argued that there should be more emphasis on the third perspective, in which the quality of care for patients is of primary importance.

  10. Current issues in medical education

    African Journals Online (AJOL)

    ing, virtual reality, the use ol' simulated subjects, e learn- ing, and the new .... leges (AAMCÏ proposed a group oi' leaming objectives as guide- lines for medical schools. .... Suggestions for action research studies of cli- mates in medical ...

  11. Engaging Stakeholders to Inform Clinical Practice Guidelines That Address Multiple Chronic Conditions.

    Science.gov (United States)

    Bennett, Wendy L; Robbins, Craig W; Bayliss, Elizabeth A; Wilson, Renee; Tabano, Heather; Mularski, Richard A; Chan, Wiley V; Puhan, Milo; Yu, Tsung; Leff, Bruce; Li, Tianjing; Dickersin, Kay; Glover, Carol; Maslow, Katie; Armacost, Karen; Mintz, Suzanne; Boyd, Cynthia M

    2017-08-01

    Having more than one chronic condition is common and is associated with greater health care utilization, higher medication burden and complexity of treatment. However, clinical practice guidelines (CPGs) do not routinely address the balance between harms and benefits of treatments for people with multiple chronic conditions (MCCs). To partner with the Kaiser Permanente Integrated Cardiovascular Health (ICVH) program to engage multiple stakeholders in a mixed-methods approach in order to: 1) identify two high-priority clinical questions related to MCCs, and 2) understand patients' and family caregivers' perceptions of meaningful outcomes to inform benefit/harm assessments for these two high-priority questions. These clinical questions and outcomes will be used to inform CPG recommendations for people with MCCs. DESIGN AND PARTICIPANTS: The ICVH program provided 130 topics rank-ordered by the potential for finding evidence that would change clinical recommendations regarding the topic. We used a modified Delphi method to identify and reword topics into questions relevant to people with MCCs. We used two sets of focus groups (n = 27) to elicit patient and caregiver perspectives on two important research questions and relevant patient-important outcomes on benefit/harm balance for people with MCCs. Co-investigators, patients and caregivers identified "optimal blood pressure goals" and "diabetes medication management" as important clinical topics for CPGs related to people with MCCs. Stakeholders identified a list of relevant outcomes to be addressed in future CPG development including 1) physical function and energy, 2) emotional health and well-being, 3) avoidance of treatment burden, side effects and risks, 4) interaction with providers and health care system, and 5) prevention of adverse long-term health outcomes. Through the application of a mixed-methods process, we identified the questions regarding optimal blood pressure goals and diabetes medication management

  12. Rapid spread of complex change: a case study in inpatient palliative care

    Directory of Open Access Journals (Sweden)

    Filipski Marta I

    2009-12-01

    Full Text Available Abstract Background Based on positive findings from a randomized controlled trial, Kaiser Permanente's national executive leadership group set an expectation that all Kaiser Permanente and partner hospitals would implement a consultative model of interdisciplinary, inpatient-based palliative care (IPC. Within one year, the number of IPC consultations program-wide increased almost tenfold from baseline, and the number of teams nearly doubled. We report here results from a qualitative evaluation of the IPC initiative after a year of implementation; our purpose was to understand factors supporting or impeding the rapid and consistent spread of a complex program. Methods Quality improvement study using a case study design and qualitative analysis of in-depth semi-structured interviews with 36 national, regional, and local leaders. Results Compelling evidence of impacts on patient satisfaction and quality of care generated 'pull' among adopters, expressed as a remarkably high degree of conviction about the value of the model. Broad leadership agreement gave rise to sponsorship and support that permeated the organization. A robust social network promoted knowledge exchange and built on an existing network with a strong interest in palliative care. Resource constraints, pre-existing programs of a different model, and ambiguous accountability for implementation impeded spread. Conclusions A complex, hospital-based, interdisciplinary intervention in a large health care organization spread rapidly due to a synergy between organizational 'push' strategies and grassroots-level pull. The combination of push and pull may be especially important when the organizational context or the practice to be spread is complex.

  13. East- African Medical Journal

    African Journals Online (AJOL)

    East African Medical Journal Vol 83 No. 8 August 2006 ... urology, ENT and orthopaedic groups and these ... no significant difference in orthopaedic patients mortality' with standard; we .... applying TRISS analysis to pediatric blunt trauma.

  14. The organizational managing methods in the medical - nursing first aid for group food poisoning events%集体食物中毒事件急救医疗护理组织管理对策

    Institute of Scientific and Technical Information of China (English)

    邓亚军; 王义亮; 潘代明

    2011-01-01

    Objective To explore the organizational managing methods for strengthening the medical - nursing first aid for group food poisoning events.Methods The measures included starting emergency plan promptly, optimizing the first aid routine, allocating human resources rationally, strengthening the management of emergency supplies and rationalizing macro - control.Results All the 252 cases of patients were clinically cured.The survival rate was 100.00% and patient satisfaction was 98.00%.No nursing errors and issues happened.Conclusion Efficient organizational management is the powerful guarantee to the successful rescue of group food poisoning patients.%目的 探讨加强集体食物中毒事件急救医疗护理组织管理方法.方法 迅速启动应急预案、优化急救流程、合理调配人力资源、强化急救物资管理、合理宏观调控等.结果 252例患者全部临床治愈出院,抢救成功率100.00%,患者满意度98.00%,无护理差错及纠纷发生.结论 高效的急救医疗护理组织管理工作是集体食物中毒事件救治成功的有力保障.

  15. Medical tourism.

    Science.gov (United States)

    Leggat, Peter

    2015-01-01

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

  16. Medical Identity

    DEFF Research Database (Denmark)

    Musaeus, Peter

    2015-01-01

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

  17. Medical Management

    Science.gov (United States)

    ... email share facebook twitter google plus linkedin Medical Management Although there’s no cure for CMT, there are ... individualized physical therapy program. For more on medical management of CMT, see Surgery Sometimes, Bracing Often, Caution ...

  18. Applying DRGs in medical quality management of the attending physician group%应用 DRGs 对主诊医师组进行医疗质量管理的探索

    Institute of Scientific and Technical Information of China (English)

    佟朝霞

    2015-01-01

    With performance evaluation management as the stepping stone,the hospital joined the DRGs with the attending in-charge method by means of enforcing the attending in charge practice,DRGs knowledge training,and identifying problems with DRGs grouped data of the attending physician group, in an effort to explore new methods of medical quality control.Two years of practice provide tools of quality control to strengthen the hospital’s fine management.At the same time,it should also be noticed that DRGs merely diversify management means,as the content and form of which still need to constantly be improved in the course.%医院以绩效考核管理为契机,通过实施主诊医师负责制、培训 DRGs 知识、利用主诊医师组的 DRGs 分组数据查找问题等措施,将 DRGs 评价与主诊医师负责制工作相结合,探索新的医疗质量管理方法。经过两年的实践,给医院和科室质量管理提供了抓手,加强了医院精细化管理,提高了医疗质量。同时,也应注意应用 DRGs 只是丰富了管理手段,在使用的过程中还需不断完善管理内容和形式。

  19. PS2-17: Diabetes Social Support Feasibility Pilot Study: Utilizing Mobile Technology and Self-Identified Supporters to Enhance Self-Monitoring of Blood Glucose

    Science.gov (United States)

    Robinson, Brandi; Roblin, Douglas; Hipkens, James; Vupputuri, Suma; McMahon, Kevin

    2010-01-01

    Background and Aims: Self-monitoring of blood glucose (SMBG) is associated with improved glycemic control among patients with type 2 diabetes, however, the practice of daily self-monitoring is not optimal. Telecommunications technology may improve adherence to recommended self-management practices by remotely transmitting automated reminders to motivate patients, and utilizing social networking for peer support. The purpose of this pilot study is to demonstrate the feasibility and usability of mobile technology and the potential added value of social support to improve SMBG frequency and glycemic control among adults with type 2 diabetes. Methods: Adults 25–74 years of age with type 2 DM and an average HbA1c > 8.0% were recruited from Kaiser Permanente Georgia (KPGA) and Oakhurst Medical Center (OMC, a community health clinic) to participate in a 3-month study using wireless technology. Enrollment sessions with presentations on SMBG techniques, use of the wireless technology, and motivational coaching to enhance social support were conducted in November 2009. During the subsequent 3-months, both diabetes patients and their self-selected supporters will receive text messages to their cell phones summarizing a patient’s SMBG frequency and levels. Participants and their supporters will attend a disenrollment session in February 2010 when feasibility and usability will be assessed in focus groups. Results: 6 of 161 eligible diabetes patients at KPGA and 9 of 28 eligible diabetes patients at OMC, and their self-selected supporters, consented to participate. The average age of diabetes patients was 49.3 years. 86.7% (N=13) were African-American; and 33.3% (N=5) were male. Five days after enrollment, 60% (N=9) of patients had connected their wireless transmitters and had current blood glucose data. Follow-up phone calls will be made to ensure that all participants are connected to the wireless technology within 10 days of the enrollment session. Conclusion

  20. Medication safety.

    Science.gov (United States)

    Keohane, Carol A; Bates, David W

    2008-03-01

    Patient safety is a state of mind, not a technology. The technologies used in the medical setting represent tools that must be properly designed, used well, and assessed on an on-going basis. Moreover, in all settings, building a culture of safety is pivotal for improving safety, and many nontechnologic approaches, such as medication reconciliation and teaching patients about their medications, are also essential. This article addresses the topic of medication safety and examines specific strategies being used to decrease the incidence of medication errors across various clinical settings.

  1. Attitudes Toward Medical Cannabis Legalization Among Serbian Medical Students.

    Science.gov (United States)

    Vujcic, Isidora; Pavlovic, Aleksandar; Dubljanin, Eleonora; Maksimovic, Jadranka; Nikolic, Aleksandra; Sipetic-Grujicic, Sandra

    2017-07-29

    Currently, medical cannabis polices are experiencing rapid changes, and an increasing number of nations around the world legalize medical cannabis for certain groups of patients, including those in Serbia. To determine medical students' attitudes toward medical cannabis legalization and to examine the factors influencing their attitudes. Fourth-year medical students at the Faculty of Medicine, University of Belgrade, had participated in a cross-sectional study. Data were collected by an anonymous questionnaire. Overall, 63.4% students supported medical cannabis legalization, and only 20.8% supported its legalization for recreational use. Students who previously used marijuana (p marijuana recreational use was also related to prior marijuana (p cancer (90.4%) and chronic pain (74.2%) were correctly reported approved medical indications by more than half the students. Students who supported medical cannabis legalization showed better knowledge about indications, in contrast to opponents for legalization who showed better knowledge about side effects. Beliefs that using medical cannabis is safe and has health benefits were correlated with support for legalization, and previous marijuana and alcohol use, while beliefs that medical cannabis poses health risks correlated most strongly with previous marijuana use. Conclusions/Importance: The medical students' attitudes toward medical cannabis legalization were significantly correlated with previous use of marijuana and alcohol, knowledge about medical indications and side effects, and their beliefs regarding medical cannabis health benefits and risks.

  2. An Intergenerational Women's Group.

    Science.gov (United States)

    Fogler, Janet

    1989-01-01

    Discusses the Intergenerational Women's Group, formed to provide social support and an interchange of ideas between women of different generations. Provides a model for such a program that may be offered in geriatric medical clinics. Discusses the impact of intergenerational support for both the old and the young. (Author/BHK)

  3. Medical Scientists

    Science.gov (United States)

    ... Projected Employment, 2024 Change, 2014-24 Employment by Industry Percent Numeric SOURCE: U.S. Bureau of Labor Statistics, Employment Projections program Medical scientists, except epidemiologists 19- ...

  4. [Ways to optimize working conditions of medical personnel servicing modern hi-tech medical equipment].

    Science.gov (United States)

    Kravchenko, O K

    2007-01-01

    The author analyzed health state of medical personnel through various parameters. Hygienic characteristics of work conditions for medical personnel subjected to physical factors when servicing modern hi-tech medical equipment are presented. Occupational groups at high risk are defined. The article covers main directions in improving work conditions and preserving health for medical personnel in these groups.

  5. 非战争军事行动中军队医院机动卫勤分队模块化抽组的建设思考%Think about constructing modular pumping grouping of military hospital's mobile medical units in the military operations other than war

    Institute of Scientific and Technical Information of China (English)

    赵从林; 李思睿

    2015-01-01

    In the military operations other than war(MOOTW),the ability and efficiency of mobile medical units of military hospitals in performing medical tasks depend on the convenience and accuracy of modular pumping grouping. The modularity approach is an effective method in dealing with complicated tasks. In an attempt to illustrate the complex problem of pumping grouping in the modular approach through combining the modularization principle and mobile medical unit pumping grouping ,this research has been an useful endeavor to improve the medical capacity of mobile medical units in military hospitals.%在非战争军事行动背景下,军队综合性医院机动卫勤分队遂行卫勤保障任务的效率和能力,取决于模块化抽组的便捷性和准确性。模块化是处理复杂问题的有效方法之一,本文将模块化原理和机动卫勤分队抽组有机结合起来,试图把复杂的抽组问题通过模块化方式得以阐述,为提高军队医院机动卫勤分队卫勤保障能力进行尝试。

  6. Medical security against burglary and vandalism.

    Science.gov (United States)

    Hoopes, J J

    1985-01-01

    With the large number of medical and pharmacy burglaries occurring every year, can any medical group practice afford to be unprotected? There is a distinct need for security against burglary and vandalism in the medical group setting. Where should the administrator go for help? Based on a discussion of the history of security, legal issues, and insurance considerations, the unique aspects of medical group security are presented and concrete recommendations made.

  7. [Euthanasia: medications and medical procedures].

    Science.gov (United States)

    Lossignol, D

    2008-09-01

    The Belgian law relative to euthanasia has been published in 2002. A physician is allowed to help a patient with intractable suffering (physical or psychological). Legal conditions are clear. However, nothing is said about medical procedures or medications to be used. The present paper will present specific clinical situations at the end of life, practical procedures and medications. A special focus is made on psychological impact of euthanasia.

  8. Group X

    Energy Technology Data Exchange (ETDEWEB)

    Fields, Susannah

    2007-08-16

    This project is currently under contract for research through the Department of Homeland Security until 2011. The group I was responsible for studying has to remain confidential so as not to affect the current project. All dates, reference links and authors, and other distinguishing characteristics of the original group have been removed from this report. All references to the name of this group or the individual splinter groups has been changed to 'Group X'. I have been collecting texts from a variety of sources intended for the use of recruiting and radicalizing members for Group X splinter groups for the purpose of researching the motivation and intent of leaders of those groups and their influence over the likelihood of group radicalization. This work included visiting many Group X websites to find information on splinter group leaders and finding their statements to new and old members. This proved difficult because the splinter groups of Group X are united in beliefs, but differ in public opinion. They are eager to tear each other down, prove their superiority, and yet remain anonymous. After a few weeks of intense searching, a list of eight recruiting texts and eight radicalizing texts from a variety of Group X leaders were compiled.

  9. Medical Abortion.

    Science.gov (United States)

    Costescu, Dustin; Guilbert, Edith; Bernardin, Jeanne; Black, Amanda; Dunn, Sheila; Fitzsimmons, Brian; Norman, Wendy V; Pymar, Helen; Soon, Judith; Trouton, Konia; Wagner, Marie-Soleil; Wiebe, Ellen; Gold, Karen; Murray, Marie-Ève; Winikoff, Beverly; Reeves, Matthew

    2016-04-01

    This guideline reviews the evidence relating to the provision of first-trimester medical induced abortion, including patient eligibility, counselling, and consent; evidence-based regimens; and special considerations for clinicians providing medical abortion care. Gynaecologists, family physicians, registered nurses, midwives, residents, and other healthcare providers who currently or intend to provide pregnancy options counselling, medical abortion care, or family planning services. Women with an unintended first trimester pregnancy. Published literature was retrieved through searches of PubMed, MEDLINE, and Cochrane Library between July 2015 and November 2015 using appropriately controlled vocabulary (MeSH search terms: Induced Abortion, Medical Abortion, Mifepristone, Misoprostol, Methotrexate). Results were restricted to systematic reviews, randomized controlled trials, clinical trials, and observational studies published from June 1986 to November 2015 in English. Additionally, existing guidelines from other countries were consulted for review. A grey literature search was not required. The quality of evidence in this document was rated using the criteria described in the Report of the Canadian Task Force for Preventive Medicine rating scale (Table 1). Medical abortion is safe and effective. Complications from medical abortion are rare. Access and costs will be dependent on provincial and territorial funding for combination mifepristone/misoprostol and provider availability. Introduction Pre-procedure care Medical abortion regimens Providing medical abortion Post-abortion care Introduction Pre-procedure care Medical abortion regimens Providing medical abortion Post-abortion care. Copyright © 2016 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.

  10. Whatever happened to medical politics?

    Science.gov (United States)

    Emmerich, Nathan

    2011-10-01

    This paper argues the case for coming to see 'medical politics' as a topic or subject within medical education. First, its absence is noted from the wide array of paramedical subjects (medical ethics, history of medicine, the medical humanities, etc) currently given attention in both the medical education literature and in specific curricula. Second the author suggests that 'the political' is implicitly recognisable in the historical roots of medical ethics education, specifically in certain of the London Medical Group's activities, and also that the medical profession, or indeed any profession, cannot be understood as an apolitical form of social organisation either in its institutional or scientific (epistemic) forms. Some brief suggestions for introductory and advanced topics in medical politics are discussed and the degree to which medical politics ought to be taken seriously and delivered as part of medical education is considered. Ultimately the author concludes that medical politics might be considered a useful subject within medical education, but it is perhaps best understood as a perspective or approach that can contribute to the development of a more expansive perspective within the extant paramedical subjects.

  11. Group morphology

    NARCIS (Netherlands)

    Roerdink, Jos B.T.M.

    2000-01-01

    In its original form, mathematical morphology is a theory of binary image transformations which are invariant under the group of Euclidean translations. This paper surveys and extends constructions of morphological operators which are invariant under a more general group TT, such as the motion group

  12. Medication counselling: physicians' perspective.

    Science.gov (United States)

    Bonnerup, Dorthe Krogsgaard; Lisby, Marianne; Eskildsen, Anette Gjetrup; Saedder, Eva Aggerholm; Nielsen, Lars Peter

    2013-12-01

    Medication reviews have the potential to lower the incidence of prescribing errors. To benefit from a medication review, the prescriber must adhere to medication counselling. Adherence rates vary from 39 to 100%. The aim of this study was to examine counselling-naive hospital physicians' perspectives and demands to medication counselling as well as study factors that might increase adherence to the counselling. The study was conducted as a questionnaire survey among physicians at Aarhus University Hospital, Denmark. The questionnaire was developed based on focus group interviews and literature search, and was pilot-tested among 30 physicians before being sent to 669 physicians. The questionnaire consisted of 35 items divided into four categories: attitudes (19 items), behaviours (3 items), assessment (8 items) and demographics (5 items). The response rate was 60% (400/669). Respondents were employed at psychiatric, medical or surgical departments. Eighty-five per cent of respondents agreed that patients would benefit of an extra medication review, and 72% agreed that there was a need for external medication counselling. The most important factor that could increase adherence was the clinical relevance of the counselling as 78% rated it of major importance. The most favoured method for receiving counselling was via the electronic patient record.

  13. Medical Malpractice

    DEFF Research Database (Denmark)

    Grembi, Veronica

    2014-01-01

    MM first came to the attention of policy makers primarily in the USA where, from the 1970s, healthcare providers denounced problems in getting insurance for medical liability, pointing out to a crisis in the MM insurance market (Sage WM (2003) Understanding the first malpractice crisis of the 21th...... in the last decades also among European countries (Hospitals of the European Union (HOPE) (2004) Insurance and malpractice, final report. Brussels, www.hope.be; OECD (2006) Medical malpractice, insurance and coverage options, policy issues in insurance n.11; EC (European Commission, D.G. Sanco) (2006) Special...... eurobarometer medical errors)...

  14. Medical Imaging.

    Science.gov (United States)

    Barker, M. C. J.

    1996-01-01

    Discusses four main types of medical imaging (x-ray, radionuclide, ultrasound, and magnetic resonance) and considers their relative merits. Describes important recent and possible future developments in image processing. (Author/MKR)

  15. Medical error

    African Journals Online (AJOL)

    QuickSilver

    Michael Berk. Department of Psychiatry, University of Melbourne, Australia .... inaccurate and inflammatory media reports their community accepted the ex- ... non-medical situations such as the aviation industry and nuclear power tech- nology ...

  16. Medical Illustration

    Science.gov (United States)

    ... Accredited programs prepare students for a career in academic or research health science centers, industry, or consulting. As members of the health career profession with strong communication skills, medical illustrators work closely with clients to interpret ...

  17. Medical education.

    Science.gov (United States)

    Krishnan, P

    1992-01-01

    In theory, the Medical Council of India (MCI) determines the standards and qualifications of medical schools. It also sanctions curricula and ensures standards. Yet no standards exist on the mode of selection in medical schools, duration of study, course content, student stipends or period of internship. It takes 4.5 years to finish medical school. Students undergo preclinical, paraclinical, and clinical training. Most courses are in English which tends to favor the urban elite. Students cannot always communicate with patients in local languages. Textbooks often provide medical examples unrelated to India. Pedagogy consists mainly of lectures and rote learning predominates. Curricula tend not to provide courses in community health. Students pick up on the elitist attitudes of the faculty. For example, faculty do not put much emphasis on community health, individual health, equity in health care delivery, and teamwork. Further the education system is not patient oriented, but hospital or disease oriented. Faculty should train students in creating sanitation programs, knowing local nutritious foods, and in making community diagnoses. Yet they tend to be practitioners 1st then educators. Further faculty are not paid well and are not always invited to take part in improving curriculum, so morale is often low. Moreover experience in health planning and management issues is not required for administrators. In addition, medical schools are not well equipped with learning aids, libraries, or teaching staff. Tax revenues finance medical education. 75% of graduating physicians set up a private practice. Further many physicians go to urban areas. 34-57% emigrate to other countries. The problems of medical education will not be solved until the political and economic system becomes more responsive to the health needs of the people.

  18. Group devaluation and group identification

    NARCIS (Netherlands)

    Leach, C.W.; Rodriguez Mosquera, P.M.; Vliek, M.L.W.; Hirt, E.

    2010-01-01

    In three studies, we showed that increased in-group identification after (perceived or actual) group devaluation is an assertion of a (preexisting) positive social identity that counters the negative social identity implied in societal devaluation. Two studies with real-world groups used order manip

  19. Medical intellectuals: resisting medical orientalism.

    Science.gov (United States)

    Aull, Felice; Lewis, Bradley

    2004-01-01

    In this paper, we propose analogies between medical discourse and Edward Said's "Orientalism." Medical discourse, like Orientalism, tends to favor institutional interests and can be similarly dehumanizing in its reductionism, textual representations, and construction of its subjects. To resist Orientalism, Said recommends that critics--"intellectuals"--adopt the perspective of exile. We apply Said's paradigm of intellectual-as-exile to better understand the work of key physician-authors who cross personal and professional boundaries, who engage with patients in mutually therapeutic relationships, and who take on the public responsibility of representation and advocacy. We call these physician-authors "medical intellectuals" and encourage others to follow in their path.

  20. Longitudinal trajectories of non-medical use of prescription medication among middle and high school students

    Science.gov (United States)

    Boyd, Carol J.; Cranford, James A.; McCabe, Sean Esteban

    2016-01-01

    The non-medical use of prescription medications has been identified as a major public health problem among youth, although few longitudinal studies have examined non-medical use of prescription medications in the context of other drug use. Previous cross-sectional studies have shown gender and race differences in non-medical use of prescription medications. It was hypothesized that (1) non-medical use of prescription medications increases with age, and (2) these increases will be stronger in magnitude among female and Caucasian adolescents. Changes in non-medical use of prescription medications across 4 years were examined and compared with changes in other drug use (e.g., alcohol and marijuana). Middle and high school students enrolled in 5 schools in southeastern Michigan completed web-based surveys at 4 annual time points. The cumulative sample size was 5,217. The sample ranged from 12 to 18 years, 61% were Caucasian, 34% were African American, and 50% were female. Using a series of repeated measures latent class analyses, the trajectories of non-medical use of prescription medications were examined, demonstrating a 2-class solution: (1) the no/low non-medical use of prescription medications group had low probabilities of any non-medical use of prescription medications across all grades, and (2) the any non-medical use of prescription medications group showed a roughly linear increase in the probability of non-medical use of prescription medications over time. The probability of any non-medical use of prescription medications increased during the transition from middle school to high school. Results from this longitudinal study yielded several noteworthy findings: Participants who were classified in the any/high non-medical use of prescription medications group showed a discontinuous pattern of non-medical use of prescription medications over time, indicating that non-medical use of prescription medications is a relatively sporadic behavior that does not persist

  1. Medical Renaissance.

    Science.gov (United States)

    Toledo-Pereyra, Luis H

    2015-06-01

    The Medical Renaissance started as the regular Renaissance did in the early 1400s and ended in the late 1600s. During this time great medical personalities and scholar humanists made unique advances to medicine and surgery. Linacre, Erasmus, Leonicello and Sylvius will be considered first, because they fit the early classic Renaissance period. Andreas Vesalius and Ambroise Paré followed thereafter, making outstanding anatomical contributions with the publication of the "Human Factory" (1543) by Vesalius, and describing unique surgical developments with the publication of the "The Apologie and Treatise of Ambroise Paré." At the end of the Renaissance and beginning of the New Science, William Harvey, noted British medical doctor and cardiovascular researcher, discovered the general circulation. He published his findings in "The Motu Cordis" in 1628 (Figure 1). The Medical Renaissance, in summary, included a great number of accomplished physicians and surgeons who made especial contributions to human anatomy; Vesalius assembled detailed anatomical information; Paré advanced surgical techniques; and Harvey, a medical genius, detailed the circulatory anatomy and physiology.

  2. Medical Applications

    CERN Document Server

    Biscari, C.

    2014-12-19

    The use of accelerators for medical applications has evolved from initial experimentation to turn-key devices commonly operating in hospitals. New applications are continuously being developed around the world, and the hadrontherapy facilities of the newest generation are placed at the frontier between industrial production and advanced R&D. An introduction to the different medical application accelerators is followed by a description of the hadrontherapy facilities, with special emphasis on CNAO, and the report closes with a brief outlook on the future of this field.

  3. Medical emplotment

    DEFF Research Database (Denmark)

    Mønsted, Troels Sune

    ’. Theoretically the project departs from Computer Supported Cooperative Work and Participatory Design and is informed by Medical Informatics, Design Research and Science and Technology Studies. Methodically the project is founded on collaborative prototyping, ethnographic studies, and design interventions...... philosophy and building on theory on narrative reasoning, the dissertation offers the notions of emplotment and re-emplotment to describe how physicians marshal information from various sources, including the medical record, the patient and coSummary to form a narrative, when making sense of patients...

  4. Medical leasing.

    Science.gov (United States)

    Holden, Elizabeth A

    2012-01-01

    Leases for medical space can have far-reaching (and sometimes unintentional) consequences for the future of the practice and the costs of the business. In order to prevent hardship and expense down the line, it is especially important to review the lease to make sure that it reflects the practice's goals, needs, and structure. This article provides a number of provisions that are especially crucial to review and negotiate when leasing medical space, including use restrictions, assignment and subleasing clauses, build-out terms, and legal compliance requirements.

  5. Medical emplotment

    DEFF Research Database (Denmark)

    Mønsted, Troels Sune

    ’. Theoretically the project departs from Computer Supported Cooperative Work and Participatory Design and is informed by Medical Informatics, Design Research and Science and Technology Studies. Methodically the project is founded on collaborative prototyping, ethnographic studies, and design interventions...... philosophy and building on theory on narrative reasoning, the dissertation offers the notions of emplotment and re-emplotment to describe how physicians marshal information from various sources, including the medical record, the patient and coSummary to form a narrative, when making sense of patients...

  6. Algebraic Groups

    DEFF Research Database (Denmark)

    2007-01-01

    The workshop continued a series of Oberwolfach meetings on algebraic groups, started in 1971 by Tonny Springer and Jacques Tits who both attended the present conference. This time, the organizers were Michel Brion, Jens Carsten Jantzen, and Raphaël Rouquier. During the last years, the subject...... of algebraic groups (in a broad sense) has seen important developments in several directions, also related to representation theory and algebraic geometry. The workshop aimed at presenting some of these developments in order to make them accessible to a "general audience" of algebraic group......-theorists, and to stimulate contacts between participants. Each of the first four days was dedicated to one area of research that has recently seen decisive progress: \\begin{itemize} \\item structure and classification of wonderful varieties, \\item finite reductive groups and character sheaves, \\item quantum cohomology...

  7. Group Grammar

    Science.gov (United States)

    Adams, Karen

    2015-01-01

    In this article Karen Adams demonstrates how to incorporate group grammar techniques into a classroom activity. In the activity, students practice using the target grammar to do something they naturally enjoy: learning about each other.

  8. MUYANG GROUP

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    @@ With its headquarters in the historic city of Yangzhou,Jiangsu Muyang Group Co.,Ltd has since its founding in 1967 grown into a well-known group corporation whose activities cover research&development.project design,manufacturing,installation and services in a multitude of industries including feed machinery and engineering,storage engineering,grain machinery and engineering,environmental protection,conveying equipment and automatic control systems.

  9. Abelian groups

    CERN Document Server

    Fuchs, László

    2015-01-01

    Written by one of the subject’s foremost experts, this book focuses on the central developments and modern methods of the advanced theory of abelian groups, while remaining accessible, as an introduction and reference, to the non-specialist. It provides a coherent source for results scattered throughout the research literature with lots of new proofs. The presentation highlights major trends that have radically changed the modern character of the subject, in particular, the use of homological methods in the structure theory of various classes of abelian groups, and the use of advanced set-theoretical methods in the study of undecidability problems. The treatment of the latter trend includes Shelah’s seminal work on the undecidability in ZFC of Whitehead’s Problem; while the treatment of the former trend includes an extensive (but non-exhaustive) study of p-groups, torsion-free groups, mixed groups, and important classes of groups arising from ring theory. To prepare the reader to tackle these topics, th...

  10. Medical Transcriptionists

    Science.gov (United States)

    ... Contact & Help Economic Releases Latest Releases » Major Economic Indicators » Schedules for news Releases » By Month By News ... employed in 2014. Most medical transcriptionists work for hospitals or in ... risk management, legal issues relating to healthcare documentation, and English ...

  11. Glaucoma medications.

    Science.gov (United States)

    Chae, Bora; Cakiner-Egilmez, Tulay; Desai, Manishi

    2013-01-01

    Glaucoma is a common eye condition that affects millions of individuals worldwide, making it the second-leading cause of blindness. Because glaucoma is associated with increased IOP level, the primary goal in treatment of glaucoma includes lowering IOP to prevent further progression of the disease. While various surgical interventions exist, medical therapy is currently the first line of treatment. Medical treatment of glaucoma includes topical beta-blockers, alpha-2 agonists, prostaglandins, parasympathomimetics and CAIs. Anti-glaucoma agents help reduce IOP by affecting the production of aqueous humor or increasing the outflow of aqueous through the trabecular or uveoscleral pathway. Choosing an appropriate medical regimen can be challenging and various factors such as efficacy, safety, cost and patient compliance must be considered. First-line treatment is often topical beta-blockers or prostaglandin analogs. However, beta-blocking agents can be associated with systemic side effects and need to be used cautiously in patients with serious concomitant cardiopulmonary disease. Alpha-2 agonists and parasympathomimetics are often considered second- or third-line treatment options but good adjunctive agents. Oral CAIs are often indicated for patients with elevated IOP in an acute setting or for patients resistant to other glaucoma medications and patients who are not good surgical candidates.

  12. Medic Bleep.

    Science.gov (United States)

    2017-03-15

    Medic Bleep is a secure instant messaging app that enables clinicians to discuss patient care quickly, securely and legally. It looks and feels like WhatsApp, but has been designed for the healthcare market to enable staff to communicate with each other, and to help speed up conversations between clinicians to increase efficiency.

  13. Medication Errors

    Science.gov (United States)

    ... Proprietary Names (PDF - 146KB) Draft Guidance for Industry: Best Practices in Developing Proprietary Names for Drugs (PDF - 279KB) ... or (301) 796-3400 druginfo@fda.hhs.gov Human Drug ... in Medication Errors Resources for You Agency for Healthcare Research and Quality: ...

  14. [Seniors and cardiovascular medications].

    Science.gov (United States)

    Kubesová, H Matejovská; Weber, P; Meluzínová, H; Matejovský, J

    2011-06-01

    Authors analyze the situation in the therapy of cardiovascular diseases--unsatisfactory situation especially from the dyslipidaemia point of view. Different groups of medications are discussed and their risks for elderly patients. Angiotensin converting enzyme blockers and their influence on the endothelial dysfunction, but the risk of hyperpotassemia are showed. The risk of gastrointestinal bleeding during the treatment with antiagregants and anticoagulants, the risk of bradycardia in beta-blockade, possible interactions with other medications lowering the heart rate are discussed. Attention is paid to calcium channel blockers, diuretics and digoxin. The table containing possible clinical symptoms of unwanted side effect of most frequently used cardiovascular medications in elderly is added as the conclusion of the article.

  15. [Education for medical teamwork in Shinshu University].

    Science.gov (United States)

    Takamiya, Osamu

    2006-03-01

    Both students of health sciences (medical technology, nursing science, physical therapy, and occupational therapy) and medical students learn medical teamwork in the primary stage by joint practice in Shinshu University. The aim of this class is for students that will become medical staff to increase their necessary communication skills for medical teamwork in addition to understanding the mutual medical professional fields in a medical institution. The 242 students of the medical department (147 students of health sciences and 95 students of medicine) take 15 classes during their first term as freshers. One teacher takes charge of a group consisting of 14 students for tutorials by mutually cooperation between teachers of medicine and health sciences. Positive relationships are expected to develop in the group, raising sociality and ethics so that both students of health science and medicine experience interdisciplinary discussion in small groups as an ideal method for continuing health care in times of poor knowledge of medicine and health care.

  16. Group Anonymity

    CERN Document Server

    Chertov, Oleg; 10.1007/978-3-642-14058-7_61

    2010-01-01

    In recent years the amount of digital data in the world has risen immensely. But, the more information exists, the greater is the possibility of its unwanted disclosure. Thus, the data privacy protection has become a pressing problem of the present time. The task of individual privacy-preserving is being thoroughly studied nowadays. At the same time, the problem of statistical disclosure control for collective (or group) data is still open. In this paper we propose an effective and relatively simple (wavelet-based) way to provide group anonymity in collective data. We also provide a real-life example to illustrate the method.

  17. 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.

  18. 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.

  19. Radiation physics for medical physicists

    CERN Document Server

    Podgorsak, Ervin B

    2006-01-01

    This book summarizes the radiation physics knowledge that professionals working in medical physics need to master for efficient and safe dealings with ionizing radiation. It contains eight chapters, each chapter covering a specific group of subjects related to radiation physics and is intended as a textbook for a course in radiation physics in medical-physics graduate programs. However, the book may also be of interest to the large number of professionals, not only medical physicists, who in their daily occupations deal with various aspects of medical physics and find a need to improve their understanding of radiation physics. The main target audience for this book is graduate students studying for M.Sc. and Ph.D. degrees in medical physics, who have to possess the necessary physics and mathematics background knowledge to be able to follow and master the complete textbook. Medical residents, technology students and biomedical engineering students may find certain sections too challenging or esoteric, yet they...

  20. Teilnehmende Beobachtung und Perspektivwechsel: Medizinethnologie in der Begegnung mit sozialen Randgruppen. Erste Erfahrungen mit einem neuen Lehrangebot [Participant observation and change of perspectives: Medical Anthropology and the encounter with socially marginalised groups. First experiences with a new teaching concept

    Directory of Open Access Journals (Sweden)

    Mohr, Berit

    2012-11-01

    Full Text Available [english] This paper examines the new teaching concept “Providing medical care on the fringe of society: Participant observation and change in perspectives” in the context of the interdisciplinary field of (the transdisciplinary section under AOÄ, the German Regulations for licensed physicians that explores the history, theory and ethics of medicine. The disciplinary approach usually adopted in Q 2 is supplemented with concepts from medical anthropology; in addition students will be exposed to people in extreme social situations. The aim is to make students aware of and invite them to reflect upon: At a more general level students will learn how to put themselves in the position of different protagonists in a range of medical settings, and practice the skill of reflecting critically upon putative conceptual/theoretical and normative-ethical assumptions in medicine.[german] Zur Diskussion gestellt wird ein neues Lehrangebot „Medizin am Rand der Gesellschaft: Teilnehmende Beobachtung und Perspektivwechsel“ im Kontext des Querschnittsbereichs 2/Q2 (AOÄ Geschichte, Theorie, Ethik der Medizin. Die methodischen Ansätze des Q 2 werden durch Konzepte aus der Medizinethnologie, in Kombination mit einer Exposition der Studierenden gegenüber Menschen in sozialen Grenzsituationen ergänzt. Ziele sind die Sensibilisierung für und Reflexion auf Auf einer allgemeineren Ebene wird die Fähigkeit eingeübt, Perspektiven unterschiedlicher Akteure in medizinischen Kontexten einzunehmen, ebenso die Fähigkeit zur kritischen Reflexion vermeintlich selbstverständlicher begrifflich-theoretischer und normativ-ethischer Prämissen in der Medizin.

  1. Informal groups

    NARCIS (Netherlands)

    E. van den Berg; P. van Houwelingen; J. de Hart

    2011-01-01

    Original title: Informele groepen Going out running with a group of friends, rather than joining an official sports club. Individuals who decide to take action themselves rather than giving money to good causes. Maintaining contact with others not as a member of an association, but through an Inter

  2. Medical imaging

    CERN Document Server

    Townsend, David W

    1996-01-01

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

  3. Medical physics

    Energy Technology Data Exchange (ETDEWEB)

    Pope, J.A. (Plymouth College (UK))

    1989-01-01

    A book on 'Medical Physics' is written in three parts. Part I discusses the physics of the human body including the expenditure of energy, human mechanics and the human response to light and sound. Part II describes the monitoring of various physiological parameters, such as temperatures and pressure using specialized transducers and systems employing radiotelemetric, ultrasonic and fibre-optic techniques. Part III on ionizing radiations discusses the production, properties and detection of the different radiations and the elements of dosimetry. The different types of radiation detectors are also described. Finally the diagnostic applications of radioactive tracer studies are discussed. The material selected for inclusion in this book reflects the requirements of the Joint Matriculation Board's A-level option on Medical Physics and at the end of each of the 15 chapters, there are questions on the content. Part III of the book has been selected and indexed separately. (UK).

  4. COMMUNICATIONS GROUP

    CERN Multimedia

    L. Taylor

    2011-01-01

    The CMS Communications Group, established at the start of 2010, has been busy in all three areas of its responsibility: (1) Communications Infrastructure, (2) Information Systems, and (3) Outreach and Education. Communications Infrastructure There are now 55 CMS Centres worldwide that are well used by physicists working on remote CMS shifts, Computing operations, data quality monitoring, data analysis and outreach. The CMS Centre@CERN in Meyrin, is the centre of the CMS offline and computing operations, hosting dedicated analysis efforts such as during the CMS Heavy Ion lead-lead running. With a majority of CMS sub-detectors now operating in a “shifterless” mode, many monitoring operations are now routinely performed from there, rather than in the main Control Room at P5. The CMS Communications Group, CERN IT and the EVO team are providing excellent videoconferencing support for the rapidly-increasing number of CMS meetings. In parallel, CERN IT and ...

  5. Lego Group

    DEFF Research Database (Denmark)

    Møller Larsen, Marcus; Pedersen, Torben; Slepniov, Dmitrij

    2010-01-01

    The last years’ rather adventurous journey from 2004 to 2009 had taught the fifth-largest toy-maker in the world - the LEGO Group - the importance of managing the global supply chain effectively. In order to survive the largest internal financial crisis in its roughly 70 years of existence......, the management had, among many initiatives, decided to offshore and outsource a major chunk of its production to Flextronics. In this pursuit of rapid cost-cutting sourcing advantages, the LEGO Group planned to license out as much as 80 per cent of its production besides closing down major parts...... of the production in high cost countries. Confident with the prospects of the new partnership, the company signed a long-term contract with Flextronics. This decision eventually proved itself to have been too hasty, however. Merely three years after the contracts were signed, LEGO management announced that it would...

  6. Group play

    DEFF Research Database (Denmark)

    Tychsen, Anders; Hitchens, Michael; Brolund, Thea

    2008-01-01

    of group dynamics, the influence of the fictional game characters and the comparative play experience between the two formats. The results indicate that group dynamics and the relationship between the players and their digital characters, are integral to the quality of the gaming experience in multiplayer......Role-playing games (RPGs) are a well-known game form, existing in a number of formats, including tabletop, live action, and various digital forms. Despite their popularity, empirical studies of these games are relatively rare. In particular there have been few examinations of the effects...... of the various formats used by RPGs on the gaming experience. This article presents the results of an empirical study, examining how multi-player tabletop RPGs are affected as they are ported to the digital medium. Issues examined include the use of disposition assessments to predict play experience, the effect...

  7. Group Connections: Whole Group Teaching.

    Science.gov (United States)

    Griffiths, Dorothy

    2002-01-01

    A learner-centered approach to adult group instruction involved learners in investigating 20th-century events. The approach allowed learners to concentrate on different activities according to their abilities and gave them opportunities to develop basic skills and practice teamwork. (SK)

  8. Medical robotics

    CERN Document Server

    Troccaz, Jocelyne

    2013-01-01

    In this book, we present medical robotics, its evolution over the last 30 years in terms of architecture, design and control, and the main scientific and clinical contributions to the field. For more than two decades, robots have been part of hospitals and have progressively become a common tool for the clinician. Because this domain has now reached a certain level of maturity it seems important and useful to provide a state of the scientific, technological and clinical achievements and still open issues. This book describes the short history of the domain, its specificity and constraints, and

  9. Medical Physics

    OpenAIRE

    Voto Bernales, Juan; Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú

    2014-01-01

    Medical Physics is to study the physical phenomena that occur in the body and exert action on the agents. It also addresses the manner taught natural agents in the study and exploration of the human body and in the way in the same agents for use in the treatment of disease can be used. La Física Médica tiene por objeto estudiar los fenómenos físicos que se realizan en el organismo y la acción que sobre el ejercen los agentes. Se ocupa, además, de enseñar la manera cómo pueden utilizarse lo...

  10. Medical revolution in Argentina.

    Science.gov (United States)

    Ballarin, V L; Isoardi, R A

    2010-01-01

    The paper discusses the major Argentineans contributors, medical physicists and scientists, in medical imaging and the development of medical imaging in Argentina. The following are presented: history of medical imaging in Argentina: the pioneers; medical imaging and medical revolution; nuclear medicine imaging; ultrasound imaging; and mathematics, physics, and electronics in medical image research: a multidisciplinary endeavor.

  11. COMMUNICATIONS GROUP

    CERN Multimedia

    L. Taylor

    2011-01-01

    The CMS Communications Group has been busy in all three areas of its responsibility: (1) Communications Infrastructure, (2) Information Systems, and (3) Outreach and Education. Communications Infrastructure The 55 CMS Centres worldwide are well used by physicists working on remote CMS shifts, Computing operations, data quality monitoring, data analysis and outreach. The CMS Centre@CERN in Meyrin, is the centre of the CMS Offline and Computing operations, and a number of subdetector shifts can now take place there, rather than in the main Control Room at P5. A new CMS meeting room has been equipped for videoconferencing in building 42, next to building 40. Our building 28 meeting room and the facilities at P5 will be refurbished soon and plans are underway to steadily upgrade the ageing equipment in all 15 CMS meeting rooms at CERN. The CMS evaluation of the Vidyo tool indicates that it is not yet ready to be considered as a potential replacement for EVO. The Communications Group provides the CMS-TV (web) cha...

  12. COMMUNICATIONS GROUP

    CERN Multimedia

    L. Taylor

    2010-01-01

    The CMS Communications Group, established at the start of 2010, has been strengthening the activities in all three areas of its responsibility: (1) Communications Infrastructure, (2) Information Systems, and (3) Outreach and Education. Communications Infrastructure The Communications Group has invested a lot of effort to support the operations needs of CMS. Hence, the CMS Centres where physicists work on remote CMS shifts, Data Quality Monitoring, and Data Analysis are running very smoothly. There are now 55 CMS Centres worldwide, up from just 16 at the start of CMS data-taking. The latest to join are Imperial College London, the University of Iowa, and the Università di Napoli. The CMS Centre@CERN in Meyrin, which is now full repaired after the major flooding at the beginning of the year, has been at the centre of CMS offline and computing operations, most recently hosting a large fraction of the CMS Heavy Ion community during the lead-lead run. A number of sub-detector shifts can now take pla...

  13. Medical robotics.

    Science.gov (United States)

    Ferrigno, Giancarlo; Baroni, Guido; Casolo, Federico; De Momi, Elena; Gini, Giuseppina; Matteucci, Matteo; Pedrocchi, Alessandra

    2011-01-01

    Information and communication technology (ICT) and mechatronics play a basic role in medical robotics and computer-aided therapy. In the last three decades, in fact, ICT technology has strongly entered the health-care field, bringing in new techniques to support therapy and rehabilitation. In this frame, medical robotics is an expansion of the service and professional robotics as well as other technologies, as surgical navigation has been introduced especially in minimally invasive surgery. Localization systems also provide treatments in radiotherapy and radiosurgery with high precision. Virtual or augmented reality plays a role for both surgical training and planning and for safe rehabilitation in the first stage of the recovery from neurological diseases. Also, in the chronic phase of motor diseases, robotics helps with special assistive devices and prostheses. Although, in the past, the actual need and advantage of navigation, localization, and robotics in surgery and therapy has been in doubt, today, the availability of better hardware (e.g., microrobots) and more sophisticated algorithms(e.g., machine learning and other cognitive approaches)has largely increased the field of applications of these technologies,making it more likely that, in the near future, their presence will be dramatically increased, taking advantage of the generational change of the end users and the increasing request of quality in health-care delivery and management.

  14. Smoking cessation medications

    Science.gov (United States)

    Smoking cessation - medications; Smokeless tobacco - medications; Medications for stopping tobacco ... Creating a plan to help you deal with smoking urges. Getting support from a doctor, counselor, or ...

  15. Cultural initiation of medical doctors.

    Science.gov (United States)

    Zsinkó-Szabó, Zoltán; Lázár, Imre

    2013-12-01

    Eighteen years experience of teaching medical anthropology at a Hungarian medical school offers insight into the dynamics of interference between the rationalist epistemological tradition of biomedicine as one of the central paradigms of modernism and the cultural relativism of medical anthropology, as cultural anthropology is considered to be one of the generators of postmodern thinking. Tracing back the informal "prehistory" of our Institute, we can reveal its psychosomatic, humanistic commitment and critical basis as having represented a kind of counterculture compared with the technocrats of state-socialist Hungary's health ideology. The historical change and socio-cultural transition in Hungary after 1989 was accompanied by changes in the medical system as well as in philosophy and in the structure of the teaching of social sciences. The developing pluralism in the medical system together with the pluralism of social ideologies allowed the substitution of the dogmatic Marxist-Leninist framework with the more pragmatic and empiricist behavioral sciences including medical sociology and medical anthropology. The conflict between the initiation function of the hard preclinical training of the first two years, and the reflective, relativistic and critical narrative on "biomedicine as culture bound entity" constructed by medical anthropology during the second year of medical training is discussed. We also submit our fieldwork data gained as a result of a two year investigation period focusing on diverse initiation types of "would be" physicians. The main proportion of our data derives from individual semi structured deep interviews together with focus group interviews carried out with medical students of upper years. Finally, the role of medical anthropology in the "rite of passage" of becoming a medical doctor is summarized, paying attention to their field work reports and the risks and gains in this process.

  16. Palliative care in medical social work support group intervention for cancer patients%姑息照护中医务社会工作支持小组对癌症患者的干预作用

    Institute of Scientific and Technical Information of China (English)

    温锦旺

    2014-01-01

    Based on the oalliative care and the social suooort theory, the social suooort grouo work is carried out through the recruitment of cancer oatients• Comoared with the traditional treatment method and the conceot, the suooort grouos of medical social work can orovide osychological and social suooort for the team, and meet their soiritual needs• Finally, the team assessment methods and tools as well as the cancer suooort grouo motivation are reflected on•%本课题以姑息照顾和社会支持理论为框架,招募癌症患者开展社会支持小组工作。与传统治疗方法相比,以姑息照顾为理念的医务社会工作支持小组的介入,可以为组员提供心理和社会支持,满足他们的灵性需求。文章对小组评估方法、工具、癌症患者支持性小组动力进行反思。

  17. Current practice in laboratory diagnostics of autoimmune diseases in Croatia. 
Survey of the Working group for laboratory diagnostics of autoimmune diseases of the Croatian Society of Medical Biochemistry and Laboratory Medicine

    Science.gov (United States)

    Kuna, Andrea Tešija; Đerek, Lovorka; Kozmar, Ana; Drvar, Vedrana

    2016-01-01

    Introduction With the trend of increasing incidence of autoimmune diseases, laboratories are faced with exponential growth of the requests for tests relating the diagnosis of these diseases. Unfortunately, the lack of laboratory personnel experienced in this specific discipline of laboratory diagnostic, as well as an unawareness of a method limitation often results in confusion for clinicians. The aim was to gain insight into number and type of Croatian laboratories that perform humoral diagnostics with the final goal to improve and harmonize laboratory diagnostics of autoimmune diseases in Croatia. Materials and methods In order to get insight into current laboratory practice two questionnaires, consisting of 42 questions in total, were created. Surveys were conducted using SurveyMonkey application and were sent to 88 medical biochemistry laboratories in Croatia for the first survey. Out of 33 laboratories that declared to perform diagnostic from the scope, 19 were selected for the second survey based on the tests they pleaded to perform. The survey comprised questions regarding autoantibody hallmarks of systemic autoimmune diseases while regarding organ-specific autoimmune diseases was limited to diseases of liver, gastrointestinal and nervous system. Results Response rate was high with 80 / 88 (91%) laboratories which answered the first questionnaire, and 19 / 19 (1.0) for the second questionnaire. Obtained results of surveys indicate high heterogeneity in the performance of autoantibody testing among laboratories in Croatia. Conclusions Results indicate the need of creating recommendations and algorithms in order to harmonize the approach to laboratory diagnostics of autoimmune diseases in Croatia.

  18. Perceived Barriers and Facilitators of Using a Web-Based Interactive Decision Aid for Colorectal Cancer Screening in Community Practice Settings: Findings From Focus Groups With Primary Care Clinicians and Medical Office Staff

    OpenAIRE

    2013-01-01

    Background Information is lacking about the capacity of those working in community practice settings to utilize health information technology for colorectal cancer screening. Objective To address this gap we asked those working in community practice settings to share their perspectives about how the implementation of a Web-based patient-led decision aid might affect patient-clinician conversations about colorectal cancer screening and the day-to-day clinical workflow. Methods Five focus group...

  19. Distributed Object Medical Imaging Model

    CERN Document Server

    Noor, Ahmad Shukri Mohd

    2009-01-01

    Digital medical informatics and images are commonly used in hospitals today,. Because of the interrelatedness of the radiology department and other departments, especially the intensive care unit and emergency department, the transmission and sharing of medical images has become a critical issue. Our research group has developed a Java-based Distributed Object Medical Imaging Model(DOMIM) to facilitate the rapid development and deployment of medical imaging applications in a distributed environment that can be shared and used by related departments and mobile physiciansDOMIM is a unique suite of multimedia telemedicine applications developed for the use by medical related organizations. The applications support realtime patients' data, image files, audio and video diagnosis annotation exchanges. The DOMIM enables joint collaboration between radiologists and physicians while they are at distant geographical locations. The DOMIM environment consists of heterogeneous, autonomous, and legacy resources. The Common...

  20. Evolution, current structure, and role of a primary care clinical pharmacy service in an integrated managed care organization.

    Science.gov (United States)

    Heilmann, Rachel M F; Campbell, Stephanie M; Kroner, Beverly A; Proksel, Jenel R; Billups, Sarah J; Witt, Daniel M; Helling, Dennis K

    2013-01-01

    The impact of the declining number of primary care physicians is exacerbated by a growing elderly population in need of chronic disease management. Primary care clinical pharmacy specialists, with their unique knowledge and skill set, are well suited to address this gap. At Kaiser Permanente of Colorado (KPCO), primary care clinical pharmacy specialists have a long history of integration with medical practices and are located in close proximity to physicians, nurses, and other members of the health care team. Since 1992, Primary Care Clinical Pharmacy Services (PCCPS) has expanded from 4 to 30 full-time equivalents (FTEs) to provide services in all KPCO medical office buildings. With this growth in size, PCCPS has evolved to play a vital role in working with primary care medical teams to ensure that drug therapy is effective, safe, and affordable. In addition, PCCPS specialists provide ambulatory teaching sites for pharmacy students and pharmacy residents. There is approximately 1 specialist FTE for every 13,000 adult KPCO members and every 9 clinical FTEs of internal medicine and family medicine physicians. All clinical pharmacy specialists in the pharmacy department are required to have a PharmD degree, to complete postgraduate year 2 residencies, and, as a condition of employment, to become board certified in an applicable specialty. The evolution, current structure, and role of PCCPS at KPCO, including factors facilitating successful integration within the medical team, are highlighted. Patient and nonpatient care responsibilities are described.

  1. [Accreditation of medical laboratories].

    Science.gov (United States)

    Horváth, Andrea Rita; Ring, Rózsa; Fehér, Miklós; Mikó, Tivadar

    2003-07-27

    In Hungary, the National Accreditation Body was established by government in 1995 as an independent, non-profit organization, and has exclusive rights to accredit, amongst others, medical laboratories. The National Accreditation Body has two Specialist Advisory Committees in the health care sector. One is the Health Care Specialist Advisory Committee that accredits certifying bodies, which deal with certification of hospitals. The other Specialist Advisory Committee for Medical Laboratories is directly involved in accrediting medical laboratory services of health care institutions. The Specialist Advisory Committee for Medical Laboratories is a multidisciplinary peer review group of experts from all disciplines of in vitro diagnostics, i.e. laboratory medicine, microbiology, histopathology and blood banking. At present, the only published International Standard applicable to laboratories is ISO/IEC 17025:1999. Work has been in progress on the official approval of the new ISO 15189 standard, specific to medical laboratories. Until the official approval of the International Standard ISO 15189, as accreditation standard, the Hungarian National Accreditation Body has decided to progress with accreditation by formulating explanatory notes to the ISO/IEC 17025:1999 document, using ISO/FDIS 15189:2000, the European EC4 criteria and CPA (UK) Ltd accreditation standards as guidelines. This harmonized guideline provides 'explanations' that facilitate the application of ISO/IEC 17025:1999 to medical laboratories, and can be used as a checklist for the verification of compliance during the onsite assessment of the laboratory. The harmonized guideline adapted the process model of ISO 9001:2000 to rearrange the main clauses of ISO/IEC 17025:1999. This rearrangement does not only make the guideline compliant with ISO 9001:2000 but also improves understanding for those working in medical laboratories, and facilitates the training and education of laboratory staff. With the

  2. Graphical user interface for a remote medical monitoring system: U.S. Army medic recommendations.

    Science.gov (United States)

    Kaushik, Sangeeta; Tharion, William J

    2009-11-01

    We obtained recommendations for a graphical user interface (GUI) design for a new medical monitoring system. Data were obtained from 26 combat-experienced medics. Volunteers were briefed on the medical monitoring system. They then completed a questionnaire on background medical treatment experience, provided drawings on how and what information should be displayed on the GUI screens for use on a personal digital assistant, and participated in focus group sessions with four to seven medics per group to obtain group consensus on what information the GUI screens should contain. Detailed displays on seven screens provide the medical and situational awareness information medics need for triage decisions and for early processing of a casualty. The created GUI screens are a combination of object-based and text-based information using a color-coded system. Medics believed the information displayed with these GUI designs would improve treatment of casualties on the battlefield.

  3. Capturing medical students' idealism.

    Science.gov (United States)

    Smith, Janice K; Weaver, Donna B

    2006-01-01

    Students' idealism and desire to work with underserved populations decline as they progress from preclinical training through clerkships and residency. With an increasingly diverse population and increasing health disparities, academic health centers need to incorporate changes in their curricula to train socially responsible and idealistic physicians. International electives can provide valuable learning experiences to help achieve these goals. Sixty-six preclinical medical students at the University of Texas Medical Branch participated in an international elective from 1997 to 2005. After 1 week of didactics, they spent 3 weeks as part of a multidisciplinary medical team in rural Nicaragua. Postelective questionnaires were administered. From students' responses, we identified common learning themes and grouped them under the categories of attitudes, awareness, and skills. Limitations included a self-selection bias, lack of a control group, and limited follow-up. After the elective, students had an increased interest in volunteerism, humanitarian efforts, and working with underserved populations both in the United States and abroad, as well as more compassion toward the underserved. Students also reported a heightened awareness of social determinants of health and public health, and a broadened global perspective, as well as increased self-awareness. Our findings illustrate that a well-structured, mentored experience in international health can have a positive impact on preclinical students' attitudes, including their compassion, volunteerism, and interest in serving under-served populations, all measures of idealism.

  4. Capturing Medical Students’ Idealism

    Science.gov (United States)

    Smith, Janice K.; Weaver, Donna B.

    2006-01-01

    PURPOSE Students’ idealism and desire to work with underserved populations decline as they progress from preclinical training through clerkships and residency. With an increasingly diverse population and increasing health disparities, academic health centers need to incorporate changes in their curricula to train socially responsible and idealistic physicians. International electives can provide valuable learning experiences to help achieve these goals. METHODS Sixty-six preclinical medical students at the University of Texas Medical Branch participated in an international elective from 1997 to 2005. After 1 week of didactics, they spent 3 weeks as part of a multidisciplinary medical team in rural Nicaragua. Postelective questionnaires were administered. From students’ responses, we identified common learning themes and grouped them under the categories of attitudes, awareness, and skills. Limitations included a self-selection bias, lack of a control group, and limited follow-up. RESULTS After the elective, students had an increased interest in volunteerism, humanitarian efforts, and working with underserved populations both in the United States and abroad, as well as more compassion toward the underserved. Students also reported a heightened awareness of social determinants of health and public health, and a broadened global perspective, as well as increased self-awareness. CONCLUSIONS Our findings illustrate that a well-structured, mentored experience in international health can have a positive impact on preclinical students’ attitudes, including their compassion, volunteerism, and interest in serving under-served populations, all measures of idealism. PMID:17003160

  5. Group Formation in Economics

    Science.gov (United States)

    Demange, Gabrielle; Wooders, Myrna

    2005-01-01

    Broad and diverse ranges of activities are conducted within and by organized groups of individuals, including political, economic and social activities. These activities have recently become a subject of intense interest in economics and game theory. Some of the topics investigated in this collection are models of networks of power and privilege, trade networks, co-authorship networks, buyer-seller networks with differentiated products, and networks of medical innovation and the adaptation of new information. Other topics are social norms on punctuality, clubs and the provision of club goods and public goods, research and development and collusive alliances among corporations, and international alliances and trading agreements. While relatively recent, the literature on game theoretic studies of group formation in economics is already vast. This volume provides an introduction to this important literature on game-theoretic treatments of situations with networks, clubs, and coalitions, including some applications.

  6. Interactive Video in Medical Education

    OpenAIRE

    Chandrasekhar, Arcot J.; Price, Ronald N.

    1989-01-01

    A variety of attributes have to be taught to a medical student. Various formats of these skills are currently in vogue, namely lectures, small group sessions, preceptorships, etc. The objective of this project is to evaluate the utility of interactive video in medical education. Lessons using interactive video were developed to teach history taking skills, procedural skills, problem solving skills and to acquire knowledge base. Evaluation strategies are being developed to assess which format,...

  7. Medical telesensors

    Science.gov (United States)

    Ferrell, Trinidad L.; Crilly, P. B.; Smith, S. F.; Wintenberg, Alan L.; Britton, Charles L., Jr.; Morrison, Gilbert W.; Ericson, M. N.; Hedden, D.; Bouldin, Donald W.; Passian, A.; Downey, Todd R.; Wig, A. G.; Meriaudeau, Fabrice

    1998-05-01

    Medical telesensors are self-contained integrated circuits for measuring and transmitting vital signs over a distance of approximately 1-2 meters. The circuits are unhoused and contain a sensor, signal processing and modulation electronics, a spread-spectrum transmitter, an antenna and a thin-film battery. We report on a body-temperature telesensor, which is sufficiently small to be placed on a tympanic membrane in a child's ear. We also report on a pulse-oximeter telesensor and a micropack receiver/long- range transmitter unit, which receives form a telesensor array and analyzes and re-transmits the vital signs over a longer range. Signal analytics are presented for the pulse oximeter, which is currently in the form of a finger ring. A multichip module is presented as the basic signal-analysis component. The module contains a microprocessor, a field=programmable gate array, memory elements and other components necessary for determining trauma and reporting signals.

  8. [MEDICAL CANNABIS].

    Science.gov (United States)

    Naftali, Timna

    2016-02-01

    The cannabis plant has been known to humanity for centuries as a remedy for pain, diarrhea and inflammation. Current research is inspecting the use of cannabis for many diseases, including multiple sclerosis, epilepsy, dystonia, and chronic pain. In inflammatory conditions cannabinoids improve pain in rheumatoid arthritis and:pain and diarrhea in Crohn's disease. Despite their therapeutic potential, cannabinoids are not free of side effects including psychosis, anxiety, paranoia, dependence and abuse. Controlled clinical studies investigating the therapeutic potential of cannabis are few and small, whereas pressure for expanding cannabis use is increasing. Currently, as long as cannabis is classified as an illicit drug and until further controlled studies are performed, the use of medical cannabis should be limited to patients who failed conventional better established treatment.

  9. COMMUNICATIONS GROUP

    CERN Multimedia

    L. Taylor

    2011-01-01

    Communications Infrastructure The 55 CMS Centres worldwide are well used by physicists working on remote CMS shifts, Computing operations, data quality monitoring, data analysis and outreach. The CMS Centre@CERN in Meyrin is particularly busy at the moment, hosting about 50 physicists taking part in the heavy-ion data-taking and analysis. Three new CMS meeting room will be equipped for videoconferencing in early 2012: 40/5B-08, 42/R-031, and 28/S-029. The CMS-TV service showing LHC Page 1, CMS Page 1, etc. (http://cmsdoc.cern.ch/cmscc/projector/index.jsp) is now also available for mobile devices: http://cern.ch/mcmstv. Figure 12: Screenshots of CMS-TV for mobile devices Information Systems CMS has a new web site: (http://cern.ch/cms) using a modern web Content Management System to ensure content and links are managed and updated easily and coherently. It covers all CMS sub-projects and groups, replacing the iCMS internal pages. It also incorporates the existing CMS public web site (http:/...

  10. COMMUNICATIONS GROUP

    CERN Multimedia

    L. Taylor

    2012-01-01

      Outreach and Education We are fortunate that our research has captured the public imagination, even though this inevitably puts us under the global media spotlight, as we saw with the Higgs seminar at CERN in December, which had 110,000 distinct webcast viewers. The media interest was huge with 71 media organisations registering to come to CERN to cover the Higgs seminar, which was followed by a press briefing with the DG and Spokespersons. This event resulted in about 2,000 generally positive stories in the global media. For this seminar, the CMS Communications Group prepared up-to-date news and public material, including links to the CMS results, animations and event displays [http://cern.ch/go/Ch8thttp://cern.ch/go/Ch8t]. There were 44,000 page-views on the CMS public website, with the Higgs news article being by far the most popular item. CMS event displays from iSpy are fast becoming the iconic media images, featuring on numerous major news outlets (BBC, CNN, MSN...) as well as in the sci...

  11. COMMUNICATIONS GROUP

    CERN Multimedia

    L. Taylor

    2010-01-01

    The recently established CMS Communications Group, led by Lucas Taylor, has been busy in all three of its main are areas of responsibility: Communications Infrastructure, Information Systems, and Outreach and Education Communications Infrastructure The damage caused by the flooding of the CMS Centre@CERN on 21st December has been completely repaired and all systems are back in operation. Major repairs were made to the roofs, ceilings and one third of the floor had to be completely replaced. Throughout these works, the CMS Centre was kept operating and even hosted a major press event for first 7 TeV collisions, as described below. Incremental work behind the scenes is steadily improving the quality of the CMS communications infrastructure, particularly Webcasting, video conferencing, and meeting rooms at CERN. CERN/IT is also deploying a pilot service of a new videoconference tool called Vidyo, to assess whether it might provide an enhanced service at a lower cost, compared to the EVO tool currently in w...

  12. Apreensão de tópicos em ética médica no ensino-aprendizagem de pequenos grupos: comparando a aprendizagem baseada em problemas com o modelo tradicional Acquisition of skills in medical ethics on the small group learning-teaching method: comparing the problem based learn with a traditional model

    Directory of Open Access Journals (Sweden)

    Eliandro José Gutierres Figueira

    2004-04-01

    Full Text Available OBJETIVO: O presente estudo tem como objetivo avaliar o ensino de ética médica durante o curso de medicina e se houve mudança na aquisição de conhecimentos em ética médica com o redirecionamento do modelo pedagógico da Faculdade de Medicina de Marília. MÉTODOS: Foi realizado estudo prospectivo e analítico, baseado na aplicação de questionários sobre temas gerais em Ética, em dois períodos distintos. RESULTADOS: Observou-se não haver diferenças significantes entre a aquisição de conhecimentos entre os dois métodos. Verificou-se que os alunos de anos mais próximos do término do curso apresentaram desempenho significativamente melhor que os ingressantes no curso. Os tópicos que apresentaram menor índice de acerto compreendiam o sigilo médico, o consentimento do responsável, a autonomia do paciente, a prescrição médica, o prontuário médico e o corporativismo em relação ao erro médico. CONCLUSÃO: A variável mais importante não foi o modelo pedagógico e sim o tempo de exposição ao tema. O modelo ABP dá chance de distribuir o tema em vários módulos e tutorias durante o curso médico ajudando a acelerar o processo de aquisição de conhecimentos em ética médica. Conclui-se que é necessário uma revitalização do ensino da Ética Médica em nossa instituição, visando a uma maior integração com a conjuntura socioeconômica de nosso país.BACKGROUND: Aiming to evaluate the acquisition of skills on Medical Ethics among medical students from Marilia Medical School, some of them from the small group learning-teaching method, others from traditional teaching method. METHODS: A prospective analytical study was done based on the application of questionnaires about general themes on Ethics, at two different times. RESULTS: There weren't significant differences on the skills' acquisition between the two methods. Students from late graduation years showed a significantly better performance than those from early

  13. Small group discussion: Students perspectives.

    Science.gov (United States)

    Annamalai, Nachal; Manivel, Rajajeyakumar; Palanisamy, Rajendran

    2015-08-01

    Various alternative methods are being used in many medical colleges to reinforce didactic lectures in physiology. Small group teaching can take on a variety of different tasks such as problem-solving, role play, discussions, brainstorming, and debate. Research has demonstrated that group discussion promotes greater synthesis and retention of materials. The aims of this study were to adopt a problem-solving approach by relating basic sciences with the clinical scenario through self-learning. To develop soft skills, to understand principles of group dynamics, and adopt a new teaching learning methodology. Experimental study design was conducted in Phase I 1(st) year medical students of 2014-2015 batch (n = 120). On the day of the session, the students were grouped into small groups (15 each). The session started with the facilitator starting off the discussion. Feedback forms from five students in each group was taken (n = 40). A five point Likert scale was used ranging from strongly agree to strongly disagree. Data were analyzed using IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp. Our results show that 70% of the students opined that small group discussion were interactive, friendly, innovative, built interaction between teacher and student. Small group discussion increased their thought process and helped them in better communication. The small group discussion was interactive, friendly, and bridged the gap between the teacher and student. The student's communication skills are also improved. In conclusion, small group discussion is more effective than the traditional teaching methods.

  14. Medications (for IBS)

    Medline Plus

    Full Text Available ... Agents Antidepressant Medications Newer IBS Medications Probiotics and Antibiotics Pharmacologic, or drug, therapy is best used in ... Agents Antidepressant Medications Newer IBS Medications Probiotics and ... Treatments Understanding Stress Cognitive Behavioral Therapy Relaxation ...

  15. Medications (for IBS)

    Medline Plus

    Full Text Available ... Agents Antidepressant Medications Newer IBS Medications Probiotics and Antibiotics Pharmacologic, or drug, therapy is best used in ... Agents Antidepressant Medications Newer IBS Medications Probiotics and Antibiotics Psychological Treatments Understanding Stress Cognitive Behavioral Therapy Relaxation ...

  16. Medication/Drug Allergy

    Science.gov (United States)

    ... Science Education & Training Home Conditions Medication/Drug Allergy Medication/Drug Allergy Make an Appointment Find a Doctor ... immediate or delayed. What Is an Allergy to Medication/Drugs? Allergies to drugs/medications are complicated, because ...

  17. Medications (for IBS)

    Medline Plus

    Full Text Available ... Agents Antidiarrheal Agents Antidepressant Medications Newer IBS Medications Probiotics and Antibiotics Pharmacologic, or drug, therapy is best ... Agents Antidiarrheal Agents Antidepressant Medications Newer IBS Medications ... Psychological Treatments Understanding Stress Cognitive Behavioral ...

  18. Value of Pharmacist Medication Interviews on Optimizing the Electronic Medication Reconciliation Process

    Science.gov (United States)

    Varma, Arjun; Boro, Maureen; Korman, Nancy

    2014-01-01

    Purpose: Few studies have explored the impact of using different methods for obtaining accurate medication histories on medication safety. This study was conducted to compare the accuracy and clinical impact of pharmacist medication histories obtained by electronic medical record review (EMRR) alone with those obtained by direct interviews combined with EMRR. Method: This 18-week prospective study included patients who were admitted to the Inpatient Medicine Service at the study institution and who had a pharmacist-conducted medication reconciliation EMRR within 48 hours of hospital admission. A chart review was performed to collect data to determine whether differences existed in the number of discrepancies, recommendations, and medication errors between the EMRR alone group compared to the EMRR combined with the patient interview group. Results: Five hundred thirteen discrepancies were identified with the EMRR group compared to 986 from the combined EMRR and patient interview group (P medication errors were identified for the EMRR alone group compared to the combination interview group (55 vs 134; P errors were omitted medications followed by extra dose/failure to discontinue therapy and wrong dose/frequency errors. Conclusion: Pharmacist-conducted admission medication interviews combined with EMRR can potentially identify harmful medication discrepancies and prevent medication errors. PMID:24958970

  19. Radiation physics for medical physicists

    Energy Technology Data Exchange (ETDEWEB)

    Podgorsak, E.B. [McGill Univ. Health Centre, Montreal, QC (Canada). Dept. of Medical Physics

    2006-07-01

    This book summarizes the radiation physics knowledge that professionals working in medical physics need to master for efficient and safe dealings with ionizing radiation. It contains eight chapters, each chapter covering a specific group of subjects related to radiation physics and is intended as a textbook for a course in radiation physics in medical-physics graduate programs. However, the book may also be of interest to the large number of professionals, not only medical physicists, who in their daily occupations deal with various aspects of medical physics and find a need to improve their understanding of radiation physics. The main target audience for this book is graduate students studying for M.Sc. and Ph.D. degrees in medical physics, who have to possess the necessary physics and mathematics background knowledge to be able to follow and master the complete textbook. Medical residents, technology students and biomedical engineering students may find certain sections too challenging or esoteric, yet they will find many sections interesting and useful in their studies. Candidates preparing for professional certification exams in any of the medical physics subspecialties should find the material useful, and some of the material would also help candidates preparing for certification examinations in medical dosimetry or radiation-related medical specialties. Numerous textbooks are available covering the various subspecialties of medical physics but they generally make a transition from the elementary basic physics directly into the intricacies of the given medical physics subspecialty. The intent of this textbook is to provide the missing link between the elementary physics on the one hand and the physics of the subspecialties on the other hand. (orig.)

  20. Institutional practices and policies in acid-base testing: a self reported Croatian survey study on behalf of the Croatian society of medical biochemistry and laboratory medicine Working Group for acid-base balance

    Science.gov (United States)

    Dukić, Lora; Šimundić, Ana-Maria

    2014-01-01

    Introduction: The aim of this survey study was to assess the current practices and policies in use related to the various steps in the blood gas testing process, across hospital laboratories in Croatia. Materials and methods: First questionnaire was sent by email to all medical biochemistry laboratories (N = 104) within general, specialized and clinical hospitals and university hospital centres to identify laboratories which perform blood gas analysis. Second questionnaire with detailed questions about sample collection, analysis and quality control procedures, was sent only to 47 laboratories identified by the first survey. Questionnaire was designed as combination of questions and statements with Likert scale. Third questionnaire was sent to all participating laboratories (N=47) for additional clarification for either indeterminate or unclear answers. Results: Blood gas analysis is performed in 47/104 hospital laboratories in Croatia. In 25/41 (0.61) of the laboratories capillary blood gas sampling is the preferred sample type for adult patient population, whereas arterial blood sample is preferentially used in only 5/44 laboratories (0.11). Blood sampling and sample processing for capillary samples is done almost always by laboratory technicians (36/41 and 37/44, respectively), whereas arterial blood sampling is almost always done by the physician (24/29) and only rarely by a nurse (5/28). Sample acceptance criteria and sample analysis are in accordance with international recommendations for majority of laboratories. 43/44 laboratories participate in the national EQA program. POCT analyzers are installed outside of the laboratory in 20/47 (0.43) institutions. Laboratory staff is responsible for education and training of ward personnel, quality control and instrument maintenance in only 12/22, 11/20 and 9/20 institutions, respectively. Conclusions: Practices related to collection and analysis for blood gases in Croatia are not standardised and vary substantially

  1. PREVALENCE OF ANEMIA IN PEDIATRIC AGE GROUP PATIENTS AND ITS CO - RELATION WITH SOCIO - DEMOGRAPHIC FACTORS IN PATIENTS PRESENTING AT DEPARTMENT OF PEDIATRICS AT ROHILKHAND MEDICAL COLLEGE AND HOSPITAL, BAREILLLY, U. P.

    Directory of Open Access Journals (Sweden)

    Tania

    2015-04-01

    Full Text Available BACKGROUND: About 2 billion people are suffering from iron deficiency anemia. India continues to be one of the countries to have highest prevalence of anemia NFHS 3 estimates reveals the prevalence of anemia to be 73% in children aged 5 - 11 years. Present study was und ertaken to determine the prevalence of anemia in pediatric age group from 6 months to 14 years. Aims and objective: To study prevalence of anemia in pediatric age group patients and its co - relation with socio - demographic factors in patients presenting at p ediatrics department R.M.C.H. Bareilly. MATERIAL METHOD S : Cross sectional study was carried out from July 2013 to December 2014. A total of 215 students (115 boys and 100 girls were studied. Parents of subjects aged less than 8 years and patients aged more than 8 years attendants were interviewed using a pretes ted questionnaire. Blood samples were taken by fingers prick method. Hb estimation was done by cyan - met hemoglobin method using calorimeter. SPSS Version 10.0, proportions were calculated and chi square test was used as a test for significance. RESULTS: Ou t of total 215 subjects, 82 (38% were found anemic. Girls were affected more as comp aired to boys. Prevalence of anemia was maximum in children belonging to lower social classes (100.0% followed by upper - lower (45%, lower middle (26% and upper middle ( 22% and this prevalence of anemia in relation to social class was found to be statistically significant (p<0.001 higher in children of illiterate mothers and working mothers (p<0.001. CONCLUSION: In India major factor responsible for nutritional anemia children is delayed weaning and insufficient semisolid and solid food intake.

  2. Essential Medical Capabilities and Medical Readiness

    Science.gov (United States)

    2016-07-01

    15-001098 Copy Essential Medical Capabilities and Medical Readiness John E. Whitley Joseph F. Adams Joseph J. Angello Jennifer T. Brooks Sarah K...other national challenges. Essential Medical Capabilities and Medical Readiness John E. Whitley Joseph F. Adams Joseph J. Angello Jennifer T. Brooks...noted that the ability of the Military Health System to provide operational healthcare is measured by the readiness of its medical personnel and

  3. Medical muddle.

    Science.gov (United States)

    Gartrell, Nanette

    2014-01-01

    Nanette Gartrell, MD, is a psychiatrist and researcher whose investigations have documented the mental health and psychological well-being of lesbian, gay, bisexual, and transgender (LGBT) people over the past four decades. Nanette is the principal investigator of an ongoing longitudinal study of lesbian families in which the children were conceived by donor insemination. Now in its 27th year, this project has been cited internationally in the debates over equality in marriage, foster care, and adoption. Previously on the faculty at Harvard Medical School and the University of California, San Francisco, Nanette is currently a Visiting Distinguished Scholar at the Williams Institute, UCLA School of Law. In 2013, Nanette received the Association of Women Psychiatrists Presidential Commendation Award for "selfless and enduring vision, leadership, wisdom, and mentorship in the fields of women's mental health, ethics, and gender research." At the age of 63, Nanette experienced a 3 ½ month period of intractable, incapacitating dizziness for which there was never a clear diagnosis.

  4. MEDICAL PROFESSIONALISH

    Directory of Open Access Journals (Sweden)

    Jože Drinovec

    2002-12-01

    Full Text Available Background. Due to restrictions imposed on a clinical freedom, interest for professionalism in healthcare has been getting bigger not only in medicine literature and various mass media but also in teaching and organisation of healthcare. Professionalism stands not only for a medicine’s contract with society, recognition of a physician status, privilege and monopoly but also for a genuine physician’s commitment to professional responsibilities.Analysis. In 2002 European and American associations approved a document on medical professionalism in the new millenium, so-called Physician Charter. This document includes fundamental principles of professionalism such as altruism, patient autonomy and social justice. In particular, it analyses a physician’s professional competency, honesty with patients, patient confidentiality, appropriate relations with patients, improvements regarding a healthcare quality, healthcare access, just distribution of finite funds, commitment to scientific knowledge, trust maintenance by managing conflicts of interest and a professional responsibility.Conclusions. Physician’s professionalism means philosophycal and sociological analysis of his/her profession and its position in a society. It includes a concern for improvements of his/ her own scientific knowledge, skills, a genuine ethic interest for an individual patient bearing in mind principles of equality and justice in society. Whether performing an organisational and public work or participating in professional health organizations, physician’s interest for a patient must prevail.

  5. Mild cognitive impairment (MCI) in medical practice: a critical review of the concept and new diagnostic procedure. Report of the MCI Working Group of the European Consortium on Alzheimer's Disease.

    Science.gov (United States)

    Portet, F; Ousset, P J; Visser, P J; Frisoni, G B; Nobili, F; Scheltens, Ph; Vellas, B; Touchon, J

    2006-06-01

    Mild cognitive impairment (MCI) was proposed as a nosological entity referring to elderly people with mild cognitive deficit but no dementia. MCI is a heterogeneous clinical entity with multiple sources of heterogeneity. The concept of MCI was reviewed and a diagnostic procedure with three different stages was proposed by the European Consortium on Alzheimer's Disease Working Group on MCI. Firstly, MCI should correspond to cognitive complaints coming from the patients or their families; the reporting of a relative decline in cognitive functioning during the past year by a patient or informant; cognitive disorders as evidenced by clinical evaluation; absence of major repercussions on daily life; and absence of dementia. These criteria, similar to those defined during an international workshop in Stockholm, make it possible to identify an MCI syndrome, which is the first stage of the diagnostic procedure. Secondly, subtypes of MCI had to be recognised. Finally, the aetiopathogenic subtype could be identified. Identifying patients at a high risk for progression to dementia and establishing more specific and adapted therapeutic strategies at an early stage, together with more structured overall management, is made possible by the diagnostic procedure proposed.

  6. Bullying among medical students in a Saudi medical school

    Directory of Open Access Journals (Sweden)

    Alzahrani Hasan

    2012-07-01

    Full Text Available Abstract Background Bullying and sexual harassment of medical students by their teachers appears to be widespread phenomenon. However, nothing is published about its prevalence in conservative countries such as Saudi Arabia. This survey aims to ascertain the extent of these mistreatments among students in a Saudi medical school. Findings A cross-sectional questionnaire survey was conducted on a group of 542 clinical years’ medical students in a Saudi medical school to explore students' perceptions of their educational environment including exposure to different kinds of bullying. Bullying was defined as “a “persistent behaviour against a medical student that is intimidating, degrading, offensive or malicious and undermines the confidence and self- esteem of the recipient”. Results revealed that more than one quarter (28.0% of the surveyed students reported exposure to some sort of bullying during their clinical. Ninety percent of the reported insults were verbal, 6% sexual and 4% physical. Males were more exposed but difference was not statistically significant. Conclusions Bullying among Saudi medical students is an existing problem. A policy against bullying and harassment should be adopted in all of medical colleges to monitor this phenomenon and support students who have been bullied.

  7. Medical informatics: past, present, future.

    Science.gov (United States)

    Haux, Reinhold

    2010-09-01

    To reflect about medical informatics as a discipline. To suggest significant future research directions with the purpose of stimulating further discussion. Exploring and discussing important developments in medical informatics from the past and in the present by way of examples. Reflecting on the role of IMIA, the International Medical Informatics Association, in influencing the discipline. Medical informatics as a discipline is still young. Today, as a cross-sectional discipline, it forms one of the bases for medicine and health care. As a consequence considerable responsibility rests on medical informatics for improving the health of people, through its contributions to high-quality, efficient health care and to innovative research in biomedicine and related health and computer sciences. Current major research fields can be grouped according to the organization, application, and evaluation of health information systems, to medical knowledge representation, and to the underlying signal and data analyses and interpretations. Yet, given the fluid nature of many of the driving forces behind progress in information processing methods and their technologies, progress in medicine and health care, and the rapidly changing needs, requirements and expectations of human societies, we can expect many changes in future medical informatics research. Future research fields might range from seamless interactivity with automated data capture and storage, via informatics diagnostics and therapeutics, to living labs with data analysis methodology, involving sensor-enhanced ambient environments. The role of IMIA, the International Medical Informatics Association, for building a cooperative, strongly connected, and research-driven medical informatics community worldwide can hardly be underestimated. Health care continuously changes as the underlying science and practice of health are in continuous transformation. Medical informatics as a discipline is strongly affected by these

  8. A study at 10 medical centers of the safety and efficacy of 48 flexible sigmoidoscopies and 8 colonoscopies during pregnancy with follow-up of fetal outcome and with comparison to control groups.

    Science.gov (United States)

    Cappell, M S; Colon, V J; Sidhom, O A

    1996-12-01

    To analyze the risks versus benefits of flexible sigmoidoscopy and colonoscopy to the pregnant female and fetus, we conducted a multiyear, retrospective study at 10 hospitals of 46 patients undergoing 48 sigmoidoscopies and 8 patients undergoing 8 colonoscopies during pregnancy. Sigmoidoscopy controls included two study control groups and the average American pregnancy outcomes. Sigmoidoscopy indications included hematochezia in 28, diarrhea in 10, abdominal pain in 4, and other in 3. Thirteen patients were in the first trimester of pregnancy, 18 were in the second trimester, and 15 were in the third trimester. Twenty-seven patients had a lesion diagnosed by sigmoidoscopy, including reactivated or newly diagnosed inflammatory bowel disease, bleeding internal hemorrhoids, and other colitidies. Twenty-two of 29 patients with rectal bleeding had a significant lesion identified by sigmoidoscopy. Sigmoidoscopy was significantly more frequently diagnostic for hematochezia than for other indications (p born infant Apgar scores were 8.2+/-1.5 (SD) at 1 min and 9.0+/-0.2 at 5 min (control mean Apgar scores: 8.1+/-1.7 at 1 min and 8.8+/-1.0 at 5 min; NS, Student's t test). Three high-risk pregnancies ended with fetal demise at 8, 9, or 12 weeks after sigmoidoscopy, from causes unrelated to sigmoidoscopy. No fetal cardiac abnormalities were detected by fetal cardiac monitoring during two sigmoidoscopies. Eight pregnant females underwent colonoscopy, without complications. Pregnancy outcomes included six healthy babies delivered at full term, one voluntary abortion, and one fetal demise in a high-risk pregnancy 4 months after colonoscopy from causes unrelated to colonoscopy. This study suggests that sigmoidoscopy does not induce labor or result in congenital malformations, that sigmoidoscopy is not contraindicated during pregnancy, and that sigmoidoscopy may be beneficial in pregnant patients with significant lower gastrointestinal bleeding. Colonoscopy during pregnancy should

  9. From mapping class groups to automorphism groups of free groups

    DEFF Research Database (Denmark)

    Wahl, Nathalie

    2005-01-01

    We show that the natural map from the mapping class groups of surfaces to the automorphism groups of free groups, induces an infinite loop map on the classifying spaces of the stable groups after plus construction. The proof uses automorphisms of free groups with boundaries which play the role...... of mapping class groups of surfaces with several boundary components....

  10. Medical care at the Super Bowl.

    Science.gov (United States)

    Ellis, J M

    2000-06-01

    Although coordinating medical care at the Super Bowl is something that we look forward to and have a lot of fun doing, we take it very seriously and understand the importance of delivering medical care at what many people consider to be the greatest sporting event in the world. It is certainly one of the most watched and recognized events in the world and because of this, we attempt to set up a system that will allow for the best medical care available and standardization of this medical care through our experience within Medical Sports Group.

  11. Measuring integrated care

    DEFF Research Database (Denmark)

    Strandberg-Larsen, Martin

    2011-01-01

    respond to these needs, patients and providers face the multiple challenges of today's healthcare environment. Decision makers, planners and managers need evidence based policy options and information on the scope of the integrated care challenges they are facing. The US managed care organization Kaiser...... Permanente has been put forward as an example for European healthcare systems to follow, although the evidence base is far from conclusive. The thesis has five objectives: 1) To contribute to the understanding of the concept of integration in healthcare systems and to identify measurement methods to capture...... and performance of the Danish healthcare system and the managed care organization Kaiser Permanente, California, US. 5) To compare primary care clinicians' perception of clinical integration in two healthcare systems: Kaiser Permanente, Northern California and the Danish healthcare system. Further to examine...

  12. Communicating Medical Needs to Non-Medical Managers

    Science.gov (United States)

    Bacal, Kira; Miller, Robert; Doerr, Harold

    2004-01-01

    Differences in communication styles and languages between groups often lead to miscommunication, confusion, and/or frustration. Engineers, computer specialists, clinicians, and managers often utilize the English language in very different ways, with different groups using the same words to represent different concepts ("complaint" is a typical example). In addition, medical issues are often perceived as "off-nominal" and not "primary mission tasks" by managers, which can cause them to assign lower priorities to medical training time and resources. Knowledge bases differ due to variations in training and skill sets, and the goals (both immediate and long-term) of the communicators may also vary, with managers being primarily concerned with overall mission objectives, while clinicians focus on individual or group health issues. Furthermore, true communication is only possible when clinicians possess a deep understanding of mission requirements as well as the ability to communicate medical requirements on a priority basis using risk assessment, added value, and cost benefit analysis. These understandable differences may contribute to difficulties in expressing concerns and ideas in an efficient manner, particularly in projects, such as the space program or many military operations, where these varied groups must collaborate, and where the final decisions must be made by fully informed mission commanders. Methods: Three scenario-based approaches were developed utilizing decision trees and problem based learning, to help define and integrate these concepts. Results: Use of these techniques by NASA and military personnel will be presented. Discussion: To enhance communication, particularly of medical needs, one must identify the concerns and motivating factors for the other groups; for example, members of management may focus on financial concerns, a desire for risk mitigation, public perceptions, mission objectives, etc. Training clinicians to frame issues in these

  13. The Jogging Group: A Positive-Wellness Strategy.

    Science.gov (United States)

    Childers, John H., Jr.; Burcky, William D.

    1984-01-01

    Describes how to organize and facilitate a jogging group, combining jogging and group counseling as an important intervention strategy for positive wellness. Describes client selection, medical clearance, liability, meeting times and places, as well as group work. (JAC)

  14. Different Groups of Medical Personnel Surgical Hand Disinfection Quality Investigation and Analysis%不同人群医务人员外科洗手与手消毒质量调查与分析

    Institute of Scientific and Technical Information of China (English)

    姚静; 邢虎; 吴洪敏; 葛惠芳

    2016-01-01

    Objective To investigate the operation of hand washing and hand disinfection in different groups of people in hospital, and to put forward some measures to improve the quality of hand washing and hand disinfection. Methods -6 months of May 2015 to the operation room sink make on-site random assessment of the operating personnel, was assessed by self-designed evaluation standards, more than 80 points for qualified, unqualified < 80. Through the summary analysis, the problem mainly in the regulation practice Pearson, students and other foreign personnel are not familiar with the washing step, the lack of proper hand washing consciousness is the main cause of the problem. Conclusion The infection management department should give full play to the function of hospital infection management committee, led by the Department, establish management system, standardize the process, establish a long-term management mechanism, effectively reduce the incidence of surgical site infection.%目的:了解医院不同人群外科洗手及手消毒操作情况。方法2015年5月-6月至手术室洗手槽点对手术人员进行现场随机抽查考核,按自行设计的考核标准进行评分,≥80分为合格,<80分为不合格。通过汇总分析,存在问题集中在规培生、实习进修生等外来人员,对洗手步骤不熟悉,缺乏正确洗手的意识是问题的主要原因。结论感染管理科应充分发挥医院感染管理委员会的功能,牵头各部门,制定管理制度,规范操作流程,建立长效管理机制,有效降低手术部位感染发生率。

  15. Relevance of medical patent output and economic benefit in Bayer Group%拜耳医药公司专利产出与经济效益相关性分析

    Institute of Scientific and Technical Information of China (English)

    路璐; 杨俊; 潘艳娟; 阎玺庆; 邱培勇

    2012-01-01

    Objective To determine the relation between the global patent application and economic output in Bayer to understand intellectual property rights strategy for enterprise economic benefits. Methods The present study analyzed the relationship among the patent output, the economic output, the drug R&D investment, and the distribution of Chinese patents in Bayer Group. Results The cumulative number of patent applications and the drug R&D investment was positively related to the drug sales income in the world. Most China patents were patent of invention, with the grant ratios of invention patents more than 50.0%. Conclusion Innovation is the source of profits. R&D investment plays a positive role in innovation. Protection of intellectual property is the strongest guarantee of innovation, and Bayer's emphasis on intellectual property directly affects the drug economic profit. New drug development and intellectual property protection are the core power of a pharmaceutical company.%目的 研究拜耳公司世界专利产出与经济产出的相关性,揭示拜耳公司知识产权战略对于企业经济效益的影响.方法 运用相关回归方法研究拜耳公司的全球专利申请数与经济产出(年销售收入/净利润)和药物研发投入的相关性,分析拜耳公司中国专利分布情况.结果 拜耳公司全球专利产出与药品相关的经济收入和药物研发投入具有相关性,方差分析极具显著性.该公司在中国申请的专利以发明专利为主,专利授权率>50%.结论 创新是企业利润的源泉,研发投入对创新有积极的推动作用,知识产权的保护是创新最有力的保障,拜耳公司对知识产权的重视程度直接影响其药品产业的经济效益.因此,新药创制和知识产权保护是医药企业发展的核心动力.

  16. Marketing audit in group practice.

    Science.gov (United States)

    Blackburn, J M

    1984-01-01

    The marketing audit, whether large-scale or small-scale, will soon be critical to the success of every medical group practice. This dynamic process, in which the many components of a group's marketing efforts are analyzed, is examined from the perspective of ideal circumstances and unlimited resources, and more pragmatically, from the perspective of various-sized groups, with different resources and marketing talent. The audit components are prioritized, possible adaptations and combinations are presented, and reasonable implementation mechanisms, designed to address audit outcomes, are suggested.

  17. The medicalization of compulsive buying.

    Science.gov (United States)

    Lee, Shirley; Mysyk, Avis

    2004-05-01

    Compulsive buying has recently been the subject of numerous articles from both consumer research and psychiatric perspectives. Identified by some researchers as a compulsion and by others as an addiction, common solutions to the problem have included drug treatments, participation in self-help groups and cognitive behaviour therapy. The purpose of this article is to examine critically the labelling of compulsive buying in terms of medicalization from the perspective of both medical and non-medical social control of "deviant" consumers. We suggest that the attempt to categorize compulsive buying as an illness represents the ongoing trend to medicalize behavioural problems which may be better understood within the wider context of related phenomena such as the fiscal crisis of the 1980s and 1990s and the consumption-driven economy of North America.

  18. TERMITES ENDANGERED TRADITIONAL MEDICAL PLANTS

    Directory of Open Access Journals (Sweden)

    Syaukani Syaukani

    2014-04-01

    Full Text Available Surveys on traditional medical plants affected by termites have been conducted since June to August 2010 at Ketambe, northern Aceh. Traditional medical plants and their natural habitats were obtained through interviewing local people. Termites were collected by adopted a Standardized Sampling Protocol and final. taxonomic confirmation was done with the help of Termite Research Group (the Natural History Museum, London. About 20 species of medical plants were attacked by termites with various levels. Nine genera and 20 species were collected from various habitats throughout Ketambe, Simpur as well as Gunung Setan villages. Coffe (Coffea arabica, hazelnut (Aleurites moluccana , and areca (Area catechu were among the worse of traditional medical  plant that had been attached by the termites.

  19. Information in medical treatment courses

    DEFF Research Database (Denmark)

    Møller, Marianne; Andersen, Stig Ejdrup; Jacobsen, Charlotte Bredahl

    INFORMATION IN MEDICAL TREATMENT COURSES - A STEERING TOOL FOR THE QUALITY – A Pilot Study Marianne Møller1,2 Stig Ejdrup Andersen3 Charlotte Bredahl Jacobsen4 Erik Hollnagel1,2 1: Centre for Quality, Middelfart Region of Southern Denmark Email: Marianne.moller3@rsyd.dk 2: Institute of Regional......, is the platform for this study. Objectives The overall purpose of this three-phased study is to investigate how information is used as a steering tool for quality in medical treatment courses. In the first part of the study, we analyze the role of information on medicine in relation to the quality of medical...... treatment courses. Methods The study investigate patient-medication as a process focusing on variability. Systems theory and cybernetics concepts (steering, timing and feedback) as well as a classic communication model is applied as theoretical frame. Two groups of patients and their information providers...

  20. Infections Requiring Hospitalization as Predictors of Pediatric-Onset Crohn’s Disease and Ulcerative Colitis

    Directory of Open Access Journals (Sweden)

    Susan Hutfless

    2015-01-01

    Full Text Available Objectives. To assess the relationship between infections and the risk of pediatric-onset inflammatory bowel disease (IBD. Methods. We conducted a nested case-control study of 501 incident cases aged ≤17 years and 9,442 controls who were members of Kaiser Permanente Northern California for at least one consecutive year between 1996 and 2006. IBD was confirmed and the incidence date was adjudicated by pediatric gastroenterologists. Hospitalized infections were identified from the principal diagnosis code of electronic inpatient records. Medications to treat infections were identified during the hospitalization. Conditional logistic regression was used to assess the associations between hospitalized infections, medications, and Crohn’s disease and ulcerative colitis. Results. In the year prior to diagnosis, both hospitalized infection of any system (OR 6.3; 95% CI 1.6–23.9 and hospitalized intestinal infection (OR 19.4; 95% CI 2.6–143.2 were associated with CD. Hospitalized infections of any system were inversely associated with UC after excluding the year prior to diagnosis (OR 0.4; 95% CI 0.2–0.9. No UC case had a hospitalized gastrointestinal infection prior to diagnosis. Conclusion. Infections appear to play opposite roles prior to the diagnosis of CD and UC. Infections may be associated with an increased risk of CD and a decreased risk of UC.

  1. The association of patient-physician gender concordance with cardiovascular disease risk factor control and treatment in diabetes.

    Science.gov (United States)

    Schmittdiel, Julie A; Traylor, Ana; Uratsu, Connie S; Mangione, Carol M; Ferrara, Assiamira; Subramanian, Usha

    2009-12-01

    Gender concordance between patients and their physicians is related to prevention screening and other quality indicators. Research suggests female physicians may place greater emphasis on preventive care than male physicians; however, little is known about whether physician gender and patient-physician gender concordance are associated with cardiovascular disease (CVD) risk factor levels and treatment. Our objective was to examine associations between patient gender, physician gender, and their interaction with CVD risk factor control, medication adherence, and treatment intensification in diabetes. In this study, 157,458 Kaiser Permanente Northern California adult diabetes patients with a primary care physician (PCP) were assessed for above target levels of hemoglobin A1c (HbA1c) (>or=8%), low-density lipoprotein cholesterol (LDL-C) (>or=100 mg/dL), and systolic blood pressure (SBP>or=130 mm Hg) in 2005. Medication adherence and appropriate CVD treatment intensification were assessed using pharmacy data. Probit models assessed the adjusted marginal effects of patient gender, PCP gender, and their interaction on control, adherence, and intensification. Female patients had lower adjusted rates of LDL-C (46% vs. 55%, pgender dyads (70% vs. 66%-68%, pintensification for high SBP (60% vs. 57%, pgender and gender concordance are modestly associated with CVD risk factor control and treatment in diabetes. Further understanding of these differences could lead to improved CVD outcomes for women.

  2. Medical emergencies in Goa

    Directory of Open Access Journals (Sweden)

    Saddichha Sahoo

    2010-01-01

    Full Text Available Background: Most emergencies in Goa arise due to road traffic accidents and drowning, which have been compounded by the rise in number of recorded accidents in 2007 to be above 4000. It is believed that 11 people meet with an accident on Goa′s roads every day and this is expected to rise by 10% by next year. Similar is the case with drownings and other medical emergencies. We therefore aimed to conduct a cross-sectional survey of medical emergencies and identify various types of emergencies presenting to emergency departments. Materials and Methods: Using a stratified random sampling design, all emergencies presenting to the three government hospitals in Goa, which handle 90% of all emergencies currently, were studied on specially designed data sheets in order to collect data. Emergency medical technicians (ETs were placed in the Casualty Ward of the medical colleges and they recorded all emergencies on the data sheet. The collected data were then analyzed for stratification and mapping of emergencies. Results: GMC Hospital attended to majority of emergencies (62%, which were mainly of the nature of accidents or assaults (17% and fever related (17%. Most emergencies were noncritical and about 1% expired. Maximum emergencies also presented from Salcette and Bardez, and occurred among young males in the age group of 19-45 years. Males were also more prone to accidents while females had pregnancies as emergencies. Conclusion: Potential emergency services need to target young males with higher concentrations required in Salcette in South Goa and Bardez in North Goa.

  3. Exposure to Environmental Air Manganese and Medication ...

    Science.gov (United States)

    Manganese (Mn) is an essential element with natural low levels found in water, food, and air, but due to industrialized processes, both workplace and the environmental exposures to Mn have increased. Recently, environmental studies have reported physical and mental health problems associated with air-Mn exposure, but medical record reviews for exposed residents are rare in the literature. When medical records and clinical testing are unavailable, examination of residents’ prescribed medication use may be used as a surrogate of health effects associated with Mn. We examined medication use among adult Ohio residents in two towns with elevated air-Mn (n=185) and one unexposed control town (n=90). Study participants recorded medication use in a health questionnaire and brought their currently prescribed medication, over-the-counter and supplement lists to their interview. Two physicians (family and psychiatric medicine) reviewed the provided medication list and developed medical categories associated with the medications used. The exposed (E) and control (C) groups were compared on the established 12 medication and 1 supplement categories using chi-square tests. The significant medication categories were further analyzed using hierarchical binomial logistic regression adjusting for education, personal income, and years of residency. The two groups were primarily white (E:94.6%; C:96.7%) but differed on education (E:13.8; C:15.2 years), residence length in their re

  4. [Occupational skin diseases in medical personnel].

    Science.gov (United States)

    2011-01-01

    Occupational skin diseases develop mostly in certain occupational groups at risk. The authors studied features of occupational skin diseases in medical personnel examined over 2003-2007. During this time, occupational skin disease was diagnosed in 118 individuals out of which 24 (20.3%) were medical staffers. All 24 examinees suffered from occupational allergic skin conditions. Most common causes of these were medicines, latex, desinfectants. Nurses are most prone to skin conditions (91.67%). Special risk group covers surgeons, psychiatrists and dentists. As medical staffers are occupational risk group for occupational skin conditions, diagnosed allergic dermatoses in them should be considered as having possible occupational occupational origin.

  5. Medical alert bracelet (image)

    Science.gov (United States)

    People with diabetes should always wear a medical alert bracelet or necklace that emergency medical workers will be able to find. Medical identification products can help ensure proper treatment in an ...

  6. Implantable Medical Devices

    Science.gov (United States)

    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More Implantable Medical Devices Updated:Sep 16,2016 For Rhythm Control ... a Heart Attack Introduction Medications Surgical Procedures Implantable Medical Devices • Life After a Heart Attack • Heart Attack ...

  7. When Medication Is Prescribed

    Science.gov (United States)

    ... page please turn Javascript on. Feature: Depression When Medication Is Prescribed Past Issues / Fall 2009 Table of ... you have about the medicine. —NIMH Types of Medications There are several types of medications used to ...

  8. Medication Use during Pregnancy

    Science.gov (United States)

    ... What's this? Submit Button Past Emails CDC Features Medication Use During Pregnancy Recommend on Facebook Tweet Share ... are taking only medications that are necessary. What Medications Can Cause Birth Defects? We know that taking ...

  9. Your Pet's Medications

    Science.gov (United States)

    ... Care Animal Welfare Veterinary Careers Public Health Your Pet's Medications When your pet has a medical condition, ... authorized. What you can do to keep your pet safe When the medication is prescribed Let your ...

  10. Medical school entrance and career plans of Malaysian medical students.

    Science.gov (United States)

    Razali, S M

    1996-11-01

    This study investigates the reasons for entry to medicine and the career perspectives of phase III medical students of the Universiti Sains Malaysia (USM). The majority of the students were Malays from low socio-economic backgrounds who entered medical school after completing a 2-year matriculation course. An interest in medicine and helping people were the two main stated reasons for entry to medical school. A group of students wishing to work in private practice was identified. In comparison to the rest of the study body, students in the group were: not well prepared to enter medical school; dissatisfied with the course; and subject to family influences. A desire for monetary gain motivated their choice of medicine as a career. Overall, 13% of the students wished to change career because they were dissatisfied with their experience of medicine as undergraduates. The study did not find a significant difference in career intentions between female and male medical students. However, women were less likely to seek entrance into private practice or pursue formal postgraduate education. The choice of surgery as a career was confined to men. About 90% of the students had already decided on their future specialty. Four well-established specialties were their most popular choices. The gender of the students had no significant influences of the decision to continue into postgraduate education. The proportion of female students who wished to marry doctors was significantly higher than for male students.

  11. Medical misadventures.

    Science.gov (United States)

    Lewis, K

    2003-03-01

    Historical perspective of terminations of unwanted pregnancies in the UK. Moral and ethical considerations imposed by established church's teachings becoming increasingly in conflict with the wishes and expectations of a more secular society. Recognition that illegal abortion was, as a matter of fact available, at great risk to vulnerable girls and women. Eventually public demand and a radical and reforming government led to the current Statutory Framework. Statutory provisions: Offences against the Person Act 1861, Sections 58 and 59; Infant Life Preservation Act 1929 Section 1. Recognition of the limited flexibility allowed by the law in the original restrictive statutory framework. The direction to the jury in July 1938 by Macnaghten J in the case of R. v. Bourne [1939] 1 KB 687, where an eminent obstetrician was acquitted after carrying out an abortion on a young rape victim. Then the modern statutory provisions: Abortion Act 1967, amended by the Human Fertilisation and Embryology Act 1990. The statutory framework provides for healthcare professionals not to have to take part in terminations if they have a conscientious objection to doing so. While there are still fierce challenges from moral pressure groups when any changes in the detail of the law are proposed--such as reducing the maximum gestation period for a lawful termination--as a whole society seems to have accepted the current law. Issues affecting doctors who consider and provide terminations; current medico-legal problems relating to wanted pregnancies that have been lost by reason of clinical negligence, and unwanted children that have been born by reason of clinical negligence.

  12. Indigenous Australian medical students' perceptions of their medical school training.

    Science.gov (United States)

    Garvey, Gail; Rolfe, Isobel E; Pearson, Sallie-Anne; Treloar, Carla

    2009-11-01

    The Australian Medical Council requires all accredited Australian medical schools to have specific admission and recruitment policies for Indigenous Australian students. However, there is no clear evidence about how these students can be retained through to graduation. This study aimed to explore the training experiences of Indigenous undergraduate medical students and their perceptions of the factors influencing their progression through training. Methods We used a qualitative methodology involving focus groups. All participants had successfully completed at least 1 year of the Bachelor of Medicine programme at the University of Newcastle, New South Wales, Australia. Sixteen of 18 eligible students participated in the study. The factors that influence an Indigenous student's progress through medical training are multi-faceted and inter-related and are associated with student support, course content and styles of learning, personal qualities (such as confidence and coping skills), discrimination and distinctive cultural issues pertinent to Indigenous students. Both academic and non-academic factors affect the progression through training of Indigenous medical students. A number of individual and systemic interventions which actively encourage a range of support networks, increase confidence and coping skills, and reduce cultural clash by assertively addressing discrimination and stereotyping need to be introduced. The outcomes of this work may provide some guidance to medical schools engaged in implementing strategies to enroll and support Indigenous students.

  13. INTRODUCTION OF SHANGHAI MEDICAL INNOVATION & DEVELOPMENT FOUNDATION

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    With the development of social economy and the deepening of the national health reform,the philanthropic organizations in C h in a’s medical health undertaking development have obtained the affirmation.Initiated by several medical professionals and Reenway Group,Shanghai Civil Affairs Bureau has approved the establishment of the Shanghai Medical Innovation&Development Foundation(SMIDF)in 5th December 2012 with the supervision from Shanghai Association for Science&

  14. INTRODUCTION OF SHANGHAI MEDICAL INNOVATION & DEVELOPMENT FOUNDATION

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    With the development of social economy and the deepening of the national health reform,the philanthropic organizations in China’s medical health undertaking development have obtained the affirmation.Initiated by several medical professionals and Reenway Group,Shanghai Civil Affairs Bureau has approved the establishment of the Shanghai Medical Innovation&Development Foundation(SMIDF)in 5th December 2012 with the supervision from Shanghai Association for Science&

  15. Medical tourism private hospitals: focus India.

    Science.gov (United States)

    Brotman, Billie Ann

    2010-01-01

    This article examines demand factors for sophisticated medical treatments offered by private hospitals operating in India. Three types of medical tourism exist: Outbound, Inbound, and Intrabound. Increased profitability and positive growth trends by private hospital chains can be attributed to rising domestic income levels within India. Not all of the chains examined were financially solvent. Some of the hospital groups in this sample that advertised directly to potential Inbound medical tourists appear to be experiencing negative cash flows.

  16. Teaching communication skills and medical ethics to undergraduate medical student

    Directory of Open Access Journals (Sweden)

    SADIA AHSIN

    2013-07-01

    Full Text Available Introduction: The purpose of this study was to improve communication skills and knowledge of bioethics of last year medical students doing clerkship and to evaluate the effectiveness of using workshops for this purpose from students’ point of view, in order to continue such programs in future. Methods: After Ethical approval for the study a two-day workshop on teaching effective communication skills and principles of medical ethics was planned and conducted by the department of Medical Education through multidisciplinary faculty of Foundation University Medical College, Pakistan. A total of 102 last year medical students participated in this workshop. The students were divided into 8 groups each containing 12 students. A team of pre trained facilitators for each group conducted the group activities. Teaching strategies including interactive discussions on basic principles of doctor-patient relationship, power point presentations, day to day case scenarios, video clips and presentations involving students in role plays were used. Pre and post workshop self evaluation proformas about knowledge and skills of communication and medical ethics were rated (0=none, 1=below average, 2=average, 3=above average, 4=very good, 5=excellent by the students. Results: 89 out of 102 participants returned the proformas. A significant percentage of students (%82 showed improvement in their knowledge and skills of appreciating bioethical issues like valid informed consent, patient confidentiality, end of life issues and breaking bad news by rating as “very good” after participation in the workshop. More than %70 students recommended this activity for other students. Conclusion: Teaching through interactive workshops was found to be an effective method as reflected by students’ feedback. Therefore, the program will be continued in future.

  17. Cognitive Medical Multiagent Systems

    Directory of Open Access Journals (Sweden)

    Barna Iantovics

    2010-01-01

    Full Text Available The development of efficient and flexible agent-based medical diagnosis systems represents a recent research direction. Medical multiagent systems may improve the efficiency of traditionally developed medical computational systems, like the medical expert systems. In our previous researches, a novel cooperative medical diagnosis multiagent system called CMDS (Contract Net Based Medical Diagnosis System was proposed. CMDS system can solve flexibly a large variety of medical diagnosis problems. This paper analyses the increased intelligence of the CMDS system, which motivates its use for different medical problem’s solving.

  18. Medications (for IBS)

    Medline Plus

    Full Text Available ... Anthony J. Lembo, MD, Instructor of Medicine, Harvard Medical School; Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, MA. Last modified on February 23, ...

  19. Medications (for IBS)

    Medline Plus

    Full Text Available ... Anthony J. Lembo, MD, Instructor of Medicine, Harvard Medical School; Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, MA. Last modified on February 23, ...

  20. Administração de medicamentos: aquisição de conhecimentos e habilidades requeridas por um grupo de enfermeiros Administración de medicamentos: adquisición de conocimientos y habilidades requeridos por un grupo de enfermeros Medication administration: acquisition of knowledge and abilities required for a group of nurses

    Directory of Open Access Journals (Sweden)

    Paulo Celso Prado Telles Filho

    2004-06-01

    é más usted necesita saber para complementar su conocimiento sobre la administración de medicamentos?" Ocho categorías de necesidades educacionales se destacaron: mecanismos de acción de los medicamentos, preparo y administración de medicamentos, obtener de informaciones y conocimiento, interacciones medicamentosas, estabilidad del medicamento, medicamentos específicos y quimioterápicos, efectos colaterales de los medicamentos y otros aspectos de la administración de medicamentos. Los autores propusieron un curso de actualización, basado en las necesidades educacionales anteriormente identificadas.Nowadays, it is known that medication administration is a multidisciplinary process and requires constant updating from the professionals in charge. However, lack of knowledge, updating and in-service education permeate this theme area. Goals: analyze the educational needs of nurses working at a university hospital in the interior of São Paulo State, Brazil with regard to medication administration, as well as discuss about the need for this group of nurses to obtain the required knowledge and abilities. The Nominal Group Technique was used by means of the following question: "What else do you need to know in order to complete your knowledge on medication administration?" Eight categories of educational needs emerged: medication effect mechanisms, medication preparation and administration, information and knowledge acquisition, medication interactions, medication stability, specific and chemotherapeutic medication, side effects of medication and other aspects of medication administration. An updating course was proposed on the basis of the identified educational needs.

  1. Try to talk about career guidance in promoting vocational medical professional obtain employment difficult groups the role and importance of employment work%试论职业指导促进高职高专医学专业就业困难群体就业的作用和重要性

    Institute of Scientific and Technical Information of China (English)

    丁丁

    2014-01-01

    The causes of higher vocational college medical professional obtain employment difficult group is a multi-level and multi-dimensional. Graduates should establish scientific,are greatly changing employment idea,strive to improve the overall quality,promote the competitiveness of the employment,at the same time,the school should stick to implement the personalized graduates employment guidance to effectively solve the problem of vocational medical students' employment.%造成高职高专医学专业就业困难群体的原因是多层次、多方面的。毕业生应树立科学就业观,转变就业观念,努力提高综合素质,提升就业竞争力;同时,学校应坚持贯彻毕业生就业个体化指导,才能有效解决高职高专医学专业学生就业难的问题。

  2. A Multifactorial Intervention to Enhance Adherence to Medications ...

    African Journals Online (AJOL)

    ... to Enhance Adherence to Medications and Disease-Related Knowledge in ... the intervention group, as evident by a reduction in fasting blood glucose level ... the patients in terms of medication adherence and promotion of healthy lifestyle.

  3. The 2017 International Joint Working Group White Paper by INDUSEM, the Emergency Medicine Association and the Academic College of Emergency Experts on Establishing Standardized Regulations, Operational Mechanisms, and Accreditation Pathways for Education and Care Provided by the Prehospital Emergency Medical Service Systems in India.

    Science.gov (United States)

    Sikka, Veronica; Gautam, V; Galwankar, Sagar; Guleria, Randeep; Stawicki, Stanislaw P; Paladino, Lorenzo; Chauhan, Vivek; Menon, Geetha; Shah, Vijay; Srivastava, R P; Rana, B K; Batra, Bipin; Kalra, O P; Aggarwal, P; Bhoi, Sanjeev; Krishnan, S Vimal

    2017-01-01

    The government of India has done remarkable work on commissioning a government funded prehospital emergency ambulance service in India. This has both public health implications and an economic impact on the nation. With the establishment of these services, there is an acute need for standardization of education and quality assurance regarding prehospital care provided. The International Joint Working Group has been actively involved in designing guidelines and establishing a comprehensive framework for ensuring high-quality education and clinical standards of care for prehospital services in India. This paper provides an independent expert opinion and a proposed framework for general operations and administration of a standardized, national prehospital emergency medical systems program. Program implementation, operational details, and regulations will require close collaboration between key stakeholders, including local, regional, and national governmental agencies of India.

  4. The 2017 International Joint Working Group white paper by INDUSEM, The Emergency Medicine Association and The Academic College of Emergency Experts on establishing standardized regulations, operational mechanisms, and accreditation pathways for education and care provided by the prehospital emergency medical service systems in India

    Directory of Open Access Journals (Sweden)

    Veronica Sikka

    2017-01-01

    Full Text Available The government of India has done remarkable work on commissioning a government funded prehospital emergency ambulance service in India. This has both public health implications and an economic impact on the nation. With the establishment of these services, there is an acute need for standardization of education and quality assurance regarding prehospital care provided. The International Joint Working Group has been actively involved in designing guidelines and establishing a comprehensive framework for ensuring high-quality education and clinical standards of care for prehospital services in India. This paper provides an independent expert opinion and a proposed framework for general operations and administration of a standardized, national prehospital emergency medical systems program. Program implementation, operational details, and regulations will require close collaboration between key stakeholders, including local, regional, and national governmental agencies of India.

  5. Distributed Object Medical Imaging Model

    Directory of Open Access Journals (Sweden)

    Ahmad Shukri Mohd Noor

    2009-09-01

    Full Text Available Digital medical informatics and images are commonly used in hospitals today. Because of the interrelatedness of the radiology department and other departments, especially the intensive care unit and emergency department, the transmission and sharing of medical images has become a critical issue. Our research group has developed a Java-based Distributed Object Medical Imaging Model(DOMIM to facilitate the rapid development and deployment of medical imaging applications in a distributed environment that can be shared and used by related departments and mobile physiciansDOMIM is a unique suite of multimedia telemedicine applications developed for the use by medical related organizations. The applications support realtime patients' data, image files, audio and video diagnosis annotation exchanges. The DOMIM enables joint collaboration between radiologists and physicians while they are at distant geographical locations. The DOMIM environment consists of heterogeneous, autonomous, and legacy resources. The Common Object Request Broker Architecture (CORBA, Java Database Connectivity (JDBC, and Java language provide the capability to combine the DOMIM resources into an integrated, interoperable, and scalable system. The underneath technology, including IDL ORB, Event Service, IIOP JDBC/ODBC, legacy system wrapping and Java implementation are explored. This paper explores a distributed collaborative CORBA/JDBC based framework that will enhance medical information management requirements and development. It encompasses a new paradigm for the delivery of health services that requires process reengineering, cultural changes, as well as organizational changes.

  6. Depression in Geriatric and Adult Medical Inpatients.

    Science.gov (United States)

    Magni, Guido; And Others

    1985-01-01

    Administered two scales for the evaluation of depression to two groups of medical inpatients: adults (N=201) and geriatric subjects (N=178). Results confirmed a high presence of depressive symptoms among patients with medical problems, particularly among geriatric subjects. Factors most predictive of depressive symptoms are identified. (JAC)

  7. Efficacy of a lay health worker led group antiretroviral medication ...

    African Journals Online (AJOL)

    Karl Peltzer, Shandir Ramlagan, Deborah Jones, Stephen M. Weiss, Henry Fomundam, and Lucia Chanetsa

    training among non-adherent HIV-positive patients in KwaZulu-Natal, South ... and task forces and was appointed to task forces under the auspices of the White ... and resistance is to be avoided. ... For example, a meta-analysis of 19 randomized controlled ... effects on adherence (d ¼ 0.62, OR ¼ 3.07), and that interven-.

  8. Secure Group Formation Protocol for a Medical Sensor Network Prototype

    DEFF Research Database (Denmark)

    Andersen, Jacob

    2009-01-01

    wireless sensors to be both secure and usable by exploring different solutions on a fully functional prototype platform. In this paper, we present an Elliptic Curve Cryptography (ECC) based protocol, which offers fully secure sensor set-up in a few seconds on standard (Telos) hardware. We evaluate...

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

    OpenAIRE

    Shahram Lotfipour; T. Kent Denmark; Christopher Erik McCoy; Srinidhi Subraya Bhat; Elizabeth ter Haar; Bharath Chakravarthy

    2011-01-01

    Medical education is rapidly evolving. With the paradigm shift to small-group didactic sessions and focus on clinically oriented case-based scenarios, simulation training has provided educators a novel way to deliver medical education in the 21st century. The field continues to expand in scope and practice and is being incorporated into medical school clerkship education, and specifically in emergency medicine (EM). The use of medical simulation in graduate medical education is well documente...

  10. Application on the Combination of Collaboration and Competition Study Group and Interactive Network Platform Teaching in Teaching in a Medical College, Hubei%小组协作竞争结合交互式网络系统教学在湖北省某高校医学教学中的应用

    Institute of Scientific and Technical Information of China (English)

    刘玉建; 黄芬; 曾和松; 贺行巍; 蒋建刚; 李柱锡; 王涛; 刘婉君; 王贝; 谭蓉; 高波

    2015-01-01

    医学课程是医学生掌握专业知识技能的重要途径,医学内容广泛,需要记忆的内容繁多,但各高校教学方法陈旧,急需进行教学改革以培养适应现代社会需求的医学生。为此,对湖北某高校48名六年制本科生实行改革教学,应用小组协作竞争与交互式网络教学,编排系统教学方案替代传统授课,以完成临床阶段循环系统的医学课程革新。通过学生自主测评的方式,发现本教学方法能激发学生主观能动性,培养良好的协作与竞争精神,节省教学资源,提高教学效率,减少低效与重复教学,但在一定程度上增加了学生课下学业负担,其长期效果还需进一步探索。%Medical curriculum is very important for medical students who are in the clinical medicine stage. However, the medical field is profound and needs to be recited. At the same time, we are eager to find a better teaching method instead of the old one to cultivate the contempo-rary medical students. Therefore, 48 six-year undergraduates were sampled and received the course which consist of the collaboration and compe-tition study group, interactive network teaching platform and system teaching. By the independent assessment, we found it can arouse the student 's curiosity, cultivate good teamwork and competition spirit and improve teaching efficiency, save resources, reduce the inefficient and repetition work. But in some extent, it also increased the academic burden. Its long-term effect still needs further exploration.

  11. The human factor: the critical importance of effective teamwork and communication in providing safe care.

    Science.gov (United States)

    Leonard, M; Graham, S; Bonacum, D

    2004-10-01

    Effective communication and teamwork is essential for the delivery of high quality, safe patient care. Communication failures are an extremely common cause of inadvertent patient harm. The complexity of medical care, coupled with the inherent limitations of human performance, make it critically important that clinicians have standardised communication tools, create an environment in which individuals can speak up and express concerns, and share common "critical language" to alert team members to unsafe situations. All too frequently, effective communication is situation or personality dependent. Other high reliability domains, such as commercial aviation, have shown that the adoption of standardised tools and behaviours is a very effective strategy in enhancing teamwork and reducing risk. We describe our ongoing patient safety implementation using this approach within Kaiser Permanente, a non-profit American healthcare system providing care for 8.3 million patients. We describe specific clinical experience in the application of surgical briefings, properties of high reliability perinatal care, the value of critical event training and simulation, and benefits of a standardised communication process in the care of patients transferred from hospitals to skilled nursing facilities. Additionally, lessons learned as to effective techniques in achieving cultural change, evidence of improving the quality of the work environment, practice transfer strategies, critical success factors, and the evolving methods of demonstrating the benefit of such work are described.

  12. Obesity during childhood and adolescence increases susceptibility to multiple sclerosis after accounting for established genetic and environmental risk factors.

    Science.gov (United States)

    Gianfrancesco, Milena A; Acuna, Brigid; Shen, Ling; Briggs, Farren B S; Quach, Hong; Bellesis, Kalliope H; Bernstein, Allan; Hedstrom, Anna K; Kockum, Ingrid; Alfredsson, Lars; Olsson, Tomas; Schaefer, Catherine; Barcellos, Lisa F

    2014-01-01

    To investigate the association between obesity and multiple sclerosis (MS) while accounting for established genetic and environmental risk factors. Participants included members of Kaiser Permanente Medical Care Plan, Northern California Region (KPNC) (1235 MS cases and 697 controls). Logistic regression models were used to estimate odds ratios (ORs) with 95% confidence intervals (95% CI). Body mass index (BMI) or body size was the primary predictor of each model. Both incident and prevalent MS cases were studied. In analyses stratified by gender, being overweight at ages 10 and 20 were associated with MS in females (prisk of MS for females with a BMI≥30kg/m(2) was observed (OR=2.15, 95% CI 1.18, 3.92). Significant associations between BMI in 20s and MS in males were not observed. Multivariate modelling demonstrated that significant associations between BMI or body size with MS in females persisted after adjusting for history of infectious mononucleosis and genetic risk factors, including HLA-DRB1*15:01 and established non-HLA risk alleles. Results show that childhood and adolescence obesity confer increased risk of MS in females beyond established heritable and environmental risk factors. Strong evidence for a dose-effect of BMI in 20s and MS was observed. The magnitude of BMI association with MS is as large as other known MS risk factors. Copyright © 2014 Asian Oceanian Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

  13. Incidence of anemia in patients diagnosed with solid tumors receiving chemotherapy, 2010–2013

    Science.gov (United States)

    Xu, Hairong; Xu, Lanfang; Page, John H; Cannavale, Kim; Sattayapiwat, Olivia; Rodriguez, Roberto; Chao, Chun

    2016-01-01

    Purpose The purpose of this study was to evaluate and characterize the risk of anemia during the course of chemotherapy among patients with five common types of solid tumors. Patients and methods Patients diagnosed with incident cancers of breast, lung, colon/rectum, stomach, and ovary who received chemotherapy were identified from Kaiser Permanente Southern California Health Plan (2010–2012). All clinical data were collected from the health plan’s electronic medical records. Incidence proportions of patients developing anemia and 95% confidence intervals were calculated overall and by anemia severity and type, as well as by stage at cancer diagnosis, and by chemotherapy regimen and cycle. Results A total of 4,426 patients who received chemotherapy were included. Across cancers, 3,962 (89.5%) patients developed anemia during the course of chemotherapy (normocytic 85%, macrocytic 10%, microcytic 5%; normochromic 47%, hyperchromic 44%, hypochromic 9%). The anemia grades were distributed as follows: 58% were grade 1, 34% grade 2, 8% grade 3, and anemia ranged from 26.3% in colorectal cancer patients to 59.2% in ovarian cancer patients. Incidence of grade 2+ anemia increased from 29% in stage I to 49% in stage IV. Incidence of grade 2+ anemia varied from 18.2% in breast cancer patients treated with cyclophosphamide + docetaxel regimen to 59.7% in patients with ovarian cancer receiving carboplatin + paclitaxel regimen. Conclusion The incidence of moderate-to-severe anemia (hemoglobin anemia was greater in patients with distant metastasis. PMID:27186078

  14. eHealth Advances in Support of People with Complex Care Needs: Case Examples from Canada, Scotland and the US.

    Science.gov (United States)

    Gray, Carolyn Steele; Mercer, Stewart; Palen, Ted; McKinstry, Brian; Hendry, Anne

    2016-01-01

    Information technology (IT) in healthcare, also referred to as eHealth technologies, may offer a promising solution to the provision of better care and support for people who have multiple conditions and complex care needs, and their caregivers. eHealth technologies can include electronic medical records, telemonitoring systems and web-based portals, and mobile health (mHealth) technologies that enable information sharing between providers, patients, clients and their families. IT often acts as an enabler of improved care delivery, rather than being an intervention per se. But how are different countries seeking to leverage adoption of these technologies to support people who have chronic conditions and complex care needs? This article presents three case examples from Ontario (Canada), Scotland and Kaiser Permanente Colorado (United States) to identify how these jurisdictions are currently using technology to address multimorbidity. A SWOT (strengths, weaknesses, opportunities, threats) analysis is presented for each case and a final discussion addresses the future of eHealth for complex care needs. The case reports presented in this manuscript mark the foundational work of the Multi-National eHealth Research Partnership Supporting Complex Chronic Disease and Disability (the eCCDD Network); a CIHR-funded project intended to support the international development and uptake of eHealth tools for people with complex care needs.

  15. Evaluation Following Staggered Implementation of the "Rethinking Critical Care" ICU Care Bundle in a Multicenter Community Setting.

    Science.gov (United States)

    Liu, Vincent; Herbert, David; Foss-Durant, Anne; Marelich, Gregory P; Patel, Anandray; Whippy, Alan; Turk, Benjamin J; Ragins, Arona I; Kipnis, Patricia; Escobar, Gabriel J

    2016-03-01

    To evaluate process metrics and outcomes after implementation of the "Rethinking Critical Care" ICU care bundle in a community setting. Retrospective interrupted time-series analysis. Three hospitals in the Kaiser Permanente Northern California integrated healthcare delivery system. ICU patients admitted between January 1, 2009, and August 30, 2013. Implementation of the Rethinking Critical Care ICU care bundle which is designed to reduce potentially preventable complications by focusing on the management of delirium, sedation, mechanical ventilation, mobility, ambulation, and coordinated care. Rethinking Critical Care implementation occurred in a staggered fashion between October 2011 and November 2012. We measured implementation metrics based on electronic medical record data and evaluated the impact of implementation on mortality with multivariable regression models for 24,886 first ICU episodes in 19,872 patients. After implementation, some process metrics (e.g., ventilation start and stop times) were achieved at high rates, whereas others (e.g., ambulation distance), available late in the study period, showed steep increases in compliance. Unadjusted mortality decreased from 12.3% to 10.9% (p Rethinking Critical Care implementation. The mean duration of mechanical ventilation and hospital stay also did not demonstrate incrementally greater declines after implementation. Rethinking Critical Care implementation was associated with changes in practice and a 12-15% reduction in the odds of short-term mortality. However, these findings may represent an evaluation of changes in practices and outcomes still in the midimplementation phase and cannot be directly attributed to the elements of bundle implementation.

  16. Transforming Medical Education: Is Competency-Based Medical Education the Right Approach?

    Science.gov (United States)

    Whitcomb, Michael E

    2016-05-01

    There is growing recognition within the medical education community that medical education in this country needs to be changed to better prepare doctors for the challenges they will face in providing their patients high-quality medical care. A competency-based medical education (CBME) approach was endorsed by the Accreditation Council for Graduate Medical Education and the American Board of Medical Specialties approximately 15 years ago, and a self-designated group-the International Competency-Based Medical Education (ICBME) Collaborators-is now calling on members of the medical education community to join them in their effort to establish CBME as the approach to be used in transforming medical education, not only in the United States but also around the world.In response to an article in this issue by a group of ICBME Collaborators, the author argues that more evidence about the effectiveness of CBME is needed before a global shift to this approach is undertaken. It is time for major organizations and foundations that are committed to improving medical education to step forward and take the lead in partnering with the medical education community to conduct a critical evaluation of CBME. In addition, maintenance of certification, relicensure, and continuing medical education programs should be evaluated for their effectiveness in ensuring that physicians are clinically competent not only at the beginning of their career but also until the end.

  17. Prevalence of Childhood and Adolescent Overweight and Obesity from 2003 to 2010 in an Integrated Health Care Delivery System

    Directory of Open Access Journals (Sweden)

    Scott Gee

    2013-01-01

    Full Text Available An observational study of the Kaiser Permanente Northern California (KPNC BMI coding distributions was conducted to ascertain the trends in overweight and obesity prevalence among KPNC members aged 2–19 between the periods of 2003–2005 and 2009-2010. A decrease in the prevalence of overweight (−11.1% change and obesity (−3.6% change and an increase in the prevalence of healthy weight (+2.7% change were demonstrated. Children aged 2–5 had the greatest improvement in obesity prevalence (−11.5% change. Adolescents aged 12–19 were the only age group to not show a decrease in obesity prevalence. Of the racial and ethnic groups, Hispanics/Latinos had the highest prevalence of obesity across all age groups. The KPNC prevalence of overweight and obesity compares favorably to external benchmarks, although differences in methodologies limit our ability to draw conclusions. Physician counseling as well as weight management programs and sociodemographic factors may have contributed to the overall improvements in BMI in the KPNC population. Physician training, practice tools, automated BMI reminders and performance feedback improved the frequency and quality of physician counseling. BMI screening and counseling at urgent visits, in addition to well-child care visits, increased the reach and dose of physician counseling.

  18. MEDICAL ETHICS COURSE IMPROVES MEDICAL PROFESSIONALISM: MEDICAL STUDENTS´ OPINIONS

    Directory of Open Access Journals (Sweden)

    Abdolreza Sotoodeh Jahromi

    2014-01-01

    Full Text Available Training physicians who are expert in many medical aspects is the most improtant mission of medical universities. One of these aspects, is professional behavior achievement. One of the important goals in training of ethics, is recognition of conflicts in different parts of ethics and having logical viewpoint for resolving and analyzing these conflicts. This descriptive and analytical study was done to evaluate the efficacy of medical ethics education in medical students´ professional attitudes improvement. One hundred and two medical students were selected randomly in different steps of education and were questioned and their opinions correlation with stage of education and gender were evaluated. There was a significant difference between female viewpoint (in roles of ethic course which is presented in preclinical step in professional attitude improvement (P = 0.009 and also a significant difference was seen in the viewpoint score between student stage with intern stage (P = 0.031. Medical students in educational student stage believe ethic course improve medical professionalism. Since there is no special course to train medical students in professionalism, some interventions are required in this field to improve this aspect of physicians' professional life.

  19. Professional representation and the free-lance medical illustrator.

    Science.gov (United States)

    Mount, K N; Daugherty, J

    1994-01-01

    We researched factors related to the success or failure in working relationships between free-lance medical illustrators and artist's representatives. In the fall of 1992, surveys were mailed to 230 medical illustrators; 105 (46%) completed surveys were returned. Respondents were divided into three categories: 1) medical illustrators currently represented, 2) medical illustrators previously represented, and 3) medical illustrators who had never been represented. Comparisons made among illustrators from the three groups included business practices, clientele, experience, and self-promotion techniques. These comparisons revealed notable differences and similarities between the three groups and were subsequently analyzed to identify the characteristics of medical illustrators who would benefit from professional representation.

  20. Medical Secretaries’ Care of Records

    DEFF Research Database (Denmark)

    Bossen, Claus; Jensen, Lotte Groth; Witt, Flemming

    2012-01-01

    We describe the cooperative work of medical secretaries at two hospital departments, during the implementation of an electronic health record system. Medical secretaries' core task is to take care of patient records by ensuring that also do information gatekeeping and articulation work. The EHR...... to health informatics and CSCW, this case study identifies their importance, and suggests that they and other non-clinical groups should be considered, when developing health care IT. We propose the term 'boundary-object trimming', to conceptualize their contributions to hospitals' cooperative work...

  1. Medical Informatics For Medical Students And Medical Practitioners

    Directory of Open Access Journals (Sweden)

    Jai MOHAN

    2010-06-01

    Full Text Available The importance of incorporating medical (or healthinformatics into the education of medical students andmedical practitioners is being increasingly recognised.The advances in information and communicationtechnology and the pervasion of the Internet intoeveryday life have important implications forhealthcare services and medical education.Students and practitioners should learn to utilisebiomedical information for problem solving anddecision making based on evidence. The extensiveintroduction of electronic health information systemsinto hospitals and clinics and at the enterprise level inMalaysia and elsewhere is driving a demand for healthprofessionals who have at least basic skills in andappreciation of the use of these technologies.The essential clinical informatics skills have beenidentified and should be incorporated into theundergraduate medical curriculum. It is recommendedthat these be introduced in stages and integrated intoexisting programmes rather than taught as a separatemodule. At the same time, medical schools shouldsupport the integration of e-learning in the educationalprocess in view of the numerous potential benefits.

  2. Influência da propaganda na utilização de medicamentos em um grupo de idosos atendidos em uma unidade básica de saúde em Aracaju (SE, Brasil The influence of the advertising in the medication use in a group of elderly attended in a primary health care unit in Aracaju (Sergipe, Brasil

    Directory of Open Access Journals (Sweden)

    Divaldo Pereira de Lyra Jr

    2010-11-01

    Full Text Available O crescimento da população idosa brasileira tem levado a uma maior tendência ao uso de medicamentos. A sua utilização inadequada pode ser induzida por vários fatores, dentre eles a propaganda, podendo trazer danos à saúde do usuário. O objetivo do estudo foi avaliar a influência da propaganda no consumo de medicamentos por um grupo de idosos atendidos em unidade básica de saúde de Aracaju, Sergipe. No período de abril a junho de 2007, um grupo de 230 idosos, com idade acima de 60 anos, de ambos os gêneros, foi entrevistado. A maioria dos entrevistados (73% possuía pelo menos uma doença crônica e 73,9% consumiam pelo menos um medicamento regularmente. Do total de entrevistados, 17,8% da amostra relataram utilizar medicamentos por influência da propaganda; 2,2% consideraram que os medicamentos veiculados na mídia nunca fazem mal e 6,5% acreditavam que eles sempre fazem bem. No estudo, correlações foram feitas e demonstraram que quem mais consome medicamentos influenciados pela propaganda também considera que eles sempre fazem bem e vice-versa (p= 0,04. Os dados revelaram que parte dos idosos sofreu influência da propaganda no consumo de medicamentos, não levando em consideração os riscos que estes poderiam causar.The growth of the Brazilian elderly people has led to a trend to an increase in the medication use. The inadequate use of drugs can be induced by some factors, like advertisement, with the risk of damaging the user's health. The objective of the study was to evaluate the advertisement influence in medication use in a group of elderly patients in a primary health care unit in Aracaju, Sergipe, Brazil. 230 elderly aging over 60 years with both genders had been interviewed from April to June of 2007. The majority of the interviewees (73% has at least a chronic health condition and 73.9% consumed regularly at least one medication. 17.8% of the sample informed to use medication motivated by publicity influence; 2

  3. Patient satisfaction with medical care

    Directory of Open Access Journals (Sweden)

    M. A. Sadovoy

    2017-01-01

    Full Text Available Patients’ evaluation of medical care is becoming more and more important due to expanding patient-centered care. For this purpose a complex index of patient satisfaction with healthcare is used. This parameter reflects the correspondence of actual healthcare services to patient’s expectations that were formed under the influence of cultural, social, economic factors, and personal experience of each patient. Satisfaction is a subjective parameter, thus, a grade of satisfaction is barely connected with quality of healthcare services itself. Moreover, medical organizations should always take into account specific features of each patient, since they can have an influence on customer attitude to medical services.This article comprises the review of publications studying determinants of patient satisfaction. In the course of the study, we analyzed data received by research teams from different countries.According to the review, we made some conclusions. First, determinants of patient satisfaction with healthcare can be divided in two groups. The first group of factors includes patients’ characteristics such as age, gender, ethnical and cultural features. However, researches from different countries revealed that there is a difference in the importance of factors belonging to this group and their influence on satisfaction of certain patient cohorts. The second group includes factors that belong to the process of healthcare services delivery and its organization. Moreover, it was found that patient satisfaction level is changing in a waveform. Thus, medical organization should not only try to increase patient satisfaction level but also maintain it. AS a result, it necessary to monitor patient satisfaction with healthcare services. That is why there is a distinct need for the development of a new tool or adaptation of existing instrument of satisfaction measurement, which would be unitized for all medical organizations in the Russian Federation 

  4. The effects of medical tourism: Thailand's experience.

    Science.gov (United States)

    NaRanong, Anchana; NaRanong, Viroj

    2011-05-01

    To explore the positive and negative effects of medical tourism on the economy, health staff and medical costs in Thailand. The financial repercussions of medical tourism were estimated from commerce ministry data, with modifications and extrapolations. Survey data on 4755 foreign and Thai outpatients in two private hospitals were used to explore how medical tourism affects human resources. Trends in the relative prices of caesarean section, appendectomy, hernia repair, cholecystectomy and knee replacement in five private hospitals were examined. Focus groups and in-depth interviews with hospital managers and key informants from the public and private sectors were conducted to better understand stakeholders' motivations and practices in connection with these procedures and learn more about medical tourism. Medical tourism generates the equivalent of 0.4% of Thailand's gross domestic product but has exacerbated the shortage of medical staff by luring more workers away from the private and public sectors towards hospitals catering to foreigners. This has raised costs in private hospitals substantially and is likely to raise them in public hospitals and in the universal health-care insurance covering most Thais as well. The "brain drain" may also undermine medical training in future. Medical tourism in Thailand, despite some benefits, has negative effects that could be mitigated by lifting the restrictions on the importation of qualified foreign physicians and by taxing tourists who visit the country solely for the purpose of seeking medical treatment. The revenue thus generated could then be used to train physicians and retain medical school professors.

  5. STS-3 medical report

    Science.gov (United States)

    Pool, S. L. (Editor); Johnson, P. C., Jr. (Editor); Mason, J. A. (Editor)

    1982-01-01

    The medical operations report for STS-3, which includes a review of the health of the crew before, during, and immediately after the third Shuttle orbital flight is presented. Areas reviewed include: health evaluation, medical debriefing of crewmembers, health stabilization program, medical training, medical 'kit' carried in flight, tests and countermeasures for space motion sickness, cardiovascular profile, biochemistry and endocrinology results, hematology and immunology analyses, medical microbiology, food and nutrition, potable water, shuttle toxicology, radiological health, and cabin acoustic noise. Environmental effects of shuttle launch and landing medical information management, and management, planning, and implementation of the medical program are also dicussed.

  6. Proteomics in medical microbiology.

    Science.gov (United States)

    Cash, P

    2000-04-01

    The techniques of proteomics (high resolution two-dimensional electrophoresis and protein characterisation) are widely used for microbiological research to analyse global protein synthesis as an indicator of gene expression. The rapid progress in microbial proteomics has been achieved through the wide availability of whole genome sequences for a number of bacterial groups. Beyond providing a basic understanding of microbial gene expression, proteomics has also played a role in medical areas of microbiology. Progress has been made in the use of the techniques for investigating the epidemiology and taxonomy of human microbial pathogens, the identification of novel pathogenic mechanisms and the analysis of drug resistance. In each of these areas, proteomics has provided new insights that complement genomic-based investigations. This review describes the current progress in these research fields and highlights some of the technical challenges existing for the application of proteomics in medical microbiology. The latter concern the analysis of genetically heterogeneous bacterial populations and the integration of the proteomic and genomic data for these bacteria. The characterisation of the proteomes of bacterial pathogens growing in their natural hosts remains a future challenge.

  7. Integrated Groups and Smooth Distribution Groups

    Institute of Scientific and Technical Information of China (English)

    Pedro J. MIANA

    2007-01-01

    In this paper, we prove directly that α-times integrated groups define algebra homo-morphisms. We also give a theorem of equivalence between smooth distribution groups and α-times integrated groups.

  8. Machine medical ethics

    CERN Document Server

    Pontier, Matthijs

    2015-01-01

    The essays in this book, written by researchers from both humanities and sciences, describe various theoretical and experimental approaches to adding medical ethics to a machine in medical settings. Medical machines are in close proximity with human beings, and getting closer: with patients who are in vulnerable states of health, who have disabilities of various kinds, with the very young or very old, and with medical professionals. In such contexts, machines are undertaking important medical tasks that require emotional sensitivity, knowledge of medical codes, human dignity, and privacy. As machine technology advances, ethical concerns become more urgent: should medical machines be programmed to follow a code of medical ethics? What theory or theories should constrain medical machine conduct? What design features are required? Should machines share responsibility with humans for the ethical consequences of medical actions? How ought clinical relationships involving machines to be modeled? Is a capacity for e...

  9. Group typicality, group loyalty and cognitive development.

    Science.gov (United States)

    Patterson, Meagan M

    2014-09-01

    Over the course of childhood, children's thinking about social groups changes in a variety of ways. Developmental Subjective Group Dynamics (DSGD) theory emphasizes children's understanding of the importance of conforming to group norms. Abrams et al.'s study, which uses DSGD theory as a framework, demonstrates the social cognitive skills underlying young elementary school children's thinking about group norms. Future research on children's thinking about groups and group norms should explore additional elements of this topic, including aspects of typicality beyond loyalty.

  10. Which finite simple groups are unit groups?

    DEFF Research Database (Denmark)

    Davis, Christopher James; Occhipinti, Tommy

    2014-01-01

    We prove that if G is a finite simple group which is the unit group of a ring, then G is isomorphic to either (a) a cyclic group of order 2; (b) a cyclic group of prime order 2^k −1 for some k; or (c) a projective special linear group PSLn(F2) for some n ≥ 3. Moreover, these groups do all occur...

  11. Semantic equivalences in Romanian medical terminology

    Directory of Open Access Journals (Sweden)

    Corina Lungu

    2014-12-01

    Full Text Available The present paper aims to underline some aspects concerning the presence of synonymy semantic relationship in specialized medical terminology, having as object of study Romanian medical terms. For this study we use a descriptive, conceptual and lexical semantic research method to provide the understanding of different couples, groups or synonymic series where medical terms have several variations: specialized/common terms, syntagms and patronyms of French or different origin. We propose a classification scheme of synonyms of medical lexicon, terms or synonymic syntagms, total and partial, in order to meet the accessibility needs in scientific communication.

  12. Impact of initial active engagement in self-monitoring with a telemonitoring device on glycemic control among patients with type 2 diabetes.

    Science.gov (United States)

    Lee, Min-Kyung; Lee, Kwang-Hyeon; Yoo, Seung-Hyun; Park, Cheol-Young

    2017-06-20

    This study aimed to investigate the effect of patient engagement in self-monitoring with a telemonitoring device on glycemic control among patients with type 2 diabetes. We conducted a subanalysis of the telemonitoring device study in Kaiser Permanente Northern California members. We divided the telemonitoring group into 53 frequent and 54 infrequent users based on self-monitoring of blood glucose (SMBG) frequency of the first 6 weeks. The frequency of SMBG transmitted from the telemonitoring device was examined over 24 weeks. Clinic and laboratory tests were collected at baseline, 6 weeks and 6 months. There was no significant difference in baseline HbA1c level between the two groups. After 6 months, change in HbA1c was -2.4 ± 1.6% among frequent users and -1.5 ± 1.5% among infrequent users (p = 0.003). The proportion of patients achieving target HbA1C level at 6 months was significantly higher among frequent users than among infrequent users. An increased frequency of SMBG was significantly correlated with a reduction in HbA1c at 6 months. In conclusion, initial active engagement in self-monitoring with a telemonitoring device could provide incremental improvement of glycemic control over 6 months.

  13. Toward a trustworthy voice: increasing the effectiveness of automated outreach calls to promote colorectal cancer screening among African Americans.

    Science.gov (United States)

    Albright, Karen; Richardson, Terri; Kempe, Karin L; Wallace, Kristin

    2014-01-01

    Colorectal cancer screening rates are lower among African-American members of Kaiser Permanente Colorado (KPCO) than among members of other races and ethnicities. This study evaluated use of a linguistically congruent voice in interactive voice response outreach calls about colorectal cancer screening as a strategy to increase call completion and response. After an initial discussion group to assess cultural acceptability of the project, 6 focus groups were conducted with 33 KPCO African-American members. Participants heard and discussed recordings of 5 female voices reading the same segment of the standard-practice colorectal cancer message using interactive voice response. The linguistic palette included the voices of a white woman, a lightly accented Latina, and 3 African-American women. Participants strongly preferred the African-American voices, particularly two voices. Participants considered these voices the most trustworthy and reported that they would be the most effective at increasing motivation to complete an automated call. Participants supported the use of African-American voices when designing outgoing automated calls for African Americans because the sense of familiarity engendered trust among listeners. Participants also indicated that effective automated messages should provide immediate clarity of purpose; explain why the issue is relevant to African Americans; avoid sounding scripted; emphasize that the call is for the listener's benefit only; sound personable, warm, and positive; and not create fear among listeners. Establishing linguistic congruence between African Americans and the voices used in automated calls designed to reach them may increase the effectiveness of outreach efforts.

  14. [History of medical ethics in Korea: focused on analysis of medical codes and covenants].

    Science.gov (United States)

    Shin, D W

    2000-12-01

    This article deals with the emergence of the codes of medical ethics and their change in Korean history. The modernized medical codes or covenants by the group of medical doctors has been made from the mid-twentieth century, although Korea has a long tradition of medical ethics, so called the Confucian medical ethics, Insul or Uido which were taken on very strong paternalistic characters. The history of the codes of medical ethics in contemporary Korea showed several revisions in 1961, 1965, 1979, and 1997 since the first establishment in 1955. Changes of political circumstances, the cultural level of the people, medical care system, and medical power leaded to the revisions. Throughout the revisions the codes or covenants of medical ethics in Korea has changed from simple translations of the codes by the World Medical Association and the American Medical Association to the reflexes of domestic medical situations; from the ones based on paternalistic doctor-patient relationship to more democratic ones; from the ones that only medical ethics were expressed to the ones that bioethics was expressed too.

  15. Experiências com a gestão autônoma da medicação: narrativa de usuários de saúde mental no encontro dos grupos focais em centros de atenção psicossocial Experiments with autonomous management of medication: narrative of mental health users in focus group meeting in psychosocial care centers

    Directory of Open Access Journals (Sweden)

    Maria Salete Bessa Jorge

    2012-01-01

    Full Text Available Objetiva-se analisar as experiências vivenciadas pelos usuários do Centro de Atenção Psicossocial no desenvolvimento do grupo para Gestão Autônoma da Medicação (GAM. Opta-se pela pesquisa qualitativa, dentro de uma perspectiva crítica que protagoniza a vivência dos participantes do grupo operativo GAM. Realizado nos Centros de Atenção Psicossocial (CAPS Geral e Álcool e outras Drogas (AD do município de Maracanaú-CE. Os participantes foram 13 usuários de CAPS Geral e Ad do referido município. Técnica de coleta das narrativas foi constituída por três grupos narrativos e a análise pautada na hermenêutica. Segundo as narrativas desvelaram, em todo o processo de discussão sobre a medicação, fica evidente a importância da escuta e do acompanhamento individual. A abordagem singular dos usuários possibilitou melhoria significativa no estado de saúde mental e na compreensão do adoecimento. Assim, é possível ressignificar a utilização precípua do medicamento e interagir com inovações terapêuticas mais voltadas para hábitos de vida saudável.The study aimed to analyze the feelings experienced by users of the Center for Psychosocial Care in developing the group for Autonomous Management of Medication (AMM. It uses qualitative research within a critical perspective that carries the experience of participating in the operative AMM group. It was conducted at the General Center for Psychosocial Care (CAPS and Alcohol and other Drugs (AD in the city of Maracanau, state of Ceara, Brazil. The participants were 13 users of General and Ad CAPS of that city. The technique of narratives' collection consisted of three groups based in the narrative analysis and hermeneutics. According to the narratives, throughout the discussion process on the medication, it is evident the importance of listening and coaching. The unique approach of users allowed significant improvement in health status and understanding of mental illness. Thus, it

  16. Information in medical treatment courses

    DEFF Research Database (Denmark)

    Møller, Marianne; Hollnagel, Erik; Andersen, Stig Ejdrup

    that goes well (Safety-II) while having a broad understanding of quality. Objectives The overall purpose is to investigate how information is used as a steering tool for quality in medical treatment courses. In this first part of the study, the role of information on medicine is analyzed in relation...... to the quality of medical treatment courses. Methods Systems theory, cybernetics (steering, timing and feedback) and a classic communication model are applied as theoretical frames. Two groups of patients and their information providers are studied using qualitative methods. The data analysis focuses...... on the aspects most relevant for the patients concerning their use of, and feed-back on, medicines information. Results Seven patients using either chronic pain medication or anticoagulants participated in the first phase. They were recruited from GPs, hospital outpatients clinics, pharmacies and patient...

  17. Copayments for medication in 2014. Final rule.

    Science.gov (United States)

    2014-05-27

    This document adopts as a final rule, without change, an interim final rule amending the Department of Veterans Affairs (VA) medical regulations to freeze the copayments required for certain medications provided by VA until December 31, 2014. Under that rule, the copayment amounts for all veterans were maintained at the same rates as they were in 2013, which were $8 for veterans in priority groups 2-6 and $9 for veterans in priority groups 7 and 8. On January 1, 2015, the copayment amounts may increase based on the prescription drug component of the Medical Consumer Price Index (CPI-P).

  18. Group Cohesion in Experiential Growth Groups

    Science.gov (United States)

    Steen, Sam; Vasserman-Stokes, Elaina; Vannatta, Rachel

    2014-01-01

    This article explores the effect of web-based journaling on changes in group cohesion within experiential growth groups. Master's students were divided into 2 groups. Both used a web-based platform to journal after each session; however, only 1 of the groups was able to read each other's journals. Quantitative data collected before and…

  19. Patient safety and technology-driven medication

    DEFF Research Database (Denmark)

    Orbæk, Janne; Gaard, Mette; Keinicke Fabricius, Pia

    2015-01-01

    ways of educating nursing students in today's medication administration. AIM: To explore nursing students' experiences and competences with the technology-driven medication administration process. METHODS: 16 pre-graduate nursing students were included in two focus group interviews which were recorded...... for the technology-driven medication process, nursing students face difficulties in identifying and adopting best practices. The impact of using technology on the frequency, type and severity of medication errors; the technologies implications on nursing professionalism and the nurses ability to secure patient......BACKGROUND: The technology-driven medication process is complex, involving advanced technologies, patient participation and increased safety measures. Medication administration errors are frequently reported, with nurses implicated in 26-38% of in-hospital cases. This points to the need for new...

  20. Medical Physics Panel Discussion

    Science.gov (United States)

    Guèye, Paul; Avery, Steven; Baird, Richard; Soares, Christopher; Amols, Howard; Tripuraneni, Prabhakar; Majewski, Stan; Weisenberger, Drew

    2006-03-01

    The panel discussion will explore opportunities and vistas in medical physics research and practice, medical imaging, teaching medical physics to undergraduates, and medical physics curricula as a recruiting tool for physics departments. Panel members consist of representatives from NSBP (Paul Guèye and Steven Avery), NIH/NIBIB (Richard Baird), NIST (Christopher Soares), AAPM (Howard Amols), ASTRO (Prabhakar Tripuraneni), and Jefferson Lab (Stan Majewski and Drew Weisenberger). Medical Physicists are part of Departments of Radiation Oncology at hospitals and medical centers. The field of medical physics includes radiation therapy physics, medical diagnostic and imaging physics, nuclear medicine physics, and medical radiation safety. It also ranges from basic researcher (at college institutions, industries, and laboratories) to applications in clinical environments.