[The function of philosophy of science in the teaching of medical history].

Science.gov (United States)

Li, Yaming

2014-05-01

The philosophy of science yields 3 important functions in the teaching of medical history. Firstly, by analyzing the development of medicine from the perspective of philosophy, we can integrate medical history into the history of human thought and clearly show the close connection between the development of humanity and the development of medical science. Secondly, philosophical analysis on the general rules of scientific discoveries involved in medical history can help medical students to understand the methodology in the research of sciences in history. Thirdly, philosophy of science offers new dimensions for understanding the relationship between medicine and the society. By making use of the relevant theory in scientific philosophy to explore the relationship between medicine and the society, the nature of medicine and the social nature and function of science can be further understood by medical students so as to exert an active role in the research and clinical work in the future.

History of Medicine in US Medical School Curricula.

Science.gov (United States)

Caramiciu, Justin; Arcella, David; Desai, Manisha S

2015-10-01

To determine the extent to which the history of medicine (HOM) and its related topics are included within the curriculum of accredited medical schools in the United States. Survey instrument. US allopathic medical schools. An online survey was sent to officials from every medical school in the US. Respondents were asked to provide institutional identifiers, the presence of an HOM elective offered to medical students, the years during which the elective is offered, the existence of an HOM department, and the contact information for that particular department. Nonresponders were contacted by phone to elicit the same information. History of medicine electives included didactic sessions and seminars with varying degrees of credit offered in different years of medical school. Based on responses from 119 of 121 contacted medical schools (98%), 45 (37%) included formal lectures or weekly seminars in the medical school curriculum. Five (11%) curricula had or have required HOM, whereas 89% offered elective HOM instruction. Course duration and credit awarded varied. Eighteen (15%) medical schools included departments dedicated to HOM. Providing education in HOM was limited by faculty interest, clinical training hours, and low interest. Data collected by our study suggest that substantial barriers exist within the academic medical community towards a wider acceptance of the importance of HOM. Causes for such lack of interest include absence of questions on written or oral tests related to HOM, difficulty in publishing articles related to HOM in peer reviewed journals, near absence of research grants in HOM, difficulty in getting academic promotions or recognition for activities related to HOM, and a lack of support from academic chairpersons for activities related to HOM. Copyright © 2015 Anesthesia History Association. Published by Elsevier Inc. All rights reserved.

Eliciting comprehensive medication histories in the emergency department: the role of the pharmacist.

Directory of Open Access Journals (Sweden)

Crook M

2007-06-01

Full Text Available The Australian Pharmaceutical Advisory Committee guidelines call for a detailed medication history to be taken at the first point of admission to hospital. Accurate medication histories are vital in optimising health outcomes and have been shown to reduce mortality rates. This study aimed to examine the accuracy of medication histories taken in the Emergency Department of the Royal Adelaide Hospital. Medication histories recorded by medical staff were compared to those elicited by a pharmacy researcher. The study, conducted over a six-week period, included 100 patients over the age of 70, who took five or more regular medications, had three or more clinical co-morbidities and/or had been discharged from hospital in three months prior to the study. Following patient interviews, the researcher contacted the patient’s pharmacist and GP for confirmation and completion of the medication history. Out of the 1152 medications recorded as being used by the 100 patients, discrepancies were found for 966 medications (83.9%. There were 563 (48.9% complete omissions of medications. The most common discrepancies were incomplete or omitted dosage and frequency information. Discrepancies were mostly medications that treated dermatological and ear, nose and throat disorders but approximately 29% were used to treat cardiovascular disorders. This study provides support for the presence of an Emergency Department pharmacist who can compile a comprehensive and accurate medication history to enhance medication management along the continuum of care. It is recommended that the patient’s community pharmacy and GP be contacted for clarification and confirmation of the medication history.

On the history of New York Medical College.

Science.gov (United States)

Greenberg, S J

1986-01-01

The history of New York Medical College reflects three distinct trends in the development of medical education: the rise and fall of homeopathy, the input of civic leaders (in this case, William Cullen Bryant) and the uneasy relationship between medical schools and hospitals caused by the dramatic increase in the complexity and cost of hospital care.

Hypertension in Asymptomatic, Young Medical Students with Parental History of Hypertension

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Simran Sidhu

2017-11-01

Full Text Available Introduction: Family history of hypertension in medical students is an important, non-modifiable risk factor for hypertension in future. Aim: To determine the prevalence of sustained hypertension in young asymptomatic medical students with a parental history of hypertension. Materials and Methods: A cross-sectional study was conducted in a medical college of Dehradun. A total of 104 medical students with parental history of hypertension (Group A and 100 medical students without a parental history of hypertension (Group B were included. Electronically blood pressures were recorded on two separate occasions at an interval of 15 days. Comparison was done using Chi-square test/Likelihood ratio, Un-paired t-test and ANCOVA. Results: Overall, Group A had significantly higher percentage of prehypertensive (56.7% and hypertensive (17.3% students as compared to Group B which were 19% and 1%, respectively. Group A students had significantly higher Systolic Blood Pressure (SBP and Diastolic Blood Pressure (DBP as compared to Group B, even after controlling for the differences in Body Mass Index (BMI and gender (p<0.001. Conclusion: Hypertension was significantly higher in asymptomatic, healthy medical students with parental history of hypertension as compared to those with normotensive parents. We need to orient medical students to improve their knowledge, attitude and lifestyle practices early in life to prevent, treat hypertension and prevent its subsequent morbidity and mortality.

Medical Genetics at McGill: The History of a Pioneering Research Group.

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Canning, Christopher; Weisz, George; Tone, Andrea; Cambrosio, Alberto

2013-01-01

The McGill Group in Medical Genetics was formed in 1972, supported by the Medical Research Council and successor Canadian Institutes for Health Research until September 2009, making it the longest active biomedical research group in the history of Canada. We document the history of the McGill Group and situate its research within a broader history of medical genetics. Drawing on original oral histories with the Group's members, surviving documents, and archival materials, we explore how the Group's development was structured around epistemological trends in medical genetics, policy choices made by research agencies, and the development of genetics at McGill University and its hospitals.

Prescription data improve the medication history in primary care

DEFF Research Database (Denmark)

Glintborg, Bente; Andersen, S K; Poulsen, H E

2010-01-01

Incomplete medication lists increase the risk of medication errors and adverse drug effects. In Denmark, dispensing data and pharmacy records are available directly online to treating physicians. We aimed (1) to describe if use of pharmacy records improved the medication history among patients co...

Seroepidemiology of Varicella and value of self-reported history of Varicella infection in Iranian medical students.

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Allami, Abbas; Mohammadi, Navid; Najar, Azade

2014-04-01

We conducted this study to assess the seroprevalence of Varicella zoster virus (VZV) antibodies in a group of Iranian medical sciences students that were at risk of Varicella and the value of self-reported history as a predictor of immunity. 255 medical, nursing and obstetrics students who had not entered as a student or worked in a hospital from 3 different schools were enrolled in the study in 2012 (Qazvin province, Iran). Demographics and other information as well as the history of Varicella were obtained through a self-administered questionnaire. Blood samples were collected to determine the Varicella IgG levels via an enzyme-linked immunosorbent assay. A statistical analysis was performed by calculating prevalences and their 95% confidence intervals. Sensitivity, specificity, positive and negative predictive values, Cohen's kappa and positive and negative likelihood ratios of recalled history were determined. p history with immunity against the virus were statistically significant. The overall rate of reported history was 57%. The positive and negative predictive values of self-reported history of Varicella were 91% and 47.3%, respectively. Immunization of students of Iranian medical sciences seems logical in the near future. Also, they should be tested for Varicella immunity regardless of the history of previous infection.

Teaching history taking to medical students: a systematic review.

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

2015-09-28

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

The History, Biology and Medical Aspects of Leprosy.

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Eichman, Phillip

1999-01-01

Presents information about the history, biology, and medical aspects of leprosy, including its description in historical documents, its cause and effects, statistics on its prevalence, and various attempts at treatment. Notes that leprosy is one of the few infectious diseases that, although treatable with medication, remains incurable. Contains 30…

Dispatch from the non-HITECH-incented Health IT world: electronic medication history adoption and utilization.

Science.gov (United States)

Gabriel, Meghan Hufstader; Smith, Jaime Y; Sow, Max; Charles, Dustin; Joseph, Seth; Wilkins, Tricia Lee

2016-05-01

To document national trends of electronic medication history use in the ambulatory setting and describe the characteristics and predicting factors of providers who regularly use medication history transaction capabilities through their e-prescribing systems. The study used provider-initiated medication history data requests, electronically sent over an e-prescribing network from all 50 states and the District of Columbia. Data from 138,000 prescribers were evaluated using multivariate analyses from 2007 to 2013. Medication history use showed significant growth, increasing from 8 to 850 million history requests during the study period. Prescribers on the network for histories more often than those in large and small cities, these findings were not significant in multivariate analyses. Providers in orthopedic surgery and internal medicine had a higher likelihood of more requests than family practice prescribers, with 12% and 7% higher likelihood, respectively. Early adopters of e-prescribing have remained medication history users and have continually increased their volume of requests for medication histories. Despite the fact that the use of medication histories through e-prescribing networks in the ambulatory care setting has not been encouraged through federal incentive programs, there has been substantial growth in the use of medication histories offered through e-prescribing networks. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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

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Steinke, Hubert; Lang, Yves

2011-10-01

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

Geographic Medical History: Advances in Geospatial Technology Present New Potentials in Medical Practice

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Faruque, F. S.; Finley, R. W.

2016-06-01

Genes, behaviour, and the environment are known to be the major risk factors for common diseases. When the patient visits a physician, typical questions include family history (genes) and lifestyle of the patient (behaviour), but questions concerning environmental risk factors often remain unasked. It is ironic that 25 centuries ago Hippocrates, known as the father of medicine, noted the importance of environmental exposure in medical investigation as documented in his classic work, "Airs, Waters, Places", yet the practice of routinely incorporating environmental risk factors is still not in place. Modern epigenetic studies have found that unhealthy lifestyle and environmental factors can cause changes to our genes that can increase disease risk factors. Therefore, attempting to solve the puzzle of diseases using heredity and lifestyle alone will be incomplete without accounting for the environmental exposures. The primary reason why environmental exposure has not yet been a routine part of the patient's medical history is mostly due to our inability to provide clinicians useful measures of environmental exposures suitable for their clinical practices. This presentation will discuss advances in geospatial technology that show the potential to catalyse a paradigm shift in medical practice and health research by allowing environmental risk factors to be documented as the patient's "Geographic Medical History". In order to accomplish this we need information on: a) relevant spatiotemporal environmental variables, and b) location of the individual in that person's dynamic environment. Common environmental agents that are known to interact with genetic make-up include air pollutants, mold spores, pesticides, etc. Until recently, the other component, location of an individual was limited to a static representation such as residential or workplace location. Now, with the development of mobile technology, changes in an individual's location can be tracked in real time if

History and development of medical physics and medical physicist in Japan

International Nuclear Information System (INIS)

Toyofuku, F.

2014-01-01

The history of medical physics in Japan dates back to the mid-1950's when radioisotope sources such as cobalt-60 were initiated into hospitals. In 1961, a total of about 30 medical physics researchers created a sub-committee of medical physics under the Japan Radiological Society (JRS), which flourished throughout the decade, and the number of members exceeded to more than 200 in 1970. Although there were great advances in medical technologies, the number of members of the medical physics community did not grow for the next two decades from 1980 to 2000. Then, the JRS began to officially recognize medical physicists as a professional group in 1987. Qualifications of candidacy for the examination included having the education equivalent of a Bachelor of Science/Engineering and being a member of the JRS. For the first official examination, 70 medical physicists were approved by the JRS. As of 2013, there are currently 700 medical physicists, however, the number of practicing clinical medical physicists remains only about 150. The main reason for this limited number of medical physicists is that the certification is not recognized as a national license and therefore is challenging to find professional employment as qualified medical personnel at hospitals. (author)

The Establishment and operation of Longjing Medical College - The History of Longjing Medical College as Frontier History: Focusing on its ‘Disconnection’ and ‘Continuity’ -

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Mira MOON

2017-08-01

Full Text Available Longjing Medial College, established in Longjing, Yanbian, China on September 12, 1945, existed for about 1 year and 6 months until it was renamed as the Medical Department of Dongbei Junzheng Daxue Jilin Fenxiao in April 1947. However, there are only few records and studies on Longjing Medical College in Yanbian as well as in Korea. In order to fill the gap, this study attempted to restore the history of Longjing Medical College built in Yanbian, China immediately after the liberation. In particular, it analyzed how and why the Longjing Medical College was founded and operated, and which relations the college had with the post-war medical educational institutions, focusing on the ‘disconnection’ and ‘continuity’ in the historical sense. Since the establishment of Manchukuo, the Japanese colonial government had made it a major “frontier” and actively promoted the mass migration of Japanese and Koreans. For them, the government also set up three Exploitation Medical Schools in 1940. As a part of these three institutions, Longjing Exploitation Medical School educated more than 150 students by 1945, of which about one third was Korean. After the liberation, the Longjing Educational Alliance decided to pursue the return-movement of the Longjing Exploitation Medical School and took over the institution. On September 12, 1945, Longjing Medical College opened at the school site of Longjing Exploitation Medical School. Longjing Medical College was founded by people who had ‘the perspective of Korean nationality’ in an atmosphere where the ‘ethnicity’ of the Koreans exercised considerable power. Nevertheless, in 1946, when the Chinese Civil War began and the Yanbian region became an important base of the Chinese Communist Party, the Party began to expand and strengthen their influences in the region. Accordingly, the operation rights of Longjing Medical College were transferred to the Yanbian Administrative offices of Supervision and

History of Medical Specialty Interest Assessment

Science.gov (United States)

Burns, Stephanie T.

2016-01-01

Medical specialties require decidedly different abilities, skills, and talents; which results in divergent experiences, lifestyles, skill sets, and income levels. To help medical students select their preferred medical specialty and alleviate shortages in medical specialty staffing, US medical schools and associations invest time and money in…

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

Science.gov (United States)

Steinke, Hubert; Lang, Yves

2011-01-01

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

Water Level Station History

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Images contain station history information for 175 stations in the National Water Level Observation Network (NWLON). The NWLON is a network of long-term,...

Level of Agreement and Factors Associated With Discrepancies Between Nationwide Medical History Questionnaires and Hospital Claims Data

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Yeon-Yong Kim

2017-09-01

Full Text Available Objectives The objectives of this study were to investigate the agreement between medical history questionnaire data and claims data and to identify the factors that were associated with discrepancies between these data types. Methods Data from self-reported questionnaires that assessed an individual’s history of hypertension, diabetes mellitus, dyslipidemia, stroke, heart disease, and pulmonary tuberculosis were collected from a general health screening database for 2014. Data for these diseases were collected from a healthcare utilization claims database between 2009 and 2014. Overall agreement, sensitivity, specificity, and kappa values were calculated. Multiple logistic regression analysis was performed to identify factors associated with discrepancies and was adjusted for age, gender, insurance type, insurance contribution, residential area, and comorbidities. Results Agreement was highest between questionnaire data and claims data based on primary codes up to 1 year before the completion of self-reported questionnaires and was lowest for claims data based on primary and secondary codes up to 5 years before the completion of self-reported questionnaires. When comparing data based on primary codes up to 1 year before the completion of self-reported questionnaires, the overall agreement, sensitivity, specificity, and kappa values ranged from 93.2 to 98.8%, 26.2 to 84.3%, 95.7 to 99.6%, and 0.09 to 0.78, respectively. Agreement was excellent for hypertension and diabetes, fair to good for stroke and heart disease, and poor for pulmonary tuberculosis and dyslipidemia. Women, younger individuals, and employed individuals were most likely to under-report disease. Conclusions Detailed patient characteristics that had an impact on information bias were identified through the differing levels of agreement.

Level of Agreement and Factors Associated With Discrepancies Between Nationwide Medical History Questionnaires and Hospital Claims Data.

Science.gov (United States)

Kim, Yeon-Yong; Park, Jong Heon; Kang, Hee-Jin; Lee, Eun Joo; Ha, Seongjun; Shin, Soon-Ae

2017-09-01

The objectives of this study were to investigate the agreement between medical history questionnaire data and claims data and to identify the factors that were associated with discrepancies between these data types. Data from self-reported questionnaires that assessed an individual's history of hypertension, diabetes mellitus, dyslipidemia, stroke, heart disease, and pulmonary tuberculosis were collected from a general health screening database for 2014. Data for these diseases were collected from a healthcare utilization claims database between 2009 and 2014. Overall agreement, sensitivity, specificity, and kappa values were calculated. Multiple logistic regression analysis was performed to identify factors associated with discrepancies and was adjusted for age, gender, insurance type, insurance contribution, residential area, and comorbidities. Agreement was highest between questionnaire data and claims data based on primary codes up to 1 year before the completion of self-reported questionnaires and was lowest for claims data based on primary and secondary codes up to 5 years before the completion of self-reported questionnaires. When comparing data based on primary codes up to 1 year before the completion of self-reported questionnaires, the overall agreement, sensitivity, specificity, and kappa values ranged from 93.2 to 98.8%, 26.2 to 84.3%, 95.7 to 99.6%, and 0.09 to 0.78, respectively. Agreement was excellent for hypertension and diabetes, fair to good for stroke and heart disease, and poor for pulmonary tuberculosis and dyslipidemia. Women, younger individuals, and employed individuals were most likely to under-report disease. Detailed patient characteristics that had an impact on information bias were identified through the differing levels of agreement.

On the borderland of medical and disability history: a survey of the fields.

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Linker, Beth

2013-01-01

This essay explores the multiple sites where disability appears in the history of medicine and suggests ways in which medical historians can self-consciously incorporate a disability perspective into their own work. Just as medical historians have much to learn from disability historians, disability historians could benefit from looking more closely at the history of medicine. While disability cannot (and should not) be reduced to disease, the fact remains that some forms of disability are brought about by disease processes, and some require daily regimes of home health care, therapy, and pain management. How the disabled have interacted with health care institutions, caretakers, and the medical establishment is too significant to be written out of its history.

A brief history of medical education in Sub-Saharan Africa.

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Monekosso, G L

2014-08-01

Developments in medical education in Sub-Saharan Africa over the past 100 years have been characterized by the continent's unique history. During the first half of the 20th century, the Europeans effectively installed medical education in their African colonies. The years 1950 to 1960 were distinguished by successful movements for independence, with new governments giving priority to medical education. By 1980, there were 51 medical schools in Sub-Saharan Africa. The period from 1975 to 1990 was problematic both politically and economically for Sub-Saharan Africa, and medical schools did not escape the general difficulties. War, corruption, mounting national debts, and political instability were characteristics of this period. In many countries, maintaining medical school assets--faculty members, buildings, laboratories, libraries--became difficult, and emigration became the goal of many health professionals. In contrast, the past 20 years have seen rapid growth in the number of medical schools in Sub-Saharan Africa. Economic growth and political stability in most Sub-Saharan African countries augur well for investment in health systems strengthening and in medical education. There are, nonetheless, major problem areas, including inadequate funding, challenges of sustainability, and the continuing brain drain. The 20th century was a time of colonialism and the struggle for independence during which medical education did not advance as quickly or broadly as it did in other regions of the world. The 21st century promises a different history, one of rapid growth in medical education, leading to better care and better health for the people of Africa.

Medical History of Elderly Patients in the Emergency Setting: Not an Easy Point-of-Care Diagnostic Marker

Directory of Open Access Journals (Sweden)

Tobias Lindner

2015-01-01

Full Text Available Background. Medical histories are a crucially important diagnostic tool. Elderly patients represent a large and increasing group of emergency patients. Due to cognitive deficits, taking a reliable medical history in this patient group can be difficult. We sought to evaluate the medical history-taking in emergency patients above 75 years of age with respect to duration and completeness. Methods. Anonymous data of consecutive patients were recorded. Times for the defined basic medical history-taking were documented, as were the availability of other sources and times to assess these. Results. Data of 104 patients were included in the analysis. In a quarter of patients (25%, n=26 no complete basic medical history could be obtained. In the group of patients where complete data could be gathered, only 16 patients were able to provide all necessary information on their own. Including other sources like relatives or GPs prolonged the time until complete medical history from 7.3 minutes (patient only to 26.4 (+relatives and 56.3 (+GP minutes. Conclusions. Medical histories are important diagnostic tools in the emergency setting and are prolonged in the elderly, especially if additional documentation and third parties need to be involved. New technologies like emergency medical cards might help to improve the availability of important patient data but implementation of these technologies is costly and faces data protection issues.

77 FR 45717 - Proposed Information Collection (Former Prisoner of War Medical History); Comment Request

Science.gov (United States)

2012-08-01

... use of other forms of information technology. Title: Former Prisoner of War (FPOW) Medical History, VA... Prisoner of War veteran. VA will use the data collected as a guide and reference for treatment planning for... Prisoner of War Medical History); Comment Request AGENCY: Veterans Health Administration, Department of...

Medical history for the masses: how American comic books celebrated heroes of medicine in the 1940s.

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Hansen, Bert

2004-01-01

When comic books rose to mass popularity in the early 1940s, one segment of the industry specialized in "true adventures," with stories about real people from the past and the present--in contrast to competing books that offered fantasy, science fiction, superheroes, detectives and crime, funny people, or funny animals. This study examines the figures from both medical history and twentieth-century medicine who were portrayed as heroes and role models in these comic books: first, to call attention to this very popular, if unknown, genre of medical history, and second, to illustrate how medical history was used at that time to popularize scientific and medical ideas, to celebrate the achievements of medical research, to encourage medical science as a career choice, and to show medicine as a humane and noble enterprise. The study explains how these medical history stories were situated in American popular culture more generally, and how the graphic power of comic books successfully conveyed both values and information while also telling a good story. Attention to this colorful genre of popular medical history enriches our picture of the mid-twentieth-century public's enthusiasm for medical progress.

The Oral History Program: II. Personal views of health sciences librarianship and the Medical Library Association.

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McKenzie, D; Pifalo, V

1998-07-01

The Medical Library Association Oral History Program uses accepted oral history techniques to collect and preserve interviews with members. The original taped interviews and transcripts are kept in the Medical Library Association archives and made available for research purposes; edited copies of the interviews are distributed through the National Network of Libraries of Medicine, and members are encouraged to borrow and read the histories. Summaries of forty-three interviews provide personal views on health sciences librarianship and the Medical Library Association.

The humanising power of medical history: responses to biomedicine in the 20th century United States.

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Warner, John Harley

2011-12-01

Most American historians of medicine today would be very hesitant about any claim that medical history humanises doctors, medical students or the larger health care enterprise. Yet, the idea that history can and ought to serve modern medicine as a humanising force has been a persistent refrain in American medicine. This essay explores the emergence of this idea from the end of the 19th century, precisely the moment when modern biomedicine became ascendant. At the same institutions where the new version of scientific medicine was most energetically embraced, some professional leaders warned that the allegiance to science driving the profession's technical and cultural success was endangering humanistic values fundamental to professionalism and the art of medicine. They saw in history a means for rehumanising modern medicine and countering the risk of cultural crisis. While some iteration of this vision of history was remarkably durable, the meanings attached to 'humanism' were both multiple and changing, and the role envisioned for history in a humanistic intervention was transformed. Starting in the 1960s as part of a larger cultural critique of the putative 'dehumanisation' of the medical establishment, some advocates promoted medical history as a tool to help fashion a new kind of humanist physician and to confront social inequities in the health care system. What has persisted across time is the way that the idea of history as a humanising force has almost always functioned as a discourse of deficiency-a response to perceived shortcomings of biomedicine, medical institutions and medical professionalism.

Utility of an Algorithm to Increase the Accuracy of Medication History in an Obstetrical Setting.

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Corbel, Aline; Baud, David; Chaouch, Aziz; Beney, Johnny; Csajka, Chantal; Panchaud, Alice

2016-01-01

In an obstetrical setting, inaccurate medication histories at hospital admission may result in failure to identify potentially harmful treatments for patients and/or their fetus(es). This prospective study was conducted to assess average concordance rates between (1) a medication list obtained with a one-page structured medication history algorithm developed for the obstetrical setting and (2) the medication list reported in medical records and obtained by open-ended questions based on standard procedures. Both lists were converted into concordance rate using a best possible medication history approach as the reference (information obtained by patients, prescribers and community pharmacists' interviews). The algorithm-based method obtained a higher average concordance rate than the standard method, with respectively 90.2% [CI95% 85.8-94.3] versus 24.6% [CI95%15.3-34.4] concordance rates (phistory in our obstetric population, without using substantial resources. Its implementation is an effective first step to the medication reconciliation process, which has been recognized as a very important component of patients' drug safety.

Rethinking the social history in the era of biolegitimacy: global health and medical education in the care of Palestinian and Syrian refugees in Beirut, Lebanon.

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Premkumar, Ashish; Raad, Kareem; Haidar, Mona H

2016-01-01

The critiques leveled towards medical humanitarianism by the social sciences have yet to be felt in medical education. The elevation of biological suffering, at the detriment of sociopolitical contextualization, has been shown to clearly impact both acute and long-term care of individuals and communities. With many medical students spending a portion of their educational time in global learning experiences, exposure to humanitarianism and its consequences becomes a unique component of biomedical education. How does the medical field reconcile global health education with the critiques of humanitarianism? This paper argues that the medical response to humanitarian reason should begin at the level of a social history. Using experiential data culled from fieldwork with Palestinian and Syrian refugees in Lebanon, the authors argue that an expanded social history, combined with knowledge derived from the social sciences, can have significant clinical implications. The ability to contextualize an individual's disease and life within a complex sociopolitical framework means that students must draw on disciplines as varied as anthropology, sociology, and political history to further their knowledge base. Moreover, situating these educational goals within the framework of physician advocacy can build a strong base in medical education from both a biomedical and activist perspective.

[The role of chronic gastritis in past medical history with NSAID administration in patients with osteoarthrosis].

Science.gov (United States)

Zak, M Iu

2014-11-01

122 patients with osteoarthrosis, who have in the past medical history verified chronic gastritis (50 males and 72 females) at the age from 42 to 64 have been examined. Control group was comprised of 40 patients with osteoarthrosis without gastroduodenal zone pathology in the past medical history. For arthralgia relief patients were prescribed meloxicam (average dose--12.5 - 1.39 mg daily) or nimesulide (average dose--150 ± 14.91 mg daily). As a result of this research it was determined that administration of selective NSAID (meloxicam and nimesulide) in patients with chronic gastritis in the past medical history raised the risk of NSAID gastropathy/dyspepsia 2.9 times (P 0.05) of erosive gastropathy. Patients with chronic gastritis in the past medical history when taking NSAID with the purpose of gastropathy prevention are recommended to undergo gastroprotective therapy.

Medical history and the onset of complex regional pain syndrome (CRPS).

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de Mos, M; Huygen, F J P M; Dieleman, J P; Koopman, J S H A; Stricker, B H Ch; Sturkenboom, M C J M

2008-10-15

Knowledge concerning the medical history prior to the onset of complex regional pain syndrome (CRPS) might provide insight into its risk factors and potential underlying disease mechanisms. To evaluate prior to CRPS medical conditions, a case-control study was conducted in the Integrated Primary Care Information (IPCI) project, a general practice (GP) database in the Netherlands. CRPS patients were identified from the records and validated through examination by the investigator (IASP criteria) or through specialist confirmation. Cases were matched to controls on age, gender and injury type. All diagnoses prior to the index date were assessed by manual review of the medical records. Some pre-specified medical conditions were studied for their association with CRPS, whereas all other diagnoses, grouped by pathogenesis, were tested in a hypothesis-generating approach. Of the identified 259 CRPS patients, 186 cases (697 controls) were included, based on validation by the investigator during a visit (102 of 134 visited patients) or on specialist confirmation (84 of 125 unvisited patients). A medical history of migraine (OR: 2.43, 95% CI: 1.18-5.02) and osteoporosis (OR: 2.44, 95% CI: 1.17-5.14) was associated with CRPS. In a recent history (1-year before CRPS), cases had more menstrual cycle-related problems (OR: 2.60, 95% CI: 1.16-5.83) and neuropathies (OR: 5.7; 95% CI: 1.8-18.7). In a sensitivity analysis, including only visited cases, asthma (OR: 3.0; 95% CI: 1.3-6.9) and CRPS were related. Psychological factors were not associated with CRPS onset. Because of the hypothesis-generating character of this study, the findings should be confirmed by other studies.

How important is medical ethics and history of medicine teaching in the medical curriculum? An empirical approach towards students' views.

Science.gov (United States)

Schulz, Stefan; Woestmann, Barbara; Huenges, Bert; Schweikardt, Christoph; Schäfer, Thorsten

2012-01-01

It was investigated how students judge the teaching of medical ethics and the history of medicine at the start and during their studies, and the influence which subject-specific teaching of the history, theory and ethics of medicine (GTE)--or the lack thereof--has on the judgement of these subjects. From a total of 533 students who were in their first and 5th semester of the Bochum Model curriculum (GTE teaching from the first semester onwards) or followed the traditional curriculum (GTE teaching in the 5th/6th semester), questionnaires were requested in the winter semester 2005/06 and in the summer semester 2006. They were asked both before and after the 1st and 5th (model curriculum) or 6th semester (traditional curriculum). We asked students to judge the importance of teaching medical ethics and the history of medicine, the significance of these subjects for physicians and about teachability and testability (Likert scale from -2 (do not agree at all) to +2 (agree completely)). 331 questionnaire pairs were included in the study. There were no significant differences between the students of the two curricula at the start of the 1st semester. The views on medical ethics and the history of medicine, in contrast, were significantly different at the start of undergraduate studies: The importance of medical ethics for the individual and the physician was considered very high but their teachability and testability were rated considerably worse. For the history of medicine, the results were exactly opposite. GTE teaching led to a more positive assessment of items previously ranked less favourably in both curricula. A lack of teaching led to a drop in the assessment of both subjects which had previously been rated well. Consistent with the literature, our results support the hypothesis that the teaching of GTE has a positive impact on the views towards the history and ethics of medicine, with a lack of teaching having a negative impact. Therefore the teaching of GTE

How Important is Medical Ethics and History of Medicine Teaching in the Medical Curriculum? An Empirical Approach towards Students' Views

Science.gov (United States)

Schulz, Stefan; Woestmann, Barbara; Huenges, Bert; Schweikardt, Christoph; Schäfer, Thorsten

2012-01-01

Objectives: It was investigated how students judge the teaching of medical ethics and the history of medicine at the start and during their studies, and the influence which subject-specific teaching of the history, theory and ethics of medicine (GTE) - or the lack thereof - has on the judgement of these subjects. Methods: From a total of 533 students who were in their first and 5th semester of the Bochum Model curriculum (GTE teaching from the first semester onwards) or followed the traditional curriculum (GTE teaching in the 5th/6th semester), questionnaires were requested in the winter semester 2005/06 and in the summer semester 2006. They were asked both before and after the 1st and 5th (model curriculum) or 6th semester (traditional curriculum). We asked students to judge the importance of teaching medical ethics and the history of medicine, the significance of these subjects for physicians and about teachability and testability (Likert scale from -2 (do not agree at all) to +2 (agree completely)). Results: 331 questionnaire pairs were included in the study. There were no significant differences between the students of the two curricula at the start of the 1st semester. The views on medical ethics and the history of medicine, in contrast, were significantly different at the start of undergraduate studies: The importance of medical ethics for the individual and the physician was considered very high but their teachability and testability were rated considerably worse. For the history of medicine, the results were exactly opposite. GTE teaching led to a more positive assessment of items previously ranked less favourably in both curricula. A lack of teaching led to a drop in the assessment of both subjects which had previously been rated well. Conclusion: Consistent with the literature, our results support the hypothesis that the teaching of GTE has a positive impact on the views towards the history and ethics of medicine, with a lack of teaching having a negative

An Effective Teaching Method to Enhance History-Taking Skills for Chinese Medical Students

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Huang, Simin; Xu, Peng; Feng, Lie; Lu, Chunting; Yang, Jing

2018-01-01

History taking is an extremely important skill for medical students to master. In China, medical students usually have opportunities to practise this skill on real patients after they have learned diagnostics and basic relevant theoretical knowledge. Today, however, several factors, such as increased enrolment of medical students and the need to…

The library of the Royal Society of Physicians in Budapest becomes today's Semmelweis Medical History Library.

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Kaproncszay, Katalin; Magyar, László András; Putnam, Constance E

2011-01-01

The 170-year history of the library of the Royal Society of Medicine in Budapest illustrates both that political and cultural context matter and that "medical" libraries, if they survive, in due course become primarily "medical history" libraries. Two of the authors are on the staff of the Semmelweis Medical History Library; the third is a US scholar who makes frequent use of the library. Together, they avail themselves of archival and published materials-and personal experience with the collection-to establish the context that produced the original library, trace its evolution, and describe its present-day incarnation. A tale of transformation emerges that reflects how collections are likely to change. The authors present events and individuals in the life of the Royal Society's library and paint a picture of the value of today's Semmelweis Medical History Library. Unique treasures in the collection are described. The story told here is of how a particular nineteenth-century library became a twenty-first-century institution. The authors establish its peculiarly Hungarian context and potential value to librarians and historians from outside Hungary. The overall message is that general medical libraries everywhere are perforce likely to become medical historical libraries over time.

Giuseppe and Aloysius Frari's works on rabies and history of Frari medical family of Sibenik, Dalmatia.

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Krnić, Anton

2007-06-01

This article is an attempt to reconstruct the family history of the Fraris, the famous Sibenik medical family. Three generations of physicians from the Frari family played an important role not only at medical and social scene of Sibenik in the 18th and 19th century, but also in Croatian and Italian medical history. I will try to provide important details on the lives, medical and social work, and publications of 5 members of the family, Giuseppe (Josip), Angelo Antonio (Andeo Antun), Sebastiano (Sebastijan), Michele Carlo (Mihovil), and Aloysius (Luigi) Frari. I would also like to pay a special attention to the works on rabies, written by Giuseppe and Luigi Frari, which are among the earliest and most accurate Croatian works on the subject. To reconstruct the history of the family, I studied the relevant editions about the medical and social history of Sibenik, Dalmatia, Venice, and Croatia, together with the Fraris' publications and reflections. This was the first time Italian and Latin language works by Giuseppe and Luigi Frari on rabies were analyzed. The story on Fraris also documents that medical publishing was a common practice in Dalmatia in the 18th and the 19th century.

Role of medical history and medication use in the aetiology of upper aerodigestive tract cancers in Europe: the ARCAGE study.

LENUS (Irish Health Repository)

Macfarlane, T V

2012-04-01

The study aimed to investigate the role of medical history (skin warts, Candida albicans, herpetic lesions, heartburn, regurgitation) and medication use (for heartburn; for regurgitation; aspirin) in the aetiology of upper aerodigestive tract (UADT) cancer.

Serum alpha-fetoprotein in the three trimesters of pregnancy: effects of maternal characteristics and medical history.

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Bredaki, F E; Sciorio, C; Wright, A; Wright, D; Nicolaides, K H

2015-07-01

To define the contribution of maternal variables which influence the measured level of maternal serum alpha-fetoprotein (AFP) in screening for pregnancy complications. Maternal characteristics and medical history were recorded and serum AFP was measured in women with a singleton pregnancy attending for three routine hospital visits at 11 + 0 to 13 + 6, 19 + 0 to 24 + 6 and 30 + 0 to 34 + 6 weeks' gestation. For pregnancies delivering phenotypically normal live births or stillbirths ≥ 24 weeks' gestation, variables from maternal demographic characteristics and medical history that are important in the prediction of AFP were determined from a linear mixed-effects multiple regression. Serum AFP was measured in 17 071 cases in the first trimester, 8583 in the second trimester and 8607 in the third trimester. Significant independent contributions to serum AFP were provided by gestational age, maternal weight, racial origin, gestational age at delivery and birth-weight Z-score of the neonate of the previous pregnancy and interpregnancy interval. Cigarette smoking was found to significantly affect serum AFP in the first trimester only. The machine used to measure serum AFP was also found to have a significant effect. Random-effects multiple regression analysis was used to define the contribution of maternal variables that influence the measured level of serum AFP and express the values as multiples of the median (MoMs). The model was shown to provide an adequate fit of MoM values for all covariates, both in pregnancies that developed pre-eclampsia and in those without this pregnancy complication. A model was fitted to express measured serum AFP across the three trimesters of pregnancy as MoMs, after adjusting for variables from maternal characteristics and medical history that affect this measurement. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.

GEOGRAPHIC MEDICAL HISTORY: ADVANCES IN GEOSPATIAL TECHNOLOGY PRESENT NEW POTENTIALS IN MEDICAL PRACTICE

Directory of Open Access Journals (Sweden)

F. S. Faruque

2016-06-01

Full Text Available Genes, behaviour, and the environment are known to be the major risk factors for common diseases. When the patient visits a physician, typical questions include family history (genes and lifestyle of the patient (behaviour, but questions concerning environmental risk factors often remain unasked. It is ironic that 25 centuries ago Hippocrates, known as the father of medicine, noted the importance of environmental exposure in medical investigation as documented in his classic work, “Airs, Waters, Places”, yet the practice of routinely incorporating environmental risk factors is still not in place. Modern epigenetic studies have found that unhealthy lifestyle and environmental factors can cause changes to our genes that can increase disease risk factors. Therefore, attempting to solve the puzzle of diseases using heredity and lifestyle alone will be incomplete without accounting for the environmental exposures. The primary reason why environmental exposure has not yet been a routine part of the patient’s medical history is mostly due to our inability to provide clinicians useful measures of environmental exposures suitable for their clinical practices. This presentation will discuss advances in geospatial technology that show the potential to catalyse a paradigm shift in medical practice and health research by allowing environmental risk factors to be documented as the patient’s “Geographic Medical History”. In order to accomplish this we need information on: a relevant spatiotemporal environmental variables, and b location of the individual in that person’s dynamic environment. Common environmental agents that are known to interact with genetic make-up include air pollutants, mold spores, pesticides, etc. Until recently, the other component, location of an individual was limited to a static representation such as residential or workplace location. Now, with the development of mobile technology, changes in an individual’s location

Evaluation of computer-based medical histories taken by patients at home.

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Slack, Warner V; Kowaloff, Hollis B; Davis, Roger B; Delbanco, Tom; Locke, Steven E; Safran, Charles; Bleich, Howard L

2012-01-01

The authors developed a computer-based general medical history to be taken by patients in their homes over the internet before their first visit with their primary care doctor, and asked six doctors and their participating patients to assess this history and its effect on their subsequent visit. Forty patients began the history; 32 completed the history and post-history assessment questionnaire and were for the most part positive in their assessment; and 23 continued on to complete their post-visit assessment questionnaire and were for the most part positive about the helpfulness of the history and its summary at the time of their visit with the doctor. The doctors in turn strongly favored the immediate, routine use of two modules of the history--the family and social histories--for all their new patients. The doctors suggested further that the summaries of the other modules of the history be revised and shortened to make it easier for them to focus on clinical issues in the order of their preference.

History of TB in the Sudan | Zaki | Sudan Journal of Medical Sciences

African Journals Online (AJOL)

Introduction: Medical history in Sudan is far from being complete. There are no reliable records. Attempt to write on the projects and development of history of TB in the Sudan is a difficult task. Objective: To study and trace the progress of TB in Sudan during the last century through their historical development. Design: A ...

Evaluation of medical record quality and communication skills among pediatric interns after standardized parent training history-taking in China.

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Yu, Mu Xue; Jiang, Xiao Yun; Li, Yi Juan; Shen, Zhen Yu; Zhuang, Si Qi; Gu, Yu Fen

2018-02-01

The effect of using standardized parent training history-taking on the quality of medical records and communication skills among pediatric interns was determined. Fifth-year interns who were undertaking a pediatric clinical practice rotation were randomized to intervention and control groups. All of the pediatric interns received history-taking training by lecture and bedside teaching. The pediatric interns in the intervention group also received standardized parent history-taking training. The following two outcome measures were used: the scores of medical records, which were written by the pediatric interns after history-taking from real parents of pediatric patients; and the communication assessment tool (CAT) assessed by real parents. The general information, history of present illness (HPI), past medical history, personal history, family history, diagnosis, diagnostic analysis, and differential diagnosis scores in the intervention group were significantly higher than the control group (p history-taking is effective in improving the quality of medical records by pediatric interns. Standardized parent training history-taking is a superior teaching tool for clinical reasoning ability, as well as communication skills in clinical pediatric practice.

Introducing medical genetics services in Ethiopia using the MiGene Family History App.

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Quinonez, Shane C; Yeshidinber, Abate; Lourie, Michael A; Bekele, Delayehu; Mekonnen, Yemisrach; Nigatu, Balkachew; Metaferia, Gesit; Jebessa, Solomie

2018-06-11

Almost all low-income countries and many middle-income countries lack the capacity to deliver medical genetics services. We developed the MiGene Family History App (MFHA), which assists doctors with family history collection and population-level epidemiologic analysis. The MFHA was studied at St. Paul's Hospital in Addis Ababa, Ethiopia. A needs assessment was used to assess Ethiopian physicians' experience with genetics services. The MFHA then collected patient data over a 6-month period. The majority of doctors provide genetics services, with only 16% reporting their genetics knowledge is sufficient. A total of 1699 patients from the pediatric ward (n = 367), neonatal intensive care unit (NICU) (n = 477), and antenatal clinic (n = 855) were collected using the MFHA with a 4% incidence of a MFHA-screened condition present. The incidence was 11.7% in the pediatric ward, 3% in the NICU, and 0.5% in the antenatal clinic. Heart malformations (5.5% of patients) and trisomy 21 (4.4% of patients) were the most common conditions in the pediatric ward. Medical genetics services are needed in Ethiopia. As other countries increase their genetics capacity, the MFHA can provide fundamental genetics services and collect necessary epidemiologic data.

[The origin, diffusion and development of healing doctrines in medical history--exemplified by homeopathy].

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Schmidt, Josef M

2007-01-01

As a paradigmatic case study of the origin, spread, and development of medical systems, this paper investigates the 200-years history of homeopathy from different perspectives of medical history. On the basis of new research on Samuel Hahnemann (1755-1843), first, a concise and critical overview on the principles, explanations, and implications of his doctrine is presented. The historical, conceptual, and social background of the founder of homeopathy is then elaborated in terms of history of medicine, science, philosophy, sociology, culture, and ideas, as well as theory of science, theory of communication, and sociology of science. The process of the world wide spread of homeopathy is examined from different points of view, ranging from history of heroes, institutions, professionalisation, politics, economics, religion, and organisations to history of patients, perception, and semiotics. Finally, a comparative approach to the different development and status of homeopathy in different countries results in the extraction of a set of crucial variables, such as charismatic personage, influential patronage, economic sponsorship, political protection, media support, and patients' demand, which might explane a major part of these differences. Eventually, the notorious splits of homeopathy's doctrine suggest the idea that--in analogy to theory of evolution--a variety of concurrent strains (rather than one monolithic block) of a doctrine may prove to be a kind of advantage for survival. In conclusion, acceptance and relevance of medical systems are determined by many factors. Since external ones are usually outweighing internal ones, medical history may offer a broader and more comprehensive understanding of the dynamics of their spread and development than clinical trials and scientific objection alone.

A Preoperative Medical History and Physical Should Not Be a Requirement for All Cataract Patients.

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Schein, Oliver D; Pronovost, Peter J

2017-07-01

Cataract surgery poses minimal systemic medical risk, yet a preoperative general medical history and physical is required by the Centers for Medicare and Medicaid Services and other regulatory bodies within 1 month of cataract surgery. Based on prior research and practice guidelines, there is professional consensus that preoperative laboratory testing confers no benefit when routinely performed on cataract surgical patients. Such testing remains commonplace. Although not yet tested in a large-scale trial, there is also no evidence that the required history and physical yields a benefit for most cataract surgical patients above and beyond the screening performed by anesthesia staff on the day of surgery. We propose that the minority of patients who might benefit from a preoperative medical history and physical can be identified prospectively. Regulatory agencies should not constrain medical practice in a way that adds enormous cost and patient burden in the absence of value.

Evaluation of forensic medical history taking from the child in cases of child physical and sexual abuse and neglect.

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Drummond, Rachel; Gall, John A M

2017-02-01

Suspected child physical abuse, sexual abuse and neglect are not uncommon presentations. As part of the assessment of these cases, a forensic medical history may be taken. This forensic history is used not only to determine the steps necessary to address the child's wellbeing but also to direct the forensic examination. Currently, there is no clear consensus on whether or not a forensic medical history should consistently be considered an integral element within the paediatric forensic evaluation. This study examines the value derived by the medical practitioner taking a forensic medical history rather than relying on hearsay evidence when a child presents for an assessment. A retrospective review of paediatric cases seen by the Victorian Forensic Paediatric Medical Service (VFPMS) between 2014 and 2015 was undertaken. 274 forensic case reports were reviewed and the data was entered into an Excel spread sheet and analysed using chi squared tests within STATA ® . With increasing age of the child, a forensic medical history is significantly more likely to be taken. Additional information is made available to the medical practitioner what would otherwise have been provided if the medical practitioner relied only on the interview conducted by the police. Discrepancies observed between the official third parties (police or child protection) report of what a child has said and what the child says to the medical practitioner decrease with age, as do discrepancies observed between the child's version of events and a third party's (eg. parents, caregivers, friends) version of events. The study showed that by taking a forensic medical history from the child additional information can be obtained. Further, that there is a value in the examining medical practitioner taking a forensic medical history from children in cases of child physical and sexual abuse and neglect. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

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

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

2012-03-01

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

Writing women into medical history in the 1930s: Kate Campbell Hurd-Mead and "medical women" of the past and present.

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Appel, Toby A

2014-01-01

Kate Campbell Hurd-Mead (1867–1941), a leader among second-generation women physicians in America, became a pioneer historian of women in medicine in the 1930s. The coalescence of events in her personal life, the declining status of women in medicine, and the growing significance of the new and relatively open field of history of medicine all contributed to this transformation in her career. While she endeavored to become part of the community of male physicians who wrote medical history, her primary identity remained that of a “medical woman.” For Hurd-Mead, the history of women in the past not only filled a vital gap in scholarship but served practical ends that she had earlier pursued by other means—those of inspiring and advancing the careers of women physicians of the present day, promoting organizations of women physicians, and advocating for equality of opportunity in the medical profession.

Implementation of an IT-guided checklist to improve the quality of medication history records at hospital admission.

Science.gov (United States)

Huber, Tanja; Brinkmann, Franziska; Lim, Silke; Schröder, Christoph; Stekhoven, Daniel Johannes; Marti, Walter Richard; Egger, Richard Robert

2017-12-01

Background Medication discrepancies often occur at transition of care such as hospital admission and discharge. Obtaining a complete and accurate medication history on admission is essential as further treatment is based on it. Objective The goal of this study was to reduce the proportion of patients with at least one medication discrepancy in the medication history at admission by implementing an IT-guided checklist. Setting Surgery ward focused on vascular and visceral surgery at a Swiss Cantonal Hospital. Method The study was divided into two phases, before and after implementation of an IT-guided checklist. For both phases a pharmacist collected and compared the medication history (defined as gold standard) with that of the admitting physician. Medication discrepancies were subdivided in omissions and commissions, incorrect medications or dose changes, and incorrect dosage forms or strength. Main outcome measure The proportion of patients with at least one medication discrepancy in the medication history before and after intervention was assessed. Results Out of 415 admissions, 228 patients that met the inclusion criteria were enrolled in the study, 113 before and 115 patients after intervention. After intervention, medication discrepancies declined from 69.9 to 29.6% (p < 0.0001) of patients, the mean medication discrepancy per patient was reduced from 2.3 to 0.6 (p < 0.0001), and the most common error, omission of a regularly used medication, was reduced from 76.4 to 44.1% (p < 0.001). Conclusion The implementation of the IT-guided checklist is associated with a significant reduction of medication discrepancies at admission and potentially improves the medication safety for the patient.

[Thoughts and methods of study on acupuncture medical history: an example of Mr. MA Ji-Xing].

Science.gov (United States)

Yang, Feng; Zhu, Ling

2014-03-01

Mr. MA Ji-xing has devoted himself into the study of acupuncture medical history for more than 70 years. As a result, a great work of Zhenjiuxue Tongshi (see text), History of Acupuncture-Moxibustion) has been completed. The author has expensively studied for history of acupuncture medicine in time and space. Base on abundant historical materials, deliberate textual research as well as strategically situated academic view, it is considered as a masterpiece of acupuncture on real significance. It is worthwhile to note that the book has a systematic and profound explanation on Bian-stone therapy, unearthed literature relics of acupuncture, the bronze figure or illustration of acupoint as well as special topics of Japan and Korea acupuncture history. Filled several gaps of the field, and explored some significant new paths of study, it laid the groundwork for the profound study and unscramble of traditional acupuncture theory as well as the investigation of the academic history, which is considered to have a profound and persistent influence. The careful sorting and profound digging of many distinguish thoughts and methods of Mr. MA Ji-xing in the study of acupuncture medical history has significant meaning in references and enlightenment of the future research on acupuncture medical history.

Effect of teaching and checklist implementation on accuracy of medication history recording at hospital admission.

Science.gov (United States)

Lea, Marianne; Barstad, Ingeborg; Mathiesen, Liv; Mowe, Morten; Molden, Espen

2016-02-01

Medication discrepancies at hospital admission is an extensive problem and knowledge is limited regarding improvement strategies. To investigate the effect of teaching and checklist implementation on accuracy of medication history recording during hospitalization. Patients admitted to an internal medicine ward were prospectively included in two consecutive periods. Between the periods, non-mandatory teaching lessons were provided and a checklist assisting medication history recording implemented. Discrepancies between the recorded medications at admission and the patient's actual drug use, as revealed by pharmacist-conducted medication reconciliation, were compared between the periods. The primary endpoint was difference between the periods in proportion of patients with minimum one discrepancy. Difference in median number of discrepancies was included as a secondary endpoint. 56 and 119 patients were included in period 1 (P1) and period 2 (P2), respectively. There was no significant difference in proportion of patients with minimum one discrepancy in P2 (68.9 %) versus P1 (76.8 %, p = 0.36), but a tendency of lower median number of discrepancies was observed in P2 than P1, i.e. 1 and 2, respectively (p = 0.087). More powerful strategies than non-mandatory teaching activities and checklist implementation are required to achieve sufficient improvements in medication history recording during hospitalization.

[The life of medical historian Miki Sakae, and the "history of Korean medicine and of diseases in Korea"].

Science.gov (United States)

Kim, Ho

2005-12-01

maintained during his entire life regarding the Korean medicine, was that 'One can only talk about the medicine of China and Japan when he or she is well versed in the medicine of Korea'. And his lifetime achievement, "History of Korean Medicine and of Diseases in Korea" was authored upon the basis established by such conviction and philosophy. First, in this book the perspective of Cultural Transmission, which considers the flow of cultural qualities and assets to be ordinarily flowing from highly developed regions to less developed ones, was firmly maintained. He argued that the medicine of China had to pass through the Korean peninsula to reach Japan. Second, he suggested that studies of medicine and diseases could only be fully and thoroughly understood when it is approached not only from the perspective devised by medical historical studies but also from perspectives devised for general and total historical examination of human life events. And third, he argued that all historical studies should be based upon proofs and evidences, and the 'development' factor of a particular type of studies or practices should be measured by whether that study or practice has reached or accomplished the level of Western modern science. Demonstrating such conviction, out of Korean traditional medical practices he particularly examined the medical procedures of treating tumors or regulations and procedures developed for forensic medicine, which he considered superior to or at least at the same level with Western medicine. In his final years he was forced to battle cancer, but he refused to be hospitalized. Instead, he exhibited his firm belief that medicine and medical practices which believe in the ultimate power of human body and soul are what the practitioners should pursue in order to acquire the very core of medicine. He died in 1992, at home, surrounded by his family. He is known to have always uttered that one of the most celebrated Medical books of Korea, the "Dongeui Bogam

Relationship Between Tetanus Antitoxin Titration Level and Vaccination History

Directory of Open Access Journals (Sweden)

Meltem Işıkgöz Taşbakan

2017-12-01

Full Text Available Objectives: We aimed to determine tetanus antitoxin levels and to evaluate their relationship with history of vaccination among patients applying to the outpatient clinics of a University hospital. Methods: A questionnaire including socio-demographic characteristics and tetanus vaccination status was applied and blood samples taken from 218 subjects between 1 and 30 June 2015. Participants were classified into five groups according to their vaccination timing. Results: The mean age of participants was 46.7±15.4 years and 134 (61.5% were women. Tetanus antitoxin levels were found weak positive in 54 (24.8% patients, positive in 44 (20.2% and strong positive in 120 (55.0%. Tetanus antitoxin level positivity was significantly associated with vaccination timing according to history. Among 105 participants who did not remember being vaccinated or who knew they were vaccinated but did not remember the date, 16 (15.2% remembered the vaccination time when their injury, military service and pregnancy were questioned specifically. Antitoxin levels decreased with increasing age independent of gender (0.9-fold increase/year. Conclusion: We found that the booster dose recommended every 10 years was not applied sufficiently. Tetanus vaccination history must be questioned in more detail among people who do not remember/know their vaccination history, with specific questions regarding pregnancy, military service and injury histories.

Peer-Assisted History-Taking Groups: A Subjective Assessment of their Impact Upon Medical Students' Interview Skills

Directory of Open Access Journals (Sweden)

Keifenheim, Katharina Eva

2017-08-01

Full Text Available Background and Objectives: Among the clinical skills needed by all physicians, history taking is one of the most important. The teaching model for peer-assisted history-taking groups investigated in the present study consists of small-group courses in which students practice conducting medical interviews with real patients. The purpose of this pilot study was to investigate the expectations, experiences, and subjective learning progress of participants in peer-assisted history-taking groups.Methods: The 42 medical student participants completed a 4-month, peer-assisted, elective history-taking course, which both began and ended with a subjective assessment of their interview skills by way of a pseudonymized questionnaire. Measures comprised the students’ self-assessment of their interview skills, their expectations of, and their experiences with the course and especially with the peer tutors. Results: Medical students’ most important motivations in attending peer-assisted history-taking groups were becoming able to complete a structured medical interview, to mitigate difficult interviewing situations, and to address patients’ emotional demands appropriately. By the end of the course, students’ self-assessment of both their interview skills and management of emotional issues improved significantly. Students especially benefitted from individual feedback regarding interview style and relationship formation, as well as generally accepted and had their expectations met by peer tutors. Conclusions: To meet the important learning objectives of history-taking and management of emotional issues, as well as self-reflection and reflection of student–patient interactions, students in the field greatly appreciate practicing medical interviewing in small, peer-assisted groups with real patients. At the same time, peer tutors are experienced to be helpful and supportive and can help students to overcome inhibitions in making contact with patients.

'What is not written does not exist': the importance of proper documentation of medication use history.

Science.gov (United States)

Silvestre, Carina Carvalho; Santos, Lincoln Marques Cavalcante; de Oliveira-Filho, Alfredo Dias; de Lyra, Divaldo Pereira

2017-10-01

Medications are perceived as health risk factors, because they might cause damage if used improperly. In this context, an adequate assessment of medication use history should be encouraged, especially in transitions of care to avoid unintended medication discrepancies (UMDs). In a case-controlled study, we investigated potential risk factors for UMDs at hospital admission and found that 150 (42%) of the 358 patients evaluated had one or more UMDs. We were surprised to find that there was no record of a patient and/or relative interview on previous use of medication in 117 medical charts of adult patients (44.8%). Similarly, in the medical charts of 52 (53.6%) paediatric patients, there was no record of parents and/or relatives interviews about prior use of medications. One hundred thirty-seven medical charts of adult patients (52.4%) and seventy-two medical charts of paediatric patients (74.2%) had no record about medication allergies and intolerances. In other words, there was a lack of basic documentation regarding the patient's medication use history. As patients move between settings in care, there is insufficient tracking of verbal and written information related to medication changes, which results in a progressive and cumulative loss of information, as evidenced by problems associated with clinical transfers and medication orders. Proper documentation of medication information during transfer is a key step in the procedure; hence, it should be rightly performed. It remains unclear whether interviews, and other investigations about medication use history have been performed but have not been recorded as health-care data. Therefore, it is crucial to the improvement of medication use safety that documentation of all drug-related information-even if not directly related to the actual event-become routine practice in health-care organizations, since 'what is not written does not exist'.

The end of medical confidentiality? Patients, physicians and the state in history.

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Rieder, Philip; Louis-Courvoisier, Micheline; Huber, Philippe

2016-09-01

Medical confidentiality has come under attack in the public sphere. In recent disasters both journalists and politicians have questioned medical confidentiality and claimed that in specific contexts physicians should be compelled to communicate data on their patients' health. The murders of innocent individuals by a suicidal pilot and a Swiss convicted criminal have generated polemical debates on the topic. In this article, historical data on medical confidentiality is used to show that medical practices of secrecy were regularly attacked in the past, and that the nature of medical confidentiality evolved through time depending on physicians' values and judgements. Our demonstration is based on three moments in history. First, at the end of the 16th century, lay authorities put pressure on physicians to disclose the names of patients suffering from syphilis. Second, in the 18th century, physicians faced constant demands for information about patients' health from relatives and friends. Third, employers and insurance companies in the 20th century requested medical data on sick employees. In these three different situations, history reveals that the concept of medical confidentiality was plastic, modelled in the first instance to defend well-to-do patients, in the second instance it was adapted to accommodate the physician's social role and, finally, to defend universal values and public health. Medical secrecy was, and is today, a medical and societal norm that is shaped collectively. Any change in its definition and enforcement was and should be the result of negotiations with all social actors concerned. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

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

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Echenberg, Donald

2007-11-28

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

Learning Language Levels in Students Accurate with a History Academic Achievement History

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Noorlela Binti Noordin

2017-11-01

Full Text Available This study was aimed to evaluate the Malay proficiency among students in Form Two especially non-Malay students and its relationship to academic achievement History. To achieve the purpose of the study there are two objectives, the first is to look at the difference between mean of Malay Language test influences min of academic achievement of History subject among non-Malay students in Form Two and the second is the relationship between the level of Malay proficiency and their academic achievement for History. This study used quantitative methods, which involved 100 people of Form Two non-Malay students in one of the schools in Klang, Selangor. This study used quantitative data were analyzed using descriptive statistics and statistical inference with IBM SPSS Statistics v22 software. This study found that there was a relationship between the proficiency of Malay language among non-Malay students with achievements in the subject of History. The implications of this study are discussed in this article.

The many and conflicting histories of medical education in Canada and the USA: an introduction to the paradigm wars.

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Hodges, Brian

2005-06-01

Medical education research is a maturing field of inquiry that derives theoretical perspectives from many domains. Yet while such theoretical diversity holds the promise of rich paradigmatic writing and debate, too often medical education researchers do not place their work in a historical or cultural context, giving the impression that they have somehow unearthed universal 'truths' about medical education. This paper introduces some of the key 'histories' of medical education from the contexts of Anglophone Canada and the USA following a review of major works in the history of medical education. There are many and conflicting histories of medical education in North America that can be classified according to different socio-historical paradigms. To avoid the error of over-generalisation, a much greater effort must be made to include historical, sociological, economic and other social science perspectives in the design, interpretation and application of medical education research.

Giuseppe and Aloysius Frari’s Works on Rabies and History of Frari Medical Family of Šibenik, Dalmatia

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Krnić, Anton

2007-01-01

This article is an attempt to reconstruct the family history of the Fraris, the famous Šibenik medical family. Three generations of physicians from the Frari family played an important role not only at medical and social scene of Šibenik in the 18th and 19th century, but also in Croatian and Italian medical history. I will try to provide important details on the lives, medical and social work, and publications of 5 members of the family, Giuseppe (Josip), Angelo Antonio (Anđeo Antun), Sebastiano (Sebastijan), Michele Carlo (Mihovil), and Aloysius (Luigi) Frari. I would also like to pay a special attention to the works on rabies, written by Giuseppe and Luigi Frari, which are among the earliest and most accurate Croatian works on the subject. To reconstruct the history of the family, I studied the relevant editions about the medical and social history of Šibenik, Dalmatia, Venice, and Croatia, together with the Fraris’ publications and reflections. This was the first time Italian and Latin language works by Giuseppe and Luigi Frari on rabies were analyzed. The story on Fraris also documents that medical publishing was a common practice in Dalmatia in the 18th and the 19th century. PMID:17589982

Pitfalls in training simulated patients to respond appropriately to questions from medical students in family history-taking activities: the current situation surrounding the training of simulated patients for learning activities at Nippon Medical School.

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Aso, Ryoko; Inoue, Chikako; Yoshimura, Akinobu; Shimura, Toshiro

2013-01-01

Our goal was to train simulated patients (SPs) to respond appropriately to questions about family history from medical students in simulated medical interviews. To this end, we carried out a survey of 91 SPs and 76 4th-year medical students to investigate their notions of what constitutes a family. All of the SPs and students surveyed deemed parents and children living together to be members of a family. In a situation where one spouse's parents live together with the basic family unit, 93% of the SPs considered them to be members of the family, whereas only 79% of the students did. Married children living apart from their parents were considered members of the family by 18% of the SPs and 39% of the students. These results indicate clear differences between the SPs and students in their notions of the family. To verify the level of understanding of the definitions of family and blood relatives in particular scenarios used in simulated medical interviews, we administered a written test to 14 SPs who were training to assist in the nationwide common achievement test in medicine, the Objective Structured Clinical Examination (OSCE). The overall score of the SPs was 93.5%; the incorrect answers were "a sibling is not a blood relative" and "a spouse is a blood relative." We analyzed the performance of these 14 SPs in medical interviews carried out after training for the OSCE, in which they were asked questions that required them to reveal their understanding of blood relatives, cohabiting relatives, and the family. All of the SPs responded appropriately to the students' questions about family history. After the OSCE, we asked the SPs to assess themselves on how well they had given their family histories and to evaluate the usefulness of the SP training they had received. Their mean self-assessment score on providing a family history was 3.6 (scale: 1-4); on the usefulness of training, it was 3.4 (scale: 1-4). In conclusion, training SPs to respond appropriately to

A short history of medical informatics in bosnia and herzegovina.

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Masic, Izet

2014-02-01

The health informatics profession in Bosnia and Herzegovina has relatively long history. Thirty five years from the introduction of the first automatic manipulation of data, thirty years from the establishment of Society for Medical Informatics BiH, twenty years from the establishment of the Scientific journal "Acta Informatica Medica (Acta Inform Med", indexed in PubMed, PubMed Central Scopus, Embase, etc.), twenty years on from the establishment of the first Cathedra for Medical Informatics on Biomedical Faculties in Bosnia and Herzegovina, ten years on from the introduction of the method of "Distance learning" in medical curriculum. The author of this article is eager to mark the importance of the above mentioned Anniversaries in the development of Health informatics in Bosnia and Herzegovina and have attempted, very briefly, to present the most significant events and persons with essential roles throughout this period.

Previous medical history of diseases in children with attention deficit hyperactivity disorder and their parents

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Ayyoub Malek

2014-02-01

Full Text Available Introduction: The etiology of Attention deficit hyperactivity disorder (ADHD is complex and most likely includes genetic and environmental factors. This study was conducted to evaluatethe role of previous medical history of diseases in ADHD children and their parents during theearlier years of the ADHD children's lives. Methods: In this case-control study, 164 ADHD children attending to Child and AdolescentPsychiatric Clinics of Tabriz University of Medical Sciences, Iran, compared with 166 normal children selected in a random-cluster method from primary and guidance schools. ADHDrating scale (Parents version and clinical interview based on schedule for Schedule forAffective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version(K-SADS were used to diagnose ADHD cases and to select the control group. Two groupswere compared for the existence of previous medical history of diseases in children andparents. Fisher's exact test and logistic regression model were used for data analysis. Results: The frequency of maternal history of medical disorders (28.7% vs. 12.0%; P = 0.001was significantly higher in children with ADHD compared with the control group. The frequency of jaundice, dysentery, epilepsy, asthma, allergy, and head trauma in the medicalhistory of children were not significantly differed between the two groups. Conclusion: According to this preliminary study, it may be concluded that the maternal historyof medical disorders is one of contributing risk factors for ADHD.

Sex in the Curriculum: The Effect of a Multi-Modal Sexual History-Taking Module on Medical Student Skills

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Lindau, Stacy Tessler; Goodrich, Katie G.; Leitsch, Sara A.; Cook, Sandy

2008-01-01

Purpose: The objective of this study was to determine the effect of a multi-modal curricular intervention designed to teach sexual history-taking skills to medical students. The Association of Professors of Gynecology and Obstetrics, the National Board of Medical Examiners, and others, have identified sexual history-taking as a learning objective…

On history of medical radiology in Ukraine: main directions of scientific development (1920-1941)

International Nuclear Information System (INIS)

Pilipenko, M.Yi.; Artamonova, N.O.; Busigyina, N.O.

1994-01-01

The work is devoted to the history of medical radiology in Ukraine. It deals with principal problems of scientific research development during 1920-1941. The authors describe both known and little known facts of the history of foundation and development of the first Ukrainian radiological, roentgenological and oncological institutes. Main achievements in radiology development i.e. foundation of large specialized research centres in Kharkov, kiev, Odessa, independent departments of roentgenology both at the majority of medical institutes and three advanced training institutes for doctors, organization of ALL-Union and Republican Congresses and Conferences of Radiologists, publication of a special journal > (Problems of Oncology) are described

Social, psychological and psychosomatic disorders in the people with combat stress in their medical histories

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L. V. Gracheva

2013-01-01

Full Text Available The authors examined three groups of patients – military men (40 men in each group with combat stress of different intensity in their medical histories (two main groups and a  control group – without combat stress. The results showed that the military men with a high level combat stress in the past (more than 5 years ago more frequently demonstrated socialmental disadaptation against the background of subclinical chronic posttraumatic stress disorder (PTSD. The conclusion is that this group of people requires dynamic followup and adequate medicopsychological aid.

Family history and medical examination of occupationally exposed employees against ionizing radiation

International Nuclear Information System (INIS)

Heinemann, G.

2000-01-01

Searching for individual radiosensitivity could improve the quality of the medical examination of occupationally exposed employees and thus provide real protection of the individual against ionizing radiation. For this purpose genetic family history should be recorded by a skilled interviewer. (orig.) [de

78 FR 50136 - Notice of Information Collection Under Emergency Review: Medical History and Examination for...

Science.gov (United States)

2013-08-16

...: Medical History and Examination for Foreign Service DS-1843 and DS-1622 ACTION: Notice of request for... methods: Web: Persons with access to the Internet may use the Federal Docket Management System (FDMS) to... History and Examination for Foreign Service. OMB Control Number: 1405-0068. Type of Request: Emergency...

A tale of Congress, continuing medical education, and the history of medicine.

Science.gov (United States)

Partin, Clyde; Kushner, Howard I; Horton, Mary E Kollmer

2014-04-01

Well-intentioned attempts by the Senate Finance Committee to improve the content and quality of continuing medical education (CME) offerings had the unanticipated consequence of decimating academically oriented history of medicine conferences. New guidelines intended to keep CME courses free of commercial bias from the pharmaceutical industry were worded in a fashion that caused CME officials at academic institutions to be reluctant to offer CME credit for history of medicine gatherings. At the 2013 annual conference of the American Association for the History of Medicine, we offered a novel solution for determining CME credit in line with current guidelines. We asked attendees to provide narrative critiques for each presentation for which they desired CME credit. In this essay, we evaluate the efficacy of this approach.

A history and overview of the certification exam for medical dosimetrists

International Nuclear Information System (INIS)

Pusey, Damien; Smith, Lisette; Zeman, Elaine M.; Adams, Robert

2005-01-01

During the last century, the creation and implementation of board certification has had a powerful impact on the medical community. Board certification has helped to shape the scope and practice of medical professionals and the care they provide, as well as to influence the way the health insurance industry sets standards for reimbursement. One profession that offers board certification to its members is medical dosimetry. The Medical Dosimetrist Certification Board exam has been administered since 1988 and its content covers a broad spectrum of information from the radiation therapy sciences. The exam has strict application requirements and is rather difficult to pass. Those who pass the exam can then call themselves Certified Medical Dosimetrists. For data purposes of this study, several members of the dosimetry community were solicited to participate in a survey regarding the exam's content and history, and to provide relevant statistical data. Currently 2,177 medical dosimetrists are board certified, with an additional 1,500 estimated to be working without certification. Although board certification is not currently required to practice medical dosimetry, new legislation known as the CARE Bill could change this. The CARE Bill, if passed, would mandate nationwide compulsory licensure and/or certification for medical dosimetrists and other medical professionals who want to work in radiation-related health care. Health maintenance organizations and other insurance carriers may likewise require certification for reimbursement purposes

Teaching history of medicine in the perspective of "medical humanities".

Science.gov (United States)

von Engelhardt, D

1999-03-01

The current interest in philosophical questions and ethical aspects of medicine turns attention towards the past and obtains suggestions and perspectives from previous descriptions and interpretations of sickness, therapy, and the relation between the patient and physician. Culture as therapy and therapy as culture are fundamental challenges for the present; physician, patient, and society, i.e., humans and humane medicine, need this dialogue, which should also be constitutive for teaching history of medicine. Through the separation of the natural sciences and the humanities, modern progress of medicine has produced many benefits but has, at the same time, raised many problems. Negative consequences of this development exist not only for the patient, but also for his personal environment and for the physician. In the course of modern history, there have been several reactions aimed at overcoming these one-sided tendencies: in the Renaissance, in the epoch of Romanticism and Idealism, and at the beginning and the end of the 19th century. This article outlines, with historical examples and contemporary reflections, the concept of teaching history of medicine in the perspective of "medical humanities".

A study on the optimization of referring method about medical images using MIH (Medical Image History)

International Nuclear Information System (INIS)

Kim, Sun Chil; Kim, Jung Min

2002-01-01

The recent development of embodiment technology of the medical images makes most medical institutions introduce PACS (Picture Archiving and Communication System) in haste. However lots of PACS solutions, currently developed and distributed, haven't been able to serve the convenience of users and to satisfy user's demand because of economic limitations and administrator-oriented con-siderations in the process of development. So we have developed MIH (Medical Image History), by which we can search and refer to the patient's medical images and information with few restrictions of time and space for diagnosis and treatment. The program will contribute to the improvement in the medical environment and meet the clients' need. We'll make more effort to develop the application which insures the better quality of medical images. MIH manages the patient's image files and medical records like film chart in connection with time. This trial will contribute to the reduction of the economical loss caused by unnecessary references and improve the quality in the medical services. The demand on the development of the program which refers to the medical data quickly and keeps them stable will be continued by the medical institute. This will satisfy the client's demand and improve the service to the patients in that the program will be modified from the standpoint of the users. MIH is trying to keep user-oriented policy and to apply the benefit of the analog system to the digital environment. It is necessary to lead the public to the better understanding that the systematic management and referring of the medical images is as important as the quality of the images

From papyrus to the electronic tablet: a brief history of the clinical medical record with lessons for the digital age.

Science.gov (United States)

Gillum, Richard F

2013-10-01

A major transition is underway in documentation of patient-related data in clinical settings with rapidly accelerating adoption of the electronic health record and electronic medical record. This article examines the history of the development of medical records in the West in order to suggest lessons applicable to the current transition. The first documented major transition in the evolution of the clinical medical record occurred in antiquity, with the development of written case history reports for didactic purposes. Benefiting from Classical and Hellenistic models earlier than physicians in the West, medieval Islamic physicians continued the development of case histories for didactic use. A forerunner of modern medical records first appeared in Paris and Berlin by the early 19th century. Development of the clinical record in America was pioneered in the 19th century in major teaching hospitals. However, a clinical medical record useful for direct patient care in hospital and ambulatory settings was not developed until the 20th century. Several lessons are drawn from the 4000-year history of the medical record that may help physicians improve patient care in the digital age. Copyright © 2013 Elsevier Inc. All rights reserved.

A history of the American College of Medical Quality.

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Fetterolf, Donald; Brodie, Bridget

2011-01-01

The American College of Medical Quality is a national organization of health care professionals who are interested in the advancement of medical quality as a field. Composed primarily of doctorate-level individuals in medicine, dentistry, and podiatry, it also includes affiliate members in preprofessional training as well as nursing. Origins of the organization date to 1973, when it was first called the American College of Utilization Review Physicians. It is formally recognized by the American Medical Association and holds a seat in its House of Delegates. The College views the advancement of medical quality as a field of study within itself and offers multiple venues for self-education, testing, and professional networking for its members. Recently, rising national awareness of quality in health care as a field of endeavor has elevated enrollment levels and increased interest in the organization.

A history of medical student debt: observations and implications for the future of medical education.

Science.gov (United States)

Greysen, S Ryan; Chen, Candice; Mullan, Fitzhugh

2011-07-01

Over the last 50 years, medical student debt has become a problem of national importance, and obtaining medical education in the United States has become a loan-dependent, individual investment. Although this phenomenon must be understood in the general context of U.S. higher education as well as economic and social trends in late-20th-century America, the historical problem of medical student debt requires specific attention for several reasons. First, current mechanisms for students' educational financing may not withstand debt levels above a certain ceiling which is rapidly approaching. Second, there are no standards for costs of medical school attendance, and these can vary dramatically between different schools even within a single city. Third, there is no consensus on the true cost of educating a medical student, which limits accountability to students and society for these costs. Fourth, policy efforts to improve physician workforce diversity and mitigate shortages in the primary care workforce are inhibited by rising levels of medical student indebtedness. Fortunately, the current effort to expand the U.S. physician workforce presents a unique opportunity to confront the unsustainable growth of medical student debt and explore new approaches to the financing of medical students' education.

Details acquired from medical history and patients’ experience of empathy – two sides of the same coin

Science.gov (United States)

2013-01-01

Background History taking and empathetic communication are two important aspects in successful physician-patient interaction. Gathering important information from the patient’s medical history is needed for effective clinical decision making while empathy is relevant for patient satisfaction. We wanted to investigate whether medical students near graduation are able to combine both skills as required in daily medical practice. Methods Thirty near graduates from Hamburg Medical School participated in an assessment for clinical competences including a consultation hour with five standardized patients. Each patient interview was videotaped and standardized patients rated participants with the CARE questionnaire for consultation and relational empathy. All videotaped interviews were rated with a checklist based on the number of important medical aspects for each case. Data were analysed with the linear mixed model to correct for random effects. Regression analysis was performed to look for correlations between the number of questions asked by a participant and their respective empathy rating. Results Of the 123 aspects that could have been gathered in total, students only requested 56.4% (95% CI 53.5-59.3). While no difference between male and female participants was found, a significant difference (p sides of the coin of history taking. While both skills have to be acquired during medical school training with particular focus on their respective learning objectives, medical students need to be provided with additional learning and feedback opportunities where they can be observed exercising both skills combined as required in physicians’ daily practice. PMID:23659369

Mining level of control in medical organizations.

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Çalimli, Olgu; Türkeli, Serkan; Eken, Emir Gökberk; Gönen, Halil Emre

2014-01-01

In literature of strategic management, there are three layers of control defined in organizational structures. These layers are strategic, tactical and operational, in which resides senior, medium level and low level managers respectively. In strategic level, institutional strategies are determined according to senior managers' perceived state of organization. In tactical level, this strategy is processed into methods and activities of a business management plan. Operational level embodies actions and functions to sustain specified business management plan. An acknowledged lead organization in Turkish medical area is examined using case study and data mining method in the scope of this paper. The level of decisions regarded in managerial purposes evaluated through chosen organization's business intelligence event logs report. Hence specification of management level importance of medical organizations is made. Case study, data mining and descriptive statistical method of taken case's reports present that positions of "Chief Executive Officer", "Outpatient Center Manager", "General Manager", monitored and analyzed functions of operational level management more frequently than strategic and tactical level. Absence of strategic management decision level research in medical area distinguishes this paper and consequently substantiates its significant contribution.

Are medical students confident in taking a sexual history? An assessment on attitude and skills from an upper middle income country.

Science.gov (United States)

Ariffin, Farnaza; Chin, Ken Lee; Ng, ChirkJenn; Miskan, Maizatullifah; Lee, Verna KarMun; Isa, Mohammad Rodi

2015-06-17

Sexual history training during undergraduate education is essential for preparing future doctors to handle patients' sexual health concerns. The purpose of this study was to assess the attitudes and perceptions of final-year medical students in Malaysia toward sexual history taking and the training they receive from their medical schools. The study used a cross-sectional survey of 379 final-year medical students from three medical schools in Malaysia. Students were asked to rate their attitudes and perceptions regarding training on taking sexual histories using a newly developed questionnaire with good internal consistency (Cronbach's alpha = 0.73). Ethics approval was obtained from the relevant medical schools, and the statistical analysis was conducted using SPSS, Version 20.0. The mean age of participants was 23.58 ± 0.65 SD. Participants reported high interest in sexual health and felt it was important for doctors to know how to take a sexual history (95%). Among the participants, only half felt comfortable in taking sexual histories from patients. The participants identified cultural and religious differences between the doctor and the patient as a potential barrier for discussing sexual health. Participants were aware of their own practice and ability, as well as their limitations, in taking sexual histories. Less than half (46%) felt that the training they received adequately prepared them to take sexual histories. This study identified gaps in sexual health training among medical schools in Malaysia. The delivery of sexual health education program should incorporate confidence building and to make students feel comfortable to take sexual histories from patients. The barrier caused by differences in culture or religion between a doctor and a patient may be overcome through cross cultural and cultural competency training. This is important for multi-faith, multi cultural societies such as Malaysia and other similar countries.

Enhancing Student Empathetic Engagement, History-Taking, and Communication Skills During Electronic Medical Record Use in Patient Care.

Science.gov (United States)

LoSasso, Alisa Alfonsi; Lamberton, Courtney E; Sammon, Mary; Berg, Katherine T; Caruso, John W; Cass, Jonathan; Hojat, Mohammadreza

2017-07-01

To examine whether an intervention on proper use of electronic medical records (EMRs) in patient care could help improve medical students' empathic engagement, and to test the hypothesis that the training would reduce communication hurdles in clinical encounters. Seventy third-year medical students from the Sidney Kimmel Medical College at Thomas Jefferson University were randomly divided into intervention and control groups during their six-week pediatric clerkship in 2012-2013. The intervention group received a one-hour training session on EMR-specific communication skills, including discussion of EMR use, the SALTED mnemonic and technique (Set-up, Ask, Listen, Type, Exceptions, Documentation), and role-plays. Both groups completed the Jefferson Scale of Empathy (JSE) at the clerkship's start and end. At clerkship's end, faculty and standardized patients (SPs) rated students' empathic engagement in SP encounters, using the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE), and their history-taking and communication skills. Faculty mean ratings on the JSPPPE, history-taking skills, and communication skills were significantly higher for the intervention group than the control group. SP mean ratings on history-taking skills were significantly higher for the intervention group than the control group. Both groups' JSE mean scores increased pretest to posttest, but the changes were not significant. The intervention group's posttest JSE mean score was higher than the control group's, but the difference was not significant. The findings suggest that a simple intervention providing specialized training in EMR-specific communication can improve medical students' empathic engagement in patient care, history-taking skills, and communication skills.

A study on the optimization of referring method about medical images using MIH (Medical Image History)

Energy Technology Data Exchange (ETDEWEB)

Kim, Sun Chil; Kim, Jung Min [College of Health Sciences, Korea University, Seoul (Korea, Republic of)

2002-09-15

The recent development of embodiment technology of the medical images makes most medical institutions introduce PACS (Picture Archiving and Communication System) in haste. However lots of PACS solutions, currently developed and distributed, haven't been able to serve the convenience of users and to satisfy user's demand because of economic limitations and administrator-oriented con-siderations in the process of development. So we have developed MIH (Medical Image History), by which we can search and refer to the patient's medical images and information with few restrictions of time and space for diagnosis and treatment. The program will contribute to the improvement in the medical environment and meet the clients' need. We'll make more effort to develop the application which insures the better quality of medical images. MIH manages the patient's image files and medical records like film chart in connection with time. This trial will contribute to the reduction of the economical loss caused by unnecessary references and improve the quality in the medical services. The demand on the development of the program which refers to the medical data quickly and keeps them stable will be continued by the medical institute. This will satisfy the client's demand and improve the service to the patients in that the program will be modified from the standpoint of the users. MIH is trying to keep user-oriented policy and to apply the benefit of the analog system to the digital environment. It is necessary to lead the public to the better understanding that the systematic management and referring of the medical images is as important as the quality of the images.

Are medical students confident in taking a sexual history? An assessment on attitude and skills from an upper middle income country

OpenAIRE

Ariffin, Farnaza; Chin, Ken Lee; Ng, ChirkJenn; Miskan, Maizatullifah; Lee, Verna KarMun; Isa, Mohammad Rodi

2015-01-01

Background Sexual history training during undergraduate education is essential for preparing future doctors to handle patients? sexual health concerns. The purpose of this study was to assess the attitudes and perceptions of final-year medical students in Malaysia toward sexual history taking and the training they receive from their medical schools. Methods The study used a cross-sectional survey of 379 final-year medical students from three medical schools in Malaysia. Students were asked to...

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

Directory of Open Access Journals (Sweden)

Kathleen Murray

2013-08-01

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

Details acquired from medical history and patients' experience of empathy--two sides of the same coin.

Science.gov (United States)

Ohm, Friedemann; Vogel, Daniela; Sehner, Susanne; Wijnen-Meijer, Marjo; Harendza, Sigrid

2013-05-09

History taking and empathetic communication are two important aspects in successful physician-patient interaction. Gathering important information from the patient's medical history is needed for effective clinical decision making while empathy is relevant for patient satisfaction. We wanted to investigate whether medical students near graduation are able to combine both skills as required in daily medical practice. Thirty near graduates from Hamburg Medical School participated in an assessment for clinical competences including a consultation hour with five standardized patients. Each patient interview was videotaped and standardized patients rated participants with the CARE questionnaire for consultation and relational empathy. All videotaped interviews were rated with a checklist based on the number of important medical aspects for each case. Data were analysed with the linear mixed model to correct for random effects. Regression analysis was performed to look for correlations between the number of questions asked by a participant and their respective empathy rating. Of the 123 aspects that could have been gathered in total, students only requested 56.4% (95% CI 53.5-59.3). While no difference between male and female participants was found, a significant difference (pexercising both skills combined as required in physicians' daily practice.

The Roman-Irish Bath: Medical/health history as therapeutic assemblage.

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Foley, Ronan

2014-04-01

The invention of a new form of hot-air bath in Blarney, Ireland in 1856, variously known in its lifetime as the Roman-Irish or Turkish Bath, acted as the starting point for a the production of a globalised therapeutic landscape. Tracking the diffusion of the Roman-Irish bath template from its local invention in Ireland to a global reach across the Victorian world and recognizing its place within a wider hydrotherapeutic history, this paper frames that diffusion as a valuable empirical addition to assemblage theory. The specific empirical history of the spread of the Roman-Irish/Turkish bath idea is drawn from primary archival and secondary historical sources. It is then discussed and, drawing from work on assemblage theory, analyzed against three broad themes: mobile networks, socio-material practices and contested emergence. The emergent relational geographies of the Roman-Irish Bath identify important roles for the diffusion and transformation of specific medical settings, identities and functions. These were linked in turn to competing social-healing pathways wherein bodies were technologically and morally managed, to produce a more inhabited form of therapeutic assemblage. In all cases the differential diffusion of the bath idea, it's shifting and fractured material forms and multiple inhabitations and discourses were contested and mobile and spoke to an assemblage approach which has ripe potential for exploration across a range of medical/health geography settings. Copyright © 2014 Elsevier Ltd. All rights reserved.

Structured communicative skills training for medical interns improves history taking skills on sensitive issues: An interventional study

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Anupama Sukhlecha

2016-01-01

Full Text Available Background: Communication is a process that allows us to interact with other people. Medical professionals need to possess good communication skills for history taking, diagnosis, and treatment. Communicative skills are hardly taught in medical schools of India. The students are expected to learn them on their own. To address this issue, we introduced communicative skills training (CST for medical interns. Objective: Primary – To determine the effectiveness of CST in improving history taking on sensitive issues by medical interns. Secondary – To improve patients' satisfaction through improved communicative skills. Materials and Methods: This was a randomized control study carried out on medical interns at Jamnagar. The interns were randomized to either Group A or Group B. Intervention in the form of CST was given to Group A while Group B was control. The topic of CST was “eliciting sexual history.” Assessment of participants was done by pre- and post-intervention objective structured clinical examination. For ethical reasons, Group B was also given CST by experts after completion of our study but their results were not included for analysis. Results: Although mean scores increased in both the groups, (from 6.4 to 13.4 in the intervention group and from 6.5 to 7.5 in controls, the percent increase was much larger in the intervention group than controls (109% vs. 15%. Students gave a positive feedback to CST. Opinion of teachers was favoring CST. Among the patients allotted to intervention group, 83% were satisfied. Conclusion: CST imparted to medical interns helps in improving doctor–patient relationship.

[About Itching and scabies. Pruritus in medical history--from ancient world to the French revolution].

Science.gov (United States)

Weisshaar, E; König, A; Diepgen, T L; Eckart, W U

2008-12-01

Pruritus (itching) as a disease state and especially as a disease symptom has been object of medical and scientific descriptions and examinations in all epochs since the antiquity and in different cultural periods. Antiquity was dominated by observations and descriptions but during the course of medical history and particularly since the establishment of dermatology, more and more emphasis has been placed on classification and etiologic research.

Directions in low-level radioactive waste management: A brief history of commercial low-level radioactive waste disposal

International Nuclear Information System (INIS)

1994-08-01

This report presents a history of commercial low-level radioactive waste disposal in the United States, with emphasis on the history of six commercially operated low-level radioactive waste disposal facilities. The report includes a brief description of important steps that have been taken during the last decade to ensure the safe disposal of low-level radioactive waste in the 1990s and beyond. These steps include the issuance of comprehensive State and Federal regulations governing the disposal of low-level radioactive waste, and the enactment of Federal laws making States responsible for the disposal of such waste generated within their borders

The history of parkinsonism: descriptions in ancient Indian medical literature.

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Ovallath, Sujith; Deepa, P

2013-05-01

The clinical syndrome of parkinsonism was identified in ancient India even before the period of Christ and was treated methodically. The earliest reference to bradykinesia dates to 600 bc. Evidences prove that as early as 300 bc, Charaka proposed a coherent picture of parkinsonism by describing tremor, rigidity, bradykinesia, and gait disturbances as its components. The scenario was further developed by Madhava, Vagbhata, and Dalhana all through history. The 15th-century classic "Bhasava rajyam" introduced the term kampavata, which may be regarded as an ayurvedic analogue of parkinsonism. The pathogenesis of kampavata centered on the concept of imbalance in the vata factor, which controls psychomotor activities. The essential element in therapy was the administration of powdered seed of Mucuna pruriens, or atmagupta, which as per reports, contains 4%-6% of levodopa. In addition to proving the existence and identification of parkinsonism in ancient India, the study points to the significance of ancient Indian Sanskrit works in medical history. Copyright © 2013 Movement Disorder Society.

[Study on medical records of acupuncture-moxibustion in The Twenty-four Histories].

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Huang, Kai-Wen

2012-03-01

Through the combination of manual retrieval and computerized retrieval, medical records of acupuncture-moxibustion in The Twenty-Four Histories were collected. Acupuncture cases from the Spring and Autumn Period (770-476 B.C.) to the end of the Ming Dynasty (1368-1644)were retrieved. From the medical records of acupuncture-moxibustion in Chinese official history books, it can be found that systematic diseases or emergent and severe diseases were already treated by physicians with the combination of acupuncture and medicine as early as in the Spring and Autumn Period as well as the Warring States Period(475-221 B.C.). CANG Gong, a famous physician of the Western Han Dynasty (206 B. C.-A. D. 24), cured diseases by selecting points along the running courses of meridians where the illness inhabited, which indicates that the theory of meridians and collaterals was served as a guide for clinical practice as early as in the Western Han Dynasty. Blood letting therapy, which has surprising effect, was often adopted by physicians of various historical periods to treat diseases. And treatment of diseases with single point was approved to be easy and effective.

Medical History: Compiling Your Medical Family Tree

Science.gov (United States)

... are missing. If you're adopted, ask your adoptive parents if they received any medical information about your biological parents at the time of your adoption. Adoption agencies also might have family medical information on file. If you were adopted ...

Impact of a Student Pharmacist Driven Medication Reconciliation and Antidepressant Treatment History Project at a Depression Clinic: A Pilot Study

Science.gov (United States)

Tang, Stella S.; Jaward, Leanna; Ward, Kristen; Parikh, Sagar V.; Bostwick, Jolene R.

2017-01-01

Objectives To improve treatment of patients with depression, a new pilot service project involving student pharmacists who would conduct medication reconciliation and review of antidepressant treatment history was created and evaluated. Experimental design A prospective study conducted at the University of Michigan Depression Center. Principal observations From an initial sample of 78 referrals, 41 subjects were reached by phone, with 34 completing medication reconciliation and antidepressant treatment history. Of the 34 patients, 25 (73.5%) had at least one discrepancy identified in their medication list, resulting in 164 medication changes in the electronic medical record (EMR). A total of 105 past antidepressant trials were documented in the 34 individuals, with 34 (32.4%) trials found to be inadequate. Thirteen (38.2%) patients reported failure to respond to two different antidepressants from different classes. All 34 patients participated well in the phone calls and were willing to consult a pharmacist at their upcoming clinic visit. Conclusions A student pharmacist pilot was feasible, identified many discrepancies in the medication record, and identified important medication treatment history in patients with depression in advance of the clinic visit. The project provides support for a specialized role for student pharmacists and demonstrates that interprofessional care can contribute to improved treatment of depression. PMID:28626270

Twelve Tips for teaching medical professionalism at all levels of medical education.

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Al-Eraky, Mohamed Mostafa

2015-01-01

Review of studies published in medical education journals over the last decade reveals that teaching medical professionalism is essential, yet challenging. According to a recent Best Evidence in Medical Education (BEME) guide, there is no consensus on a theoretical or practical model to integrate the teaching of professionalism into medical education. The aim of this article is to outline a practical manual for teaching professionalism at all levels of medical education. Drawing from research literature and author's experience, Twelve Tips are listed and organised in four clusters with relevance to (1) the context, (2) the teachers, (3) the curriculum, and (4) the networking. With a better understanding of the guiding educational principles for teaching medical professionalism, medical educators will be able to teach one of the most challenging constructs in medical education.

Significance of experts' overall ratings for medical student competence in relation to history-taking

Directory of Open Access Journals (Sweden)

Luiz Ernesto de Almeida Troncon

Full Text Available CONTEXT AND OBJECTIVE: Overall ratings (ORs of competence, given by expert physicians, are increasingly used in clinical skills assessments. Nevertheless, the influence of specific components of competence on ORs is incompletely understood. The aim here was to investigate whether ORs for medical student history-taking competence are influenced by performance relating to communication skills, completeness of questioning and asking contentdriven key questions. DESIGN AND SETTING: Descriptive, quantitative study at Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. METHODS: Thirty-six medical students were examined in a 15-station high-stake objective structured clinical examination (OSCE. At four stations devoted to history-taking, examiners filled out checklists covering the components investigated and independently rated students’ overall performance using a five-point scale from 1 (poor to 5 (excellent. Physician ratings were aggregated for each student. Nonparametric correlations were made between ORs. RESULTS: ORs presented significant correlations with checklist scores (Spearman’s rs = 0.38; p = 0.02 and OSCE general results (rs = 0.52; p < 0.001. Scores for "communication skills" tended to correlate with ORs (rs = 0.31, but without reaching significance (p = 0.06. Neither the scores for "completeness" (rs = 0.26; p = 0.11 nor those for "asking key questions" (rs = 0.07; p = 0.60 correlated with ORs. CONCLUSIONS: Experts’ overall ratings for medical student competence regarding history-taking is likely to encompass a particular dimension, since ratings were only weakly influenced by specific components of performance.

Relative accuracy and availability of an Irish National Database of dispensed medication as a source of medication history information: observational study and retrospective record analysis.

LENUS (Irish Health Repository)

Grimes, T

2013-01-27

WHAT IS KNOWN AND OBJECTIVE: The medication reconciliation process begins by identifying which medicines a patient used before presentation to hospital. This is time-consuming, labour intensive and may involve interruption of clinicians. We sought to identify the availability and accuracy of data held in a national dispensing database, relative to other sources of medication history information. METHODS: For patients admitted to two acute hospitals in Ireland, a Gold Standard Pre-Admission Medication List (GSPAML) was identified and corroborated with the patient or carer. The GSPAML was compared for accuracy and availability to PAMLs from other sources, including the Health Service Executive Primary Care Reimbursement Scheme (HSE-PCRS) dispensing database. RESULTS: Some 1111 medication were assessed for 97 patients, who were median age 74 years (range 18-92 years), median four co-morbidities (range 1-9), used median 10 medications (range 3-25) and half (52%) were male. The HSE-PCRS PAML was the most accurate source compared to lists provided by the general practitioner, community pharmacist or cited in previous hospital documentation: the list agreed for 74% of the medications the patients actually used, representing complete agreement for all medications in 17% of patients. It was equally contemporaneous to other sources, but was less reliable for male than female patients, those using increasing numbers of medications and those using one or more item that was not reimbursable by the HSE. WHAT IS NEW AND CONCLUSION: The HSE-PCRS database is a relatively accurate, available and contemporaneous source of medication history information and could support acute hospital medication reconciliation.

Medical physics personnel for medical imaging: requirements, conditions of involvement and staffing levels-French recommendations

International Nuclear Information System (INIS)

Isambert, Aurelie; Valero, Marc; Rousse, Carole; Blanchard, Vincent; Le Du, Dominique; Guilhem, Marie-Therese; Dieudonne, Arnaud; Pierrat, Noelle; Salvat, Cecile

2015-01-01

The French regulations concerning the involvement of medical physicists in medical imaging procedures are relatively vague. In May 2013, the ASN and the SFPM issued recommendations regarding Medical Physics Personnel for Medical Imaging: Requirements, Conditions of Involvement and Staffing Levels. In these recommendations, the various areas of activity of medical physicists in radiology and nuclear medicine have been identified and described, and the time required to perform each task has been evaluated. Criteria for defining medical physics staffing levels are thus proposed. These criteria are defined according to the technical platform, the procedures and techniques practised on it, the number of patients treated and the number of persons in the medical and paramedical teams requiring periodic training. The result of this work is an aid available to each medical establishment to determine their own needs in terms of medical physics. (authors)

Influence of gender, BMI, and ethnicity on serum ALT levels of healthy students of a medical school

International Nuclear Information System (INIS)

Bilal, M.; Tariq, A.; Khan, S.; Quratulain, A.; Tariq, A.; Shahid, M.F.; Khan, M.W.; Naveed, A.K.

2011-01-01

Background: Alanine Aminotransferase (ALT) is an enzyme found in Liver and indicates injury to Hepatocytes. It is influenced by various factors. The objectives of this study were to identify the correlates of ALT activity among healthy medical students of Army Medical College, National University of Sciences and Technology, aged 18-22 years. This was to establish the mean ALT levels of the students and compare them with those in various parts of the world and observe various correlations that exist and factors that may influence ALT levels. Methods: This population included 143 volunteer students (93 men and 50 women) selected on the basis of negative answers to a detailed medical questionnaire including past medical history, drug and alcohol consumption, on the absence of clinical signs of liver disease, on the negativity of serological testing for Hepatitis B and C virus. Results: The mean ALT level of the entire population was 28.7 IU/L. A major sex-difference in ALT value was observed, the mean ALT value being higher in men than in women (32.1+- 21.7 vs. 22.6 +- 9.7 IU/L, p<0.004). According to WHO criteria for Asians, normal BMI was taken from 18.5-23.0 Kg/m/sup 2/. There was a positive significant correlation between serum ALT level and BMI (p<0.002). ALT level strongly correlates with body mass index and gender. There was no significant variation in ALT levels among Punjabis and Sindhis, Balochis, Pathans, and Kashmiris. Conclusion: We suggest the need of taking into account these parameters in a clinical interpretation of ALT level. (author)

Directions in low-level radioactive waste management: A brief history of commercial low-level radioactive waste disposal

International Nuclear Information System (INIS)

1990-10-01

This report presents a history of commercial low-level radioactive waste management in the United States, with emphasis on the history of six commercially operated low-level radioactive waste disposal facilities. The report includes a brief description of important steps that have been taken during the 1980s to ensure the safe disposal of low-level waste in the 1990s and beyond. These steps include the issuance of Title 10 Code of Federal Regulations Part 61, Licensing Requirements for the Land Disposal of Radioactive Waste, the Low-Level Radioactive Waste Policy Act of 1980, the Low-Level Radioactive Waste Policy Amendments Act of 1985, and steps taken by states and regional compacts to establish additional disposal sites. 42 refs., 13 figs., 1 tab

The effective and preventive factors of taking patients\\' history from the viewpoint of the students of Birjand Medical School in 2010-2011

Directory of Open Access Journals (Sweden)

Z. Khazaee

2013-06-01

Full Text Available Introduction: Taking patients' history and doing physical examinations help physicians to diagnose correctly and treat accordingly. There are several factors which may affect the quality of taking patients' history. This study aims to assess determinants of taking patients' history from the viewpoint of the students of Birjand Medical School. Methods: This descriptive study was carried out in 2010-2011 on all 137 medical trainees and interns studying at Birjand Medical School. To determine the students’ attitudes towards history taking and to evaluate their performance a questionnaire and a check-list were used, respectively. The data analyzed using SPSS software. Descriptive-deductive statistics (T-test were applied on the data. Results: The average score of the motivational factors was more than the preventive factors. Among the motivational factors, the statement “taking patient history is a basis of proper diagnosis and treatment” (3.58 and among the preventive factors the statement “taking patient history just to evade responsibility”(2.57had the highest scores. Moreover, there was a significant difference between the performance of trainees and interns in taking and recording patients’ history (P<0.005. Conclusion: Although the students held a positive attitude toward taking patients' history, they didn’t have satisfactory performance in recording disease symptoms, diagnosis and treatment plans this entails more attention. Observation of trainers on the process of history taking may help.

Competing risks model in screening for preeclampsia by maternal characteristics and medical history.

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Wright, David; Syngelaki, Argyro; Akolekar, Ranjit; Poon, Leona C; Nicolaides, Kypros H

2015-07-01

The purpose of this study was to develop a model for preeclampsia based on maternal demographic characteristics and medical history. This was a screening study of 120,492 singleton pregnancies at 11-13 weeks' gestation, including 2704 pregnancies (2.2%) that experienced preeclampsia. A survival-time model for the gestational age at delivery with preeclampsia was developed from variables of maternal characteristics and history. This approach assumes that, if the pregnancy was to continue indefinitely, all women would experience preeclampsia and that whether they do so or not before a specified gestational age depends on competition between delivery before or after development of preeclampsia. A 5-fold cross validation study was conducted to compare the performance of the new model with the National Institute for Health and Clinical Excellence (NICE) guidelines. In the new model, increased risk for preeclampsia, with a consequent shift in the Gaussian distribution of the gestational age at delivery with preeclampsia to the left, is provided by advancing maternal age, increasing weight, Afro-Caribbean and South Asian racial origin, medical history of chronic hypertension, diabetes mellitus and systemic lupus erythematosus or antiphospholipid syndrome, family history and personal history of preeclampsia, and conception by in vitro fertilization. The risk for preeclampsia decreases with increasing maternal height and in parous women with no previous preeclampsia; in the latter, the protective effect, which is related inversely to the interpregnancy interval, persists beyond 15 years. At a screen-positive rate of 11%, as defined by NICE, the new model predicted 40%, 48%, and 54% of cases of total preeclampsia and preeclampsia requiring delivery at preeclampsia. Such estimation of the a priori risk for preeclampsia is an essential first step in the use of Bayes theorem to combine maternal factors with biomarkers for the continuing development of more effective methods of

Rhazes, a genius physician in diagnosis and treatment of kidney calculi in medical history.

Science.gov (United States)

Changizi Ashtiyani, Saeed; Cyrus, Ali

2010-04-01

Abu Bakr Mohammad Ibn Zakariya Razi, known in the west as Rhazes (865 to 925 AD), was born in the ancient city of Rayy, near Tehran, Iran. He was a renowned physician in medical history and not only followed Hippocrates and Galen, but also greatly extended the analytical approach of his predecessors. Based on the existing documents, he was known as the most distinguished character in the world of medicine up to the 17th century. A great number of innovations and pioneering works in the medical science have been recorded in the name of Rhazes. His fundamental works in urology as part of his research in the realm of medicine have remained unknown. Pathophysiology of the urinary tract, venereal diseases, and kidney and bladder calculi are among his main interests in this field. He also purposed and developed methods for diagnosis and treatment of kidney calculi for the first time in medical history. He also presented a very exact and precise description of neuropathic bladder followed by vertebral fracture. He advanced urine analysis and studied function and diseases of the kidneys. Rhazes recommendations for the prevention of calculi are quite scientific and practical and in accordance with current recommendations to avoid hypercalciuria and increased saturation of urine. Rhazes was not only one of the most important Persian physician-philosophers of his era, but for centuries, his writings became fundamental teaching texts in European medical schools. Some important aspects of his contributions to medicine are reviewed.

Medical physics personnel for medical imaging: requirements, conditions of involvement and staffing levels-French recommendations.

Science.gov (United States)

Isambert, Aurélie; Le Du, Dominique; Valéro, Marc; Guilhem, Marie-Thérèse; Rousse, Carole; Dieudonné, Arnaud; Blanchard, Vincent; Pierrat, Noëlle; Salvat, Cécile

2015-04-01

The French regulations concerning the involvement of medical physicists in medical imaging procedures are relatively vague. In May 2013, the ASN and the SFPM issued recommendations regarding Medical Physics Personnel for Medical Imaging: Requirements, Conditions of Involvement and Staffing Levels. In these recommendations, the various areas of activity of medical physicists in radiology and nuclear medicine have been identified and described, and the time required to perform each task has been evaluated. Criteria for defining medical physics staffing levels are thus proposed. These criteria are defined according to the technical platform, the procedures and techniques practised on it, the number of patients treated and the number of persons in the medical and paramedical teams requiring periodic training. The result of this work is an aid available to each medical establishment to determine their own needs in terms of medical physics. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

[The life of Dr. RO Kishun, a reflection of modern Korean medical history of the borders].

Science.gov (United States)

Shin, Young-Jeon; Park, Se-Hong

2009-06-01

borderlands or frontiers of Joseon Korea, China, and Japan, where the history of the three nations met and intermingled with one another. He was a biochemist and researcher, practicing physician and medical professor of the era under Japanese Rule and the one following it. In modern Korean medicine, his life is viewed as a history of the borders, or a transnational legacy going beyond individual history of Korea, China, and Japan.

Characteristics of medically related low-level radioactive waste

International Nuclear Information System (INIS)

Weir, G.J. Jr.; Teele, B.

1986-07-01

This report describes a survey that identified the current sources of medically generated radioactive wastes. Included are recommendations on how to reduce the volume of medically-related material classified as low-level radioactive wastes, to improve handling techniques for long-lived radioisotopes, and for options for the use of radioactive materials in medical studies. 8 refs., 11 tabs

An Unbiased View of the History of Polish Medical Physics by a Senior Polish Medical Physicist

International Nuclear Information System (INIS)

Chomicki, O. A.

2008-01-01

Here is a story told by Maria Sklodowska-Curie at the meeting of the International Committee of Intellectual Cooperation in 1921: 'In a free literary competition on the role and importance of elephants the Englishman's story was 'My adventures while shooting elephants in South Africa', the Frenchman was more concerned with 'The sexual and erotic life of elephants', while the Polish approach was invariably 'The elephant versus Poland's national independence', which seemed quite understandable in the light of over 120 years when Poland was partitioned and lost its independence. Since then this saying has become proverbial and came to express the unmistakably Polish tendency to see everything in terms of Polish interests. In my remarks and reminiscences on the history of the Polish Society of Medical Physics you will quickly recognize the same tendency. First, I will, among other things, try to open some old cupboards to 'produce good [things] from the store of good' (Matthew 12:35), especially concerning the first few years of the activity in medical physics in Poland, and second, I will draw some conclusions and/or offer suggestions based on what a senior medical physicist has seen for more than 50 years of his activity in this field. (author)

Level of empathy among medical students in Kuwait University, Kuwait.

Science.gov (United States)

Hasan, S; Al-Sharqawi, N; Dashti, F; AbdulAziz, M; Abdullah, A; Shukkur, M; Bouhaimed, M; Thalib, L

2013-01-01

To evaluate the level of empathy among medical students in Kuwait University Medical School and its association with sociodemographic factors, stress levels and personality. A cross-sectional survey of 264 medical students was conducted in the Faculty of Medicine, Kuwait University. Empathy levels were measured using the Jefferson Scale, personality was assessed using the Zuckerman-Kuhlman Personality Scale and the Perceived Stress Scale was used to measure stress levels. Factors associated with empathy were evaluated using t test/ANOVA for categorical variables and correlation for continuous predictors. Mean empathy score was 104.6 ± 16.3. Empathy scores were significantly associated with gender, year of study, mother's level of education, household income, satisfactory relationship with the mother and stress levels. Male medical students in their clinical years also had significantly lower empathy levels. However, factors such as grade point average, desired specialty, marital status of parents, father's educational level and relationship with father were not significantly (p > 0.05) associated with levels of empathy. Stress scores were significantly and positively associated with empathy (r = 0.13; p = 0.041). Medical students in Kuwait University had low empathy level and this may be a cause for concern; as such we suggest a possible inclusion of emphasis on empathy in the curriculum. Copyright © 2013 S. Karger AG, Basel.

Diagnostic reference levels in medical imaging

International Nuclear Information System (INIS)

Rosenstein, M.

2001-01-01

The paper proposes additional advice to national or local authorities and the clinical community on the application of diagnostic reference levels as a practical tool to manage radiation doses to patients in diagnostic radiology and nuclear medicine. A survey was made of the various approaches that have been taken by authoritative bodies to establish diagnostic reference levels for medical imaging tasks. There are a variety of ways to implement the idea of diagnostic reference levels, depending on the medical imaging task of interest, the national or local state of practice and the national or local preferences for technical implementation. The existing International Commission on Radiological Protection (ICRP) guidance is reviewed, the survey information is summarized, a set of unifying principles is espoused and a statement of additional advice that has been proposed to ICRP Committee 3 is presented. The proposed advice would meet a need for a unifying set of principles to provide a framework for diagnostic reference levels but would allow flexibility in their selection and use. While some illustrative examples are given, the proposed advice does not specify the specific quantities to be used, the numerical values to be set for the quantities or the technical details of how national or local authorities should implement diagnostic reference levels. (author)

Medication refusal in children with oppositional defiant disorder or conduct disorder and comorbid attention-deficit/hyperactivity disorder: medication history and clinical correlates.

Science.gov (United States)

Demidovich, Mark; Kolko, David J; Bukstein, Oscar G; Hart, Jonathan

2011-02-01

Abstract Objective: This study examines the characteristics of 96 children with attention-deficit/hyperactivity disorder (ADHD) and their families who refused a recommendation for medication as part of their treatment for disruptive disorders. The ADHD cases were taken from a sample of 139 youth (age 6-11) who were recruited for a clinical trial that compared the administration of a modular psychosocial treatment in an outpatient clinic or community settings. Medication management was an optional treatment module for children with ADHD in both conditions. Children who were (vs. were not) taking medication at intake, and children who accepted (vs. refused) medication recommendations during the study were compared on diagnostic and clinical measures related to child, school, parent, and family domains of functioning. Parents of 30% of the children refused study medication for ADHD. Parental medication acceptability and intake correlated highly with both medication history and study refusal of medication. Increased parental self-efficacy and emotional support for their youth correlated with medication refusal. No demographics and few child or school factors were associated with medication refusal. Medication use was associated with reductions in some key ADHD symptoms, but did not affect disruptive behaviors as did the psychosocial interventions. Medication refusers remain poorly understood but certain correlates, such as parental self-efficacy, parental emotional support for their youth, and medication acceptability, warrant further evaluation.

The effect of some medications given to CKD patients on vitamin D levels.

Science.gov (United States)

Yuste, Claudia; Quiroga, Borja; de Vinuesa, Soledad García; Goicoechea, Maria Angeles; Barraca, Daniel; Verdalles, Ursula; Luño, Jose

2015-01-01

Vitamin D deficiency and polypharmacy is a common problem over chronic kidney disease (CKD) population. To assess the clinical and analytical characteristics of CKD patients with 25-OH-D3 deficiency (<15 ng/mL), including the possible role of associated drugs. A single center observational review of 137 incident patients referred to our outpatient clinic with different stages of CKD and 25-OH-D3<15ng/mL (male gender 53.3%, mean age 70.8 [±16.1] years, mean GFR (MDRD-4) 43.6 [±25.5] ml/min/1.73 m²). 25-OH-D3 levels were collected in spring. Clinical and biochemical data and associated medications were recorded. Mean 25-OH-D3 levels were 8.23 [±4.03] ng/ml. Eighty-eight patients (64.7%) had 3 or more concomitant drugs. Only 7 patients (5.1%) were not receiving any medication. Patients were divided in three groups according the therapies into none (n=26), RAS inhibitors or allopurinol (n=81), and RAS inhibitors plus allopurinol (n=30); with the aim to study the influence of statin therapy. Patients under renin angiotensin (RAS) inhibitors or Allopurinol treatment presented significantly higher 25-OH-D3 levels (p=0.001 and p=0.01 respectively), however patients with Statins treatment had lower 25-OH-D3 level (p=0.039). Personal history of diabetes, cardiovascular events or other therapies did not modify 25-OH-D3 levels, adjusted by age and eGFR. CKD patients with vitamin D deficiency who received RAS inhibitors or Allopurinol treatment had higher 25-OH-D3 levels, however those with statins treatment had lower vitamin D levels. Randomized controlled trials are required to confirm these findings. Copyright © 2015. Published by Elsevier España, S.L.U.

Importance of philosophy of science to the history of medical thinking.

Science.gov (United States)

Zalewski, Z

1999-03-01

Popular approach to the history of medicine rests on naive assumptions that: 1) only the present state of medical knowledge can be counted as scientific and only those elements of the former knowledge and practice which fitted the body of contemporary science should be regarded by the historians of medicine (presentism); 2) medical sciences, like the other natural sciences, portray natural phenomena as they really are (naturalism); 3) progress in sciences consists of cumulative growth of information and explanation. The twentieth century philosophical critique of science revealed that none of these assumptions were true. Empirical facts, which are taken as a basis for any true knowledge, are dependent on the presumed theories; theories are intertwined into a broader socio-cultural context; theory-changing processes are caused by social factors rather than by the theoretical content. Therefore, it is a common task of historians of medicine and philosophers of science to reveal all theoretical and cultural premises on which our comprehension of the contemporary medicine is founded.

[[History of Community Health in Africa. The Swiss Medical Missionaries' Endeavour in South Africa].

Science.gov (United States)

Mabika, Hines

2015-01-01

It was not Dutch settlers nor British colonizers who introduced public and community health practice in north-eastern South Africa but medical doctors of the Swiss mission in southern Africa. While the history of medical knowledge transfer into 19th-20th century Africa emphasises colonial powers, this paper shows how countries without colonies contributed to expand western medical cultures, including public health. The Swiss took advantage of the local authorities' negligence, and implemented their own model of medicalization of African societies, understood as the way of improving health standards. They moved from a tolerated hospital-centred medicine to the practice of community health, which was uncommon at the time. Elim hospital's physicians moved back boundaries of segregationist policies, and sometime gave the impression of being involved in the political struggle against Apartheid. Thus, Swiss public health activities could later be seen as sorts of seeds that were planted and would partly reappear in 1994 with the ANC-projected national health policy.

[Teaching courses on aspects of medical history taking and communication skills in Germany: a survey among students of 12 medical faculties].

Science.gov (United States)

Schildmann, Jan; Kampmann, Margareta; Schwantes, Ulrich

2004-06-01

Good communication between patients and doctors has positive effects on health and the patients' quality of life. Communication skills can be trained. In many countries communication skills training is an important part of medical education and continuing medical education. In this study German medical students were questioned about current communication training. Questionnaires were sent to 28 Medical Schools in Germany and distributed in General Practice courses. Using Likert scales students were asked to rate both existing teaching courses on communication skills and their ability to communicate. 377 students of 12 Medical Schools participated in this study. Two Medical Schools offer teaching courses on communication skills as part of their regular curriculum. On a scale ranging from 1 (no such courses available) to 7 (courses fully available) students assessed the practical teaching of communication skills to be 3 (median). In addition, on a scale ranging from 1 to 7 students rated their general communication skills as 3 (median) and their ability of taking a sexual history and breaking bad news as 4 (median). Although these results are not representative, they give a general idea of communication skills teaching in Germany. During their clinical education students should be especially trained for difficult situations in the patient-doctor encounter. The international experience of other Medical Schools should be taken into account when implementing communication skills training as part of medical education.

Using medical history embedded in biometrics medical card for user identity authentication: privacy preserving authentication model by features matching.

Science.gov (United States)

Fong, Simon; Zhuang, Yan

2012-01-01

Many forms of biometrics have been proposed and studied for biometrics authentication. Recently researchers are looking into longitudinal pattern matching that based on more than just a singular biometrics; data from user's activities are used to characterise the identity of a user. In this paper we advocate a novel type of authentication by using a user's medical history which can be electronically stored in a biometric security card. This is a sequel paper from our previous work about defining abstract format of medical data to be queried and tested upon authentication. The challenge to overcome is preserving the user's privacy by choosing only the useful features from the medical data for use in authentication. The features should contain less sensitive elements and they are implicitly related to the target illness. Therefore exchanging questions and answers about a few carefully chosen features in an open channel would not easily or directly expose the illness, but yet it can verify by inference whether the user has a record of it stored in his smart card. The design of a privacy preserving model by backward inference is introduced in this paper. Some live medical data are used in experiments for validation and demonstration.

Using Medical History Embedded in Biometrics Medical Card for User Identity Authentication: Privacy Preserving Authentication Model by Features Matching

Directory of Open Access Journals (Sweden)

Simon Fong

2012-01-01

Full Text Available Many forms of biometrics have been proposed and studied for biometrics authentication. Recently researchers are looking into longitudinal pattern matching that based on more than just a singular biometrics; data from user’s activities are used to characterise the identity of a user. In this paper we advocate a novel type of authentication by using a user’s medical history which can be electronically stored in a biometric security card. This is a sequel paper from our previous work about defining abstract format of medical data to be queried and tested upon authentication. The challenge to overcome is preserving the user’s privacy by choosing only the useful features from the medical data for use in authentication. The features should contain less sensitive elements and they are implicitly related to the target illness. Therefore exchanging questions and answers about a few carefully chosen features in an open channel would not easily or directly expose the illness, but yet it can verify by inference whether the user has a record of it stored in his smart card. The design of a privacy preserving model by backward inference is introduced in this paper. Some live medical data are used in experiments for validation and demonstration.

Family history, not lack of medication use, is associated with the development of postpartum depression in a high-risk sample.

Science.gov (United States)

Kimmel, Mary; Hess, Edward; Roy, Patricia S; Palmer, Jennifer Teitelbaum; Meltzer-Brody, Samantha; Meuchel, Jennifer M; Bost-Baxter, Emily; Payne, Jennifer L

2015-02-01

We sought to determine clinical predictors of postpartum depression (PPD), including the role of medication, in a sample of women followed prospectively during and after pregnancy. Women with a history of mood disorder were recruited and evaluated during each trimester and 1 week, 1 month, and 3 months postpartum. DSM-IV criteria for a major depressive episode were assessed by a psychiatric interview at each time point. Sixty-three women with major depression and 30 women with bipolar disorder entered the study and 75.4 % met DSM-IV criteria for a MDE during pregnancy, postpartum, or both. We modeled depression in a given time period (second trimester, third trimester, or 1 month postpartum) as a function of medication use during the preceding period (first, second, or third trimester). The odds of being depressed for those who did not use medication in the previous period was approximately 2.8 times that of those who used medication (OR 2.79, 95 % CI 1.38-5.66, p = 0.0048). Of 38 subjects who were psychiatrically well during the third trimester, 39.5 % (N = 15) met the criteria for a MDE by 4 weeks postpartum. In women who developed PPD, there was a high rate of a family history of PPD (53.3 %) compared to women who did not develop PPD (11.8 %, p = 0.02). While the use of psychiatric medications during pregnancy reduced the odds of being depressed overall, the use of psychiatric medications during pregnancy may not protect against PPD in women at high risk, particularly those with a family history of PPD.

What goes around, comes around: a history of medical tuition*

Science.gov (United States)

Duffin, Jacalyn

2001-01-01

IN THIS ARTICLE THE ACTUAL AND RELATIVE COSTS OF TUITION AT 3 Ontario medical schools are traced over the past 150 years. In addition, the factors that led to Ontario's nearly 4-decade experiment in private medical education (and to its eventual demise) are presented. In relative terms, tuition was stable for over a century, then declined (after 1960) as government support rose. Access to medical training for students from middle-income families may also have improved steadily until the late 1980s. Because there is no shortage of people wanting to become doctors, there seems to be no limit to the price that could be set for a medical education. The recent hikes in tuition have outstripped inflation and may be reducing accessibility to restrictive levels, similar to those that prevailed in the 19th century. The author invites readers to question current trends. PMID:11202668

What goes around, comes around: a history of medical tuition.

Science.gov (United States)

Duffin, J

2001-01-09

In this article the actual and relative costs of tuition at 3 Ontario medical schools are traced over the past 150 years. In addition, the factors that led to Ontario's nearly 4-decade experiment in private medical education (and to its eventual demise) are presented. In relative terms, tuition was stable for over a century, then declined (after 1960) as government support rose. Access to medical training for students from middle-income families may also have improved steadily until the late 1980s. Because there is no shortage of people wanting to become doctors, there seems to be no limit to the price that could be set for a medical education. The recent hikes in tuition have outstripped inflation and may be reducing accessibility to restrictive levels, similar to those that prevailed in the 19th century. The author invites readers to question current trends.

Medical History in the Hellenic Journal of Nuclear Medicine.

Science.gov (United States)

Otte, Andreas

2017-01-01

The Hellenic Journal of Nuclear Medicine is about to celebrate its 20th anniversary end of 2017. On board of the editorial team since 2003, this journal has influenced me like a good friend over the many past years. From time to time, the journal has published interesting and valuable historical notes. They show that nuclear medicine has a history and that medicine is its basis. They also teach us today, and some of the ancient perspectives and approaches are still valid. The reader of HJNM may be interested in these historical contributions, as they are timeless. Therefore, it was our idea to summarize these in the following pages. Where there is a link to the free article, this is noted. Upon opening all articles, you will find out that these are a book or so of its own. In thanks to the editor-in-chief of the Journal for his continuing support on the historical section. Below we refer to the historical papers of the Journal: History of Nuclear Medicine. Nuclear Medicine and History of Science and Philosophy: Atomic Theory of the Matter. G.N. Sfakianakis, 2001; 4(3); 155-60. Editorial. Pioneers of nuclear medicine, Madame Curie. P.C. Grammaticos. 2004; 7(1); 29-30. http://nuclmed.web.auth.gr/ magazine/eng/jan04/editorial.htm Editor's note. Hippocrates' Oath. The editor. 2004; 7(1); 31. Editorial. Useful known and unknown views of the father of modern medicine, Hippocrates and his teacher Democritus. P. Grammaticos, A. Diamantis. 2008; 11(1): 2-4. http://nuclmed.web.auth.gr/magazine/eng/jan08/2.pdf Special Article. The contribution of Maria Sklodowska-Curie and Pierre Curie to Nuclear and Medical Physics. A hundred and ten years after the discovery of radium. A. Diamantis, E. Magiorkinis, 2008; 11(1): 33-8. http://nuclmed.web.auth.gr/magazine/ eng/jan08/33.pdf Brief Historical Review. Lymphatic system and lymphoscintigraphy. P. Valsamaki. 2009; 12(1): 87-89. http://nuclmed.web. auth.gr/magazine/eng/jan09/89.pdf (In Greek) Historical Review. The philosophic and

Internet use and its addiction level in medical students

Directory of Open Access Journals (Sweden)

Upadhayay N

2017-09-01

Full Text Available Namrata Upadhayay,1 Sanjeev Guragain2 1Department of Physiology; 2Department of Pharmacology, Gandaki Medical College, Pokhara Lekhnath, Nepal Objective: To compare the Internet addiction levels between male and female medical students.Methods: One hundred medical students (male: 50, female: 50 aged 17–30 years were included in a cross-sectional study. A standardized questionnaire was used to assess their Internet addiction level. Additionally, a self-designed questionnaire was used to identify the various purposes of Internet use among the students. The Internet addiction score (based on the Internet Addiction Test was compared between male and female students by using the Mann–Whitney U test (p≤0.05. After knowing their addiction level, we interviewed students to know if Internet use had any bad/good impact on their life. Results: The Internet Addiction Test scores obtained by the students were in the range of 11–70. Out of 100 students, 21 (male: 13, female: 8 were found to be slightly addicted to the Internet. The remaining 79 students were average online users. There was no significant difference between male and female students in the addiction level (score. However, males were more addicted than females. The major use of Internet was to download and watch movies and songs and to communicate with friends and family (76/100. Some students (24/100 used the Internet to assess information that helped them in their educational and learning activities. Some students mentioned that overuse of the Internet lead to insufficient amounts of sleep and affected their concentration levels in the classroom during lectures.Conclusion: Medical students are experiencing problems due to Internet overuse. They experience poor academic progress and lack of concentration while studying. The main use of the Internet was for entertainment and to communicate with friends and family. Keywords: addiction, Internet, medical students, entertainment

Argentina enacts first law on medical use of the cannabis plant. History and perspectives

Directory of Open Access Journals (Sweden)

Eduardo L De Vito

2017-10-01

Full Text Available In the last few years, great expectations have risen in the society concerning the eventual therapeutic usefulness of compounds derived from the cannabis plant. It is well known that these compounds are being used in treating certain health conditions, either through medical prescription or self-administration. Extreme opinions range from believing that it is a harmful and dangerous drug to sustaining that it is a panacea. However, the sheer existence of an endocannabinoid system in the brain compels us to study its dimensions and derivations thoroughly. It is expected that controversies and knowledge gaps will be clarified within the framework of this new law. Prohibitionism should not be a category of analysis. Regardless of the therapeutic effects of cannabinoid compounds, demonstrated or to be demonstrated, there are already severe restrictions on their use, which mirror the still existing restrictions to the use of opioids (drugs of definite utility but on which a huge taboo persists. This review presents the first Argentine law on the medical use of cannabis. Milestones in the history of marijuana at the national level are pointed out, which are inextricably linked to world trends either in favor or against prohibition. The current status of the use of cannabis oil in the country and evidences for its therapeutic value are also analyzed. Evidences on its therapeutic value are also analyzed as well as the current status of the use of cannabis oil in our country.

Observable phenomena that reveal medical students' clinical reasoning ability during expert assessment of their history taking: a qualitative study.

Science.gov (United States)

Haring, Catharina M; Cools, Bernadette M; van Gurp, Petra J M; van der Meer, Jos W M; Postma, Cornelis T

2017-08-29

During their clerkships, medical students are meant to expand their clinical reasoning skills during their patient encounters. Observation of these encounters could reveal important information on the students' clinical reasoning abilities, especially during history taking. A grounded theory approach was used to analyze what expert physicians apply as indicators in their assessment of medical students' diagnostic reasoning abilities during history taking. Twelve randomly selected clinical encounter recordings of students at the end of the internal medicine clerkships were observed by six expert assessors, who were prompted to formulate their assessment criteria in a think-aloud procedure. These formulations were then analyzed to identify the common denominators and leading principles. The main indicators of clinical reasoning ability were abstracted from students' observable acts during history taking in the encounter. These were: taking control, recognizing and responding to relevant information, specifying symptoms, asking specific questions that point to pathophysiological thinking, placing questions in a logical order, checking agreement with patients, summarizing and body language. In addition, patients' acts and the course, result and efficiency of the conversation were identified as indicators of clinical reasoning, whereas context, using self as a reference, and emotion/feelings were identified by the clinicians as variables in their assessment of clinical reasoning. In observing and assessing clinical reasoning during history taking by medical students, general and specific phenomena to be used as indicators for this process could be identified. These phenomena can be traced back to theories on the development and the process of clinical reasoning.

Medical conditions, family history of cancer, and the risk of biliary tract cancers.

Science.gov (United States)

Rosato, Valentina; Bosetti, Cristina; Dal Maso, Luigino; Montella, Maurizio; Serraino, Diego; Negri, Eva; La Vecchia, Carlo

2016-06-02

Scanty data exist on the role of personal medical conditions, except for gallstones, and family history of cancer on the risk of biliary tract cancers (BTC). We analyzed this issue using data from two Italian case-control studies, including 159 cases of BTC and 795 matched hospital controls. Odds ratios (ORs) of BTC and corresponding 95% confidence intervals (CIs) were estimated using multiple logistic regression models. Gallstones were associated with a 2-fold excess risk of BTC (95% CI 1.24-3.45). No significant associations were observed with other conditions investigated, including diabetes (OR 1.15, 95% CI 0.63-2.11), hypertension (OR 0.65, 95% CI 0.39-1.11), hyperlipidemia (OR 0.61, 95% CI 0.31-1.21), allergy (OR 0.64, 95% CI 0.29-1.40), gastroduodenal ulcer (OR 0.52, 95% CI 0.24-1.12), hepatitis (OR 2.02, 95% CI 0.35-11.67), benign thyroid diseases (OR 1.16, 95% CI 0.56-2.40), hysterectomy (OR 1.19, 95% CI 0.53-2.68), unilateral oophorectomy (OR 1.75, 95% CI 0.44-6.93), and bilateral oophorectomy (OR 2.48, 95% CI 0.79-7.82). We found an excess risk of BTC in relation to family history of any cancer (OR 1.52, 95% CI 1.03-2.24) and family history of gallbladder cancer (OR 3.83, 95% CI 0.59-24.75). The present study confirms a strong association between BTC and history of gallstones, and provides further evidence of a positive association with family history of cancer.

Job insecurity and the use of antidepressant medication among Danish employees with and without a history of prolonged unemployment: a 3.5-year follow-up study

DEFF Research Database (Denmark)

Rugulies, R; Thielen, K; Nygaard, E

2010-01-01

A study was undertaken to investigate whether job insecurity predicts incident use of antidepressant medication and whether the association is modified by a history of prolonged unemployment.......A study was undertaken to investigate whether job insecurity predicts incident use of antidepressant medication and whether the association is modified by a history of prolonged unemployment....

A history of the INTERNIST-1 and Quick Medical Reference (QMR) computer-assisted diagnosis projects, with lessons learned.

Science.gov (United States)

Miller, R A

2010-01-01

The INTERNIST-1/Quick Medical Reference (QMR) diagnostic decision support project spans four decades, from 1971-onward. This paper describes the history of the project and details insights gained of relevance to the general clinical and informatics communities.

The choice of surgical specialization by medical students and their syncopal history.

Science.gov (United States)

Rudnicki, Jerzy; Zyśko, Dorota; Kozłowski, Dariusz; Kuliczkowski, Wiktor; Koźluk, Edward; Lelonek, Małgorzata; Piątkowska, Agnieszka; Gajek, Jacek; Negrusz-Kawecka, Marta; Agrawal, Anil Kumar

2013-01-01

The aim of the study was to assess whether medical students' fainting outside the university or while witnessing surgical procedures and/or autopsies influenced their choice of a specialization. The study group consisted of 605 medical students (from fourth to sixth year of study) from five medical universities in Poland (325 women, 212 men and 8 responders of an unspecified gender). The median age of subjects studied was 23 years, and the interquartile range was 23-24 years. The students at each university were chosen randomly by the author who worked there and had contact with them. An anonymous questionnaire was developed to gather information regarding demographics, the specialization which each student wanted to choose, the syncope occurrence in the medical history, the syncope and presyncope occurrence during surgery and autopsy as well as the syncopal events' characteristics. The group of 15% of women and 30% of men declared to have pursued the surgical specialization (P<0.001), 29% of women and 56% of men declared the intention to pursue an invasive specialization (P<0.001). As many as 36.0% of women studied and 13.1% of men studied reported syncopal spells outside university (P<0.001). Only 41 students (6.8%) reported that syncope or presyncope in any studied circumstances had an impact on their specialization choice. The multivariate analysis showed that the choice of surgical specialization is related to the male gender and the absence of syncopal spells outside the university. Syncopal and presyncopal spells may affect the professional choices of the medical students. The male gender and a lack of syncope occurrence outside operating room are related to the choice of surgical specialization.

Radiology Physician Extenders: A Literature Review of the History and Current Roles of Physician Extenders in Medical Imaging.

Science.gov (United States)

Sanders, Vicki L; Flanagan, Jennifer

2015-01-01

The purpose of the literature review was to assess the origins of radiology physician extenders and examine the current roles found in the literature of advanced practice physician extenders within medical imaging. Twenty-six articles relating to physician assistants (PAs), nurse practitioners (NPs), radiologist assistants (RAs), and nuclear medicine advanced associates (NMAAs) were reviewed to discern similarities and differences in history, scope of practice, and roles in the medical imaging field. The literature showed PAs and NPs are working mostly in interventional radiology. PAs, NPs, and RAs perform similar tasks in radiology, including history and physicals, evaluation and management, preprocedure work-up, obtaining informed consent, initial observations/reports, and post-procedure follow-up. NPs and PAs perform a variety of procedures but most commonly vascular access, paracentesis, and thoracentesis. RAs perform gastrointestinal, genitourinary, nonvascular invasive fluoroscopy procedures, and vascular access procedures. The review revealed NMAAs are working in an advanced role, but no specific performances of procedures was found in the literature, only suggested tasks and clinical competencies. PAs, NPs, and RAs are currently the three main midlevel providers used in medical imaging. These midlevel providers are being used in a variety of ways to increase the efficiency of the radiologist and provide diagnostic and therapeutic radiologic procedures to patients. NMAAs are being used in medical imaging but little literature is available on current roles in clinical practice. More research is needed to assess the exact procedures and duties being performed by these medical imaging physician extenders.

Reflex syncope, anxiety level, and family history of cardiovascular disease in young women: case-control study.

Science.gov (United States)

Zyśko, D; Szewczuk-Bogusławska, M; Kaczmarek, M; Agrawal, A K; Rudnicki, J; Gajek, J; Melander, O; Sutton, R; Fedorowski, A

2015-02-01

Anxiety is an emotion, which stimulates sympathetic nervous outflow potentially facilitating vasovagal reflex syncope (VVS) but reports on anxiety levels in patients with VVS are sparse. We studied anxiety levels in young women (21-40 years) referred for unexplained transient loss of consciousness (TLOC), and age-matched female controls with or without past history of TLOC (≈probable VVS). Referred patients underwent head-up tilt (HUT) according to current ESC Guidelines. State and Trait Anxiety Inventory questionnaire evaluated anxiety levels plus a questionnaire explored risk factors for cardiovascular disease (CVD). Sixty-five of 91 women were diagnosed with VVS on HUT. Among 549 controls, 223 (40.6%) reported at least one episode of TLOC. State-anxiety level in patients with VVS undergoing HUT (42.4 ± 9.3) was higher compared with both controls with (38.3 ± 10.2; P < 0.01) and without past TLOC history (35.9 ± 9.8; P < 0.001). Trait anxiety in patients with VVS (42.7 ± 8.4), and controls with TLOC history (42.4 ± 8.4) was higher compared with controls without TLOC history (39.7 ± 8.5; P < 0.01). In the logistic regression using controls without TLOC as reference, both VVS diagnosis and past history of TLOC were associated with family history of CVD [odds ratio (OR) 2.4, 95% confidence interval (CI), 1.3-4.4; P = 0.007, and 2.3, 1.4-3.6; P = 0.001, respectively], and this association was independent of anxiety level. Trait anxiety and family history of CVD are increased in both young women with VVS and controls with history of TLOC. However, the height of anxiety level does not explain CVD heredity and other mechanisms may link syncope with CVD. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.

Relationship Between Tetanus Antitoxin Titration Level and Vaccination History

OpenAIRE

Işıkgöz Taşbakan, Meltem; Durusoy, Raika; Tosun, Selma

2017-01-01

Objectives: We aimed to determine tetanus antitoxin levels and to evaluate their relationship with history of vaccination among patients applying to the outpatient clinics of a University hospital. Methods: A questionnaire including socio-demographic characteristics and tetanus vaccination status was applied and blood samples taken from 218 subjects between 1 and 30 June 2015. Participants were classified into five groups according to their vaccination timing. Results: The mean age of...

Best possible medication history for hemodialysis patients obtained by a pharmacy technician.

Science.gov (United States)

Leung, Marianna; Jung, Joanne; Lau, Wynnie; Kiaii, Mercedeh; Jung, Beverly

2009-09-01

Outpatients undergoing hemodialysis are at high risk for adverse drug events. Limited resources make it challenging for pharmacists to routinely obtain a best possible medication history (BPMH). The primary objective was to determine whether, for patients undergoing hemodialysis, a pharmacy technician has the skills to obtain a BPMH that would allow a pharmacist to identify drug-related problems. The secondary objectives were to determine the number and types of medication discrepancies and drug-related problems identified and the time required by the technician to complete the BPMH. All patients treated in the hemodialysis unit during the study period were included, except for those who required an interpreter or were unable to participate in an in-person interview. A single technician was taught how to interview patients according to a structured format. For each patient, the technician's BMPH was verified by a pharmacist. The agreement rate between technician and pharmacists was determined, along with the number and types of discrepancies and drug-related problems identified. The technician interviewed 99 patients. Of the 1334 medication orders reviewed, the technician and pharmacists agreed on all but 15 (agreement rate 98.9%). A total of 358 medication discrepancies were noted for 93 patients (3.8 discrepancies per patient). Of these, 210 (59%) were undocumented intentional discrepancies, and 148 (41%) were unintentional discrepancies (most commonly errors of commission). Of the 135 drug-related problems identified, the majority involved dosing problems or nonadherence. The technician required an average of 17 min for each interview. An adequately trained technician was capable of interviewing patients to create a BPMH. A variety of medication discrepancies and drug-related problems were identified. Generation of a BPMH by a technician is a useful approach allowing pharmacists to identify drug-related problems.

The choice of surgical specialization by medical students and their syncopal history.

Directory of Open Access Journals (Sweden)

Jerzy Rudnicki

Full Text Available BACKGROUND: The aim of the study was to assess whether medical students' fainting outside the university or while witnessing surgical procedures and/or autopsies influenced their choice of a specialization. MATERIALS AND METHODS: The study group consisted of 605 medical students (from fourth to sixth year of study from five medical universities in Poland (325 women, 212 men and 8 responders of an unspecified gender. The median age of subjects studied was 23 years, and the interquartile range was 23-24 years. The students at each university were chosen randomly by the author who worked there and had contact with them. An anonymous questionnaire was developed to gather information regarding demographics, the specialization which each student wanted to choose, the syncope occurrence in the medical history, the syncope and presyncope occurrence during surgery and autopsy as well as the syncopal events' characteristics. RESULTS: The group of 15% of women and 30% of men declared to have pursued the surgical specialization (P<0.001, 29% of women and 56% of men declared the intention to pursue an invasive specialization (P<0.001. As many as 36.0% of women studied and 13.1% of men studied reported syncopal spells outside university (P<0.001. Only 41 students (6.8% reported that syncope or presyncope in any studied circumstances had an impact on their specialization choice. The multivariate analysis showed that the choice of surgical specialization is related to the male gender and the absence of syncopal spells outside the university. CONCLUSIONS: Syncopal and presyncopal spells may affect the professional choices of the medical students. The male gender and a lack of syncope occurrence outside operating room are related to the choice of surgical specialization.

Observable phenomena that reveal medical students' clinical reasoning ability during expert assessment of their history taking: a qualitative study

NARCIS (Netherlands)

Haring, C.M.; Cools, B.M.; Gurp, P.J.M. van; Meer, J.W.M. van der; Postma, C.T.

2017-01-01

BACKGROUND: During their clerkships, medical students are meant to expand their clinical reasoning skills during their patient encounters. Observation of these encounters could reveal important information on the students' clinical reasoning abilities, especially during history taking. METHODS: A

"Modern medical science and the divine providence of god": rethinking the place of religion in postwar U.S. medical history.

Science.gov (United States)

Golden, Janet; Abel, Emily K

2014-10-01

Drawing on a large cache of letters to John and Frances Gunther after the death of their son as well as memoirs and fiction by bereaved parents, this essay challenges the assumptions of secularization that infuse histories of twentieth-century American medicine. Many parents who experienced the death of children during the postwar period relied heavily on religion to help make sense of the tragedies medicine could not prevent. Parental accounts included expression of belief in divine intervention and the power of prayer, gratitude for God's role in minimizing suffering, confidence in the existence of an afterlife, and acceptance of the will of God. Historians seeking to understand how parents and families understood both the delivery of medical care and the cultural authority of medical science must integrate an understanding of religious experiences and faith into their work. © The Author 2013. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Prediction of hemoglobin levels in whole blood donors: how to model donation history

NARCIS (Netherlands)

Baart, A.M.; Vergouwe, Y.; Atsma, F.; Moons, K.G.; Kort, W.L. de

2014-01-01

BACKGROUND: Recently, prediction models for hemoglobin (Hb) deferral risk have been developed. These models consider the previous Hb level plus change in Hb. Here, we investigated if the performance of models could be improved by considering more information on Hb level history. STUDY DESIGN AND

Levels of Distress in Women With a Family History of Ovarian Cancer

National Research Council Canada - National Science Library

Kash, Kathryn

2005-01-01

The overall goal of this study is to determine the levels of distress in women with a family history of ovarian cancer and to identify the mediating factors between risk of developing ovarian cancer...

Medical history, lifestyle, family history, and occupational risk factors for adult acute lymphocytic leukemia: the InterLymph Non-Hodgkin Lymphoma Subtypes Project.

Science.gov (United States)

Skibola, Christine F; Slager, Susan L; Berndt, Sonja I; Lightfoot, Tracy; Sampson, Joshua N; Morton, Lindsay M; Weisenburger, Dennis D

2014-08-01

Acute lymphoblastic leukemia/lymphoma (ALL) in adults is a rare malignancy with a poor clinical outcome, and few reported etiologic risk factors. We performed an exploratory pooled study of 152 ALL cases and 23096 controls from 16 case-control studies to investigate the role of medical history, lifestyle, family history, and occupational risk factors and risk of ALL. Age- race/ethnicity-, sex-, and study-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression. An increased risk of ALL was found in those with a family history of a hematological malignancy (OR = 2.6, 95% CI = 1.22 to 5.54) and in leather (OR = 3.91, 95% CI = 1.35 to 11.35) and sewing/embroidery workers (OR = 2.92, 95% CI = 1.00 to 8.49). Consumers of alcohol had an increased risk of B-cell ALL (OR = 2.87, 95% CI = 1.18 to 6.95). The small number of statistically significant risk factors identified out of the 112 variables examined could be chance findings and will require further replication to assess their role in the etiology of adult ALL. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Levels of Distress in Women With a Family History of Ovarian Cancer

National Research Council Canada - National Science Library

Kash, Kathryn

2001-01-01

The overall goal of this study is to determine the levels of distress in women with a family history of ovarian cancer and to identify the mediating factors between risk of developing ovarian cancer and distress...

Fish consumption and its motives in households with versus without self-reported medical history of CVD: A consumer survey from five European countries

Directory of Open Access Journals (Sweden)

Brunsø Karen

2008-09-01

Full Text Available Abstract Background The purpose of this study was to explore the cross-cultural differences in the frequency of fish intake and in motivations for fish consumption between people from households with (CVD+ or without (CVD- medical history of cardiovascular disease, using data obtained in five European countries. Methods A cross-sectional consumer survey was carried out in November-December 2004 with representative household samples from Belgium, the Netherlands, Denmark, Poland and Spain. The sample consisted of 4,786 respondents, aged 18–84 and who were responsible for food purchasing and cooking in the household. Results Individuals from households in the CVD+ group consumed fish more frequently in Belgium and in Denmark as compared to those in the CVD- group. The consumption of fatty fish, which is the main sources of omega-3 PUFA associated with prevention of cardiovascular diseases, was on the same level for the two CVD groups in the majority of the countries, except in Belgium where CVD+ subjects reported to eat fatty fish significantly more frequently than CVD- subjects. All respondents perceived fish as a very healthy and nutritious food product. Only Danish consumers reported a higher subjective and objective knowledge related to nutrition issues about fish. In the other countries, objective knowledge about fish was on a low level, similar for CVD+ as for CVD- subjects, despite a higher claimed use of medical information sources about fish among CVD+ subjects. Conclusion Although a number of differences between CVD- and CVD+ subjects with respect to their frequency of fish intake are uncovered, the findings suggest that fish consumption traditions and habits – rather than a medical history of CVD – account for large differences between the countries, particularly in fatty fish consumption. This study exemplifies the need for nutrition education and more effective communication about fish, not only to the people facing chronic

The accuracy of self-reported medical history: a preliminary analysis of the promise of internet-based research in Inflammatory Bowel Diseases.

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Kelstrup, Anne Mette; Juillerat, Pascal; Korzenik, Joshua

2014-05-01

Internet-based surveys provide a potentially important tool for Inflammatory Bowel Disease (IBD) research. The advantages include low cost, large numbers of participants, rapid study completion and less extensive infrastructure than traditional methods. The aim was to determine the accuracy of patient self-reporting in internet-based IBD research and identify predictors of greater reliability. 197 patients from a tertiary care center answered an online survey concerning personal medical history and an evaluation of disease specific knowledge. Self-reported medical details were compared with data abstracted from medical records. Agreement was assessed by kappa (κ) statistics. Participants responded correctly with excellent agreement (κ=0.96-0.97) on subtype of IBD and history of surgery. The agreement was also excellent for colectomy (κ=0.88) and small bowel resection (κ=0.91), moderate for abscesses and fistulas (κ=0.60 and 0.63), but poor regarding partial colectomy (κ=0.39). Time since last colonoscopy was self-reported with better agreement (κ=0.84) than disease activity. For disease location/extent, moderate agreements at κ=69% and 64% were observed for patients with Crohn's disease and ulcerative colitis, respectively. Subjects who scored higher than the average in the IBD knowledge assessment were significantly more accurate about disease location than their complementary group (74% vs. 59%, p=0.02). This study demonstrates that IBD patients accurately report their medical history regarding type of disease and surgical procedures. More detailed medical information is less reliably reported. Disease knowledge assessment may help in identifying the most accurate individuals and could therefore serve as validity criteria. Internet-based surveys are feasible with high reliability about basic disease features only. However, the participants in this study were engaged at a tertiary center, which potentially leads to a bias and compromises generalization to

Entry to medical schools with 'A' level in mathematics rather than biology.

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Spurgin, C B

1975-09-01

The majority of British medical schools now accept for their shortest courses students who have mathematics at A level in place of the former requirement of biology A level. Only a small fraction of the entry, less than one-fifth, enters this way, in spite of statements by most medical schools that they make no distinction between those with mathematics and those with biology when making conditional offers of places. There is no evidence that those without biology are at a disadvantage in the courses. If the prospects of entry without A level biology were better publicized medical schools would have a wider field of possibly abler entrants, and pupils entering sixth forms could defer for a year a choice between a medical (or dental) career and one involving physical science, engineering, or other mathematics-based university education.

Analysis of differences in exercise recognition by constraints on physical activity of hospitalized cancer patients based on their medical history.

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Choi, Mi-Ri; Jeon, Sang-Wan; Yi, Eun-Surk

2018-04-01

The purpose of this study is to analyze the differences among the hospitalized cancer patients on their perception of exercise and physical activity constraints based on their medical history. The study used questionnaire survey as measurement tool for 194 cancer patients (male or female, aged 20 or older) living in Seoul metropolitan area (Seoul, Gyeonggi, Incheon). The collected data were analyzed using frequency analysis, exploratory factor analysis, reliability analysis t -test, and one-way distribution using statistical program SPSS 18.0. The following results were obtained. First, there was no statistically significant difference between cancer stage and exercise recognition/physical activity constraint. Second, there was a significant difference between cancer stage and sociocultural constraint/facility constraint/program constraint. Third, there was a significant difference between cancer operation history and physical/socio-cultural/facility/program constraint. Fourth, there was a significant difference between cancer operation history and negative perception/facility/program constraint. Fifth, there was a significant difference between ancillary cancer treatment method and negative perception/facility/program constraint. Sixth, there was a significant difference between hospitalization period and positive perception/negative perception/physical constraint/cognitive constraint. In conclusion, this study will provide information necessary to create patient-centered healthcare service system by analyzing exercise recognition of hospitalized cancer patients based on their medical history and to investigate the constraint factors that prevents patients from actually making efforts to exercise.

History of Aral Sea level variability and current scientific debates

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Cretaux, Jean-François; Letolle, René; Bergé-Nguyen, Muriel

2013-11-01

The Aral Sea has shrunk drastically over the past 50 years, largely due to water abstraction from the Amu Darya and Syr Darya rivers for land irrigation. Over a longer timescale, Holocene palaeolimnological reconstruction of variability in water levels of the Aral Sea since 11,700 BP indicates a long history of alternating phases of regression and transgression, which have been attributed variously to climate, tectonic and anthropogenic forcing. The hydrological history of the Aral Sea has been investigated by application of a variety of scientific approaches, including archaeology, palaeolimnological palaeoclimate reconstruction, geophysics, sedimentology, and more recently, space science. Many issues concerning lake level variability over the Holocene and more recent timescales, and the processes that drive the changes, are still a matter for active debate. Our aim in this article is to review the current debates regarding key issues surrounding the causes and magnitude of Aral Sea level variability on a variety of timescales from months to thousands of years. Many researchers have shown that the main driving force of Aral Sea regressions and transgressions is climate change, while other authors have argued that anthropogenic forcing is the main cause of Aral Sea water level variations over the Holocene. Particular emphasis is made on contributions from satellite remote sensing data in order to improve our understanding of the influence of groundwater on the current hydrological water budget of the Aral Sea since 2005. Over this period of time, water balance computation has been performed and has shown that the underground water inflow to the Aral Sea is close to zero with an uncertainty of 3 km3/year.

Comparison of Pilot Medical History and Medications Found In Postmortem Specimens

National Research Council Canada - National Science Library

Canfield, Dennis V; Salazar, Guillermo J; Lewis, Russell J; Whinnery, James E

2006-01-01

Pilots are required by FAA regulations to report all medications and medical conditions to the FAA Office of Aerospace Medicine for review as to the overall suitability of the pilot for flight activities...

Low plasma eicosapentaenoic acid levels are associated with elevated trait aggression and impulsivity in major depressive disorder with a history of comorbid substance use disorder.

Science.gov (United States)

Beier, Anne Mette; Lauritzen, Lotte; Galfalvy, Hanga C; Cooper, Thomas B; Oquendo, Maria A; Grunebaum, Michael F; Mann, J John; Sublette, M Elizabeth

2014-10-01

Major depressive disorder (MDD) is associated with low levels of omega-3 polyunsaturated fatty acids (PUFAs), holding promise for new perspectives on disease etiology and treatment targets. As aggressive and impulsive behaviors are associated with low omega-3 PUFA levels in some clinical contexts, we investigated plasma PUFA relationships with trait aggression and impulsivity in patients with MDD. Medication-free MDD patients (n = 48) and healthy volunteers (HV, n = 35) were assessed with the Brown-Goodwin Aggression Inventory. A subset (MDD, n = 39; HV, n = 33) completed the Barratt Impulsiveness Scale. Plasma PUFAs eicosapentaenoic acid (EPA, 20:5n-3), docosahexaenoic acid (DHA, 22:6n-3), and arachidonic acid (AA, 20:4n-6) were quantified and ln-transformed to mitigate distributional skew. Ln-transformed PUFA (lnPUFA) levels were predictors in regression models, with aggression or impulsivity scores as outcomes, and cofactors of sex and diagnostic status (MDD with or without a history of substance use disorder [SUD], or HV). Interactions were tested between relevant PUFAs and diagnostic status. Additional analyses explored possible confounds of depression severity, self-reported childhood abuse history, and, in MDD patients, suicide attempt history. Among PUFA, lnEPA but not lnDHA predicted aggression (F1,76 = 12.493, p = 0.001), and impulsivity (F1,65 = 5.598, p = 0.021), with interactions between lnEPA and history of SUD for both aggression (F1,76 = 7.941, p = 0.001) and impulsivity (F1,65 = 3.485, p = 0.037). Results remained significant when adjusted for childhood abuse, depression severity, or history of suicide attempt. In conclusion, low EPA levels were associated with aggression and impulsivity only in patients with MDD and comorbid SUD, even though in most cases SUD was in full sustained remission. Copyright © 2014 Elsevier Ltd. All rights reserved.

Internet use and its addiction level in medical students.

Science.gov (United States)

Upadhayay, Namrata; Guragain, Sanjeev

2017-01-01

To compare the Internet addiction levels between male and female medical students. One hundred medical students (male: 50, female: 50) aged 17-30 years were included in a cross-sectional study. A standardized questionnaire was used to assess their Internet addiction level. Additionally, a self-designed questionnaire was used to identify the various purposes of Internet use among the students. The Internet addiction score (based on the Internet Addiction Test) was compared between male and female students by using the Mann-Whitney U test ( p ≤0.05). After knowing their addiction level, we interviewed students to know if Internet use had any bad/good impact on their life. The Internet Addiction Test scores obtained by the students were in the range of 11-70. Out of 100 students, 21 (male: 13, female: 8) were found to be slightly addicted to the Internet. The remaining 79 students were average online users. There was no significant difference between male and female students in the addiction level (score). However, males were more addicted than females. The major use of Internet was to download and watch movies and songs and to communicate with friends and family (76/100). Some students (24/100) used the Internet to assess information that helped them in their educational and learning activities. Some students mentioned that overuse of the Internet lead to insufficient amounts of sleep and affected their concentration levels in the classroom during lectures. Medical students are experiencing problems due to Internet overuse. They experience poor academic progress and lack of concentration while studying. The main use of the Internet was for entertainment and to communicate with friends and family.

Lithostratigraphy, depositional history and sea level changes of the Cauvery Basin, southern India

Directory of Open Access Journals (Sweden)

Muthuvairvasamy Ramkumar

2003-01-01

Full Text Available The sedimentary sequence exposed in the erstwhile Tiruchirapalli district hosts a more or less complete geological record of the Upper Cretaceous-Tertiary period. Systematic field mapping, collation of data on the micro-meso scale lithology, sedimentary structures, petrography, faunal assemblage and facies relationships of these rocks, in the light of modern stratigraphic concepts, helped to enumerate the lithostratigraphic setup and depositional history of the basin. Spatial and temporal variations of the lithologies and revised stratigraphic units are presented in this paper. Many high frequency sea level cycles (presumably fourth or higher order which stack up to form third order sea level cycles (six in number, which in turn form part of second order cycles (two in number, including seven eustatic sea level peaks, have been recorded in this basin. Trend analysis of sea level curves indicates a gradual increase of the sea level from Barremian to Coniacian and a gradual decrease from Coniacian to Danian. Such lasting sea level trends had their influence on the sedimentation pattern and facies association. It is inferred that depositional bathymetry was maintained at a shallow-moderate level, primarily influenced by a lack of major subsidence during the depositional history of this basin. The study also revealed a prevalent simple basin filling process and dominant control by sea level changes, rather than tectonic movements over the depositional regime.

Strategic management of Public Hospitals' medical services.

Science.gov (United States)

Hao, Aimin; Yi, Tao; Li, Xia; Wei, Lei; Huang, Pei; Xu, Xinzhou; Yi, Lihua

2016-01-01

Purpose: The quality of medical services provided by competing public hospitals is the primary consideration of the public in determining the selection of a specific hospital for treatment. The main objective of strategic planning is to improve the quality of public hospital medical services. This paper provides an introduction to the history, significance, principles and practices of public hospital medical service strategy, as well as advancing the opinion that public hospital service strategy must not merely aim to produce but actually result in the highest possible level of quality, convenience, efficiency and patient satisfaction.

Accuracy of family history of cancer : clinical genetic implications

NARCIS (Netherlands)

Sijmons, RH; Boonstra, AE; Reefhuis, J; Hordijk-Hos, JM; de Walle, HEK; Oosterwijk, JC; Cornel, MC

Family medical history is the cornerstone of clinical genetic diagnosis and management in cases of familial cancer. The soundness of medical decisions can be compromised if reports by the family on affected relatives are inaccurate. Although very time consuming, family medical histories are

Medical ethics in an era of bioethics: resetting the medical profession's compass.

Science.gov (United States)

Pellegrino, Edmund D

2012-02-01

What it means to be a medical professional has been defined by medical ethicists throughout history and remains a contemporary concern addressed by this paper. A medical professional is generally considered to be one who makes a public promise to fulfill the ethical obligations expressed in the Hippocratic Code. This presentation summarizes the history of medical professionalism and refocuses attention on the interpersonal relationship of doctor and patient. This keynote address was delivered at the Founders of Bioethics International Congress (June, 2010).

The role of translation in undergraduate medical English instruction

Directory of Open Access Journals (Sweden)

Sofija Micic

2008-10-01

Full Text Available For most of its history of undergraduate medical English instruction at Belgrade University, translation was a major part of teaching and assessment. Educational reforms in the early 21st century resulted in a shift towards content-based instruction with the focus on reading comprehension and less translation. The paper analyses the new role of translation in the reformed Serbian curriculum. A brief history of Medical English instruction is outlined. The role of lexicon and the level of discourse within the teaching of English translation in the Serbian curriculum are explored. Some suggestions for the improvement of medical English translation in the Serbian curriculum are offered. It has been shown that translation is a valuable skill to be mastered. Translation exercises allow instructors to recognize language-related comprehension problems. Furthermore, teaching translation is important in that future medical professionals are able to recognize different medical genres and structural differences between English and Serbian.

TERMITES ENDANGERED TRADITIONAL MEDICAL PLANTS

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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.

[Medical manuscripts in the library of the Deontology Department of the Ankara University Medical School].

Science.gov (United States)

Arda, B

1998-01-01

At every academical platform on medical history and its instruction, lack of Turkish medical historiography is mainly emphasized. There are two main factors determining the situation: 1-There isn't any comprehensive Turkish medical history textbook. 2-There are difficulties in reaching the primary sources in this field. Everybody agrees with the importance of reaching medical manuscripts easily and reading and evaluating them in medical history. For this reason, it is important to know where we can find them. In this article, medical manuscripts which are available in the library of the Deontology Department of Ankara University Medical School are introduced. The manuscripts have been listed in alphabetical order of the authors' name. The bibliographic items, such as the size, writing style, and type of paper used, are mentioned.

A state-level analysis of the economic impacts of medical tourism in Malaysia

NARCIS (Netherlands)

Klijs, J.; Ormond, M.E.; Mainil, T.; Peerlings, J.H.M.; Heijman, W.J.M.

2016-01-01

In Malaysia, a country that ranks among the world's most recognised medical tourism destinations, medical tourism is identified as a potential economic growth engine for both medical and non-medical sectors. A state-level analysis of economic impacts is important, given differences between states in

Relationship between family history of alcohol addiction, parents' education level, and smartphone problem use scale scores.

Science.gov (United States)

Beison, Ashley; Rademacher, David J

2017-03-01

Background and aims Smartphones are ubiquitous. As smartphones increased in popularity, researchers realized that people were becoming dependent on their smartphones. The purpose here was to provide a better understanding of the factors related to problematic smartphone use (PSPU). Methods The participants were 100 undergraduates (25 males, 75 females) whose ages ranged from 18 to 23 (mean age = 20 years). The participants completed questionnaires to assess gender, ethnicity, year in college, father's education level, mother's education level, family income, age, family history of alcoholism, and PSPU. The Family Tree Questionnaire assessed family history of alcoholism. The Mobile Phone Problem Use Scale (MPPUS) and the Adapted Cell Phone Addiction Test (ACPAT) were used to determine the degree of PSPU. Whereas the MPPUS measures tolerance, escape from other problems, withdrawal, craving, and negative life consequences, the ACPAT measures preoccupation (salience), excessive use, neglecting work, anticipation, lack of control, and neglecting social life. Results Family history of alcoholism and father's education level together explained 26% of the variance in the MPPUS scores and 25% of the variance in the ACPAT scores. The inclusion of mother's education level, ethnicity, family income, age, year in college, and gender did not significantly increase the proportion of variance explained for either MPPUS or ACPAT scores. Discussion and conclusions Family history of alcoholism and father's education level are good predictors of PSPU. As 74%-75% of the variance in PSPU scale scores was not explained, future studies should aim to explain this variance.

Internet use and its addiction level in medical students

Science.gov (United States)

Upadhayay, Namrata; Guragain, Sanjeev

2017-01-01

Objective To compare the Internet addiction levels between male and female medical students. Methods One hundred medical students (male: 50, female: 50) aged 17–30 years were included in a cross-sectional study. A standardized questionnaire was used to assess their Internet addiction level. Additionally, a self-designed questionnaire was used to identify the various purposes of Internet use among the students. The Internet addiction score (based on the Internet Addiction Test) was compared between male and female students by using the Mann–Whitney U test (p≤0.05). After knowing their addiction level, we interviewed students to know if Internet use had any bad/good impact on their life. Results The Internet Addiction Test scores obtained by the students were in the range of 11–70. Out of 100 students, 21 (male: 13, female: 8) were found to be slightly addicted to the Internet. The remaining 79 students were average online users. There was no significant difference between male and female students in the addiction level (score). However, males were more addicted than females. The major use of Internet was to download and watch movies and songs and to communicate with friends and family (76/100). Some students (24/100) used the Internet to assess information that helped them in their educational and learning activities. Some students mentioned that overuse of the Internet lead to insufficient amounts of sleep and affected their concentration levels in the classroom during lectures. Conclusion Medical students are experiencing problems due to Internet overuse. They experience poor academic progress and lack of concentration while studying. The main use of the Internet was for entertainment and to communicate with friends and family. PMID:28989293

Sexual History-Taking: Using Educational Interventions to Overcome Barriers to Learning

Science.gov (United States)

Jayasuriya, Ashini N.; Dennick, Reg

2011-01-01

Sexual history-taking is a basic medical skill that is traditionally taught poorly in medical school. Practising medical professionals have frequently reported feeling inadequately trained at taking these histories or discussing sexual risk. In order to promote and enhance the learning of this basic skill, those who teach sexual history-taking…

Medical History's Moment in Art Photography (1920 to 1950): How Lejaren à Hiller and Valentino Sarra Created a Fashion for Scenes of Early Surgery.

Science.gov (United States)

Hansen, Bert

2017-10-01

Two groups of black-and-white photographs are found in medical rare book rooms and the collections of historically minded physicians. They were created by artists Hiller and Sarra to bring medical history to life for members of the health professions and, to some extent, for a wider public. These were not didactic illustrations for a textbook, but elegant scenes of great figures from Antiquity to the nineteenth century, evocation not documentation even though they were based on research. As pieces of fine art, cherished in portfolios or framed on the wall, the quality prints were intended to stimulate curiosity about the achievements of the figures portrayed. While familiar to some archivists and librarians, these photographs have received almost no attention in the scholarship of medical history. Only one short article examined them in 1983. In recent years these photographers have been given new consideration by scholars of advertising and photography. Using those works and primary sources, this article expands both men's biographies, and it explores their working methods, their artistry, and their achievements. An appreciation of these photographs enlarges our understanding of the place of medical history in American culture during the first half of the twentieth century. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Pilot Trial of an Electronic Family Medical History in US Faith-Based Communities.

Science.gov (United States)

Newcomb, Patricia; Canclini, Sharon; Cauble, Denise; Raudonis, Barbara; Golden, Paulette

2014-07-01

In spite of the acknowledged importance of collecting family health information, methods of collecting, organizing, and storage of pedigree data are not uniformly utilized in practice, though several electronic tools have been developed for the purpose. Using electronic tools to gather health information may empower individuals to take responsibility in managing their family health history. The purpose of this study was to describe the feasibility and outcomes of introducing small groups to the My Family Health Portrait tool in faith-based communities using faith community nurses (FCNs). This pilot project adopted a mixed methods approach to assess the potential of an educational intervention delivered by FCNs for increasing the use of electronic technologies for organizing and storing family health histories among the general public. Treatment and control groups were recruited from four faith-based communities in north Texas using a parallel-groups quasi-experimental design. Qualitative data were gleaned from field notes made by investigators interacting with FCNs and observing their teaching. A majority of respondents believed that knowing one's health history and passing it on to family and medical personnel is important. Those receiving face-to-face instruction on the electronic tool were significantly more likely to have written down family health information than the control group who received only an informational handout (χ(2) = 5.96, P = .015). Barriers to teaching about and using the electronic tool included FCNs' lack of facility with computers in the educational context and FCN and respondent mistrust of electronic storage for family health information. © The Author(s) 2014.

Assessment of medical resident's attention to the health literacy level of newly admitted patients

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Cecile Karsenty

2013-12-01

Full Text Available Objectives: The objective of this study was to assess communication at the bedside in the emergency room between residents and their patients in order to identify common communication gaps. We also intended to evaluate whether residents for whom English is a second language (ESL residents communicate less effectively. Methods: A scorable checklist was developed in order to assess and identify communication gaps between the residents and their patients. Medical students observed the internal medicine and family medicine residents while they admitted patients to the medical service in the Emergency Room. Before this, medical students were trained for two weeks with a senior internist. The role of the medical student was not revealed; rather they were self-described as observers of the admission process. Results: Over an 8 week period, 71 observations were made of 27 medicine residents. 71 patient intakes were observed, evaluating 27 residents. In 52.1% of these interactions, the residents used medical acronyms when communicating with the patients. During 66.2% of interactions, technical medical terms or expressions were used during the history taking and in only 27.6% of those cases were the terms explained at least partially. Teach back technique was not observed in any of the interactions evaluated. Data was also analyzed based on whether the doctors were ESL residents or native English speakers. ESL residents tended to use significantly more technical language than the native English speakers, but the native English speakers tended to use more acronyms. Conclusions: How much patients understand of what their doctor says is called “health literacy.” Resident physicians often overestimate their patients’ health literacy, and this leads to communication gaps which have the potential to result in poorer health outcomes for the patients. The checklist developed for this pilot study assessed how well residents tailor their communication to

Aprendizaje de la historia clínica con pacientes simulados en el grado de Medicina Learning to take medical histories through patients simulation in undergraduate Medical School students

Directory of Open Access Journals (Sweden)

M. Cristina Rodríguez-Díez

2012-03-01

methods have been proposed: virtual patients, high fidelity devices and standard patients. We propose the use of 5th-6th year Medical School students acting as patients when teaching history taking to their 1st year colleagues. Subjects and methods. A total of 207 students from 1st year Medical School underwent training in history taking at the Simulation Center, with senior students acting as actors. The quality of the written medical records was evaluated by two medical doctors. The satisfaction of all students involved in the course was evaluated through an anonymous voluntary questionnaire. Results. The average score of the written medical histories was 8.2/10, more than satisfactory for our goals. Students' satisfaction rate was high. Mean score on questions inquiring the usefulness of patient simulation in learning how to perform a clinical history was 9/10 and 9.2/10 for first and fifth-sixth year students respectively. Questions on improvement of communication skills scored 8.6/10 and 8.6/10 respectively. The fruitfulness of training with simulated patients before practicing with real patients was 9.3/10 and 9.3/10 respectively. Finally, the assessment of the whole course with simulated patients was of 9.3/10. Conclusion. Learning history taking in first year Medical School with simulated patients acted by senior students was beneficial and user-friendly for both students and actors. An early contact with the clinical practice through simulated patients could improve performance and safety.

Corticosterone profiles in northern cardinals (Cardinalis cardinalis): Do levels vary through life history stages?

Science.gov (United States)

Duckworth, Benjamin M; Jawor, Jodie M

2018-04-17

As animals move through life history stages, energy requirements for each stage will vary. Both daily and annual variation in the glucocoriticoid hormones (specifically corticosterone, or CORT, in birds) helps provide the variable energy needed through life history stages. In many bird species, CORT is higher in the breeding season when energy demands can be quite high and is often lower in the non-breeding season. Additionally, CORT has a role to play in the response to stressful stimuli and the level to which CORT is elevated following stressful events can vary through the annual cycle as well. Here we report on baseline and stress-induced CORT levels in both sexes of northern cardinals, Cardinalis cardinalis, a non-migrating, year-round territorial species across life history stages. Corticosterone is overall higher in the non-breeding season than the breeding season in both sexes. Males tend to have higher levels of stress-induced CORT than females, although the observed patterns are complex. Our findings differ from one of the more common profile reported in songbirds where breeding season CORT tends to be higher than non-breeding levels. A strong influence may be the prolonged breeding season seen in cardinals; lower levels of CORT during breeding may guard against adverse maternal effects, interruptions in breeding behaviors, or egg production. Additional investigation of species with similar ecologies to northern cardinals, and more populations of cardinals, may show that annual glucocorticoid profiles are more labile than previously appreciated. Copyright © 2018 Elsevier Inc. All rights reserved.

Sexual orientation and medical history among Iranian people with Complete Androgen Insensitivity Syndrome and Congenital Adrenal Hyperplasia.

Science.gov (United States)

Khorashad, Behzad S; Roshan, Ghasem M; Reid, Alistair G; Aghili, Zahra; Hiradfar, Mehran; Afkhamizadeh, Mozhgan; Talaei, Ali; Aarabi, Azadeh; Ghaemi, Nosrat; Taghehchian, Negin; Saberi, Hedieh; Farahi, Nazanin; Abbaszadegan, Mohammad Reza

2017-01-01

To report sexual orientation, relationship status and medical history of Iranian people with Differences of Sex Development (DSD) who were raised female. Our participants consisted of nineteen 46,XY individuals with Complete Androgen Insensitivity Syndrome (CAIS) and eighteen 46,XX individuals with Congenital Adrenal Hyperplasia (CAH) who were raised as females and older than 13years. As well as their relationship status and detailed medical history, an expert psychiatrist assessed their sexual orientation by a semi-structured psychiatric interview with them and, where applicable, their parents. Five percent of CAH participants and 42% of CAIS participants were in a relationship, which was significantly different. All CAH individuals had been diagnosed at birth; 89% of CAIS had been diagnosed after puberty and due to primary amenorrhea and 11% were diagnosed in childhood due to inguinal hernia. Genital reconstructive surgery had been performed in 100% of CAH participants and 37% of CAIS. Regarding sexual contact experiences and sexual fantasies (androphilic, gynephilic or both), no significant differences were found. However, CAH females had significantly more gynephilic dreams (P=0.045). This study, notable as one of the rare from a non-western culture, described sexual, medical and socioeconomic status of 46,XX CAH and 46,XY CAIS individuals living in Iran. Although broadly in line with previous findings from Western cultures, Iranian CAH individuals had fewer romantic relationships, but in contrast to previous studies their sexual orientation was only different from CAIS in the contents of sexual dreams. Copyright © 2016 Elsevier Inc. All rights reserved.

Hannah's Feeding Journey: A Multidisciplinary Treatment Approach to Establishing Oral Acceptance for a Toddler with a Complex Medical History

Science.gov (United States)

Dunn, Dena M.; Galbally, Sandra Lynn; Markowitz, Goldie; Pucci, Kristy N.; Brochi, Ligia; Cohen, Sherri Shubin

2017-01-01

This article presents the importance of multidisciplinary, family-centered care, and a developmental bio-psycho-social approach to treating feeding difficulties in a child with a complex medical history. Hannah spent the first 9 months of her life in the hospital and was discharged dependent on nasogastric tube feeding. Her journey to recovery…

Education at the Dittrick Museum of Medical History, Case Western Reserve University, Cleveland, Ohio, USA.

Science.gov (United States)

Edmonson, James M

2009-01-01

The Dittrick Museum of Medical History pursues an educational mission as being part of a major research university. While the Dittrick dates to 1899 as a historical committee of the Cleveland Medical Library Association, it first affiliated with Case Western Reserve University in 1966, and became a department of the College of Arts and Sciences of CWRU in 1998. The Dittrick maintains a museum exhibition gallery that is open to the public free of charge, and museum staff provide guided tours on appointment. Much of the teaching and instruction at the Dittrick is conducted by university professors; their classes meet in the museum and use museum resources in the form of artifacts, images, archives, and rare books. Class projects using Dittrick collections may take the form of research papers, exhibitions, and online presentations. Dittrick staff assist in these classes and are available to help researchers use museum resources.

CHRONICLES OF MEDICAL HISTORY IN AFRICA Medical Icon and ...

African Journals Online (AJOL)

Joly was the Foundation Dean of the Faculty of Medicine, University. College, Ibadan (1948 ... when female education was considered unimportant. Beatrice made up ... best prizes. She went on to pursue a successful postgraduate medical.

[Organization of anesthesia management and advanced life support at military medical evacuation levels].

Science.gov (United States)

Shchegolev, A V; Petrakov, V A; Savchenko, I F

2014-07-01

Anesthesia management and advanced life support for the severely wounded personnel at military medical evacuation levels in armed conflict (local war) is time-consuming and resource-requiring task. One of the mathematical modeling methods was used to evaluate capabilities of anesthesia and intensive care units at tactical level. Obtained result allows us to tell that there is a need to make several system changes of the existing system of anesthesia management and advanced life support for the severely wounded personnel at military medical evacuation levels. In addition to increasing number of staff of anesthesiology-critical care during the given period of time another solution should be the creation of an early evacuation to a specialized medical care level by special means while conducting intensive monitoring and treatment.

Postglacial relative sea-level history of the Prince Rupert area, British Columbia, Canada

Science.gov (United States)

Letham, Bryn; Martindale, Andrew; Macdonald, Rebecca; Guiry, Eric; Jones, Jacob; Ames, Kenneth M.

2016-12-01

This paper presents a history of relative sea level (RSL) change for the last 15,000 years in the Prince Rupert region on the northern coast of British Columbia, Canada. One hundred twenty-three radiocarbon ages of organic material from isolation basin cores, sediment sequence exposures, and archaeological sites having a recognized relation to past sea levels constrain postglacial RSL. The large number of new measurements relating to past sea-level provides a well constrained RSL curve that differs in significant ways from previously published results. After deglaciation following the Last Glacial Maximum, the region experienced an isostatically-induced rapid RSL drop from as much 50 m asl to as low as -6.3 m asl in as little as a few centuries between 14,500 BP and 13,500 BP. After a lowstand below current sea level for about 2000 years during the terminal Pleistocene, RSL rose again to a highstand at least 6 m asl after the end of the Younger Dryas. RSL slowly dropped through the Holocene to close to its current position by 2000-1500 BP, with some potential fluctuations between 3500 and 1500 BP. This study highlights variation in RSL histories across relatively short distances, which must be accounted for by local RSL reconstructions such as this one. This RSL curve aided in the identification of an 8000-9000 year old archaeological site on a 10-12 m asl terrace, which is currently the earliest dated archaeological site in the area, and it provides guidance for searching for even older archaeological remains. We highlight the utility and potential of this refined RSL history for developing surveys for other archaeological sites associated with paleoshorelines.

A history of shaker nurse-herbalists, health reform, and the american botanical medical movement (1830-1860).

Science.gov (United States)

Libster, Martha M

2009-12-01

During the mid 19th century, herbal remedies were the platform for a major health reform movement in America known as the Botanical Medical Movement (BMM). A number of histories have been written on the BMM from the perspectives of physicians and pharmacists. This article describes the history of nurse-herbalism during the period and the impact that Shaker nurses, in particular, had on the BMM. The article traces the history and findings of a triangulated case study. Shaker nurses used herbs extensively in their caring and curing practices. They applied the botanical remedies recommended by BMM leaders. The nurses were also expert herbal medicine makers who used their own remedies in patient care. The Shaker infirmary was the nurses' behind-the-scenes research and development laboratory for the Shaker herbal cottage industry, which ultimately developed into an international, entrepreneurial endeavor. The Shaker infirmary was the nurses' organized proving ground for the implementation of the botanical health reforms of the mid 19th century. The nurse-herbalists' contribution to the promotion and production of herbal remedies had a significant impact on the success of botanical health reform in America.

State of Digital Education Options in the areas of Medical Terminology and the History, Theory and Ethics of Medicine.

Science.gov (United States)

Schochow, Maximilian; Steger, Florian

2015-01-01

Institutes of the history of medicine, the theory of medicine, and medical ethics at German institutions of higher learning have created various e-learning options that are based on different learning platforms and tailored to the specific curricular needs of individual teaching. Up to now no valid data has been available about the types of such e-learning options as well as possibilities of future developments thanks to coordinated cooperation among the different institutes. Of 31 German institutes of the history and theory of medicine and medical ethics that were asked to fill out a questionnaire, 30 answered, which equals a return rate of 97 per cent. The questionnaire was completed between July and August 2012 using a telephone survey. Available to students online, digitally interactive teaching tools have boomed in the course of the last few years at German institutes of the history of medicine, the theory of medicine, and medical ethics. This trend is also reflected in a willingness of more than half of the respective departments (67 per cent) to expand their e-learning options on the basis of previous experience. The offered e-learning systems are accepted very well by the students. 57 per cent of the institutes stated, that 90-100 per cent of the students use the offered systems regularly. E-learning courses for terminology are offered particularly often, this is also reflected in the intended extension of these courses by the majority of institutes which plan to expand their e-learning systems. This article discusses the results of a comprehensive empirical survey about e-learning. It illustrates ways in which individual German institutes plan to expand their e-learning options in the future. Finally, specific proposals for cooperation among institutions (not just online) are introduced, the purpose of which is to produce synergy in e-learning.

State of Digital Education Options in the areas of Medical Terminology and the History, Theory and Ethics of Medicine

Science.gov (United States)

Schochow, Maximilian; Steger, Florian

2015-01-01

Background: Institutes of the history of medicine, the theory of medicine, and medical ethics at German institutions of higher learning have created various e-learning options that are based on different learning platforms and tailored to the specific curricular needs of individual teaching. Up to now no valid data has been available about the types of such e-learning options as well as possibilities of future developments thanks to coordinated cooperation among the different institutes. Methods: Of 31 German institutes of the history and theory of medicine and medical ethics that were asked to fill out a questionnaire, 30 answered, which equals a return rate of 97 per cent. The questionnaire was completed between July and August 2012 using a telephone survey. Results: Available to students online, digitally interactive teaching tools have boomed in the course of the last few years at German institutes of the history of medicine, the theory of medicine, and medical ethics. This trend is also reflected in a willingness of more than half of the respective departments (67 per cent) to expand their e-learning options on the basis of previous experience. The offered e-learning systems are accepted very well by the students. 57 per cent of the institutes stated, that 90-100 per cent of the students use the offered systems regularly. E-learning courses for terminology are offered particularly often, this is also reflected in the intended extension of these courses by the majority of institutes which plan to expand their e-learning systems. Conclusions: This article discusses the results of a comprehensive empirical survey about e-learning. It illustrates ways in which individual German institutes plan to expand their e-learning options in the future. Finally, specific proposals for cooperation among institutions (not just online) are introduced, the purpose of which is to produce synergy in e-learning. PMID:26038682

Relationship between family history of alcohol addiction, parents’ education level, and smartphone problem use scale scores

Science.gov (United States)

Beison, Ashley; Rademacher, David J.

2017-01-01

Background and aims Smartphones are ubiquitous. As smartphones increased in popularity, researchers realized that people were becoming dependent on their smartphones. The purpose here was to provide a better understanding of the factors related to problematic smartphone use (PSPU). Methods The participants were 100 undergraduates (25 males, 75 females) whose ages ranged from 18 to 23 (mean age = 20 years). The participants completed questionnaires to assess gender, ethnicity, year in college, father’s education level, mother’s education level, family income, age, family history of alcoholism, and PSPU. The Family Tree Questionnaire assessed family history of alcoholism. The Mobile Phone Problem Use Scale (MPPUS) and the Adapted Cell Phone Addiction Test (ACPAT) were used to determine the degree of PSPU. Whereas the MPPUS measures tolerance, escape from other problems, withdrawal, craving, and negative life consequences, the ACPAT measures preoccupation (salience), excessive use, neglecting work, anticipation, lack of control, and neglecting social life. Results Family history of alcoholism and father’s education level together explained 26% of the variance in the MPPUS scores and 25% of the variance in the ACPAT scores. The inclusion of mother’s education level, ethnicity, family income, age, year in college, and gender did not significantly increase the proportion of variance explained for either MPPUS or ACPAT scores. Discussion and conclusions Family history of alcoholism and father’s education level are good predictors of PSPU. As 74%–75% of the variance in PSPU scale scores was not explained, future studies should aim to explain this variance. PMID:28316252

Unesco – to preserve Slovenian medical history

Directory of Open Access Journals (Sweden)

Darinka Soban

2006-03-01

Full Text Available Abstract: The beginnings of university studies of medicine in Ljubljana, and wartime interruptions. – One hundred years of anesthesia on the European continent as part of the surgeon’s work and responsibility. – The organization of health service (1942–1945 within the partisan resistance struggle. – Clandestine partisan hospitals. The wounded, the staff, the physicians. – Wartime anesthesia: an overview and perspectives. – SVPB Franja: a description. The efforts invested so far for the recognition of this war memorial as a UNESCO World Heritage Site. – From the 1982 International Symposium on the History of Modern Anesthesia to ISHA – the international society for the history of anesthesia.

Online nutrition and T2DM continuing medical education course launched on state-level medical association.

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Hicks, Kristen K; Murano, Peter S

2017-01-01

The purpose of this research study was to determine whether a 1-hour online continuing medical education (CME) course focused on nutrition for type 2 diabetes would result in a gain in nutrition knowledge by practicing physicians. A practicing physician and dietitian collaborated to develop an online CME course (both webinar and self-study versions) on type 2 diabetes. This 1-hour accredited course was launched through the state-level medical association's education library, available to all physicians. Physicians (n=43) registered for the course, and of those, 31 completed the course in its entirety. A gain in knowledge was found when comparing pre- versus post-test scores related to the online nutrition CME ( P Online CME courses launched via state-level medical associations offer convenient continuing education to assist practicing physicians in addressing patient nutrition and lifestyle concerns related to chronic disease. The present diabetes CME one-credit course allowed physicians to develop basic nutrition care concepts on this topic to assist patients in a better way.

History of the Rochester Epidemiology Project: half a century of medical records linkage in a US population.

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Rocca, Walter A; Yawn, Barbara P; St Sauver, Jennifer L; Grossardt, Brandon R; Melton, L Joseph

2012-12-01

The Rochester Epidemiology Project (REP) has maintained a comprehensive medical records linkage system for nearly half a century for almost all persons residing in Olmsted County, Minnesota. Herein, we provide a brief history of the REP before and after 1966, the year in which the REP was officially established. The key protagonists before 1966 were Henry Plummer, Mabel Root, and Joseph Berkson, who developed a medical records linkage system at Mayo Clinic. In 1966, Leonard Kurland established collaborative agreements with other local health care providers (hospitals, physician groups, and clinics [primarily Olmsted Medical Center]) to develop a medical records linkage system that covered the entire population of Olmsted County, and he obtained funding from the National Institutes of Health to support the new system. In 1997, L. Joseph Melton III addressed emerging concerns about the confidentiality of medical record information by introducing a broad patient research authorization as per Minnesota state law. We describe how the key protagonists of the REP have responded to challenges posed by evolving medical knowledge, information technology, and public expectation and policy. In addition, we provide a general description of the system; discuss issues of data quality, reliability, and validity; describe the research team structure; provide information about funding; and compare the REP with other medical information systems. The REP can serve as a model for the development of similar research infrastructures in the United States and worldwide. Copyright © 2012 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Self-reported activity level and knee function in amateur football players: the influence of age, gender, history of knee injury and level of competition.

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Frobell, R B; Svensson, E; Göthrick, M; Roos, E M

2008-07-01

The aim of this study is to investigate if self-reported activity level or knee functions are influenced by subject characteristics, level of competition and history of knee injury. Cross-Sectional study using questionnaires distributed at a personal visit. One hundred and eighty-eight (65 women) amateur football players in 10 football clubs from each division below national level participated in the study. Self-reported Tegner Activity Scale, and the Knee injury and Osteoarthritis Outcome Score (KOOS) are the main outcome measures. Older age, female gender and lower level of competition (football division) were independently associated with lower self-reported Tegner Activity Scale (P history of knee injury had significantly worse KOOS scores (P football players, KOOS scores do not need adjustment for age and gender.

On history of medical radiology development in Ukraine: war period and after war reconstruction (1941-1947)

International Nuclear Information System (INIS)

Pilipenko, M.Yi.; Artamonova, N.O.; Busigyina, N.O.; Kononenko, O.K.

1994-01-01

The paper is devoted to history of Ukrainian medical radiology development, namely main problems of its scientific and practical aspects of development during 1941-1947. The authors describe the work of Ukrainian roentgenologists and radiologists during the war and after war restoration of radiological service. Contribution of Ukrainian scientists to practical and theoretical achievements of military roentgenology is shown. Operative mobilization of all the forces for restoration of destroyed during the war years roentgenological service allowed to start scientific research within a short term (already in 1945)

Experiences of building a medical data acquisition system based on two-level modeling.

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Li, Bei; Li, Jianbin; Lan, Xiaoyun; An, Ying; Gao, Wuqiang; Jiang, Yuqiao

2018-04-01

Compared to traditional software development strategies, the two-level modeling approach is more flexible and applicable to build an information system in the medical domain. However, the standards of two-level modeling such as openEHR appear complex to medical professionals. This study aims to investigate, implement, and improve the two-level modeling approach, and discusses the experience of building a unified data acquisition system for four affiliated university hospitals based on this approach. After the investigation, we simplified the approach of archetype modeling and developed a medical data acquisition system where medical experts can define the metadata for their own specialties by using a visual easy-to-use tool. The medical data acquisition system for multiple centers, clinical specialties, and diseases has been developed, and integrates the functions of metadata modeling, form design, and data acquisition. To date, 93,353 data items and 6,017 categories for 285 specific diseases have been created by medical experts, and over 25,000 patients' information has been collected. OpenEHR is an advanced two-level modeling method for medical data, but its idea to separate domain knowledge and technical concern is not easy to realize. Moreover, it is difficult to reach an agreement on archetype definition. Therefore, we adopted simpler metadata modeling, and employed What-You-See-Is-What-You-Get (WYSIWYG) tools to further improve the usability of the system. Compared with the archetype definition, our approach lowers the difficulty. Nevertheless, to build such a system, every participant should have some knowledge in both medicine and information technology domains, as these interdisciplinary talents are necessary. Copyright © 2018 Elsevier B.V. All rights reserved.

Family history record and hereditary cancer risk perception according to National Cancer Institute criteria in a Spanish medical oncology service: a retrospective study.

Science.gov (United States)

Márquez-Rodas, Iván; López-Trabada, Daniel; Rupérez Blanco, Ana Belén; Custodio Cabello, Sara; Peligros Gómez, María Isabel; Orera Clemente, María; Calvo, Felipe A; Martín, Miguel

2012-01-01

Identification of patients at risk of hereditary cancer is an essential component of oncology practice, since it enables clinicians to offer early detection and prevention programs. However, the large number of hereditary syndromes makes it difficult to take them all into account in daily practice. Consequently, the National Cancer Institute (NCI) has suggested a series of criteria to guide initial suspicion. It was the aim of this study to assess the perception of the risk of hereditary cancer according to the NCI criteria in our medical oncology service. We retrospectively analyzed the recordings of the family history in new cancer patients seen in our medical oncology service from January to November 2009, only 1 year before the implementation of our multidisciplinary hereditary cancer program. The family history was recorded in only 175/621 (28%) patients. A total of 119 (19%) patients met 1 or more NCI criteria (1 criterion, n = 91; 2 criteria, n = 23; 3 criteria, n = 4; and 4 criteria, n = 1), and only 14 (11.4%) patients were referred to genetic counseling. This study shows that few clinicians record the family history. The perception of the risk of hereditary cancer is low according to the NCI criteria in our medical oncology service. These findings can be explained by the lack of a multidisciplinary hereditary cancer program when the study was performed. Copyright © 2012 S. Karger AG, Basel.

Perspective: Medical education in medical ethics and humanities as the foundation for developing medical professionalism.

Science.gov (United States)

Doukas, David J; McCullough, Laurence B; Wear, Stephen

2012-03-01

Medical education accreditation organizations require medical ethics and humanities education to develop professionalism in medical learners, yet there has never been a comprehensive critical appraisal of medical education in ethics and humanities. The Project to Rebalance and Integrate Medical Education (PRIME) I Workshop, convened in May 2010, undertook the first critical appraisal of the definitions, goals, and objectives of medical ethics and humanities teaching. The authors describe assembling a national expert panel of educators representing the disciplines of ethics, history, literature, and the visual arts. This panel was tasked with describing the major pedagogical goals of art, ethics, history, and literature in medical education, how these disciplines should be integrated with one another in medical education, and how they could be best integrated into undergraduate and graduate medical education. The authors present the recommendations resulting from the PRIME I discussion, centered on three main themes. The major goal of medical education in ethics and humanities is to promote humanistic skills and professional conduct in physicians. Patient-centered skills enable learners to become medical professionals, whereas critical thinking skills assist learners to critically appraise the concept and implementation of medical professionalism. Implementation of a comprehensive medical ethics and humanities curriculum in medical school and residency requires clear direction and academic support and should be based on clear goals and objectives that can be reliably assessed. The PRIME expert panel concurred that medical ethics and humanities education is essential for professional development in medicine.

Oral health Status, Medical History, Xerostomia dan Quality of Life of elderly In Luwu Timur, Sulawesi Selatan

OpenAIRE

Samad, Rasmidar

2013-01-01

Xerostomia is a common condition in elderly people which may result in permanent impairtment that would be one risk factor for decreased quality of life Objective the aim of this study is to determine the relathionship of sociodemographic status, medical history, xerostomia, tooth loss and caries status with quality of life of elderly in luwu timur Xerostomia is a common condition in elderly people which may result in permanent impairtment that would be one risk factor for decreased qua...

A state-level analysis of the economic impacts of medical tourism in Malaysia

OpenAIRE

Klijs, J.; Ormond, M.E.; Mainil, T.; Peerlings, J.H.M.; Heijman, W.J.M.

2016-01-01

In Malaysia, a country that ranks among the world's most recognised medical tourism destinations, medical tourism is identified as a potential economic growth engine for both medical and non-medical sectors. A state-level analysis of economic impacts is important, given differences between states in economic profiles and numbers, origins, and expenditure of medical tourists. We applied input–output (I–O) analysis, based on state-specific I–O data and disaggregated foreign patient data. The an...

Plasma homovanillic acid and family history of psychotic disorders in bipolar I patients.

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Zumárraga, Mercedes; Dávila, Ricardo; Basterreche, Nieves; Arrue, Aurora; Goienetxea, Biotza; González-Torres, Miguel Angel; Guimón, José

2009-04-01

It has been suggested that the family history of psychotic disorders is useful in defining homogeneous groups of bipolar patients. The plasma homovanillic acid (pHVA) concentrations have been related to the effect of antipsychotic treatment in psychotic patients. We have studied the influence of a positive family history of psychotic disorders both on the variation of pHVA levels and on the relation between pHVA concentrations and the clinical response to treatment. Clinical status and pHVA levels were assessed in 58 medication free patients before and after 4 weeks of treatment with olanzapine and lithium. Clinical improvement correlated positively with pHVA levels on the 28th day of treatment only in the patients having first degree relatives with psychotic disorders. The pHVA levels did not decrease after 28 days of treatment. Our results reinforce the idea that a positive family history of psychosis in psychotic bipolar disorders may constitute a good basis for sub-grouping these patients.

Student-Life Stress Level and its Related Factors among Medical Students of Hamadan University of Medical Sciences in 2015

OpenAIRE

Roya Nikanjam; Majid Barati; Saeed Bashirian*; Mohammad Babamiri; Ali Fattahi; Alireza Soltanian

2016-01-01

Background and Objectives: Student-life stress can lead to various negative consequences such as physical illness, mental disorders or exhaustion. The present study was conducted to evaluate the level of student life stress and its related factors among medical students of Hamadan University of Medical Sciences. Materials and Methods: This cross-sectional study applied multistage random sampling to select 500university students at Hamadan University of Medical Sciences during 2015. The dat...

Student-Life Stress Level and its Related Factors among Medical Students of Hamadan University of Medical Sciences in 2015

Directory of Open Access Journals (Sweden)

Roya Nikanjam

2016-03-01

Full Text Available Background and Objectives: Student-life stress can lead to various negative consequences such as physical illness, mental disorders or exhaustion. The present study was conducted to evaluate the level of student life stress and its related factors among medical students of Hamadan University of Medical Sciences. Materials and Methods: This cross-sectional study applied multistage random sampling to select 500university students at Hamadan University of Medical Sciences during 2015. The data collection tool used in this study was a self-report questionnaire containing two parts: a section on subjects' demographic details and another section for Student-Life Stress Inventory (SLSI. Data were analyzed in SPSS20-using descriptive and inferential statistics, such as independent t-test, Pearson’s correlation test and one-way ANOVA. Results: This study revealed that %57of the students had moderate levels of stress. The most important stressors included self-impose and pressure, and also the most important reactions to stressors included cognitive appraisal and emotional reactions, respectively. There was a significant association between exam stressors and branch, educational level, and mother's and father's education level (P< 0.05. Conclusions: According to the high level of stress in students and the recognition of demographic factors, effective educational interventions can be conducted to reduce stress.

Empathy levels among first year Malaysian medical students: an observational study

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Williams B

2014-05-01

Full Text Available Brett Williams,1 Sivalal Sadasivan,2 Amudha Kadirvelu,2 Alexander Olaussen11Department of Community Emergency Health and Paramedic Practice, Melbourne, Australia; 2Jeffrey Cheah School of Medicine and Health Sciences, Sunway Campus, Selangor, MalaysiaBackground: The literature indicates that medical practitioners experience declining empathy levels in clinical practice. This highlights the need to educate medical students about empathy as an attribute early in the academic curriculum. The objective of this study was to evaluate year one students' self-reported empathy levels following a 2-hour empathy workshop at a large medical school in Malaysia.Methods: Changes in empathy scores were examined using a paired repeated-measures t-test in this prospective before and after study.Results: Analyzing the matched data, there was a statistically significant difference and moderate effect size between mean empathy scores before and 5 weeks after the workshop (112.08±10.67 versus 117.93±13.13, P<0.0001, d=0.48 using the Jefferson Scale Physician Empathy (Student Version.Conclusion: The results of this observational study indicate improved mean self-reported empathy scores following an empathy workshop.Keywords: empathy, medical students, Malaysia

Goleman?s Leadership styles at different hierarchical levels in medical education

OpenAIRE

Saxena, Anurag; Desanghere, Loni; Stobart, Kent; Walker, Keith

2017-01-01

Background With current emphasis on leadership in medicine, this study explores Goleman?s leadership styles of medical education leaders at different hierarchical levels and gain insight into factors that contribute to the appropriateness of practices. Methods Forty two leaders (28 first-level with limited formal authority, eight middle-level with wider program responsibility and six senior- level with higher organizational authority) rank ordered their preferred Goleman?s styles and provided...

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.

Self-reported medical, medication and laboratory error in eight countries: risk factors for chronically ill adults.

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Scobie, Andrea

2011-04-01

To identify risk factors associated with self-reported medical, medication and laboratory error in eight countries. The Commonwealth Fund's 2008 International Health Policy Survey of chronically ill patients in eight countries. None. A multi-country telephone survey was conducted between 3 March and 30 May 2008 with patients in Australia, Canada, France, Germany, the Netherlands, New Zealand, the UK and the USA who self-reported being chronically ill. A bivariate analysis was performed to determine significant explanatory variables of medical, medication and laboratory error (P error: age 65 and under, education level of some college or less, presence of two or more chronic conditions, high prescription drug use (four+ drugs), four or more doctors seen within 2 years, a care coordination problem, poor doctor-patient communication and use of an emergency department. Risk factors with the greatest ability to predict experiencing an error encompassed issues with coordination of care and provider knowledge of a patient's medical history. The identification of these risk factors could help policymakers and organizations to proactively reduce the likelihood of error through greater examination of system- and organization-level practices.

Data base for radioactive waste management: review of low-level radioactive waste disposal history

International Nuclear Information System (INIS)

Clancy, J.J.; Gray, D.F.; Oztunali, O.I.

1981-11-01

This document is prepared in three volumes and provides part of the technical support to the draft environmental impact statement (NUREG-0782) on a proposed regulation, 10CFR Part 61, setting forth licensing requirements for land disposal of low level radioactive waste. Volume 1 is a summary and analysis of the history of low level waste disposal at both commercial and government disposal facilities

Goleman's Leadership styles at different hierarchical levels in medical education.

Science.gov (United States)

Saxena, Anurag; Desanghere, Loni; Stobart, Kent; Walker, Keith

2017-09-19

With current emphasis on leadership in medicine, this study explores Goleman's leadership styles of medical education leaders at different hierarchical levels and gain insight into factors that contribute to the appropriateness of practices. Forty two leaders (28 first-level with limited formal authority, eight middle-level with wider program responsibility and six senior- level with higher organizational authority) rank ordered their preferred Goleman's styles and provided comments. Eight additional senior leaders were interviewed in-depth. Differences in ranked styles within groups were determined by Friedman tests and Wilcoxon tests. Based upon style descriptions, confirmatory template analysis was used to identify Goleman's styles for each interviewed participant. Content analysis was used to identify themes that affected leadership styles. There were differences in the repertoire and preferred styles at different leadership levels. As a group, first-level leaders preferred democratic, middle-level used coaching while the senior leaders did not have one preferred style and used multiple styles. Women and men preferred democratic and coaching styles respectively. The varied use of styles reflected leadership conceptualizations, leader accountabilities, contextual adaptations, the situation and its evolution, leaders' awareness of how they themselves were situated, and personal preferences and discomfort with styles. The not uncommon use of pace-setting and commanding styles by senior leaders, who were interviewed, was linked to working with physicians and delivering quickly on outcomes. Leaders at different levels in medical education draw from a repertoire of styles. Leadership development should incorporate learning of different leadership styles, especially at first- and mid-level positions.

[Study on elasticity of medical service demand at the township level in China].

Science.gov (United States)

Shi, Hong-xing; Lv, Jun; Xie, Yi-ping; Wang, Ying; Jia, Jin-zhong; Chang, Feng-shui; Duan, Lin; Sun, Mei; Wang, Zhi-feng; Hao, Mo

2010-06-18

To find out the economic laws regulating medical service demand in accordance with influencing factors at the township level, thus to provide references for further adjusting the medical service demand reasonably in the future. The model of medical service demand was established to measure the elasticity of demand in 49 township health clinics in 1995, 1999, 2003 and 2007. The price elasticity of outpatient and inpatient demand was stable during the four periods, and the average value was -0.029 and -0.132 respectively; the average value of income elasticity was 0.973 and 0.977, registering a downward trend in general. The medical service demand at the township level is price inelastic, indicating that it is a necessity for rural residents. The downward trend of income elasticity under the influence of some health policies illustrates a lightening in economic burden for medical service demand among rural residents in township health clinics.

Texas Medication Algorithm Project, phase 3 (TMAP-3): clinical results for patients with a history of mania.

Science.gov (United States)

Suppes, Trisha; Rush, A John; Dennehy, Ellen B; Crismon, M Lynn; Kashner, T Michael; Toprac, Marcia G; Carmody, Thomas J; Brown, E Sherwood; Biggs, Melanie M; Shores-Wilson, Kathy; Witte, Bradley P; Trivedi, Madhukar H; Miller, Alexander L; Altshuler, Kenneth Z; Shon, Steven P

2003-04-01

The Texas Medication Algorithm Project (TMAP) assessed the clinical and economic impact of algorithm-driven treatment (ALGO) as compared with treatment-as-usual (TAU) in patients served in public mental health centers. This report presents clinical outcomes in patients with a history of mania (BD), including bipolar I and schizoaffective disorder, bipolar type, during 12 months of treatment beginning March 1998 and ending with the final active patient visit in April 2000. Patients were diagnosed with bipolar I disorder or schizoaffective disorder, bipolar type, according to DSM-IV criteria. ALGO was comprised of a medication algorithm and manual to guide treatment decisions. Physicians and clinical coordinators received training and expert consultation throughout the project. ALGO also provided a disorder-specific patient and family education package. TAU clinics had no exposure to the medication algorithms. Quarterly outcome evaluations were obtained by independent raters. Hierarchical linear modeling, based on a declining effects model, was used to assess clinical outcome of ALGO versus TAU. ALGO and TAU patients showed significant initial decreases in symptoms (p =.03 and p <.001, respectively) measured by the 24-item Brief Psychiatric Rating Scale (BPRS-24) at the 3-month assessment interval, with significantly greater effects for the ALGO group. Limited catch-up by TAU was observed over the remaining 3 quarters. Differences were also observed in measures of mania and psychosis but not in depression, side-effect burden, or functioning. For patients with a history of mania, relative to TAU, the ALGO intervention package was associated with greater initial and sustained improvement on the primary clinical outcome measure, the BPRS-24, and the secondary outcome measure, the Clinician-Administered Rating Scale for Mania (CARS-M). Further research is planned to clarify which elements of the ALGO package contributed to this between-group difference.

Medical abortion reversal: science and politics meet.

Science.gov (United States)

Bhatti, Khadijah Z; Nguyen, Antoinette T; Stuart, Gretchen S

2018-03-01

Medical abortion is a safe, effective, and acceptable option for patients seeking an early nonsurgical abortion. In 2014, medical abortion accounted for nearly one third (31%) of all abortions performed in the United States. State-level attempts to restrict reproductive and sexual health have recently included bills that require physicians to inform women that a medical abortion is reversible. In this commentary, we will review the history, current evidence-based regimen, and regulation of medical abortion. We will then examine current proposed and existing abortion reversal legislation. The objective of this commentary is to ensure physicians are armed with rigorous evidence to inform patients, communities, and policy makers about the safety of medical abortion. Furthermore, given the current paucity of evidence for medical abortion reversal, physicians and policy makers can dispel bad science and misinformation and advocate against medical abortion reversal legislation. Copyright © 2017 Elsevier Inc. All rights reserved.

Medical robotics

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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

Reliability of the information about the history of diagnosis and treatment of hypertension. Differences in regard to sex, age, and educational level. The pró-saúde study

Directory of Open Access Journals (Sweden)

Faerstein Eduardo

2001-01-01

Full Text Available OBJECTIVE: To assess the intraobserver reliability of the information about the history of diagnosis and treatment of hypertension. METHODS: A multidimensional health questionnaire, which was filled out by the interviewees, was applied twice with an interval of 2 weeks, in July '99, to 192 employees of the University of the State of Rio de Janeiro (UERJ, stratified by sex, age, and educational level. The intraobserver reliability of the answers provided was estimated by the kappa statistic and by the coefficient of intraclass correlation (CICC. RESULTS: The general kappa (k statistic was 0.75 (95% CI=0.73-0.77. Reliability was higher among females (k=0.88, 95% CI=0.85-0.91 than among males (k=0.62, 95% CI=0.59-0.65.The reliability was higher among individuals 40 years of age or older (k=0.79; 95% CI=0.73-0.84 than those from 18 to 39 years (k=0.52; 95% CI=0.45-0.57. Finally, the kappa statistic was higher among individuals with a university educational level (k=0.86; 95% CI=0.81-0.91 than among those with high school educational level (k=0.61; 95% CI=0.53-0.70 or those with middle school educational level (k=0.68; 95% CI=0.64-0.72. The coefficient of intraclass correlation estimated by the intraobserver agreement in regard to age at the time of the diagnosis of hypertension was 0.74. A perfect agreement between the 2 answers (k=1.00 was observed for 22 interviewees who reported prior prescription of antihypertensive medication. CONCLUSION: In the population studied, estimates of the reliability of the history of medical diagnosis of hypertension and its treatment ranged from substantial to almost perfect reliability.

Prevalence of depression and its relation to stress level among medical students in Puducherry, India

Directory of Open Access Journals (Sweden)

S Ganesh Kumar

2017-01-01

Full Text Available Background: Currently, depression among medical students is an important health issue at the global level. There is also a paucity of information on its relation to the stress level. Objective: The aim of this study is to assess the prevalence of depression and its relation to stress level and other factors among medical students. Materials and Methods: A cross-sectional study was conducted among medical students at a tertiary care medical institution in Puducherry, coastal south India. Beck Depression Inventory Scale was used for screening of depression and Cohen's Perceived Stress scale to assess perceived stress level. Data on associated factors were collected by self-administered questionnaire. Results: The overall prevalence of depression was found to be 48.4% (215/444. According to the cutoff scores, 229 (51.6% students scored as normal (0–9, 149 (33.6% as mild (10–18, 60 (13.5% as moderate (19–29, 3 (0.7% as severe (30–40, and 3 (0.7% students scored as very severe (>40 depression. Depression was significantly less among those with mild stress (adjusted odds ratio [OR] = 0.010 and moderate stress level (adjusted OR = 0.099 compared to severe stress level and those without interpersonal problems (adjusted OR = 0.448. Conclusion: Depression is more common among medical students. Stress coping mechanisms and improvement of interpersonal relationship may help to reduce depressive symptoms among medical students.

CURRENT LEVELS OF MEDICAL EXPOSURE IN RUSSIA

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M. I. Balonov

2015-01-01

Full Text Available We considered conditions of patients’ medical radiation exposure in Russian diagnostic radiology and nuclear medicine basing on the data of our own research, of the Unified system of individual dose control and of some relevant literature. We analyzed the data on the number of diagnostic examinations, patients’ individual and collective doses and their distribution by examination types. Time trends of the studied parameters are presented for the period between 1999 and 2013. Current level of Russian patients’ medical exposure is the lowest over the whole observation period and one of the lowest among the developed countries. The annual number of X-ray diagnostic examinations is 1.8 per capita. In 2013 median effective dose of medical exposure per capita in Russia was 0.45 mSv and median dose per procedure was 0.25 mSv. The major contribution to collective dose of medical exposure was from computed tomography and radiography; the largest individual doses were caused by interventional radiology, computed X-Ray and nuclear medicine tomographic examinations. The range of median doses comprises about four orders of magnitude, i.e. from several microSv in dental X-ray examinations up to several tens of milliSv in interventional and multistage tomographic examinations. The median effective dose of adult patients increases by about an order of magnitude with each transition from dental X-ray examinations to conventional radiology and further to computed tomography and interventional radiology examinations. During interventional X-Ray examinations, absorbed skin doses at radiation beam entrance site may reach several Gray, which may lead to deterministic radiation effects in skin and subcutaneous tissues. Due to replacement of low-dose ‘functional’ nuclear medicine examinations with more informative modern scintigraphy and tomography examination, patient doses substantially increased over the last decade. With current trend for re-equipment of

Secondary School Mathematics Teachers' Knowledge Levels and Use of History of Mathematics

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Bütüner, Suphi Önder

2018-01-01

This study describes secondary school mathematics teachers' use of history of mathematics in their classes and their knowledge levels in this field. The study population included a total of 58 secondary school mathematics teachers working at the secondary schools located in Yozgat city center, and the sample included 32 mathematics teachers from…

Missed opportunities in primary care: the importance of identifying depression through screening, family history, and chronic disease management.

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Maradiegue, Ann H; Khan, Fakiha

2013-02-01

This study explored the adequacy of depression screening in a community health center. The medical charts of individuals (N = 90) enrolled at a community health center were randomly selected, reviewed, and compared to current standard-of-care guidelines for four elements: family history, screening for depression, control of chronic illnesses, and missed opportunities for preventive care. Family history documentation collected by the providers was limited and 44.4% had no family history. There was no routine depression screening process, although 48.9% of the clients had red flags (warning signals) for depression. Laboratory values used for screening control of chronic disease in the medical records were: fasting glucose levels ⩽100 mg/dL (46%), total cholesterol levels ⩽200 mg/dL (38%), and blood pressure ⩽120/80 mmHg (23%). The results highlight the need to focus on depression screening as part of preventive care and the management of chronic disease in the primary care setting. Copyright 2013, SLACK Incorporated.

Clinical examination & record-keeping: Part 2: History taking.

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Hadden, A M

2017-12-15

This article is the second part of a BDJ series of Practice papers on the subject of clinical examination and related record keeping. The series is taken from the Faculty of General Dental Practice UK (FGDP[UK]) 2016 Good Practice Guidelines book on this topic, edited by A. M. Hadden. This particular article discusses history taking, where information may be gathered prior to the patient seeing the clinician or, in some cases, this may be carried out chairside by the individual. The information gathered can include a medical history, socio-behavioural history, and patient anxiety levels. It is important to note that throughout this article (and the BDJ series and associated FGDP[UK] book), the specific guidelines will be marked as follows: A: Aspirational, B: Basic, C: Conditional. Further information about this guideline notation system is provided in Part 1 of this series ( 2017; 223: 765-768).

Application of diagnostic reference levels in medical practice

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Bourguignon, Michel [Faculty of Medicine of Paris, Deputy Director General, Nuclear Safety Authority (ASN), Paris (France)

2006-07-01

Diagnosis reference levels (D.R.L.) are defined in the Council Directive 97/43 EURATOM as 'Dose levels in medical radio diagnosis practices or in the case of radiopharmaceuticals, levels of activity, for typical examinations for groups of standards-sized patients or standards phantoms for broadly defined types of equipment. These levels are expected not to be exceeded for standard procedures when good and normal practice regarding diagnostic and technical performance is applied'. Thus D.R.L. apply only to diagnostic procedures and does not apply to radiotherapy. Radiation protection of patients is based on the application of 2 major radiation protection principles, justification and optimization. The justification principle must be respected first because the best way to protect the patient is not to carry a useless test. Radiation protection of the patient is a continuous process and local dose indicator values in the good range should not prevent the radiologist or nuclear medicine physician to continue to optimize their practice. (N.C.)

Application of diagnostic reference levels in medical practice

International Nuclear Information System (INIS)

Bourguignon, Michel

2006-01-01

Diagnosis reference levels (D.R.L.) are defined in the Council Directive 97/43 EURATOM as 'Dose levels in medical radio diagnosis practices or in the case of radiopharmaceuticals, levels of activity, for typical examinations for groups of standards-sized patients or standards phantoms for broadly defined types of equipment. These levels are expected not to be exceeded for standard procedures when good and normal practice regarding diagnostic and technical performance is applied'. Thus D.R.L. apply only to diagnostic procedures and does not apply to radiotherapy. Radiation protection of patients is based on the application of 2 major radiation protection principles, justification and optimization. The justification principle must be respected first because the best way to protect the patient is not to carry a useless test. Radiation protection of the patient is a continuous process and local dose indicator values in the good range should not prevent the radiologist or nuclear medicine physician to continue to optimize their practice. (N.C.)

Medical profession and nuclear war: a social history

International Nuclear Information System (INIS)

Day, B.; Waitzkin, H.

1985-01-01

Since World War II, individual physicians and medical organizations in the US have cooperated with the federal government in preparing for nuclear war. While most physicians have maintained a neutral stance, a minority have resisted federal policies. Health professionals participated actively at the wartime laboratories that developed the atomic bomb and in the medical research that followed Hiroshima and Nagasaki. Professional organizations helped with civil defense planning for nuclear conflict during the Cold War of the late 1950s and early 1960s. Medical resistance to nuclear war began in the same period, gained wide attention with the growth of Physicians for Social Responsibility in the early 1960s, declined during the Vietnam War, and vastly increased in the early 1980s. Activism by health professionals usually has responded to government policies that have increased the perceived risk of nuclear conflict. The recent return of civil defense planning has stimulated opposition in medical circles. Ambiguities of medical professionalism limit the scope of activism in the nuclear arena. These ambiguities concern the interplay of organized medicine and government, tensions between science and politics, and the difficulties of day-to-day work in medicine while the arms race continues

[Remarks to the quality of historical contributions in recent medical journals. Critical comments on the example of the history of traumatology].

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WeiBer, Christoph

2004-01-01

Review articles on the history of medical topics in recent medical (non-historical) journals are often of a much worse quality than observational and experimental articles. The criteria of quality of a historical review article, elaborated on the example of the contribution. "300 years of intramedullary fixation - from Aztec practice to standard treatment modality" by U. Knothe, M. L. Knothe Tate, and S. M. Perren, are: clear definition of the theme treated, extensive heuristic investigations, exact study of source material and original publications, critical sifting of secondary literature, naming of the first names and biographical data of historical persons, account of the historical background, use of historical evidences, and reviewing by a medical historian. By taking notice of these items historical misjudgements can be avoided.

Perspective: Teaching and mentoring the history of medicine: an Oslerian perspective.

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Bryan, Charles S; Longo, Lawrence D

2013-01-01

Many predict a takeover (seen by some as hostile, and by others as inadvertent) of professional virtues and values by government and capitalism. One source of professional virtues and values consists of lessons from the history of medicine as taught and mentored by Sir William Osler. Some medical schools have required courses in medical history, but proposing a new requirement would probably be a tough sell to most curriculum committees. Osler himself argued against compulsory courses in medical history. The authors propose that exposing medical students to the history of medicine promotes at least two of the seven types of professionalism identified by Hafferty and Castellani. Exposure to the evolution of medical science and to exemplary physicians of bygone eras promotes nostalgic professionalism, which, although in some ways suspect and naïve, fosters a sense of belonging and solidarity as members of a profession, not a trade, whereas exposure to the evolution of medicine as a public service, to the sad history of health care disparities, and to patients' perspectives promotes activist professionalism, fostering a sense of civic responsibility and opposition to excessive commercialism.Steps to promote such exposure include (1) identifying faculty, community physicians, and others interested in the history of medicine, (2) including the history of medicine in faculty development programs, (3) considering a segment in the history of medicine during the introduction to each major course, (4) sponsoring history clubs, and (5) promoting environments favorable for mentor-protégé relationships for faculty and students with further interest.

Dietary modification, Body Mass Index (BMI), Blood Pressure (BP) and cardiovascular risk in medical students of a government medical college of Karachi

International Nuclear Information System (INIS)

Raza, S.; Sheikh, M.A.; Hussain, M.F.A.; Siddiqui, S.E.; Muhammad, R.; Aziz, S.; Qamar, S.; Saleem, M.A.; Waki, N.; Faruqi, H.; Zia, A.

2010-01-01

Objective: To determine the prevalence of major risk factors including dietary modification, Body Mass Index (BMI), Blood Pressure (BP) and physical activity in medical students of government teaching hospitals of Karachi. Methods: A cross sectional study was conducted on students of Dow Medical College, Karachi, Pakistan through a structured pre-tested questionnaire. Non-probability purposive sampling was used. Smoking, hypertension, family history of cardiovascular disease (CVD), overweight and low physical activity levels are risk factors the presence of which can lead to development of CVD. Prevalence of these risk factors was determined by asking appropriate questions and through measurement of BMI and blood pressure for overweight and hypertension respectively. Awareness of risk factors was determined through knowledge of the effect of various food substances on development of CVD and of adoption of dietary changes keeping in mind the risk of developing CVD. SPSS 16.0 was used for statistical analysis. Results: A total of 132 medical students were included in the study of which 57 (43.2%) and 75 (56.8%) were male and female respectively with mean age of 20.85 +- 1.21 years. About 15.9% of students had elevated blood pressure i.e. > 140/90 mmHg. Twenty eight percent of the total students were found to be underweight and 17.4% were overweight, 5% had some history of CVD, 56.8% had family history of CVD, 9.4% were smokers and 29.5% had high physical activity level. About 87.1% had modified their diet for preventing CVD. Most of the students had adequate knowledge about the cardiovascular risk factors Conclusion: Majority of students were not overweight. A high prevalence of cardiovascular risk factors; family history and elevated blood pressure was present. Awareness in terms of knowledge was satisfactory but implementation in terms of diet modification and adequate physical activity was lacking. (author)

Dispersal, dormancy and life-history tradeoffs at the individual, population and species levels in southern African Asteraceae.

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de Waal, Caroli; Anderson, Bruce; Ellis, Allan G

2016-04-01

Dispersal and dormancy are important risk-reducing strategies in unpredictable environments. Negative covariation between these strategies is theoretically expected, but empirical evidence is limited and inconsistent. Moreover, covariation may be affected by other life-history traits and may vary across levels of biological organization. We assessed dispersal (vertical fall time of fruits, a proxy for wind dispersal ability) and dormancy (germination fractions measured during germination trials) in populations of 15 annual and 12 perennial wind-dispersed species in six Asteraceae genera from South Africa. Dormancy was higher in annuals than in perennials, whereas fall time was largely determined by evolutionary history. Controlling for phylogeny, dispersal and dormancy was negatively associated across species and life-history categories. Negative covariation between dispersal and dormancy was not evident at either the individual level (except for seed heteromorphic species) or the population level. Our study provides rare empirical support for the theoretical expectation of tradeoffs between dormancy and the alternative risk-reducing strategies, perenniality and dispersal, but refutes the expectation of increased dispersability in perennials. Although negative covariation between dispersal and dormancy at the species level appears not to be a simple consequence of upscaling individual-level mechanistic tradeoffs, our findings suggest that selection for one strategy may constrain evolution of the other. © 2015 The Authors. New Phytologist © 2015 New Phytologist Trust.

The Teaching of Controversial Issues during Elementary-Level History Instruction: Greek-Cypriot Teachers' Perceptions and Emotions

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Zembylas, Michalinos; Kambani, Froso

2012-01-01

This article reports on a phenomenological study of 18 Greek-Cypriot teachers' perceptions and emotions in relation to the teaching of controversial issues during elementary-level history instruction. Findings indicate that although participating teachers see the general value of this approach at the elementary school level, they become less…

38 CFR 4.41 - History of injury.

Science.gov (United States)

2010-07-01

... DISABILITIES Disability Ratings The Musculoskeletal System § 4.41 History of injury. In considering the residuals of injury, it is essential to trace the medical-industrial history of the disabled person from the... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false History of injury. 4.41...

Development of a Computerized Medical History Profile for Children in Out-of-Home Placement Using Medicaid Data

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Chisolm, Deena J.; Scribano, Philip V.; Purnell, Tanjala S.; Kelleher, Kelly J.

2010-01-01

Children in out-of-home placements (foster children) often undergo multiple placement changes while under the care of child protective services. This instability can result in lack of health care continuity and poor health outcomes. This brief describes the development of a medical history profile, or passport, developed from Medicaid administrative data. A purposive sample of 25 youths was provided from a county child protective services agency. The patients were systematically matched with data from the state Medicaid agency. Using Medicaid claims/encounter data we generated health care profiles that provided information on historical use of ambulatory care, diagnoses, providers seen, medications used, and inpatient admissions. Profiles were however limited by missing provider information and non-specific diagnostic coding. Despite these limitations, Medicaid data-based profiles show the potential to be a cost efficient method for improving continuity of care for children in out-of-home placement. PMID:19648702

MEDICAL TOURISM : Demand for Cuban Medical Tourism by Russian Consumers

OpenAIRE

Ulanova, Anastasia

2015-01-01

Medical tourism, often addressed as health tourism, is a new concept in terms of tourism industry in general, and it is also one of the rapidly developing and growing ones. This thesis gives information on the medical tourism in general and its history. It also revises the development stages of the medical tourism in the world. Cuban medical tourism is analyzed on its own, as well as Russian medical tourism and the demand for it. Medical tourism is rather popular among Russians due to various...

History of the term prostate.

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Josef Marx, Franz; Karenberg, Axel

2009-02-01

We comprehensively review the history of the word "prostate" and related terms from 600 BC to the present. Both medical and non-medical ancient texts were searched to clarify the term's etymology and use. Anatomy textbooks of the 16th through the 18th century were analyzed to identify descriptions, illustrations and various expressions used by contemporary authors to designate the prostate. In ancient Greek the masculine term "prostatēs" meant "president" and was exclusively used in a non-medical sense. It was not until the Renaissance that anatomists discovered the organ naming it "glandulous body." In 1600 the French physician du Laurens introduced the metaphoric denomination "prostatae." However he and his contemporaries misinterpreted the history of the organ and the term, choose the wrong gender when translating it into Latin, and believed that it designated a double organ. Only in the 1800s was this anatomical error corrected while the grammatical one lived on. The history of the term "prostate" is a prime example of the difficulties with which the development of a precise urologic terminology had to struggle. At the same time this retrospective view provides a stimulus to avoid linguistic ambiguity in the future.

MO-D-211-01: Medical Physics Practice Guidelines - The Minimum Level of Medical Physics Support in Clinical Practice Settings.

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Chan, M; Fontenot, J; Halvorsen, P

2012-06-01

The American Association of Physicists in Medicine (AAPM) has long advocated a consistent level of medical physics practice, and has published many guidelines and position statements toward that goal, such as Science Council Task Group reports related to calibration and quality assurance, Education Council and Professional Council Task Group reports related to education, training, and peer review, and Board-approved Position Statements related to the Scope of Practice, physicist qualifications, and other aspects of medical physicspractice. Despite these concerted and enduring efforts, the profession does not have a clear and concise statement of the acceptable practice guidelines for routine clinical medical physics. As accreditation of clinical practices becomes more common, Medical Physics Practice Guidelines (MPPGs) will be crucial to ensuring a consistent benchmark for accreditation programs. The AAPM will lead the development of MPPGs in collaboration with other professional societies. The MPPGs will be freely available to the general public. Accrediting organizations, regulatory agencies and legislators will be encouraged to reference these MPPGs when defining their respective requirements. MPPGs are intended to provide the medical community with a clear description of the minimum level of medical physics support that the AAPM would consider to be prudent in all clinical practice settings. Support includes but is not limited to staffing, equipment, machine access, and training. These MPPGs are not designed to replace extensive Task Group reports or review articles, but rather to describe the recommended minimum level of medical physics support for specific clinical services. This course will describe the purpose and scope of MPPGs, the procedure for the development of a MPPG, as well as the progress of Therapy MPPG TG #1 on "Evaluation and quality assurance of x-ray based image guided radiotherapy systems" and Diagnostic MPPG TG #2 on "CT Protocol management

Metabolic syndrome and parental history of cardiovascular disease in young adults in urban Ghana.

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Yeboah, Kwame; Dodam, Kennedy Konlan; Affrim, Patrick Kormla; Adu-Gyamfi, Linda; Bado, Anormah Rashid; Owusu Mensah, Richard N A; Adjei, Afua Bontu; Gyan, Ben

2017-08-03

Metabolic syndrome (MetS) in young adults poses significant cardiovascular diseases (CVD) risk for later years. Parental history of CVDs is known to affect the prevalence of CVD risk in adulthood. In sub-Saharan Africa, the burden of MetS in young adults and its relationship with parental CVDs is largely unknown. We studied the gender-specific prevalence of MetS and its association with parental history of diabetes, hypertension and CVDs in young adults resident in urban Ghana. In a cross-sectional design, 364 young adults aged 20-30 years were randomly recruited from students of University of Ghana. A structured questionnaire was used to collect data on demography, lifestyle, medical and parental medical history. Anthropometric indices and blood pressures were measured. Fasting blood samples were collected to measure plasma levels of glucose, lipid profile, urea and creatinine. MetS was defined according to the Joint Scientific Statement criteria. The prevalence of MetS was 12.4%, higher in females than male participants (18.4% vs 5.7, p = 0.019). Female participants had higher levels of all the components of MetS than the male participants. Compared to participants with no history of parental CVDs, participants with parental CVDs had a higher proportion of abdominal obesity. A positive history of parental CVDs was associated with increase in odds of MetS [OR (95% CI): 1.23 (1.12-3.04), p = 0.037]. In our study population, there is relatively high prevalence of MetS; higher in females compared to male participants. Parental history of CVDs was associated with MetS.

Nazi Medical Research in Neuroscience: Medical Procedures, Victims, and Perpetrators.

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Loewenau, Aleksandra; Weindling, Paul J

Issues relating to the euthanasia killings of the mentally ill, the medical research conducted on collected body parts, and the clinical investigations on living victims under National Socialism are among the best-known abuses in medical history. But to date, there have been no statistics compiled regarding the extent and number of the victims and perpetrators, or regarding their identities in terms of age, nationality, and gender. "Victims of Unethical Human Experiments and Coerced Research under National Socialism," a research project based at Oxford Brookes University, has established an evidence-based documentation of the overall numbers of victims and perpetrators through specific record linkages of the evidence from the period of National Socialism, as well as from post-WWII trials and other records. This article examines the level and extent of these unethical medical procedures as they relate to the field of neuroscience. It presents statistical information regarding the victims, as well as detailing the involvement of the perpetrators and Nazi physicians with respect to their post-war activities and subsequent court trials.

Predicting Risk of Suicide Attempt Using History of Physical Illnesses From Electronic Medical Records

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Luo, Wei; Tran, Truyen; Berk, Michael; Venkatesh, Svetha

2016-01-01

Background Although physical illnesses, routinely documented in electronic medical records (EMR), have been found to be a contributing factor to suicides, no automated systems use this information to predict suicide risk. Objective The aim of this study is to quantify the impact of physical illnesses on suicide risk, and develop a predictive model that captures this relationship using EMR data. Methods We used history of physical illnesses (except chapter V: Mental and behavioral disorders) from EMR data over different time-periods to build a lookup table that contains the probability of suicide risk for each chapter of the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10) codes. The lookup table was then used to predict the probability of suicide risk for any new assessment. Based on the different lengths of history of physical illnesses, we developed six different models to predict suicide risk. We tested the performance of developed models to predict 90-day risk using historical data over differing time-periods ranging from 3 to 48 months. A total of 16,858 assessments from 7399 mental health patients with at least one risk assessment was used for the validation of the developed model. The performance was measured using area under the receiver operating characteristic curve (AUC). Results The best predictive results were derived (AUC=0.71) using combined data across all time-periods, which significantly outperformed the clinical baseline derived from routine risk assessment (AUC=0.56). The proposed approach thus shows potential to be incorporated in the broader risk assessment processes used by clinicians. Conclusions This study provides a novel approach to exploit the history of physical illnesses extracted from EMR (ICD-10 codes without chapter V-mental and behavioral disorders) to predict suicide risk, and this model outperforms existing clinical assessments of suicide risk. PMID:27400764

Women in medicine and dermatology: history and advances.

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França, Katlein; Ledon, Jennifer; Savas, Jessica; Nouri, Keyvan

2014-01-01

The history of women in medicine has been marked by many challenges and achievements. Although the role of women in the "art of healing" can be traced back many centuries, only males are traditionally highlighted in history. Across antiquity, access to medical education was denied to females. Dermatology is a medical specialty in which women displayed particular skill and proficiency. Gradually, determination and competence allowed women to lay claim in an essentially male-dominated world. This article presents a brief review of the performance, progress and achievements of women in the history of medicine and dermatology.

Women in medicine and dermatology: history and advances*

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França, Katlein; Ledon, Jennifer; Savas, Jessica; Nouri, Keyvan

2014-01-01

The history of women in medicine has been marked by many challenges and achievements. Although the role of women in the "art of healing" can be traced back many centuries, only males are traditionally highlighted in history. Across antiquity, access to medical education was denied to females. Dermatology is a medical specialty in which women displayed particular skill and proficiency. Gradually, determination and competence allowed women to lay claim in an essentially male-dominated world. This article presents a brief review of the performance, progress and achievements of women in the history of medicine and dermatology. PMID:24626675

Impact of a pharmacy technician-centered medication reconciliation program on medication discrepancies and implementation of recommendations.

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Kraus, Sarah K; Sen, Sanchita; Murphy, Michelle; Pontiggia, Laura

2017-01-01

To evaluate the impact of a pharmacy-technician centered medication reconciliation (PTMR) program by identifying and quantifying medication discrepancies and outcomes of pharmacist medication reconciliation recommendations. A retrospective chart review was performed on two-hundred patients admitted to the internal medicine teaching services at Cooper University Hospital in Camden, NJ. Patients were selected using a stratified systematic sample approach and were included if they received a pharmacy technician medication history and a pharmacist medication reconciliation at any point during their hospital admission. Pharmacist identified medication discrepancies were analyzed using descriptive statistics, bivariate analyses. Potential risk factors were identified using multivariate analyses, such as logistic regression and CART. The priority level of significance was set at 0.05. Three-hundred and sixty-five medication discrepancies were identified out of the 200 included patients. The four most common discrepancies were omission (64.7%), non-formulary omission (16.2%), dose discrepancy (10.1%), and frequency discrepancy (4.1%). Twenty-two percent of pharmacist recommendations were implemented by the prescriber within 72 hours. A PTMR program with dedicated pharmacy technicians and pharmacists identifies many medication discrepancies at admission and provides opportunities for pharmacist reconciliation recommendations.

Impact of a pharmacy technician-centered medication reconciliation program on medication discrepancies and implementation of recommendations

Directory of Open Access Journals (Sweden)

Kraus SK

2017-06-01

Full Text Available Objectives: To evaluate the impact of a pharmacy-technician centered medication reconciliation (PTMR program by identifying and quantifying medication discrepancies and outcomes of pharmacist medication reconciliation recommendations. Methods: A retrospective chart review was performed on two-hundred patients admitted to the internal medicine teaching services at Cooper University Hospital in Camden, NJ. Patients were selected using a stratified systematic sample approach and were included if they received a pharmacy technician medication history and a pharmacist medication reconciliation at any point during their hospital admission. Pharmacist identified medication discrepancies were analyzed using descriptive statistics, bivariate analyses. Potential risk factors were identified using multivariate analyses, such as logistic regression and CART. The priority level of significance was set at 0.05. Results: Three-hundred and sixty-five medication discrepancies were identified out of the 200 included patients. The four most common discrepancies were omission (64.7%, non-formulary omission (16.2%, dose discrepancy (10.1%, and frequency discrepancy (4.1%. Twenty-two percent of pharmacist recommendations were implemented by the prescriber within 72 hours. Conclusion: A PTMR program with dedicated pharmacy technicians and pharmacists identifies many medication discrepancies at admission and provides opportunities for pharmacist reconciliation recommendations.

Does the patients′ educational level and previous counseling affect their medication knowledge?

Directory of Open Access Journals (Sweden)

Abdulmalik M Alkatheri

2013-01-01

Conclusions: The education level of the patient and previous counseling are positively linked to medication knowledge. Knowledge of the medications′ side effects proved to be the most difficult task for the participants in this study, requiring the highest level of education, and was improved by previous counseling.

Literature, history and the humanization of bioethics.

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Emmerich, Nathan

2011-02-01

This paper considers the disciplines of literature and history and the contributions each makes to the discourse of bioethics. In each case I note the pedagogic ends that can be enacted though the appropriate use of the each of these disciplines in the sphere of medical education, particularly in the medical ethics classroom.(1) I then explore the contribution that both these disciplines and their respective methodologies can and do bring to the academic field of bioethics. I conclude with a brief consideration of the relations between literature and history with particular attention to the possibilities for a future bioethics informed by history and literature after the empirical turn. © 2010 Blackwell Publishing Ltd.

Comparison of Mucin Levels at the Ocular Surface of Postmenopausal Women With and Without a History of Dry Eye

Science.gov (United States)

Gipson, Ilene K.; Spurr-Michaud, Sandra J.; Senchyna, Michelle; Ritter, Robert; Schaumberg, Debra

2011-01-01

Purpose Determine 1) if levels of the glycocalyx membrane mucins, MUC1 and MUC16, and the secreted goblet cell mucin MUC5AC are altered in conjunctival cells and tears of postmenopausal women presenting with a history of non-Sjögren's dry eye, and 2) if mucin levels correlate with dry eye clinical diagnostic data. Methods Eighty-four postmenopausal women with a history of non-Sjögren's dry eye and 30 normal subjects were recruited for this study. Impression cytology samples were collected for mucin mRNA and protein analysis. Tears were collected for mucin protein assay. qPCR, western blot, and ELISA assays were used to quantitate MUC1, MUC16 and MUC5AC levels. Results Postmenopausal women with a history of dry eye displayed significantly increased MUC1 mRNA expression and cellular protein compared to normal subjects (Pdry eye patients with a history of dry eye may be a compensatory response to irritation and inflammation associated with the disease. Understanding the pattern of mucin expression associated with dry eye pathology may clarify factors involved in the progression of the disease and enhance the development of targeted therapies. PMID:22089171

Facultative anadromy in salmonids: linking habitat, individual life history decisions, and population-level consequences

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Steven F. Railsback; Bret C. Harvey; Jason L. White

2014-01-01

Modeling and management of facultative anadromous salmonids is complicated by their ability to select anadromous or resident life histories. Conventional theory for this behavior assumes individuals select the strategy offering highest expected reproductive success but does not predict how population-level consequences such as a stream’s smolt production emerge from...

History of psychiatry

Science.gov (United States)

Shorter, Edward

2013-01-01

Purpose of review The present review examines recent contributions to the evolving field of historical writing in psychiatry. Recent findings Interest in the history of psychiatry continues to grow, with an increasing emphasis on topics of current interest such as the history of psychopharmacology, electroconvulsive therapy, and the interplay between psychiatry and society. The scope of historical writing in psychiatry as of 2007 is as broad and varied as the discipline itself. Summary More than in other medical specialties such as cardiology or nephrology, treatment and diagnosis in psychiatry are affected by trends in the surrounding culture and society. Studying the history of the discipline provides insights into possible alternatives to the current crop of patent-protected remedies and trend-driven diagnoses. PMID:18852567

Development of Colonial Medical and Health Services in Ibadan ...

African Journals Online (AJOL)

Journal of History and Diplomatic Studies ... There is no doubt that medicine is important in the history of any society. ... This limitation of colonial medical intervention coupled with age old medical ideas in Ibadan consequently occasioned the continuity of indigenous medical culture and adaptation of Western medicine in ...

Creating a medical education enterprise: leveling the playing fields of medical education vs. medical science research within core missions.

Science.gov (United States)

Thammasitboon, Satid; Ligon, B Lee; Singhal, Geeta; Schutze, Gordon E; Turner, Teri L

2017-01-01

Unlike publications of medical science research that are more readily rewarded, clinician-educators' scholarly achievements are more nebulous and under-recognized. Create an education enterprise that empowers clinician-educators to engage in a broad range of scholarly activities and produce educational scholarship using strategic approaches to level the playing fields within an organization. The authors analyzed the advantages and disadvantages experienced by medical science researchers vs. clinician educators using Bolman and Deal's (B&D) four frames of organization (structural, human resource, political, symbolic). The authors then identified organizational approaches and activities that align with each B&D frame and proposed practical strategies to empower clinician-educators in their scholarly endeavors. Our medical education enterprise enhanced the structural frame by creating a decentralized medical education unit, incorporated the human resource component with an endowed chair to support faculty development, leveraged the political model by providing grant supports and expanding venues for scholarship, and enhanced the symbolic frame by endorsing the value of education and public recognition from leaderships. In five years, we saw an increased number of faculty interested in becoming clinician-educators, had an increased number of faculty winning Educational Awards for Excellence and delivering conference presentations, and received 12 of the 15 college-wide awards for educational scholarship. These satisfactory trends reflect early success of our educational enterprise. B&D's organizational frames can be used to identify strategies for addressing the pressing need to promote and recognize clinician-educators' scholarship. We realize that our situation is unique in several respects, but this approach is flexible within an institution and transferable to any other institution and its medical education program. B&D: Bolman and Deal; CRIS: Center for Research

Value of pharmacist medication interviews on optimizing the electronic medication reconciliation process.

Science.gov (United States)

Lee, Audrey; Varma, Arjun; Boro, Maureen; Korman, Nancy

2014-06-01

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. 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. Five hundred thirteen discrepancies were identified with the EMRR group compared to 986 from the combined EMRR and patient interview group (P < .001). Significantly more recommendations were made in the combination interview group compared to the EMRR alone group (260 vs 97; P < .001). Fewer medication errors were identified for the EMRR alone group compared to the combination interview group (55 vs 134; P < .001). The most common errors were omitted medications followed by extra dose/failure to discontinue therapy and wrong dose/frequency errors. Pharmacist-conducted admission medication interviews combined with EMRR can potentially identify harmful medication discrepancies and prevent medication errors.

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

Science.gov (United States)

Comer, Rachel; Lizer, Mitsi

2017-10-01

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

Supporting medical education research quality: the Association of American Medical Colleges' Medical Education Research Certificate program.

Science.gov (United States)

Gruppen, Larry D; Yoder, Ernie; Frye, Ann; Perkowski, Linda C; Mavis, Brian

2011-01-01

The quality of the medical education research (MER) reported in the literature has been frequently criticized. Numerous reasons have been provided for these shortcomings, including the level of research training and experience of many medical school faculty. The faculty development required to improve MER can take various forms. This article describes the Medical Education Research Certificate (MERC) program, a national faculty development program that focuses exclusively on MER. Sponsored by the Association of American Medical Colleges and led by a committee of established medical education researchers from across the United States, the MERC program is built on a set of 11 interactive workshops offered at various times and places across the United States. MERC participants can customize the program by selecting six workshops from this set to fulfill requirements for certification. This article describes the history, operations, current organization, and evaluation of the program. Key elements of the program's success include alignment of program content and focus with needs identified by prospective users, flexibility in program organization and logistics to fit participant schedules, an emphasis on practical application of MER principles in the context of the participants' activities and interests, consistency in program content and format to ensure standards of quality, and a sustainable financial model. The relationship between the national MERC program and local faculty development initiatives is also described. The success of the MERC program suggests that it may be a possible model for nationally disseminated faculty development programs in other domains.

The use of virtual patients to teach medical students history taking and communication skills.

Science.gov (United States)

Stevens, Amy; Hernandez, Jonathan; Johnsen, Kyle; Dickerson, Robert; Raij, Andrew; Harrison, Cyrus; DiPietro, Meredith; Allen, Bryan; Ferdig, Richard; Foti, Sebastian; Jackson, Jonathan; Shin, Min; Cendan, Juan; Watson, Robert; Duerson, Margaret; Lok, Benjamin; Cohen, Marc; Wagner, Peggy; Lind, D Scott

2006-06-01

At most institutions, medical students learn communication skills through the use of standardized patients (SPs), but SPs are time and resource expensive. Virtual patients (VPs) may offer several advantages over SPs, but little data exist regarding the use of VPs in teaching communication skills. Therefore, we report our initial efforts to create an interactive virtual clinical scenario of a patient with acute abdominal pain to teach medical students history-taking and communication skills. In the virtual scenario, a life-sized VP is projected on the wall of an examination room. Before the virtual encounter, the student reviews patient information on a handheld tablet personal computer, and they are directed to take a history and develop a differential diagnosis. The virtual system includes 2 networked personal computers (PCs), 1 data projector, 2 USB2 Web cameras to track the user's head and hand movement, a tablet PC, and a microphone. The VP is programmed with specific answers and gestures in response to questions asked by students. The VP responses to student questions were developed by reviewing videotapes of students' performances with real SPs. After obtaining informed consent, 20 students underwent voice recognition training followed by a videotaped VP encounter. Immediately after the virtual scenario, students completed a technology and SP questionnaire (Maastricht Simulated Patient Assessment). All participants had prior experience with real SPs. Initially, the VP correctly recognized approximately 60% of the student's questions, and improving the script depth and variability of the VP responses enhanced most incorrect voice recognition. Student comments were favorable particularly related to feedback provided by the virtual instructor. The overall student rating of the virtual experience was 6.47 +/- 1.63 (1 = lowest, 10 = highest) for version 1.0 and 7.22 +/- 1.76 for version 2.0 (4 months later) reflecting enhanced voice recognition and other

Risk factors for medical complications after long-level internal fixation in the treatment of adult degenerative scoliosis.

Science.gov (United States)

Zhang, Xi-Nuo; Sun, Xiang-Yao; Meng, Xiang-Long; Hai, Yong

2018-04-13

This study evaluates baseline patient characteristics and surgical parameters for risk factors of medical complications in ASD patients received posterior long level internal fixation. Analysis of consecutive patients who underwent posterior long-level instruction fixation for adult degenerative scoliosis (ADS) with a minimum of two year follow-up was performed. Pre-operative risk factors, intraoperative variables, peri-operative radiographic parameters, and surgical-related risk factors were collected to analyze the effect of risk factors on medical complications. Patients were separated into groups with and without medical complication. Then, complication group was further classified as major or minor medical complications. Potential risk factors were identified by univariate testing. Multivariate logistic regression was used to evaluate independent predictors of medical complications. One hundred and thirty-one ADS patients who underwent posterior long segment pedicle screws fixation were included. Total medical complication incidence was 25.2%, which included infection (12.2%), neurological (11.5%), cardiopulmonary (7.6%), gastrointestinal (6.1%), and renal (1.5%) complications. Overall, 7.6% of patients developed major medical complications, and 17.6% of patients developed minor medical complications. The radiographic parameters of pre-operative and last follow-up had no significant difference between the groups of medical complications and the major or minor medical complications subgroups. However, the incidence of cerebrospinal fluid leak (CFL) in patients who without medical complications was much lower than that with medical complications (18.4 vs. 42.4%, P = 0.005). Independent risk factors for development of medical complications included smoking (OR = 6.45, P = 0.012), heart disease (OR = 10.07, P = 0.012), fusion level (OR = 2.12, P = 0.001), and length of hospital stay (LOS) (OR = 2.11, P = 0.000). Independent

Communication pitfalls of traditional history and physical write-up documentation.

Science.gov (United States)

Brown, Jeffrey L

2017-01-01

An unofficial standardized "write-up" outline is commonly used for documenting history and physical examinations, giving oral presentations, and teaching clinical skills. Despite general acceptance, there is an apparent discrepancy between the way clinical encounters are conducted and how they are documented. Fifteen medical school websites were randomly selected from search-engine generated lists. One example of a history and physical write-up from each of six sites, one teaching outline from each of nine additional sites, and recommendations for documentation made in two commonly used textbooks were compared for similarities and differences. Except for minor variations in documenting background information, all sampled materials utilized the same standardized format. When the examiners' early perceptions of the patients' degree of illness or level of distress were described, they were categorized as "general appearance" within the physical findings. Contrary to clinical practice, none of the examples or recommendations documented these early perceptions before chief concerns and history were presented. An examiner's initial perceptions of a patient's affect, degree of illness, and level of distress can influence the content of the history, triage decisions, and prioritization of likely diagnoses. When chief concerns and history are shared without benefit of this information, erroneous assumptions and miscommunications can result. This survey confirms common use of a standardized outline for documenting, communicating, and teaching history-taking and physical examination protocol. The present outline shares early observations out of clinical sequence and may provide inadequate context for accurate interpretation of chief concerns and history. Corrective actions include modifying the documentation sequence to conform to clinical practice and teaching contextual methodology for sharing patient information.

Comparisons between written and computerised patient histories

NARCIS (Netherlands)

Quaak, Martien; Westerman, R. Frans; van Bemmel, Jan H.

1987-01-01

Patient histories were obtained from 99 patients in three different ways: by a computerised patient interview (patient record), by the usual written interview (medical record), and by the transcribed record, which was a computerised version of the medical record. Patient complaints, diagnostic

Low-level radioactive waste transportation safety history

International Nuclear Information System (INIS)

McClure, J.D.

1997-01-01

The Radioactive Materials Incident Report (RMIR) database was developed fin 1981 at the Transportation Technology Center of Sandia National Laboratories to support its research and development activities for the US department of Energy (DOE). This database contains information about radioactive material (RAM) transportation incidents that have occurred in the US since 1971. These data were drawn from the US Department of Transportation's (DOT) Hazardous Materials Incident Report system, from Nuclear Regulatory Commission (NRC) files, and from various agencies including state radiological control offices. Support for the RMIR data base is funded by the US DOE National Transportation Program (NTP). Transportation events in RMIR are classified in one of the following ways: as a transportation accident, as a handling accident, or as a reported incident. This presentation will provide definitions for these classifications and give examples of each. The primary objective of this presentation is to provide information on nuclear materials transportation accident/incident events involving low-level waste (LLW) that have occurred in the US for the period 1971 through 1996. Among the areas to be examined are: transportation accidents by mode, package response during accidents, and an examination of accidents where release of contents has occurred. Where information is available, accident and incident history and package response for LLW packages in transportation accidents will be described

Library Collaboration with Medical Humanities in an American Medical College in Qatar

Directory of Open Access Journals (Sweden)

Sally Birch

2013-11-01

Full Text Available The medical humanities, a cross-disciplinary field of practice and research that includes medicine, literature, art, history, philosophy, and sociology, is being increasingly incorporated into medical school curricula internationally. Medical humanities courses in Writing, Literature, Medical Ethics and History can teach physicians-in-training communication skills, doctor-patient relations, and medical ethics, as well as empathy and cross-cultural understanding. In addition to providing educational breadth and variety, the medical humanities can also play a practical role in teaching critical/analytical skills. These skills are utilized in differential diagnosis and problem-based learning, as well as in developing written and oral communications. Communication skills are a required medical competency for passing medical board exams in the U.S., Canada, the UK and elsewhere. The medical library is an integral part of medical humanities training efforts. This contribution provides a case study of the Distributed eLibrary at the Weill Cornell Medical College in Qatar in Doha, and its collaboration with the Writing Program in the Premedical Program to teach and develop the medical humanities. Programs and initiatives of the DeLib library include: developing an information literacy course, course guides for specific courses, the 100 Classic Books Project, collection development of ‘doctors’ stories’ related to the practice of medicine (including medically-oriented movies and TV programs, and workshops to teach the analytical and critical thinking skills that form the basis of humanistic approaches to knowledge. This paper outlines a ‘best practices’ approach to developing the medical humanities in collaboration among the medical library, faculty and administrative stakeholders.

Library collaboration with medical humanities in an american medical college in qatar.

Science.gov (United States)

Birch, Sally; Magid, Amani; Weber, Alan

2013-11-01

The medical humanities, a cross-disciplinary field of practice and research that includes medicine, literature, art, history, philosophy, and sociology, is being increasingly incorporated into medical school curricula internationally. Medical humanities courses in Writing, Literature, Medical Ethics and History can teach physicians-in-training communication skills, doctor-patient relations, and medical ethics, as well as empathy and cross-cultural understanding. In addition to providing educational breadth and variety, the medical humanities can also play a practical role in teaching critical/analytical skills. These skills are utilized in differential diagnosis and problem-based learning, as well as in developing written and oral communications. Communication skills are a required medical competency for passing medical board exams in the U.S., Canada, the UK and elsewhere. The medical library is an integral part of medical humanities training efforts. This contribution provides a case study of the Distributed eLibrary at the Weill Cornell Medical College in Qatar in Doha, and its collaboration with the Writing Program in the Premedical Program to teach and develop the medical humanities. Programs and initiatives of the DeLib library include: developing an information literacy course, course guides for specific courses, the 100 Classic Books Project, collection development of 'doctors' stories' related to the practice of medicine (including medically-oriented movies and TV programs), and workshops to teach the analytical and critical thinking skills that form the basis of humanistic approaches to knowledge. This paper outlines a 'best practices' approach to developing the medical humanities in collaboration among the medical library, faculty and administrative stakeholders.

Differences in Simulated Doctor and Patient Medical Decision Making: A Construal Level Perspective

Science.gov (United States)

Zhang, Yan; Liu, Quanhui; Miao, Danmin; Xiao, Wei

2013-01-01

Background Patients are often confronted with diverse medical decisions. Often lacking relevant medical knowledge, patients fail to independently make medical decisions and instead generally rely on the advice of doctors. Objective This study investigated the characteristics of and differences in doctor–patient medical decision making on the basis of construal level theory. Methods A total of 420 undergraduates majoring in clinical medicine were randomly assigned to six groups. Their decisions to opt for radiotherapy and surgery were investigated, with the choices described in a positive/neutral/negative frame × decision making for self/others. Results Compared with participants giving medical advice to patients, participants deciding for themselves were more likely to select radiotherapy (F1, 404 = 13.92, p = 011). Participants from positive or neutral frames exhibited a higher tendency to choose surgery than did those from negative frames (F2, 404 = 22.53, peffect of framing on independent decision making was nonsignificant (F2, 404 = 1.07, p = 35); however the effect of framing on the provision of advice to patients was significant (F2, 404 = 12.95, peffect of construal level was significant in the positive frame (F1, 404 = 8.06, p = 005) and marginally significant in the neutral frame (F2, 404 = 3.31, p = 07) but nonsignificant in the negative frame (F2, 404 = .29, p = 59). Conclusion Both social distance and framing depiction significantly affected medical decision making and exhibited a significant interaction. Differences in medical decision making between doctors and patients need further investigation. PMID:24244445

Differences in simulated doctor and patient medical decision making: a construal level perspective.

Directory of Open Access Journals (Sweden)

Jiaxi Peng

Full Text Available BACKGROUND: Patients are often confronted with diverse medical decisions. Often lacking relevant medical knowledge, patients fail to independently make medical decisions and instead generally rely on the advice of doctors. OBJECTIVE: This study investigated the characteristics of and differences in doctor-patient medical decision making on the basis of construal level theory. METHODS: A total of 420 undergraduates majoring in clinical medicine were randomly assigned to six groups. Their decisions to opt for radiotherapy and surgery were investigated, with the choices described in a positive/neutral/negative frame × decision making for self/others. RESULTS: Compared with participants giving medical advice to patients, participants deciding for themselves were more likely to select radiotherapy (F1, 404 = 13.92, p = 011. Participants from positive or neutral frames exhibited a higher tendency to choose surgery than did those from negative frames (F2, 404 = 22.53, p<.001. The effect of framing on independent decision making was nonsignificant (F2, 404 = 1.07, p = 35; however the effect of framing on the provision of advice to patients was significant (F2, 404 = 12.95, p<.001. The effect of construal level was significant in the positive frame (F1, 404 = 8.06, p = 005 and marginally significant in the neutral frame (F2, 404 = 3.31, p = 07 but nonsignificant in the negative frame (F2, 404 = .29, p = 59. CONCLUSION: Both social distance and framing depiction significantly affected medical decision making and exhibited a significant interaction. Differences in medical decision making between doctors and patients need further investigation.

Impulsive aggression, delay discounting, and adolescent suicide attempts: effects of current psychotropic medication use and family history of suicidal behavior.

Science.gov (United States)

Bridge, Jeffrey A; Reynolds, Brady; McBee-Strayer, Sandra M; Sheftall, Arielle H; Ackerman, John; Stevens, Jack; Mendoza, Kristen; Campo, John V; Brent, David A

2015-03-01

Impulsive-aggressive behaviors have been consistently implicated in the phenomenology, neurobiology, and familial aggregation of suicidal behavior. The purpose of this study was to extend previous work by examining laboratory behavioral measures of delayed reward impulsivity and impulsive aggression in adolescent suicide attempters and never-suicidal comparison subjects. Using the Point Subtraction Aggression Paradigm (PSAP) and the Delay Discounting Task (DDQ), the authors examined delay discounting and impulsive aggression in 40 adolescent suicide attempters, ages 13-18, and 40 never-suicidal, demographically matched psychiatric comparison subjects. Overall, suicide attempters and comparison subjects performed similarly on the PSAP and DDQ. There was a significant group by current psychotropic medication use interaction (p=0.013) for mean aggressive responses on the PSAP. Group comparisons revealed that attempters emitted more aggressive responses per provocation than comparison subjects, only in those not on psychotropic medication (p=0.049), whereas for those currently treated with psychotropic medication, there were no group differences (p>0.05). This interaction effect was specific to current antidepressant use. Among all subjects, family history of suicidal behavior (suicide or suicide attempt) in first degree relatives was significantly correlated with both delay discounting (r=-0.22, p=0.049), and aggressive responding (r=0.27, p=0.015). Family history of suicidal behavior was associated with delay discounting, but not with aggressive responding on the PSAP, after controlling for relevant covariates. In this study, impulsive-aggressive responding was associated with suicide attempt only in those not being treated with antidepressants. Future work to replicate and extend these findings could have important therapeutic implications for the treatment of depressed suicide attempters, many of whom are affected by impulsive aggression.

The Hidden History of a Famous Drug : Tracing the Medical and Public Acculturation of Peruvian Bark in Early Modern Western Europe (c. 1650-1720)

NARCIS (Netherlands)

Klein, Wouter; Pieters, Toine

2016-01-01

The history of the introduction of exotic therapeutic drugs in early modern Europe is usually rife with legend and obscurity and Peruvian bark is a case in point. The famous antimalarial drug entered the European medical market around 1640, yet it took decades before the bark was firmly established

[The attempts at drug therapy of cancer by Anton Störck (1731-1803). History of experimental pharmacology in the old Vienna Medical School].

Science.gov (United States)

Schweppe, K W; Probst, C

1982-03-15

The essay deals with the development of medical research in Vienna - especially the development of therapeutic drugs. This progress is related to the philosophical, historical, and political background of the enlightened absolutism and the reformatory efforts of van Swieten during the regency of Maria Theresia in Austria. Anton Störck's research on hemlock (Conium maculatum) is used as an example. The method of Störck's research-work is described. Furthermore it is demonstrated to what extent Störck's data, deduced from empirical examinations, are integrated in the official medical system, i.e. Boerhaave's iatromechanic system. Finally the attempt is made to correlate these processes of medical history with the scientific-historical model of Thomas Kuhn.

Raised Anxiety Levels Among Outpatients Preparing to Undergo a Medical Imaging Procedure: Prevalence and Correlates.

Science.gov (United States)

Forshaw, Kristy L; Boyes, Allison W; Carey, Mariko L; Hall, Alix E; Symonds, Michael; Brown, Sandy; Sanson-Fisher, Rob W

2018-04-01

To examine the percentage of patients with raised state anxiety levels before undergoing a medical imaging procedure; their attribution of procedural-related anxiety or worry; and sociodemographic, health, and procedural characteristics associated with raised state anxiety levels. This prospective cross-sectional study was undertaken in the outpatient medical imaging department at a major public hospital in Australia, with institutional board approval. Adult outpatients undergoing a medical imaging procedure (CT, x-ray, MRI, ultrasound, angiography, or fluoroscopy) completed a preprocedural survey. Anxiety was measured by the short-form state scale of the six-item State-Trait Anxiety Inventory (STAI: Y-6). The number and percentage of participants who reported raised anxiety levels (defined as a STAI: Y-6 score ≥ 33.16) and their attribution of procedural-related anxiety or worry were calculated. Characteristics associated with raised anxiety were examined using multiple logistic regression analysis. Of the 548 (86%) patients who consented to participate, 488 (77%) completed all STAI: Y-6 items. Half of the participants (n = 240; 49%) experienced raised anxiety, and of these, 48% (n = 114) reported feeling most anxious or worried about the possible results. Female gender, imaging modality, medical condition, first time having the procedure, and lower patient-perceived health status were statistically significantly associated with raised anxiety levels. Raised anxiety is common before medical imaging procedures and is mostly attributed to the possible results. Providing increased psychological preparation, particularly to patients with circulatory conditions or neoplasms or those that do not know their medical condition, may help reduce preprocedural anxiety among these subgroups. Copyright © 2018 American College of Radiology. Published by Elsevier Inc. All rights reserved.

State-level medical and absenteeism cost of asthma in the United States.

Science.gov (United States)

Nurmagambetov, Tursynbek; Khavjou, Olga; Murphy, Louise; Orenstein, Diane

2017-05-01

For medically treated asthma, we estimated prevalence, medical and absenteeism costs, and projected medical costs from 2015 to 2020 for the entire population and separately for children in the 50 US states and District of Columbia (DC) using the most recently available data. We used multiple data sources, including the Medical Expenditure Panel Survey, U.S. Census Bureau, Kaiser Family Foundation, Medical Statistical Information System, and Current Population Survey. We used a two-part regression model to estimate annual medical costs of asthma and a negative binomial model to estimate annual school and work days missed due to asthma. Per capita medical costs of asthma ranged from $1,860 (Mississippi) to $2,514 (Michigan). Total medical costs of asthma ranged from $60.7 million (Wyoming) to $3.4 billion (California). Medicaid costs ranged from $4.1 million (Wyoming) to $566.8 million (California), Medicare from $5.9 million (DC) to $446.6 million (California), and costs paid by private insurers ranged from $27.2 million (DC) to $1.4 billion (California). Total annual school and work days lost due to asthma ranged from 22.4 thousand (Wyoming) to 1.5 million days (California) and absenteeism costs ranged from $4.4 million (Wyoming) to $345 million (California). Projected increase in medical costs from 2015 to 2020 ranged from 9% (DC) to 34% (Arizona). Medical and absenteeism costs of asthma represent a significant economic burden for states and these costs are expected to rise. Our study results emphasize the urgency for strategies to strengthen state level efforts to prevent and control asthma attacks.

21 CFR 820.184 - Device history record.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Device history record. 820.184 Section 820.184 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES QUALITY SYSTEM REGULATION Records § 820.184 Device history record. Each manufacturer shall...

[The First World War and medical school of Petrograd].

Science.gov (United States)

Rostovtsev, E A; Sidorchuk, I V

2014-09-01

The article is devoted to the history of higher medical education of the Petrograd just before and during the First World War. The topical issue is the lack of information concerning this period of the history of Russian medicine and medical education, and the history of development of domestic medicine during the First World War, the centenary of which is celebrated this year. On the basis of a wide range of published and archival sources the authors show the basic vectors of development of medical education and exploring the role of St. Petersburg as one of the leading academic medical centres in the country.

American College of Medical Toxicology

Science.gov (United States)

... Publications Journal of Medical Toxicology About ACMT About Us History of ACMT ACMT Fact Sheet Strategic Plan ACMT ... Policies IJMT JMT Editorial Board About ACMT About Us History of ACMT ACMT Fact Sheet Strategic Plan ACMT ...

[History in the public communication of specialist scientific societies: history marketing].

Science.gov (United States)

Moll, F H; Halling, T; Rathert, P; Fangerau, H

2014-10-01

History is nowadays used as an economic factor. The past is therefore specifically targeted and cultivated, which for specialist scientific associations and societies often fullfils totally different functions in comparison to the open market, although the techniques and requirements are similar. Within medical specialties these facts are often still unknown. Museums and archives as well as the historians and curators working in them are very familiar with the special cultures of communication within these scientific communities and they play a major role in the establishment and development of history as a modern part of public relations and public identity.

Aspects of development of leader creative thinking of medical student at the undergraduate level of medical education.

Science.gov (United States)

Sydorchuk, Аniuta S; Moskaliuk, Vasyl D; Randiuk, Yuriy O; Sorokhan, Vasyl D; Golyar, Oksana I; Sydorchuk, Leonid І; Humenna, Anna V

Current issue deals with analysis of possible ways to develop leadership in medical students. Taking into consideration the reforming in National Ukrainian educative system and contemporary tendencies of world integration, the development of skillful personality is the prioritize task. The aim of study is to emphasize on the best-used ways for a development of leader creative thinking at the first basic level of medical education. methodology used here is descriptive analytical investigation based upon the own experience have been since 2005-2015 with undergraduate foreign medical students who studied disciplines « Infectious diseases » and «Epidemiology of Infectious diseases»,«Tropical Medicine and Clinical Parasitology» at the Higher state educational establishment of Ukraine « Bukovinian State Medical University » (Chernivtsi, Ukraine). the authors state that creative thinking of a leader is necessary and important part of innovative pedagogy nowadays. From the positive side of it, formation of new generation of medical students learned by competence-based approach with readiness to carry out multitasks. Coupled with, « thinking out of the box » development in individual person helps to discover maximum features of personality. From the negative side of it, there are difficulties to keep activity within certain limits. Most pre-graduate medical students actively express their best creativity in extra-class time within university events like Round Tables dedicated to International days of hepatitis B&C, malaria, HIV etc. to share with others of prevention recommendations. There are many methods to develop creativity and flexibility of cognitive processes, such as brainstorming session, case study, micro-reality, SCAMPER and lateral thinking method etc. Thus, leadership skills and creative thinking both had targeted for excellent qualitative medical education.

Archives of Medical Education; 1876 - 1971.

Science.gov (United States)

Association of American Medical Colleges, Washington, DC.

This bibliography of the archives of the Association of Medical Colleges includes: general history entries (1876-1971); AMA history publications (1904-1970); other history publications (1934-1962); biomedical research policy publications (1955-1971); reports of conferences, seminars, institutes, workshops, and special studies (1910-1971); Council…

ANALISIS TERHADAP PERLUNYA PENYESUAIAN LAPORAN KEUANGAN HISTORIS (CONVENTIONAL ACCOUNTING MENJADI BERDASARKAN TINGKAT HARGA UMUM (GENERAL PRICE LEVEL ACCOUNTING

Directory of Open Access Journals (Sweden)

Pwee Leng

2002-01-01

Full Text Available Generally, in conventional accounting, financial statements are based on the historical cost principle that assumes that prices (monetery unit are stable. Conventional accounting recognizes neither changes in the general price level nor changes in the specific price level. Consequently, if there are any changes in purchasing power such as in inflation period, the historical financial statement are not economically relevant and also income is usually overstated, and the fixed assets are usually understated. Actually, there are several methods on accounting for the effect of changing prices, such as constant accounting, current value accounting, and general price level accounting. General price level accounting will do restatement the components of financial statement to be a rupiah on a similar level of purchasing power, but without changes in accounting principles which using on conventional accounting. In practice, the controversy concerning the relevance of general price level accounting has been continuing. Pros and cons general price level accounting will be presented on this paper. Also the result of two researches concerning the influence of applied general price level accounting on the financial statement will be compared as considerations whether the general price level adjustment is necessary needed. Abstract in Bahasa Indonesia : Secara umum, dalam akuntansi konvensional, laporan keuangan disajikan berdasarkan nilai historis yang mengasumsikan bahwa harga-harga (unit moneter adalah stabil. Akuntansi konvensional tidak mengakui adanya perubahan tingkat harga umum maupun perubahan tingkat harga khusus. Sebagai konsekuensinya, jika terjadi perubahan daya beli seperti pada periode inflasi, maka laporan keuangan historis secara ekonomis tidaklah relevan. Pada periode ini pendapatan umumnya dinilai lebih tinggi sedangkan aktiva tetap dinilai lebih rendah. Sebenarnya, terdapat beberapa metode akuntansi mengenai pengaruh perubahan harga

A brief history of plastic surgery in Iran.

Science.gov (United States)

Kalantar-Hormozi, Abdoljalil

2013-03-01

 Although the exact time of performing plastic surgery is not addressed in the medical and historical literature, it can be supposed that these surgical procedures have a long and fascinating history.  Recent excavations provided many documents regarding the application of medical instruments, surgical and even reconstructive procedures during the pre-historic and ancient periods. Actually, there is no historical definite time-zone separating general and cosmetic operations in the pre-modern time; however, historically there have been many surgeons who tried to perform reconstructive procedures during their usual medical practice. This article presents a brief look at the history of plastic surgery form the ancient to the contemporary era, with a special focus on Iran.

Lifetime depression history and sexual function in women at midlife.

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Cyranowski, Jill M; Bromberger, Joyce; Youk, Ada; Matthews, Karen; Kravitz, Howard M; Powell, Lynda H

2004-12-01

We examined the association between lifetime depression history and sexual function in a community-based sample of midlife women. Specifically, 914 women aged 42-52 who were participants in the Study of Women's Health Across the Nation completed a self-report assessment of their sexual behaviors, sexual desire, sexual arousal, and sexual satisfaction over the past 6 months. On the basis of the Structured Clinical Interview for the DSM-IV , participants were categorized into 1 of 3 lifetime major depressive disorder (MDD) history groups: no MDD history, single episode MDD, and recurrent MDD. In line with previous reports, women with a history of recurrent MDD reported experiencing less frequent sexual arousal, less physical pleasure, and less emotional satisfaction within their current sexual relationships. Although the groups did not differ in their reported frequency of sexual desire or partnered sexual behaviors, lifetime depression history was associated with increased rates of self-stimulation (masturbation). Associations between lifetime depression history and lower levels of physical pleasure within partnered sexual relationships and higher rates of masturbation remained significant following control for current depressive symptoms, study site, marital status, psychotropic medication use, and lifetime history of anxiety or substance abuse/dependence disorder. Future research is needed to characterize the temporal and etiologic relationships among lifetime depressive disorder, current mood state, and sexual function in women across the lifespan.

Student's Readiness Level towards Implementation of paper 3 Subject History

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Siti Aishah Suhaimi

2017-11-01

Full Text Available This study focuses on the student towards paper implementation 3 subject of history. This study use where survey research design as many as 50 from respondent 4 in School orchid, Cheras, chosen by gregarious sample and use instrument in obtaining quantitative data. This research using Social learning theory Albert Bandura, theory of constructivism and also Bloom's Taxonomy model. Data analyzed by using Excel Microsoft software 2010 (Statistic pack 2.0 (SPSS. Finding of correlation analysis show there is a significant relationship between student attitude approach with students’ knowledge towards paper of 3 history subject (r, =.846=, n=50, p<.0.5. Therefore, the paper 3 subject of history is seen as platform that is able to increase the understanding and performance of students in the general history often associated with subjects that are boring and hard to get better performance by students in examinations due to lack of interest, learning techniques are obsolete and inadequate learning.

Local gray level S-curve transformation - A generalized contrast enhancement technique for medical images.

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Gandhamal, Akash; Talbar, Sanjay; Gajre, Suhas; Hani, Ahmad Fadzil M; Kumar, Dileep

2017-04-01

Most medical images suffer from inadequate contrast and brightness, which leads to blurred or weak edges (low contrast) between adjacent tissues resulting in poor segmentation and errors in classification of tissues. Thus, contrast enhancement to improve visual information is extremely important in the development of computational approaches for obtaining quantitative measurements from medical images. In this research, a contrast enhancement algorithm that applies gray-level S-curve transformation technique locally in medical images obtained from various modalities is investigated. The S-curve transformation is an extended gray level transformation technique that results into a curve similar to a sigmoid function through a pixel to pixel transformation. This curve essentially increases the difference between minimum and maximum gray values and the image gradient, locally thereby, strengthening edges between adjacent tissues. The performance of the proposed technique is determined by measuring several parameters namely, edge content (improvement in image gradient), enhancement measure (degree of contrast enhancement), absolute mean brightness error (luminance distortion caused by the enhancement), and feature similarity index measure (preservation of the original image features). Based on medical image datasets comprising 1937 images from various modalities such as ultrasound, mammograms, fluorescent images, fundus, X-ray radiographs and MR images, it is found that the local gray-level S-curve transformation outperforms existing techniques in terms of improved contrast and brightness, resulting in clear and strong edges between adjacent tissues. The proposed technique can be used as a preprocessing tool for effective segmentation and classification of tissue structures in medical images. Copyright © 2017 Elsevier Ltd. All rights reserved.

Early modern natural history: Contributions from the Americas

Indian Academy of Sciences (India)

Early modern natural history: Contributions from the Americas and India. Rajesh Kochhar. Perspectives Volume 37 Issue ... Keywords. India; medical botany; natural history; scientific botany; the Americas. Author Affiliations. Rajesh Kochhar1. Indian Institute of Science Education and Research, Mohali 140 306 Punjab, India ...

Endogenous ROS levels in C. elegans under exogenous stress support revision of oxidative stress theory of life-history tradeoffs.

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Smith, Samson W; Latta, Leigh C; Denver, Dee R; Estes, Suzanne

2014-07-24

The oxidative stress theory of life-history tradeoffs states that oxidative stress caused by damaging free radicals directly underpins tradeoffs between reproduction and longevity by altering the allocation of energetic resources between these tasks. We test this theory by characterizing the effects of exogenous oxidative insult and its interaction with thermal stress and diet quality on a suite of life-history traits and correlations in Caenorhabditis elegans nematodes. We also quantify demographic aging rates and endogenous reactive oxygen species (ROS) levels in live animals. Our findings indicate a tradeoff between investment in reproduction and antioxidant defense (somatic maintenance) consistent with theoretical predictions, but correlations between standard life-history traits yield little evidence that oxidative stress generates strict tradeoffs. Increasing oxidative insult, however, shows a strong tendency to uncouple positive phenotypic correlations and, in particular, to reduce the correlation between reproduction and lifespan. We also found that mild oxidative insult results in lower levels of endogenous ROS accompanied by hormetic changes in lifespan, demographic aging, and reproduction that disappear in combined-stress treatments--consistent with the oxidative stress theory of aging. Our findings demonstrate that oxidative stress is a direct contributor to life-history trait variation and that traditional tradeoffs are not necessary to invoke oxidative stress as a mediator of relationships between life-history traits, supporting previous calls for revisions to theory.

Genetics: A New Landscape for Medical Geography

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Carrel, Margaret; Emch, Michael

2014-01-01

The emergence and re-emergence of human pathogens resistant to medical treatment will present a challenge to the international public health community in the coming decades. Geography is uniquely positioned to examine the progressive evolution of pathogens across space and through time, and to link molecular change to interactions between population and environmental drivers. Landscape as an organizing principle for the integration of natural and cultural forces has a long history in geography, and, more specifically, in medical geography. Here, we explore the role of landscape in medical geography, the emergent field of landscape genetics, and the great potential that exists in the combination of these two disciplines. We argue that landscape genetics can enhance medical geographic studies of local-level disease environments with quantitative tests of how human-environment interactions influence pathogenic characteristics. In turn, such analyses can expand theories of disease diffusion to the molecular scale and distinguish the important factors in ecologies of disease that drive genetic change of pathogens. PMID:24558292

The Hidden History of a Famous Drug: Tracing the Medical and Public Acculturation of Peruvian Bark in Early Modern Western Europe (c. 1650-1720).

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Klein, Wouter; Pieters, Toine

2016-10-01

The history of the introduction of exotic therapeutic drugs in early modern Europe is usually rife with legend and obscurity and Peruvian bark is a case in point. The famous antimalarial drug entered the European medical market around 1640, yet it took decades before the bark was firmly established in pharmaceutical practice. This article argues that the history of Peruvian bark can only be understood as the interplay of its trajectories in science, commerce, and society. Modern research has mostly focused on the first of these, largely due to the abundance of medico-historical data. While appreciating these findings, this article proposes to integrate the medical trajectory in a richer narrative, by drawing particular attention to the acculturation of the bark in commerce and society. Although the evidence we have for these two trajectories is still sketchy and disproportionate, it can nevertheless help us to make sense of sources that have not yet been an obvious focus of research. Starting from an apparently isolated occurrence of the drug in a letter, this article focuses on Paris as the location where medical and public appreciation of the bark took shape, by exploring several contexts of knowledge circulation and medical practice there. These contexts provide a new window on the early circulation of knowledge of the bark, at a time when its eventual acceptance was by no means certain. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Weaving together peer assessment, audios and medical vignettes in teaching medical terms

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Khan, Lateef M.

2015-01-01

Objectives The current study aims at exploring the possibility of aligning peer assessment, audiovisuals, and medical case-report extracts (vignettes) in medical terminology teaching. In addition, the study wishes to highlight the effectiveness of audio materials and medical history vignettes in preventing medical students' comprehension, listening, writing, and pronunciation errors. The study also aims at reflecting the medical students' attitudes towards the teaching and learning process. Methods The study involved 161 medical students who received an intensive medical terminology course through audio and medical history extracts. Peer assessment and formative assessment platforms were applied through fake quizzes in a pre- and post-test manner. An 18-item survey was distributed amongst students to investigate their attitudes and feedback towards the teaching and learning process. Quantitative and qualitative data were analysed using the SPSS software. Results The students did better in the posttests than on the pretests for both the quizzes of audios and medical vignettes showing a t-test of -12.09 and -13.60 respectively. Moreover, out of the 133 students, 120 students (90.22%) responded to the survey questions. The students gave positive attitudes towards the application of audios and vignettes in the teaching and learning of medical terminology and towards the learning process. Conclusions The current study revealed that the teaching and learning of medical terminology have more room for the application of advanced technologies, effective assessment platforms, and active learning strategies in higher education. It also highlights that students are capable of carrying more responsibilities of assessment, feedback, and e-learning. PMID:26637986

Trauma history is associated with prior suicide attempt history in hospitalized patients with major depressive disorder.

Science.gov (United States)

Brown, Lily A; Armey, Michael A; Sejourne, Corinne; Miller, Ivan W; Weinstock, Lauren M

2016-09-30

Although the relationships between PTSD, abuse history, and suicidal behaviors are well-established in military and outpatient samples, little data is available on this relationship in inpatient samples. This study examines the relationships between these variables and related demographic and clinical correlates in a sample of psychiatric inpatients with a diagnosis of major depressive disorder using electronic medical record (EMR) data. Controlling for relevant demographic and clinical variables, PTSD diagnosis and history of abuse were both significantly associated with history of suicide attempt, but in a combined model, only history of abuse remained as a significant predictor. Whereas history of abuse was associated with a history multiple suicide attempts, PTSD diagnosis was not. Both insurance status and gender acted as significant moderators of the relationship between history of abuse and history of suicide attempt, with males and those with public/no insurance having greater associations with history of suicide attempts when an abuse history was present. These data indicate the importance of documentation of PTSD, abuse history, and history of suicide attempts. The results also suggest that in the presence of an abuse history or PTSD diagnosis, additional time spent on safety and aftercare planning following hospital discharge may be indicated. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Theoretical parameter histories of dynamic tests during power commissioning of Mochovce units power level up to 100 % Nnom

International Nuclear Information System (INIS)

Jagrik, J.; Mraz, M.; Rapant, M.; Stefanovic, P.; Kotasek, J.; Gieci, A.; Macko, J.; Mosny, J.

1998-01-01

Theoretical histories of selected parameters for dynamic tests carried out in the course of power commissioning of the Mochovce Unit 1 at the power level 100% N nom are shown in the report. The expected histories given were developed based on calculations performed by means of simulator in Nuclear Power Plants Research Institute Trnava, Inc., simulator in EGU Praha and simulator at the Mochovce plant, as well as based on similar tests at both Bohunice and Dukovany plants

[The history of the institutionalization of medical psychology in Austria].

Science.gov (United States)

Hirnsperger, Hans; Mundschütz, Reinhard; Sonneck, Gernot

2011-01-01

Beginning with Freudian psychoanalysis and the Zürich school of psychiatry, which in the early 20th century were the first to call for studies in medical psychology at universities, the article traces the path to the institutionalization of medical psychology in Austria especially in Vienna. Particular attention is devoted to the Academic Society for Medical Psychology (Akademischer Verein für Medizinische Psychologie) which held lectures and courses at the University of Vienna from 1926 to 1938. The Society can thus be viewed as a predecessor of the foundation of the institutes for medical psychology and psychotherapeutic clinics, starting in the late 1960s and continuing into the early 1980s.

Prevalence and Sociodemographic Determinants of Hypertension History among Women in Reproductive Age in Ghana

Directory of Open Access Journals (Sweden)

Samuel H. Nyarko

2016-01-01

Full Text Available Background. Hypertension is a global health problem. Yet, studies on hypertension rarely focus on women in Ghana. The purpose of this study is to ascertain the prevalence and sociodemographic determinants of hypertension history among Ghanaian women in reproductive age. Methods. This study used data from the 2014 Ghana Demographic and Health Survey. Bivariate and logistic regression analyses were carried out to ascertain the prevalence and determinants of hypertension history among the respondents. Results. The study found that the overall prevalence of hypertension history among the respondents was 7.5%; however, there were vast variations within most of the sociodemographic categories. Age, level of education, marital status, work status, and wealth status had a significant relationship with hypertension history among the respondents. Women in advanced age groups, highly educated, married, and widowed/divorced/separated, nonworking women, and women from wealthy households were at higher risk of having hypertension history. Conclusion. Myriads of sociodemographic factors determine the hypertension history of women in Ghana. It is therefore essential to target medical and psychosocial hypertension interventions at Ghanaian women in the higher risk groups.

Analysis of Forensic Autopsy in 120 Cases of Medical Disputes Among Different Levels of Institutional Settings.

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Yu, Lin-Sheng; Ye, Guang-Hua; Fan, Yan-Yan; Li, Xing-Biao; Feng, Xiang-Ping; Han, Jun-Ge; Lin, Ke-Zhi; Deng, Miao-Wu; Li, Feng

2015-09-01

Despite advances in medical science, the causes of death can sometimes only be determined by pathologists after a complete autopsy. Few studies have investigated the importance of forensic autopsy in medically disputed cases among different levels of institutional settings. Our study aimed to analyze forensic autopsy in 120 cases of medical disputes among five levels of institutional settings between 2001 and 2012 in Wenzhou, China. The results showed an overall concordance rate of 55%. Of the 39% of clinically missed diagnosis, cardiovascular pathology comprises 55.32%, while respiratory pathology accounts for the remaining 44. 68%. Factors that increase the likelihood of missed diagnoses were private clinics, community settings, and county hospitals. These results support that autopsy remains an important tool in establishing causes of death in medically disputed case, which may directly determine or exclude the fault of medical care and therefore in helping in resolving these cases. © 2015 American Academy of Forensic Sciences.

[Medical history impressions of Karl Marx 1983].

Science.gov (United States)

Kaiser, W

1983-12-15

Excerpts of his London era first published on the occasion of the Karl Marx testimonials of 1983 gave rise to extend the memory of the fundamental achievements of Karl Marx to medico-historical aspects. In this case Karl Marx paid special attention to the working and living conditions of the working class and an analysis of his adequate statements and records shows multifarious details which give a research basis also for the history of medicine. Marx and Engels had friendly contacts with several physicians who shared the opinions of the two classics: their way of life is shown in the most important points.

Evaluation of Randomly Selected Completed Medical Records Sheets in Teaching Hospitals of Jahrom University of Medical Sciences, 2009

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Mohammad Parsa Mahjob

2011-06-01

Full Text Available Background and objective: Medical record documentation, often use to protect the patients legal rights, also providing information for medical researchers, general studies, education of health care staff and qualitative surveys is used. There is a need to control the amount of data entered in the medical record sheets of patients, considering the completion of these sheets is often carried out after completion of service delivery to the patients. Therefore, in this study the prevalence of completeness of medical history, operation reports, and physician order sheets by different documentaries in Jahrom teaching hospitals during year 2009 was analyzed. Methods and Materials: In this descriptive / retrospective study, the 400 medical record sheets of the patients from two teaching hospitals affiliated to Jahrom medical university was randomly selected. The tool of data collection was a checklist based on the content of medical history sheet, operation report and physician order sheets. The data were analyzed by SPSS (Version10 software and Microsoft Office Excel 2003. Results: Average of personal (Demography data entered in medical history, physician order and operation report sheets which is done by department's secretaries were 32.9, 35.8 and 40.18 percent. Average of clinical data entered by physician in medical history sheet is 38 percent. Surgical data entered by the surgeon in operation report sheet was 94.77 percent. Average of data entered by operation room's nurse in operation report sheet was 36.78 percent; Average of physician order data in physician order sheet entered by physician was 99.3 percent. Conclusion: According to this study, the rate of completed record papers reviewed by documentary in Jahrom teaching hospitals were not desirable and in some cases were very weak and incomplete. This deficiency was due to different reason such as medical record documentaries negligence, lack of adequate education for documentaries, High work

Electronic medical history designed by a multidisciplinary unit mastology; Historia clinica electronica disenada por una unidad de mastologia multidisciplinaria

Energy Technology Data Exchange (ETDEWEB)

Camejo, N.; Castillo, C.; Vaca, N.; Camargo, B.; Artagaveytia, N.; Acuna, S.; Milans, S.; Lavina, G.; Carzoglio, J.; Jacobo, O.; Pressa, C.; Delgado, L. [Servicio de Oncologia, Hospital de Clinicas, Montevideo (Uruguay)

2012-11-15

Full text: Objective: To facilitate the collection, organization and analysis of data from patients Unit assisted in Mastology by producing an electronic health record. Materials and Methods: We evaluated forms provided by medical oncologists, radio therapists, radiologists, pathologists, and plastic surgeons mastologists collect data interrogation, physical examination, complementary examinations, diagnoses, anatomy pathological evolution and treatment instituted and generating the system was computerized {sup U}nit Mastology - Electronic Health Record ( UMAHCE){sup .} Results: The story was designed in modules that collect data on instances arising diagnostic, treatment and monitoring of patients. Each module is represented by an icon that changes color to enter data, allowing the objectify doctor if they are or not the data for that module. The system can attach images recorded by breast exam photos, photos of study, imaging (mammography, CT, MRI) in the same way that the surgeon to enter the protocol surgical or anatomical pathologist enter a pathological report of a study untimely or after definitive surgery. The system can generate an automatic report of the input data that can be printed and placed in the patient's medical history. It also can generate the e mail alerts doctors on pathological results were entered into regarding the diagnosis or treatment breast cancer (eg, mammography B I-Rads 4 or 5, report positive cytologic puncture malignancy, H R and Her status). Conclusions: We developed an electronic medical record that allows different doctors involved in the management of breast disease can be accessed through the web regardless of where they are ( pathology laboratory, room radiology reports, clinic, operation theater), both for information about a patient to enter data the same in relation to their specialty. Moreover, homogenize manages the type and quality of the data and therefore can improve the care and research activities as well as

Analysis of Factors Affecting Patients’ Compliance to Topical Antiglaucoma Medications in Egypt as a Developing Country Model

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Nahla B. Abu Hussein

2015-01-01

Full Text Available Purpose. To study factors affecting patients’ compliance to antiglaucoma medications in Egypt where there are unique factors as a developing country. Patients and Methods. A cross-sectional descriptive study on 440 Egyptian patients with open angle glaucoma (OAG recruited for over two years. The patients were thoroughly interviewed about their age, education level, duration of glaucoma, difficulty in instilling the drops, medication regimens, a family history of glaucoma, knowledge of the disease, and the presence of medical insurance. Results. 236 (53.6% were noncompliant compared to 204 (46.4% who were compliant. Females had a tendency for higher compliance (p=0.061. Patient age above 50 years and low level of education and negative family history of glaucoma were factors significantly associated with poor compliance (p<0.0001. Polytherapy and lack of medical insurance could be contributing factors. Conclusion. Egyptian patients have a high rate of noncompliance compared to the average in literature. Great effort is needed in educating patients about the importance of medications and the risk and the prognosis of this disease. Economic factors must also be taken into consideration in developing countries with large number of poor patients. We recommend simplifying drug regimens, incorporating electronic dose monitors, and creating reminders for follow-up visits of glaucoma patients.

Examination of image diagnosis system at high level emergency medical service

International Nuclear Information System (INIS)

Hirose, Masaharu; Endo, Toshio; Aoki, Tomio

1983-01-01

This is a report of the basic idea on imaging system focussing on a necessary X-ray system for high-level emergencies which was worked out due to the establishment of the independent emergency medical institute specialized in the tertiary lifesaving and emergency, and of examinations on satisfactory results we gained for about three years of usage. (author)

The history of genetics in Mexico in the light of A Cultural History of Heredity.

Science.gov (United States)

Barahona, Ana

2013-01-01

In this paper I analyze the conditions for scientific research and the social relationships that allowed the establishment of genetics in Mexico, in the laboratory, the clinic and in agronomy. I give three examples to illustrate how the cultural history of heredity has enlightened this work: the introduction and institutionalization of Mendelism in Mexico, the hereditarian ideas of medical doctors in the late nineteenth century, and the introduction of medical genetics in Mexico.

Carboxyhemoglobin levels in medical intensive care patients: a retrospective, observational study.

Science.gov (United States)

Fazekas, Andreas S; Wewalka, Marlene; Zauner, Christian; Funk, Georg-Christian

2012-01-11

Critical illness leads to increased endogenous production of carbon monoxide (CO) due to the induction of the stress-response enzyme, heme oxygenase-1 (HO-1). There is evidence for the cytoprotective and anti-inflammatory effects of CO based on animal studies. In critically ill patients after cardiothoracic surgery, low minimum and high maximum carboxyhemoglobin (COHb) levels were shown to be associated with increased mortality, which suggests that there is an 'optimal range' for HO-1 activity. Our study aimed to test whether this relationship between COHb and outcome exists in non-surgical ICU patients. We conducted a retrospective, observational study in a medical ICU at a university hospital in Vienna, Austria involving 868 critically ill patients. No interventions were undertaken. Arterial COHb was measured on admission and during the course of treatment in the ICU. The association between arterial COHb levels and ICU mortality was evaluated using bivariate tests and a logistic regression model. Minimum COHb levels were slightly lower in non-survivors compared to survivors (0.9%, 0.7% to 1.2% versus 1.2%, 0.9% to 1.5%; P=0.0001), and the average COHb levels were marginally lower in non-survivors compared to survivors (1.5%, 1.2% to 1.8% versus 1.6%, 1.4% to 1.9%, P=0.003). The multivariate logistic regression analysis revealed that the association between a low minimum COHb level and increased mortality was independent of the severity of illness and the type of organ failure. Critically ill patients surviving the admission to a medical ICU had slightly higher minimum and marginally higher average COHb levels when compared to non-survivors. Even though the observed differences are statistically significant, the minute margins would not qualify COHb as a predictive marker for ICU mortality.

Damage Level Prediction of Reinforced Concrete Building Based on Earthquake Time History Using Artificial Neural Network

Directory of Open Access Journals (Sweden)

Suryanita Reni

2017-01-01

Full Text Available The strong motion earthquake could cause the building damage in case of the building not considered in the earthquake design of the building. The study aims to predict the damage-level of building due to earthquake using Artificial Neural Networks method. The building model is a reinforced concrete building with ten floors and height between floors is 3.6 m. The model building received a load of the earthquake based on nine earthquake time history records. Each time history scaled to 0,5g, 0,75g, and 1,0g. The Artificial Neural Networks are designed in 4 architectural models using the MATLAB program. Model 1 used the displacement, velocity, and acceleration as input and Model 2 used the displacement only as the input. Model 3 used the velocity as input, and Model 4 used the acceleration just as input. The output of the Neural Networks is the damage level of the building with the category of Safe (1, Immediate Occupancy (2, Life Safety (3 or in a condition of Collapse Prevention (4. According to the results, Neural Network models have the prediction rate of the damage level between 85%-95%. Therefore, one of the solutions for analyzing the structural responses and the damage level promptly and efficiently when the earthquake occurred is by using Artificial Neural Network

[Cracow medical chamber in the special collection of the main medical library].

Science.gov (United States)

Szkudaj, T

2000-01-01

The article on Cracow Medical Chamber in the Special Collection of the Main Medical Library concerns the history of establishing medical chambers and covers the period from 1893 to 1950. It presents in detail the territorial extent of Cracow Medical Chamber, its membership and presidents' functions as well as the composition of its various boards and councils. It also talks about the legal acts regulating the functioning of medical chambers and their sphere of activity. The collection of archived records kept in the Special Collection of Main Medical Library constitutes a small percentage of the preserved records; these being mainly personal files of doctors comprising personal questionnaires, registration cards and photographs.

Improving students' confidence levels in communicating with patients and introducing students to the importance of history taking

International Nuclear Information System (INIS)

Halkett, Georgia K.B.; McKay, Janice; Shaw, Therese

2011-01-01

Background: Radiographers can have a marked impact on the way patients deal with their illness because they are often one of the first health professionals that patients see. Therefore, it is essential that radiographers have effective communication skills and are able to provide patients with the information they require. The purpose of this study was to test whether the introduction of additional education on communication and history taking improved students' communication skills. Methods: A short program on communication skills and history taking was introduced to third year undergraduate students prior to a clinical placements period. Three workshops were run; the third included a role play exercise using professional actors as simulated patients. Students completed questionnaires at baseline, following the three workshops and after their subsequent clinical placement. Descriptive statistics were calculated and logistic regression Generalized Estimating Equations models were fitted to test for differences over time in students' confidence levels. Results: Twenty-seven out of 36 students completed the baseline and final surveys. Students indicated they were highly satisfied with the workshops provided. Statistically significant differences were observed for seven items relating to student's confidence levels in communicating with patients after they had participated in the workshops and their subsequent clinical placement. Conclusion: The use of communication skills workshops involving actor/patients is an effective method of assisting students to develop their communication and history taking skills. This program has now been implemented into the mentioned undergraduate course and it is recommended that radiography students at other institutions be provided with the opportunity to develop their communication and history taking skills.

Medical education: Changes and perspectives

Science.gov (United States)

Zhang, Qin; Lee, Liming; Gruppen, Larry D.; Ba, Denian

2013-01-01

As medical education undergoes significant internationalization, it is important for the medical education community to understand how different countries structure and provide medical education. This article highlights the current landscape of medical education in China, particularly the changes that have taken place in recent years. It also examines policies and offers suggestions about future strategies for medical education in China. Although many of these changes reflect international trends, Chinese medical education has seen unique transformations that reflect its particular culture and history. PMID:23631405

Comparability of outcome frameworks in medical education: Implications for framework development.

Science.gov (United States)

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

2015-01-01

Given the increasing mobility of medical students and practitioners, there is a growing need for harmonization of medical education and qualifications. Although several initiatives have sought to compare national outcome frameworks, this task has proven a challenge. Drawing on an analysis of existing outcome frameworks, we identify factors that hinder comparability and suggest ways of facilitating comparability during framework development and revisions. We searched MedLine, EmBase and the Internet for outcome frameworks in medical education published by national or governmental organizations. We analyzed these frameworks for differences and similarities that influence comparability. Of 1816 search results, 13 outcome frameworks met our inclusion criteria. These frameworks differ in five core features: history and origins, formal structure, medical education system, target audience and key terms. Many frameworks reference other frameworks without acknowledging these differences. Importantly, the level of detail of the outcomes specified differs both within and between frameworks. The differences identified explain some of the challenges involved in comparing outcome frameworks and medical qualifications. We propose a two-level model distinguishing between "core" competencies and culture-specific "secondary" competencies. This approach could strike a balance between local specifics and cross-national comparability of outcome frameworks and medical education.

Medical record validation of maternally reported history of preeclampsia

NARCIS (Netherlands)

M. Coolman (Marianne); C.J.M. de Groot (Christianne); V.W.V. Jaddoe (Vincent); A. Hofman (Albert); H. Raat (Hein); E.A.P. Steegers (Eric)

2010-01-01

textabstractObjective: In this study, we assessed the validity of maternally self-reported history of preeclampsia. Study Design and Setting: This study was embedded in the Generation R Study, a population-based prospective cohort study. Data were obtained from prenatal questionnaires and one

Radiation shielding and health physics instrumentation for PET medical cyclotrons

International Nuclear Information System (INIS)

Mukherjee, B.

2002-01-01

Full text: Modern Medical Cyclotrons produce a variety of short-lived positron emitting PET radioisotopes, and as a result are the source of intense neutron and gamma radiations. Since such cyclotrons are housed within hospitals or medical clinics, there is significant potential for un-intentional exposure to staff or patients in proximity to cyclotron facilities. Consequently, the radiological hazards associated with Cyclotrons provide the impetus for an effective radiological shielding and continuous monitoring of various radiation levels in the cyclotron environment. Management of radiological hazards is of paramount importance for the safe operation of a Medical Cyclotron facility. This work summarised the methods of shielding calculations for a compact hospital based Medical Cyclotron currently operating in Canada, USA and Australia. The design principle and operational history of a real-time health physics monitoring system (Watchdog) operating at a large multi-energy Medical Cyclotron is also highlighted

"History, Theory and Ethics of Medicine": The Last Ten Years. A Survey of Course Content, Methods and Structural Preconditions at Twenty-nine German Medical Faculties.

Science.gov (United States)

Schildmann, Jan; Bruns, Florian; Hess, Volker; Vollmann, Jochen

2017-01-01

Objective: "History, Theory, Ethics of Medicine" (German: "Geschichte, Theorie, Ethik der Medizin", abbreviation: GTE) forms part of the obligatory curriculum for medical students in Germany since the winter semester 2003/2004. This paper presents the results of a national survey on the contents, methods and framework of GTE teaching. Methods: Semi-structured questionnaire dispatched in July 2014 to 38 institutions responsible for GTE teaching. Descriptive analysis of quantitative data and content analysis of free-text answers. Results: It was possible to collect data from 29 institutes responsible for GTE teaching (response: 76%). There is at least one professorial chair for GTE in 19 faculties; two professorial chairs or professorships remained vacant at the time of the survey. The number of students taught per academic year ranges from 350. Teaching in GTE comprises an average of 2.18 hours per week per semester (min: 1, max: 6). Teaching in GTE is proportionally distributed according to an arithmetic average as follows: history: 35.4%, theory 14.7% and ethics 49.9%. Written learning objectives were formulated for GTE in 24 faculties. The preferred themes of teaching in history, theory or ethics which according to respondents should be taught comprise a broad spectrum and vary. Teaching in ethics (79 from a max. of 81 possible points) is, when compared to history (61/81) and theory (53/81), attributed the most significance for the training of medical doctors. Conclusion: 10 years after the introduction of GTE the number of students and the personnel resources available at the institutions vary considerably. In light of the differences regarding the content elicited in this study the pros and cons of heterogeneity in GTE should be discussed.

Should applicants to Nottingham University Medical School study a non-science A-level?: a cohort study

OpenAIRE

Yates, Janet; Smith, Jennifer; James, David; Ferguson, Eamonn

2009-01-01

Abstract Background It has been suggested that studying non-science subjects at A-level should be compulsory for medical students. Our admissions criteria specify only Biology, Chemistry and one or more additional subjects. This study aimed to determine whether studying a non-science subject for A-level is an independent predictor of achievement on the undergraduate medical course. Methods The subjects of this retrospective cohort study were 164 students from one entry-year group (October 200...

Blood lead levels and chronic blood loss

Energy Technology Data Exchange (ETDEWEB)

Manci, E.A.; Cabaniss, M.L.; Boerth, R.C.; Blackburn, W.R.

1986-03-01

Over 90% of lead in blood is bound to the erythrocytes. This high affinity of lead for red cells may mean that chronic blood loss is a significant means for excretion of lead. This study sought correlations between blood lead levels and clinical conditions involving chronic blood loss. During May, June and July, 146 patients with normal hematocrits and red cell indices were identified from the hospital and clinic populations. For each patient, age, race, sex and medical history were noted, and a whole blood sample was analyzed by flameless atomic absorption spectrophotometry. Age-and race-matched pairs showed a significant correlation of chronic blood loss with lead levels. Patients with the longest history of blood loss (menstruating women) had the lowest level (mean 6.13 ..mu..g/dl, range 3.6-10.3 ..mu..g/dl). Post-menopausal women had levels (7.29 ..mu..g/dl, 1.2-14 ..mu..g/dl) comparable to men with peptic ulcer disease, or colon carcinoma (7.31 ..mu..g/dl, 5.3-8.6 ..mu..g/dl). The highest levels were among men who had no history of bleeding problems (12.39 ..mu..g/dl, 2.08-39.35 ..mu..g/dl). Chronic blood loss may be a major factor responsible for sexual differences in blood lead levels. Since tissue deposition of environmental pollutants is implicated in diseases, menstruation may represent a survival advantage for women.

[Staffing levels in medical radiation physics in radiation therapy in Germany. Summary of a questionnaire].

Science.gov (United States)

Leetz, Hans-Karl; Eipper, Hermann Hans; Gfirtner, Hans; Schneider, Peter; Welker, Klaus

2003-10-01

To get a general idea of the actual staffing level situation in medical radiation physics in 1999 a survey was carried out by the task-group "Personalbedarf" of Deutsche Gesellschaft für Medizinische Physik (DGMP) among all DGMP-members who are active in this field. Main components for equipment and activities are defined in Report 8 and 10 of DGMP for staffing requirements in medical radiation physics. 322 forms were sent out, 173 of them have been evaluated. From the answers regarding equipment and activities numbers for staff are calculated by the methods given in Report 8 and 10 for this spot check target and compared with effective staffing levels. The data of the spot check are then extrapolated on total Germany. The result is a calculated deficit of 865 medical physicists for the whole physics staff, 166 of them in radiation therapy. From the age distribution of DGMP-members and the calculated deficit resulted a training capacity of about 100 medical physicists at all per year (19 in radiation therapy) if the deficit shall be cut back in 10 years.

Interacting with History: Reflections on Philosophy and the Pedagogy of Dance History

Science.gov (United States)

Carter, Alexandra

2004-01-01

Dance history is studied at all levels of the curriculum, whether as a named course or part of other domains of enquiry. Debates drawn from the philosophy of history and historiographic practice can impact on the teaching and learning of dance history in order to produce a more imaginative and personal engagement with the field. These debates are…

Governmental oversight of prescribing medications: history of the US Food and Drug Administration and prescriptive authority.

Science.gov (United States)

Plank, Linda S

2011-01-01

The evolution of drug regulation and awarding of prescriptive authority is a complex and sometimes convoluted process that can be confusing for health care providers. A review of the history of how drugs have been manufactured and dispensed helps explain why this process has been so laborious and complicated. Because the federal and state governments have the responsibility for protecting the public, most regulations have been passed with the intentions of ensuring consumer safety. The current system of laws and regulations is the result of many years of using the legal system to correct drug marketing that had adverse health consequences. Government oversight will continue as prescribing medications transitions to an electronic form and as health care professionals in addition to physicians seek to gain prescriptive authority. © 2011 by the American College of Nurse-Midwives.

Introducing medical humanities in the medical curriculum in Saudi Arabia: A pedagogical experiment

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Rabie E Abdel-Halim

2012-01-01

Full Text Available In a marked shift from the modern positivist materialist philosophy that influenced medical education for more than a century, Western medical educators are now beginning to realize the significance of the spiritual element of human nature. Consensus is currently building up in Europe and North America on the need to give more emphasis to the study of humanities disciplines such as history of medicine, ethics, religion, philosophy, medically related poetry, literature, arts and medical sociology in medical colleges with the aim of allowing graduates to reach to the heart of human learning about meaning of life and death and to become kinder, more reflective practitioners. The medicine taught and practiced during the Islamic civilization era was a vivid example of the unity of the two components of medical knowledge: natural sciences and humanities. It was also a brilliant illustration of medical ethics driven by a divine moral code. This historical fact formed the foundation for the three medical humanities courses presented in this article reporting a pedagogical experiment in preparation for starting a humanities program in Alfaisal University Medical College in Riyadh. In a series of lectures alternating with interactive sessions, active learning strategies were employed in teaching a course on history of medicine during the Islamic era and another on Islamic medical ethics. Furthermore, a third course on medically relevant Arabic poetry was designed and prepared in a similar way. The end-of-the-course feedback comments reflected effectiveness of the courses and highlighted the importance of employing student-centered learning techniques in order to motivate medical students to become critical thinkers, problem solvers, life-long learners and self-learners.

chronicles of medical history biomimetics: the early years

African Journals Online (AJOL)

2014-12-22

Dec 22, 2014 ... basic sciences of physics, mathematics and chemistry ... Department of Pharmacology and Therapeutics, Faculty of Basic Medical Sciences, College of ... approach man's tool for the ultimate conquest of sickness and disease ...

Levels of empathy and professional ethics in candidates to Medical Graduate School

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José Luis Jiménez-López

2017-07-01

Full Text Available The current perception of a dehumanized medical attention and its low quality has questioned the empathic capacity and ethics of the health professionals. The research in this field reports variations in this attributes along the doctors’ education. Objective: to explore the global levels of empathy and professional ethics, as well as the levels of each component of both attributes in a sample of applicants to a medical graduate program. Methodology: 65 residents that applied for graduation studies in a very specialized medical unit were included. As part of the application process, they answered the Cognitive and Affective Empathy Test and the Professional Ethical Attitudes Scale. Results: The average scores of the sample got Average in empathy and Optimal in professional ethics. The comparison by gender, specialty and competences showed less affective and better ethical competence in women, more cognitive empathy in surgical specialties, and in general an absence of correlation between the two variables and specifically by competence. Conclusions: The importance of measuring the specific competences of each attribute is highlighted given that the variation in specific competences impact in different aspects the doctor’s education, as the specialty choice, the student selection, the development of academic programs and the adequate learning about the construction of an effective relation doctor-patient. © Revista Colombiana de Ciencias Sociales

Electronic medical devices: a primer for pathologists.

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Weitzman, James B

2003-07-01

Electronic medical devices (EMDs) with downloadable memories, such as implantable cardiac pacemakers, defibrillators, drug pumps, insulin pumps, and glucose monitors, are now an integral part of routine medical practice in the United States, and functional organ replacements, such as the artificial heart, pancreas, and retina, will most likely become commonplace in the near future. Often, EMDs end up in the hands of the pathologist as a surgical specimen or at autopsy. No established guidelines for systematic examination and reporting or comprehensive reviews of EMDs currently exist for the pathologist. To provide pathologists with a general overview of EMDs, including a brief history; epidemiology; essential technical aspects, indications, contraindications, and complications of selected devices; potential applications in pathology; relevant government regulations; and suggested examination and reporting guidelines. Articles indexed on PubMed of the National Library of Medicine, various medical and history of medicine textbooks, US Food and Drug Administration publications and product information, and specifications provided by device manufacturers. Studies were selected on the basis of relevance to the study objectives. Descriptive data were selected by the author. Suggested examination and reporting guidelines for EMDs received as surgical specimens and retrieved at autopsy. Electronic medical devices received as surgical specimens and retrieved at autopsy are increasing in number and level of sophistication. They should be systematically examined and reported, should have electronic memories downloaded when indicated, will help pathologists answer more questions with greater certainty, and should become an integral part of the formal knowledge base, research focus, training, and practice of pathology.

Spirituality, depression and quality of life in medical students in KwaZulu-Natal

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Narushni Pillay

2016-03-01

Full Text Available Background: The majority of studies on spirituality demonstrate its positive association with mental health. Despite the increasing number of studies, there remains a dearth of studies emanating from African countries looking at the relationship between mental illness, quality of life and measures of spirituality. The present study evaluates the role of spirituality in relation to current depression and quality of life in medical students, who are known to be at high risk for depression. Objectives: The aim of this study was to determine the prevalence of moderate and severe depressive symptoms in this population and explore potential correlations between spirituality, depression and quality of life. Methods: 230 medical students were surveyed at the University of KwaZulu-Natal Medical School, using the Zung Self-Rating Depression Scale (Zung SDS, Spiritual Involvement and Beliefs Scale (SIBS, WHO Quality of Life Scale (WHOQOL and a demographic data sheet. Results: There was a high prevalence of depressive symptoms in the medical students, with a significant proportion (15.6% showing evidence of severe depressive symptoms (indicating likely depressive illness. Those with a history of mental illness or of having attended traditional, complementary or alternate medical practitioners showed higher levels of depression. Lower spirituality was associated with non-adherence to a major religion and a history of mental illness. Quality of life was better in second and fifth year students and poorer in those with a history of mental illness. Conclusion: Medical students’ experiences of depression (most probably due to stress and its relationship with spirituality and quality of life merit further investigation with a view to establishing policy guidelines for dealing with this issue.

Background radiation levels and medical exposure levels in Australia

International Nuclear Information System (INIS)

Webb, D.V.; Solomon, S.B.; Thomson, J.E.M.

1999-01-01

The average effective background dose received by the Australian population has been reassessed to be ∼1.5 millisievert (mSv) per year. Over half of this exposure arises from exposure from terrestrial radiation and cosmic rays, the remainder from radionuclides within the body and from inhalation of radon progeny. This background is to be compared with medical radiation, primarily diagnostic, which could add half as much again to the population exposure. This paper reviews research programmes carried out by the Australian Radiation Laboratory to study radiation exposure from natural background and from medical use. While the latter exposure is accepted to have a social benefit, there is a need to ensure that doses are no more than necessary to provide effective diagnosis and optimal treatment. Copyright (1999) Australasian Radiation Protection Society Inc

Teaching National and General History of Music at College Level and at the University of Zagreb

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Stanislav Tuksar

2017-01-01

Full Text Available The teaching of music history at various colleges and at the University of Zagreb (founded in 1669, and renewed in 1874 started during the 1920s. However, its prehistory goes back to the 1890s: the first courses in music history were taught at the music school of the Narodni zemaljski glasbeni zavod (Institute of Music from 1890 on, only to be continued later at the Croatian Conservatory (1916. With the Academy of Music (1922 music history began to be taught at university level as a main, compulsory subject, while at the Faculty of Humanities (in 1928-1938; 1981-1994, the Catholic Theological Faculty with its Institute for Church Music (probably since 1951, the Teacher’s College (since 1951 and Croatian Studies (since 1994, all within the University of Zagreb (to which the Academy of Music joined only in 1980, it was taught in the form of a mixture of obligatory and elective subjects. Among a number of more or less outstanding personalities who figured as teachers of music history, including composers, music theorists, conductors, organists, music critics, and expert music historians, mention should be made of the world-known musicologist Dragan Plamenac (who served as ‘Privatdozent’ at the Faculty of Humanities in 1928-1938 period and of Josip Andreis, who taught Croatian and European music history in parallel at the Academy of Music from 1948 to 1972. In 1970 a modern Department of Musicology was created replacing the old Historical Department, where the new generation of musicologists such as Ivan Supičić and Koraljka Kos introduced new international standards in teaching methods. Tutorial books and other necessary literature for students were at first written by domestic musicologists, so that, for example, from 1950s to 1990s J. Andreis was the author of influential books covering both history of Croatian music and the history of European music, used not only in Croatia but also throughout the former Yugoslavia. The present teaching

Does a medical history of hypertension influence disclosing genetic testing results of the risk for salt-sensitive hypertension, in primary care?

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Okayama M

2016-07-01

Full Text Available Masanobu Okayama,1,2 Taro Takeshima,2 Masanori Harada,3 Ryusuke Ae,4 Eiji Kajii2 1Division of Community Medicine and Medical Education, Kobe University Graduate School of Medicine, Kobe, Hyogo, 2Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University, Shimotsuke, Tochigi, 3Department of Support of Rural Medicine, Yamaguchi Grand Medical Center, Hofu, Yamaguchi, 4Division of Public Health, Center for Community Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan Objective: Disclosing genetic testing results may contribute to the prevention and management of many common diseases. However, whether the presence of a disease influences these effects is unclear. This study aimed to clarify the difference in the effects of disclosing genetic testing results of the risk for developing salt-sensitive hypertension on the behavioral modifications with respect to salt intake in hypertensive and nonhypertensive patients.Methods: A cross-sectional study using a self-administered questionnaire was conducted for outpatients aged >20 years (N=2,237 at six primary care clinics and hospitals in Japan. The main factors assessed were medical histories of hypertension, salt preferences, reduced salt intakes, and behavior modifications for reducing salt intake. Behavioral modifications of participants were assessed using their behavior stages before and after disclosure of the hypothetical genetic testing results. Results: Of the 2,237 participants, 1,644 (73.5% responded to the survey. Of these respondents, 558 (33.9% patients were hypertensive and 1,086 (66.1% were nonhypertensive. After being notified of the result “If with genetic risk”, the nonhypertensive participants were more likely to make positive behavioral modifications compared to the hypertensive patients among all participants and in those aged <65 years (adjusted relative ratio [ad-RR], 1.76; 95% confidence interval, 1.12−2.76 and ad-RR, 1

Rhazes, a pioneer in contribution to trials in medical practice.

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Ghaffari, Farzaneh; Naseri, Mohsen; Jafari Hajati, Razieh; Zargaran, Arman

2017-12-01

Medical history explains that Persian physicians used scientific methods based on clinical experiences and observations for treatment from pre-Islamic time (before 637 AD) and centuries later (in the Islamic era). Rhazes was one of the Persian physicians acknowledged as a pharmacist, chemist and prominent scientific writer on various subjects of medicine and philosophy. In this study, we aimed to investigate clinical experiences, as well as the ethical and critical views of Rhazes in medical practice. Rhazes promoted ethics in the medical profession. He expressed critical key points about ancient written texts. He broke ancient physicians' taboos in medical theories and evaluated them based on his own experiences. He designed animal and preclinical evaluations for his theories and also performed the first clinical trials with control groups in the history. His critical views about medical sciences as well as his beliefs in experiments resulted in many medical, chemical and pharmaceutical findings. Therefore, in history, he can be considered as the pioneer in using trials and experiments for approving medical methods.

The history of neuromyelitis optica

Science.gov (United States)

2013-01-01

The discovery of a novel serum autoantibody (termed NMO-IgG or AQP4-Ab) in a subset of patients in 2004 has revived interest in neuromyelitis optica (NMO). While the history of classical multiple sclerosis has been extensively studied, only little is known about the history of NMO. In the present article, we provide a comprehensive review of the early history of this rare but intriguing syndrome. We trace the origins of the concept of NMO in the 19th century medical literature and follow its evolution throughout the 20th and into the 21st century. Finally, we discuss recent proposals to revise the concept of NMO and explain why there is indeed a need for a more systematic and descriptive nomenclature. PMID:23320783

Why Teach Physical Education History?

Science.gov (United States)

Patterson, Jan

2004-01-01

The physical education discipline has had a long development, incorporating concepts learned and appreciated from ancient and modern Olympics, exercise and training, physical activity and sport, and the history of physical education itself. Nevertheless, it continues to evolve as educators improve their instructional methods, medical experts…

Battling demons with medical authority: werewolves, physicians and rationalization.

Science.gov (United States)

Metzger, Nadine

2013-09-01

Werewolves and physicians experienced their closest contact in the context of early modern witch and werewolf trials. For medical critics of the trials, melancholic diseases served as reference points for medical explanations of both individual cases and werewolf beliefs in general. This paper attempts to construct a conceptual history of werewolf beliefs and their respective medical responses. After differentiating the relevant terms, pre-modern werewolf concepts and medical lycanthropy are introduced. The early modern controversy between medical and demonological explanations forms the main part of this study. The history of werewolves and their medical explanations is then traced through to present times. An important point of discussion is to what extent the physicians' engagements with werewolves can be characterized as rationalization.

Why doctors have difficulty with sex histories.

Science.gov (United States)

Merrill, J M; Laux, L F; Thornby, J I

1990-06-01

Studies have shown that physicians' performance has not been as good as it should be in detecting sexually transmitted diseases (STDs) and in counseling patients about their transmission. The AIDS pandemic has underscored the need to find out why this is true. In our study, we identified the major reasons physicians believe other doctors fail to take adequate sex histories. Scales were then developed to measure the three principal reasons given by these physicians: embarrassment, belief that the sex history is not relevant to the patient's chief complaint, and belief by the physicians that they are not adequately trained. When 350 senior medical students were surveyed, 93% thought that knowledge of a patient's sexual practices is an important part of their patient's medical history, but 50% felt poorly trained to take this history and 25% felt embarrassed to ask the necessary questions. To learn why some students score well on these three dimensions and others do not, a limited number of personal attributes were measured and correlated with the scores on these three measures. Shyness and social anxiety as a personal trait predicted which student was most likely to experience embarrassment in taking a sex history. A nonsympathetic view of patients' psychosocial problems was the variable most closely related to the belief that the sex history was of little importance in understanding a patient's problem. Students who believed this most strongly were the same ones who were most homophobic, authoritarian, and had the greatest fear of AIDS infection. The sense of not feeling adequately trained to take a sex history related most strongly to low self-esteem. How these barriers to STD risk assessment might be overcome is discussed.

14 CFR 67.213 - General medical condition.

Science.gov (United States)

2010-01-01

... established medical history or clinical diagnosis of diabetes mellitus that requires insulin or any other... unable to perform those duties or exercise those privileges. (c) No medication or other treatment that... relating to the medication or other treatment involved, finds— (1) Makes the person unable to safely...

14 CFR 67.113 - General medical condition.

Science.gov (United States)

2010-01-01

... established medical history or clinical diagnosis of diabetes mellitus that requires insulin or any other... unable to perform those duties or exercise those privileges. (c) No medication or other treatment that... relating to the medication or other treatment involved, finds— (1) Makes the person unable to safely...

14 CFR 67.313 - General medical condition.

Science.gov (United States)

2010-01-01

... established medical history or clinical diagnosis of diabetes mellitus that requires insulin or any other... unable to perform those duties or exercise those privileges. (c) No medication or other treatment that... relating to the medication or other treatment involved, finds— (1) Makes the person unable to safely...

Response of single bacterial cells to stress gives rise to complex history dependence at the population level

Science.gov (United States)

Mathis, Roland; Ackermann, Martin

2016-01-01

Most bacteria live in ever-changing environments where periods of stress are common. One fundamental question is whether individual bacterial cells have an increased tolerance to stress if they recently have been exposed to lower levels of the same stressor. To address this question, we worked with the bacterium Caulobacter crescentus and asked whether exposure to a moderate concentration of sodium chloride would affect survival during later exposure to a higher concentration. We found that the effects measured at the population level depended in a surprising and complex way on the time interval between the two exposure events: The effect of the first exposure on survival of the second exposure was positive for some time intervals but negative for others. We hypothesized that the complex pattern of history dependence at the population level was a consequence of the responses of individual cells to sodium chloride that we observed: (i) exposure to moderate concentrations of sodium chloride caused delays in cell division and led to cell-cycle synchronization, and (ii) whether a bacterium would survive subsequent exposure to higher concentrations was dependent on the cell-cycle state. Using computational modeling, we demonstrated that indeed the combination of these two effects could explain the complex patterns of history dependence observed at the population level. Our insight into how the behavior of single cells scales up to processes at the population level provides a perspective on how organisms operate in dynamic environments with fluctuating stress exposure. PMID:26960998

Systems of medicine and nationalist discourse in India: towards "new horizons" in medical anthropology and history.

Science.gov (United States)

Khan, Shamshad

2006-06-01

While accepting medical "pluralism" as a historical reality, as an intrinsic value inherent in any medical system, and as an ideal or desired goal that any multicultural society ought to achieve, this paper argues the need to go beyond the liberal pluralist tendencies that have dominated the debate so far. It holds that while documenting or dealing with the "co-existence" of varied medical traditions and practices, we must not ignore or underplay issues of power, domination and hegemony and must locate our work in a larger historical, social and political context. With this perspective, and based essentially on Assembly proceedings, private papers, official documents and archival materials from the first half of the 20th-century, this paper identifies three major streams in the nationalist discourse in India: conformity, defiance and the quest for an alternative. It shows that while the elements of conformity to biomedicine and its dominance remained more pronounced and emphatic, those of defiance were conversely weak and at times even apologetic. The quest for alternatives, on the other hand, although powerful and able to build trenchant civilizational and institutional critique of modern science and medicine, could never find adequate space in the national agenda for social change. The paper further holds that although the "cultural authority" and hegemony of biomedicine over indigenous science and knowledge were initiated by the colonial state, they were extended by the mainstream national leaderships and national governments with far more extensive and profound implications and less resistance. In light of the growing global networking of "traditional", "complementary" and "alternative" health systems on the one hand and the hegemonic and homogenizing role and presence of multilateral organizations (such as the World Bank and IMF) in shaping national health policies on the other, such insights from history become extraordinarily important.

Should applicants to Nottingham University Medical School study a non-science A-level? A cohort study.

Science.gov (United States)

Yates, Janet; Smith, Jennifer; James, David; Ferguson, Eamonn

2009-01-21

It has been suggested that studying non-science subjects at A-level should be compulsory for medical students. Our admissions criteria specify only Biology, Chemistry and one or more additional subjects. This study aimed to determine whether studying a non-science subject for A-level is an independent predictor of achievement on the undergraduate medical course. The subjects of this retrospective cohort study were 164 students from one entry-year group (October 2000), who progressed normally on the 5-year undergraduate medical course at Nottingham. Pre-admission academic and socio-demographic data and undergraduate course marks were obtained. T-test and hierarchical multiple linear regression analyses were undertaken to identify independent predictors of five course outcomes at different stages throughout the course. There was no evidence that the choice of science or non-science as the third or fourth A-level subject had any influence on course performance. Demographic variables (age group, sex, and fee status) had some predictive value but ethnicity did not. Pre-clinical course performance was the strongest predictor in the clinical phases (pre-clinical Themes A&B (knowledge) predicted Clinical Knowledge, p A-level requirements should specify the choice of third or fourth subject.

Medical studies and Nazi medicine: Nazi medicine as perceived by Austrian medical students.

Science.gov (United States)

Nowak, Stefan; Rásky, Éva; Freidl, Wolfgang

2016-02-01

Austrian medical universities have not covered the topic of Nazi medicine in their curricula to any satisfactory degree to date. In the context of medical-ethical education and on-going medical ethics debates, it seems indispensable to be confronted also with the dark chapters of medical history, and especially Nazi medicine. Students should learn to understand controversial discussions, e.g. about euthanasia, in a historical context. The purpose of this study was to investigate whether students had, during their studies, been confronted with Nazi medical crime and whether they considered such a confrontation as important. The survey also focused on extant knowledge about this topic. From late 2012 to May 2013, 341 late semester students of the medical universities in Vienna, Graz, and Innsbruck were questioned about the coverage of Nazi medicine during their courses, using multiple choice questionnaires. The data were evaluated using a descriptive-statistical approach. The study has shown a low level of knowledge of students about Nazi medicine in the three universities. Only a third of the students had ever heard about "Aktion T4". About 65% of the participants found it important to be comprehensively informed about Nazi medicine during their studies, e.g. with a view to their future career. On average across the three universities, only 43% of the students had been confronted with this topic. The study found a clear wish for more information about Nazi medicine. Universities should, therefore, offer students various opportunities and ways of discussing this issue in the university context.

High 15-F2t-Isoprostane Levels in Patients with a Previous History of Nonmelanoma Skin Cancer: The Effects of Supplementary Antioxidant Therapy

Directory of Open Access Journals (Sweden)

Betânia de Jesus e Silva de Almendra Freitas

2015-01-01

Full Text Available Background. Phase I of this study was aimed at comparing the profiles of oxidative stress biomarkers in patients with history of nonmelanoma skin cancer (NMSC, previously treated with surgery, to the healthy subjects. Phase II aimed to evaluate the effects of supplementary antioxidant therapy on the levels of biomarkers in the case group. Materials and Methods. In Phase I, oxidative stress biomarkers were measured in blood samples obtained from 24 healthy subjects and 60 patients with history of NMSC previously treated with surgery. In Phase II, the 60 patients with history of NMSC were randomized into two subgroups, one receiving placebo (n=34 and the other (n=26 receiving vitamin C, vitamin E, and zinc supplementation for 8 weeks, followed by reevaluation of biomarkers. Results. In Phase I, patients with history of NMSC showed increased plasma concentrations of all biomarkers, but only 15-F2t-isoprostane was significantly higher than in the healthy subjects. Risk of NMSC increased by 4% for each additional 1 pg/mL increase in 15-F2t-isoprostane. In Phase II, supplementation did not significantly reduce levels of oxidative stress biomarkers. Conclusion. Patients with history of NMSC had significantly high 15-F2t-isoprostane plasma levels; supplementation did not result in significant reduction of oxidative stress biomarkers. This trial was registered with ClinicalTrials.gov (ID NCT02248584.

A Clinical Decision Support Engine Based on a National Medication Repository for the Detection of Potential Duplicate Medications: Design and Evaluation.

Science.gov (United States)

Yang, Cheng-Yi; Lo, Yu-Sheng; Chen, Ray-Jade; Liu, Chien-Tsai

2018-01-19

A computerized physician order entry (CPOE) system combined with a clinical decision support system can reduce duplication of medications and thus adverse drug reactions. However, without infrastructure that supports patients' integrated medication history across health care facilities nationwide, duplication of medication can still occur. In Taiwan, the National Health Insurance Administration has implemented a national medication repository and Web-based query system known as the PharmaCloud, which allows physicians to access their patients' medication records prescribed by different health care facilities across Taiwan. This study aimed to develop a scalable, flexible, and thematic design-based clinical decision support (CDS) engine, which integrates a national medication repository to support CPOE systems in the detection of potential duplication of medication across health care facilities, as well as to analyze its impact on clinical encounters. A CDS engine was developed that can download patients' up-to-date medication history from the PharmaCloud and support a CPOE system in the detection of potential duplicate medications. When prescribing a medication order using the CPOE system, a physician receives an alert if there is a potential duplicate medication. To investigate the impact of the CDS engine on clinical encounters in outpatient services, a clinical encounter log was created to collect information about time, prescribed drugs, and physicians' responses to handling the alerts for each encounter. The CDS engine was installed in a teaching affiliate hospital, and the clinical encounter log collected information for 3 months, during which a total of 178,300 prescriptions were prescribed in the outpatient departments. In all, 43,844/178,300 (24.59%) patients signed the PharmaCloud consent form allowing their physicians to access their medication history in the PharmaCloud. The rate of duplicate medication was 5.83% (1843/31,614) of prescriptions. When

A levels and intelligence as predictors of medical careers in UK doctors: 20 year prospective study

Science.gov (United States)

McManus, I C; Smithers, Eleni; Partridge, Philippa; Keeling, A; Fleming, Peter R

2003-01-01

Objective To assess whether A level grades (achievement) and intelligence (ability) predict doctors' careers. Design Prospective cohort study with follow up after 20 years by postal questionnaire. Setting A UK medical school in London. Participants 511 doctors who had entered Westminster Medical School as clinical students between 1975 and 1982 were followed up in January 2002. Main outcome measures Time taken to reach different career grades in hospital or general practice, postgraduate qualifications obtained (membership/fellowships, diplomas, higher academic degrees), number of research publications, and measures of stress and burnout related to A level grades and intelligence (result of AH5 intelligence test) at entry to clinical school. General health questionnaire, Maslach burnout inventory, and questionnaire on satisfaction with career at follow up. Results 47 (9%) doctors were no longer on the Medical Register. They had lower A level grades than those who were still on the register (P < 0.001). A levels also predicted performance in undergraduate training, performance in postregistration house officer posts, and time to achieve membership qualifications (Cox regression, P < 0.001; b=0.376, SE=0.098, exp(b)=1.457). Intelligence did not independently predict dropping off the register, career outcome, or other measures. A levels did not predict diploma or higher academic qualifications, research publications, or stress or burnout. Diplomas, higher academic degrees, and research publications did, however, significantly correlate with personality measures. Conclusions Results of achievement tests, in this case A level grades, which are particularly used for selection of students in the United Kingdom, have long term predictive validity for undergraduate and postgraduate careers. In contrast, a test of ability or aptitude (AH5) was of little predictive validity for subsequent medical careers. PMID:12869457

Medical screening and evaluation for heat stress

International Nuclear Information System (INIS)

Kenney, L.W.

1985-01-01

Wide interindividual variation exists with respect to heat tolerance, making it difficult to predict individual responses. However, several general physical and physiological characteristics are associated with excessive strain and early exhaustion during work in the heat. Included among these correlates of heat intolerance are a medical history of heat illness, acclimation state, age, body composition and size, aerobic fitness level, hypertension, and drug and alcohol use. The approach of choice for medical evaluation for heat exposure is a two-stage evaluation. First, the examining physician should be encouraged to screen out those workers whose characteristics increase their risk of heat intolerance. Secondly, a short exercise test is proposed which accurately predicts relative heat tolerance across a working population. This test is recommended as an adjunct screening test at the examining physician's disgression

History magazines in the UK

OpenAIRE

Haydn, Terry

2013-01-01

The paper explores the phenomenon of popular history magazines as a facet of public history. The UK has seen a substantial increase in the number of popular history magazines available to the public, with some magazines reaching high levels of circulation. The paper looks at the range of magazines available – from ‘heritage’ and ‘family’ history, to special interest magazines, and more ‘serious’ and scholarly history magazines. What is it that makes history magazines sell, and what influence ...

The legacy of Douglas Guthrie (1885-1975), surgeon and medical historian.

Science.gov (United States)

Macintyre, Iain

2018-01-01

After graduating in medicine Douglas Guthrie embarked on a career as an ENT surgeon. When his Edinburgh hospital appointment ended in 1936 he began to write History of Medicine, which, thanks to a favourable review by George Bernard Shaw, became a worldwide best seller when first published in 1945. This marked the start of Guthrie's second career as a lecturer in history of medicine at the University of Edinburgh where his prime responsibility was delivering systematic lectures on medical history to medical undergraduates. At a time when history of medicine was virtually the exclusive preserve of medical doctors, Guthrie promoted to them the historiography techniques of the academic historian. His vision that social historians should become involved in the field and that history of medicine should be taught in arts and humanities faculties began to be adopted in British universities a decade or so after Guthrie made the recommendation. His legacy includes the Scottish Society of the History of Medicine and the British Society for the History of Medicine, both of which he helped to found. His name is commemorated in various charitable trusts which he established to promote the study of history of medicine.

Guide of good practices in medical physics - French Society of Medical Physics

International Nuclear Information System (INIS)

Rosenwald, Jean-Claude; Aventin, Christophe; Coste, Frederic; Francois, Pascal; Ginestet, Chantal; Perrin, Benedicte; Salvat, Cecile; Caselles, Olivier; Dedieu, Veronique; Dejean, Catherine; Batalla, Alain; Guillaume, Bonniaud; Le Du, Dominique; Lisbona, Albert; Marchesi, Vincent; Sarrazin, Thierry; Mazeron, Jean-Jacques; Lipinski, Francis; Vera, Pierre; Vermandel, Maximilien; Ducou le Pointe, Hubert; Vidal, Vincent; Henry, Cecile; Mazeau-Woynar, Valerie; Prot, Camille; Valero, Marc; Aubert, Bernard; Etard, Cecile; Jimonet, Christine; Roue, Amelie; Sage, Julie; Bardies, Manuel; Beauvais, Helene; Bey, Pierre; Costa, Andre; Desblancs, Claire; Eudaldo, Teresa; Farman, Bardia; Ferrand, Regis; Garcia, Robin; Giraud, Jean-Yves; Husson, Francois; Koulibaly, Malick; Carlan, Loic de; Manens, Jean-Pierre; Naudy, Suzanne; Noel, Alain; Pilette, Pierre; Verdun, Francis; Bouette, Aurelien; Breen, Stephen; Bridier, Andre; Chauvenet, Bruno; Chavaudra, Jean; Gardin, Isabelle; Herlevin, Karine

2012-01-01

After a presentation of the methodological approach used to write this book, the first chapter addresses the profession of medical physicist: medical physics in France (history, evolution of the profession, of the education and of regulation), legal framework (related to the medical use of ionizing radiations, legal texts directly concerning medical physics, regulations impacting the professional practice of medical physicists), scopes of intervention of the medical physicist (context, missions, dose management, image quality, quality management and safety, relationship with the patient, education, training and research, relationships with industry, cost management), operating conditions, and good professional practices. The second chapter addresses the principles of management of quality and safety: quality management in medical physics, safety management, quality and safety in health care facilities. The third part addresses good practices in medical physics: general principles of working methods, equipment management, participation to clinic activities

[The history of kidney transplantation].

Science.gov (United States)

Kessler, Michèle

2016-12-01

Medical advances which have marked the history of transplantation include the work of Jean Dausset on the HLA system from 1952, brain death described in 1959 and prolonged organ preservation. This article looks back at the major turning points. Copyright © 2016. Publié par Elsevier Masson SAS.

Post-cold war United Nations peacekeeping operations: a review of the case for a hybrid level 2+ medical treatment facility.

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Johnson, Ralph Jay

2015-01-01

Post-Cold War, UN peacekeeping operations (UN PKOs) have become larger, more mobile, multi-faceted and conducted over vast areas of remote, rugged, and harsh geography. They have been increasingly involved in dangerous areas with ill-defined boundaries, simmering internecine armed conflict, and disregard on the part of some local parties for peacekeepers' security and role. Yet progressively there have been expectations of financial restraint and austerity. Additionally, UN PKOs have become more "robust," that is, engaged in preemptive, assertive operations. A statistically positive and significant relationship exists between missions' size, complexity, remoteness, and aggressive tenor and a higher probability of trauma or death, especially as a result of hostile actions or disease. Therefore, in the interest of "force protection" and optimizing operations, a key component of UN PKOs is health care and medical treatment. The expectation is that UN PKO medical support must conform to the general intent and structure of current UN PKOs to become more streamlined, portable, mobile, compartmentalized, and specialized, but also more varied and complex to address the medical aspects of these missions cost-efficiently. This article contends that establishing a hybrid level 2-a level 2 with level 3 modules and components (i.e., level 2+)-is a viable course of action when considering trends in the medical aspects of Post-Cold War UN PKOs. A level 2 medical treatment facility has the potential to provide needed forward mobile medical treatment, especially trauma care, for extended, complex, large-scale, and comprehensive UN PKOs. This is particularly the case for missions that include humanitarian outreach, preventive medicine, and psychiatry. The level 2 treatment facility is flexible enough to expand into a hybrid level 2+ with augmentation of modules based on changes in mission requirements and variation in medical aspects.

Low plasma eicosapentaenoic acid levels are associated with elevated trait aggression and impulsivity in major depressive disorder with a history of comorbid substance use disorder

DEFF Research Database (Denmark)

Beier, Anne Mette; Lauritzen, Lotte; Galfalvy, Hanga C

2014-01-01

-reported childhood abuse history, and, in MDD patients, suicide attempt history. Among PUFA, lnEPA but not lnDHA predicted aggression (F1,76 = 12.493, p = 0.001), and impulsivity (F1,65 = 5.598, p = 0.021), with interactions between lnEPA and history of SUD for both aggression (F1,76 = 7.941, p = 0.......001) and impulsivity (F1,65 = 3.485, p = 0.037). Results remained significant when adjusted for childhood abuse, depression severity, or history of suicide attempt. In conclusion, low EPA levels were associated with aggression and impulsivity only in patients with MDD and comorbid SUD, even though in most cases SUD......Major depressive disorder (MDD) is associated with low levels of omega-3 polyunsaturated fatty acids (PUFAs), holding promise for new perspectives on disease etiology and treatment targets. As aggressive and impulsive behaviors are associated with low omega-3 PUFA levels in some clinical contexts...

Asthma Heredity, Cord Blood IgE and Asthma-Related Symptoms and Medication in Adulthood: A Long-Term Follow-Up in a Swedish Birth Cohort.

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Hartmut Vogt

Full Text Available Cord blood IgE has previously been studied as a possible predictor of asthma and allergic diseases. Results from different studies have been contradictory, and most have focused on high-risk infants and early infancy. Few studies have followed their study population into adulthood. This study assessed whether cord blood IgE levels and a family history of asthma were associated with, and could predict, asthma medication and allergy-related respiratory symptoms in adults. A follow-up was carried out in a Swedish birth cohort comprising 1,701 consecutively born children. In all, 1,661 individuals could be linked to the Swedish Prescribed Drug Register and the Medical Birth Register, and 1,227 responded to a postal questionnaire. Cord blood IgE and family history of asthma were correlated with reported respiratory symptoms and dispensed asthma medication at 32-34 years. Elevated cord blood IgE was associated with a two- to threefold increased risk of pollen-induced respiratory symptoms and dispensed anti-inflammatory asthma medication. Similarly, a family history of asthma was associated with an increased risk of pollen-induced respiratory symptoms and anti-inflammatory medication. However, only 8% of the individuals with elevated cord blood IgE or a family history of asthma in infancy could be linked to current dispensation of anti-inflammatory asthma medication at follow-up. In all, 49 out of 60 individuals with dispensed anti-inflammatory asthma medication at 32-34 years of age had not been reported having asthma at previous check-ups of the cohort during childhood. Among those, only 5% with elevated cord blood IgE and 6% with a family history of asthma in infancy could be linked to current dispensation of anti-inflammatory asthma medication as adults. Elevated cord blood IgE and a positive family history of asthma were associated with reported respiratory symptoms and dispensed asthma medication in adulthood, but their predictive power was poor

Predicting healthcare trajectories from medical records: A deep learning approach.

Science.gov (United States)

Pham, Trang; Tran, Truyen; Phung, Dinh; Venkatesh, Svetha

2017-05-01

Personalized predictive medicine necessitates the modeling of patient illness and care processes, which inherently have long-term temporal dependencies. Healthcare observations, stored in electronic medical records are episodic and irregular in time. We introduce DeepCare, an end-to-end deep dynamic neural network that reads medical records, stores previous illness history, infers current illness states and predicts future medical outcomes. At the data level, DeepCare represents care episodes as vectors and models patient health state trajectories by the memory of historical records. Built on Long Short-Term Memory (LSTM), DeepCare introduces methods to handle irregularly timed events by moderating the forgetting and consolidation of memory. DeepCare also explicitly models medical interventions that change the course of illness and shape future medical risk. Moving up to the health state level, historical and present health states are then aggregated through multiscale temporal pooling, before passing through a neural network that estimates future outcomes. We demonstrate the efficacy of DeepCare for disease progression modeling, intervention recommendation, and future risk prediction. On two important cohorts with heavy social and economic burden - diabetes and mental health - the results show improved prediction accuracy. Copyright © 2017 Elsevier Inc. All rights reserved.

Trust and risk: a model for medical education.

Science.gov (United States)

Damodaran, Arvin; Shulruf, Boaz; Jones, Philip

2017-09-01

Health care delivery, and therefore medical education, is an inherently risky business. Although control mechanisms, such as external audit and accreditation, are designed to manage risk in clinical settings, another approach is 'trust'. The use of entrustable professional activities (EPAs) represents a deliberate way in which this is operationalised as a workplace-based assessment. Once engaged with the concept, clinical teachers and medical educators may have further questions about trust. This narrative overview of the trust literature explores how risk, trust and control intersect with current thinking in medical education, and makes suggestions for potential directions of enquiry. Beyond EPAs, the importance of trust in health care and medical education is reviewed, followed by a brief history of trust research in the wider literature. Interpersonal and organisational levels of trust and a model of trust from the management literature are used to provide the framework with which to decipher trust decisions in health care and medical education, in which risk and vulnerability are inherent. In workplace learning and assessment, the language of 'trust' may offer a more authentic and practical vocabulary than that of 'competency' because clinical and professional risks are explicitly considered. There are many other trust relationships in health care and medical education. At the most basic level, it is helpful to clearly delineate who is the trustor, the trustee, and for what task. Each relationship has interpersonal and organisational elements. Understanding and considered utilisation of trust and control mechanisms in health care and medical education may lead to systems that maturely manage risk while actively encouraging trust and empowerment. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

Vocal Health Education and Medical Resources for Graduate-Level Vocal Performance Students.

Science.gov (United States)

Latham, Katherine; Messing, Barbara; Bidlack, Melissa; Merritt, Samantha; Zhou, Xian; Akst, Lee M

2017-03-01

Most agree that education about vocal health and physiology can help singers avoid the development of vocal disorders. However, little is known about how this kind of education is provided to singers as part of their formal training. This study describes the amount of instruction in these topics provided through graduate-level curricula, who provides this instruction, and the kinds of affiliations such graduate singing programs have with medical professionals. This is an online survey of music schools with graduate singing programs. Survey questions addressed demographics of the programs, general attitudes about vocal health instruction for singers, the amount of vocal health instruction provided and by whom it was taught, perceived barriers to including more vocal health instruction, and any affiliations the voice program might have with medical personnel. Eighty-one survey responses were received. Instruction on vocal health was provided in 95% of the schools. In 55% of the schools, none of this instruction was given by a medical professional. Limited time in the curriculum, lack of financial support, and lack of availability of medical professional were the most frequently reported barriers to providing more instruction. When programs offered more hours of instruction, they were more likely to have some of that instruction given by a medical professional (P = 0.008) and to assess the amount of instruction provided positively (P = 0.001). There are several perceived barriers to incorporating vocal health education into graduate singing programs. Opportunity exists for more collaboration between vocal pedagogues and medical professionals in the education of singers about vocal health. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Hearing Voices: Lessons from the History of Psychiatry in Ireland.

Science.gov (United States)

Kelly, B D

2017-03-10

The history of psychiatry is a history of therapeutic enthusiasm, with all of the triumph and tragedy, hubris and humility that such enthusiasm brings. During the 1800s and early 1900s, Ireland-s public asylums were routinely overcrowded, unhygienic and, quite commonly, fatal. The asylums became all-too-convenient options for a society with an apparently insatiable hunger for institutions, incarceration and control. The emergence of clinical professionals, both medical and nursing, was inevitably a factor in this complex mix, but the effects of any search for professional prestige were dwarfed by asylum doctors' clear outrage at what the asylum system became. There were powerful, non-medical, vested interests in keeping large asylums open. Irish society consistently failed to generate solutions to real human suffering (mental illness, disability, disease, poverty, ill fortune) other than the extraordinary network of institutions that characterised so much of Irish history: orphanages, industrial schools, reformatories, workhouses, laundries, borstals, prisons and asylums. As a result, Ireland's remarkable asylum system was primarily a social creation rather than a medical one. Notwithstanding this complex history, Ireland's mental health services have been transformed over the past five decades, although real challenges remain, especially in relation to the homeless mentally ill, the mentally ill in prison, and providing meaningful support to families.

Investigating diet and physical activity in Malaysia: education and family history of diabetes relate to lower levels of physical activity.

Science.gov (United States)

Tam, Cai Lian; Bonn, Gregory; Yeoh, Si Han; Wong, Chee Piau

2014-01-01

The National Health and Morbidity Survey (NHMS, 2011), estimates that the number of Malaysian adults suffering from type 2 diabetes has increased from 8.3 to 31.2% since 1996. This study is a preliminary investigation of possible factors contributing to this epidemic. Knowledge of diabetes, health locus of control, diet and exercise habits, as well as family history, education level and other demographic factors to better understand the correlates of risky and healthy behaviors. This was done as part of a larger initiative to improve prevention efforts. Questionnaires were completed by 770 individuals from three Malaysian states: Selangor, Penang, and Terengganu. Findings showed that people with better health knowledge and those who have a family history of type 2 diabetes were more likely to have healthy diets. Also, health knowledge related to lower alcohol consumption. Participants with diabetic family members, however, also reported higher levels of stress. Counterintuitively, higher educational levels, higher internal locus of control, better health knowledge, as well as a family history of diabetes all correlated with lower levels of physical activity. Thus, it is suggested that, while increasing health knowledge will be important in addressing the type 2 diabetes epidemic in Malaysia, especially in relation to diet, other cultural factors, specifically norms related to exercise and physical activity, also need to be addressed if the spread of type 2 diabetes is to be addressed over the long term.

Investigating diet and physical activity in Malaysia: Education and family history of diabetes relate to lower levels of physical activity

Directory of Open Access Journals (Sweden)

Cai Lian eTam

2014-12-01

Full Text Available The National Health and Morbidity Survey (NHMS, 2011, estimates that the number of Malaysian adults suffering from type 2 diabetes has increased from 8.3% to 31.2% since 1996. This study is a preliminary investigation of possible factors contributing to this epidemic. Knowledge of diabetes, health locus of control, diet and exercise habits, as well as family history, education level and other demographic factors to better understand the correlates of risky and healthy behaviours. This was done as part of a larger initiative to improve prevention efforts. Questionnaires were completed by 770 individuals from three Malaysian states: Selangor, Penang, and Terengganu. Findings showed that people with better health knowledge and those who have a family history of type 2 diabetes were more likely to have healthy diets. Also, health knowledge related to lower alcohol consumption. Participants with diabetic family members, however, also reported higher levels of stress. Counterintuitively, higher educational levels, higher internal locus of control, better health knowledge, as well as a family history of diabetes all correlated with lower levels of physical activity. Thus, it is suggested that, while increasing health knowledge will be important in addressing the type 2 diabetes epidemic in Malaysia, especially in relation to diet, other cultural factors, specifically norms related to exercise and physical activity, also need to be addressed if the spread of type 2 diabetes is to be addressed over the long term.

Differences in simulated doctor and patient medical decision making: a construal level perspective.

Science.gov (United States)

Peng, Jiaxi; He, Fei; Zhang, Yan; Liu, Quanhui; Miao, Danmin; Xiao, Wei

2013-01-01

Patients are often confronted with diverse medical decisions. Often lacking relevant medical knowledge, patients fail to independently make medical decisions and instead generally rely on the advice of doctors. This study investigated the characteristics of and differences in doctor-patient medical decision making on the basis of construal level theory. A total of 420 undergraduates majoring in clinical medicine were randomly assigned to six groups. Their decisions to opt for radiotherapy and surgery were investigated, with the choices described in a positive/neutral/negative frame × decision making for self/others. Compared with participants giving medical advice to patients, participants deciding for themselves were more likely to select radiotherapy (F1, 404 = 13.92, p = 011). Participants from positive or neutral frames exhibited a higher tendency to choose surgery than did those from negative frames (F2, 404 = 22.53, pframing on independent decision making was nonsignificant (F2, 404 = 1.07, p = 35); however the effect of framing on the provision of advice to patients was significant (F2, 404 = 12.95, pframe (F1, 404 = 8.06, p = 005) and marginally significant in the neutral frame (F2, 404 = 3.31, p = 07) but nonsignificant in the negative frame (F2, 404 = .29, p = 59). Both social distance and framing depiction significantly affected medical decision making and exhibited a significant interaction. Differences in medical decision making between doctors and patients need further investigation.

Sodium serum levels in hypoalbuminemic adults at general medical wards

Directory of Open Access Journals (Sweden)

Cunha Daniel Ferreira da

1999-01-01

Full Text Available Hypoalbuminemia may cause interstitial edema and hemodilution, which we hypothesized may influence serum sodium levels. Our purpose was to compare serum sodium levels of hospitalized adults with or without hypoalbuminemia. All sodium and albumin serum levels of 142 adults hospitalized at general medical wards over a six-month period were searched at a University Hospital mainframe computer. Relevant laboratory data and clinical details were also registered. Hypoalbuminemia was defined by serum albumin concentration < 3.3 g/dl Fisher, Mann-Whitney, and Student's t tests were applied to compare groups with or without hypoalbuminemia. Ninety-nine patients, classified as hypoalbuminemic, had lower blood hemoglobin (10.68 ± 2.62 vs. 13.54 ± 2.41, and sodium (135.1 ± 6.44 vs. 139.9 ± 4.76mEq/l and albumin (2.74 ± 0.35 vs. 3.58 ± 0.28g/dl serum levels than non-hypoalbuminemic (n=43. Pearson's coefficient showed a significant direct correlation between albumin and sodium serum levels (r=0.40 and between serum albumin and blood hemoglobin concentration (r=0.46. Our results suggest that hypoalbuminemic adults have lower serum sodium levels than those without hypoalbuminemia, a phenomenon that may be at least partially attributed to body water retention associated with acute phase response syndrome.

The introduction of medical humanities in the undergraduate curriculum of Greek medical schools: challenge and necessity.

Science.gov (United States)

Batistatou, A; Doulis, E A; Tiniakos, D; Anogiannaki, A; Charalabopoulos, K

2010-10-01

Medical humanities is a multidisciplinary field, consisting of humanities (theory of literature and arts, philosophy, ethics, history and theology), social sciences (anthropology, psychology and sociology) and arts (literature, theater, cinema, music and visual arts), integrated in the undergraduate curriculum of Medical schools. The aim of the present study is to discuss medical humanities and support the necessity of introduction of a medical humanities course in the curriculum of Greek medical schools. Through the relevant Pub-Med search as well as taking into account various curricula of medical schools, it is evident that medical education today is characterized by acquisition of knowledge and skills and development of medical values and attitudes. Clinical observation with the recognition of key data and patterns in the collected information, is crucial in the final medical decision, i.e. in the complex process, through which doctors accumulate data, reach conclusions and decide on therapy. All sciences included in medical humanities are important for the high quality education of future doctors. The practice of Medicine is in large an image-related science. The history of anatomy and art are closely related, already from the Renaissance time. Studies have shown that attendance of courses on art critics improves the observational skills of medical students. Literature is the source of information about the nature and source of human emotions and behavior and of narratives of illness, and increases imagination. Philosophy aids in the development of analytical and synthetical thinking. Teaching of history of medicine develops humility and aids in avoiding the repetition of mistakes of the past, and quite often raises research and therapeutic skepticism. The comprehension of medical ethics and professional deontology guides the patient-doctor relationship, as well as the relations between physicians and their colleagues. The Medical Humanities course, which is

Longing for the Present in the History of History Education

Science.gov (United States)

Wils, Kaat; Verschaffel, Tom

2012-01-01

The public debates on history education that occurred in many countries over the past decades have given rise to the idea that people live in an age of "history wars". While these wars are primarily fought on a national level, they are increasingly looked at as a global phenomenon. In most cases, they are the expression of tensions between the…

The Impact of State Medical Malpractice Reform on Individual-Level Health Care Expenditures.

Science.gov (United States)

Yu, Hao; Greenberg, Michael; Haviland, Amelia

2017-12-01

Past studies of the impact of state-level medical malpractice reforms on health spending produced mixed findings. Particularly salient is the evidence gap concerning the effect of different types of malpractice reform. This study aims to fill the gap. It extends the literature by examining the general population, not a subgroup or a specific health condition, and controlling for individual-level sociodemographic and health status. We merged the Database of State Tort Law Reforms with the Medical Expenditure Panel Survey between 1996 and 2012. We took a difference-in-differences approach to specify a two-part model for analyzing individual-level health spending. We applied the recycled prediction method and the bootstrapping technique to examining the difference in health spending growth between states with and without a reform. All expenditures were converted to 2010 U.S. dollars. Only two of the 10 major state-level malpractice reforms had significant impacts on the growth of individual-level health expenditures. The average annual expenditures in states with caps on attorney contingency fees increased less than that in states without the reform (p negligence rule, the average annual expenditures increased more in both states with a pure comparative fault reform (p < .05) and states with a comparative fault reform that barred recovery if the plaintiff's fault was equal to or greater than the defendant's (p < .05). A few state-level malpractice reforms had significantly affected the growth of individual-level health spending, and the direction and magnitude of the effects differed by type of reform. © Health Research and Educational Trust.

[Who decides what data should be recorded in the medical history in relation to the biological origin?

Science.gov (United States)

Gallego Riestra, Sergio; Riaño Galán, Isolina

2018-02-01

There is an increasing request by patients or their representatives not to have some data registered in their clinical history or if such data exists to be deleted. Without doubt, this is so because such clinical data is accessed by various professionals who in most cases are not directly involved in caring for such patients. On the other hand, such data is copied and iteratively and unnecessary reproduced in various discharge reports and others forms. The problem arises when such controversial data refer to particularly sensitive clinical aspects such as assisted reproduction techniques, which invades personal and family privacy. Therefore, the question is who determines what data should be recorded in the medical records and according to what criteria should be taken that decision? Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Preparing medical students for obstetrics and gynecology milestone level one: a description of a pilot curriculum

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Helen Morgan

2014-11-01

Full Text Available Background: The implementation of the Accreditation Council for Graduate Medical Education (ACGME Milestones in the field of obstetrics and gynecology has arrived with Milestones Level One defined as the level expected of an incoming first-year resident. Purpose: We designed, implemented, and evaluated a 4-week elective for fourth-year medical school students, which utilized a multimodal approach to teaching and assessing the Milestones Level One competencies. Methods: The 78-hour curriculum utilized traditional didactic lectures, flipped classroom active learning sessions, a simulated paging curriculum, simulation training, embalmed cadaver anatomical dissections, and fresh-frozen cadaver operative procedures. We performed an assessment of student knowledge and surgical skills before and after completion of the course. Students also received feedback on their assessment and management of eight simulated paging scenarios. Students completed course content satisfaction surveys at the completion of each of the 4 weeks. Results: Students demonstrated improvement in knowledge and surgical skills at the completion of the course. Paging confidence trended toward improvement at the completion of the course. Student satisfaction was high for all of the course content, and the active learning components of the curriculum (flipped classroom, simulation, and anatomy sessions had higher scores than the traditional didactics in all six categories of our student satisfaction survey. Conclusions: This pilot study demonstrates a practical approach for preparing fourth-year medical students for the expectations of Milestones Level One in obstetrics and gynecology. This curriculum can serve as a framework as medical schools and specific specialties work to meet the first steps of the ACGME's Next Accreditation System.

Status of medical mycology education.

Science.gov (United States)

Steinbach, William J; Mitchell, Thomas G; Schell, Wiley A; Espinel-Ingroff, Ana; Coico, Richard F; Walsh, Thomas J; Perfect, John R

2003-12-01

The number of immunocompromised patients and subsequent invasive fungal infections continues to rise. However, the education of future medical mycologists to engage this growing problem is diminishing. While there are an increasing number of publications and grants awarded in mycology, the time and detail devoted to teaching medical mycology in United States medical schools are inadequate. Here we review the history in medical mycology education and the current educational opportunities. To accurately gauge contemporary teaching we also conducted a prospective survey of microbiology and immunology departmental chairpersons in United States medical schools to determine the amount and content of contemporary education in medical mycology.

Improving students' confidence levels in communicating with patients and introducing students to the importance of history taking

Energy Technology Data Exchange (ETDEWEB)

Halkett, Georgia K.B., E-mail: g.halkett@curtin.edu.a [WA Centre for Cancer and Palliative Care/Curtin Health Innovation Research Institute, Curtin University of Technology, Perth, Western Australia (Australia); Department of Imaging and Applied Physics, Curtin University of Technology, Perth, Western Australia (Australia); McKay, Janice [Department of Imaging and Applied Physics, Curtin University of Technology, Perth, Western Australia (Australia); Shaw, Therese [Child Health Promotion Research Centre, School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Perth, Western Australia (Australia)

2011-02-15

Background: Radiographers can have a marked impact on the way patients deal with their illness because they are often one of the first health professionals that patients see. Therefore, it is essential that radiographers have effective communication skills and are able to provide patients with the information they require. The purpose of this study was to test whether the introduction of additional education on communication and history taking improved students' communication skills. Methods: A short program on communication skills and history taking was introduced to third year undergraduate students prior to a clinical placements period. Three workshops were run; the third included a role play exercise using professional actors as simulated patients. Students completed questionnaires at baseline, following the three workshops and after their subsequent clinical placement. Descriptive statistics were calculated and logistic regression Generalized Estimating Equations models were fitted to test for differences over time in students' confidence levels. Results: Twenty-seven out of 36 students completed the baseline and final surveys. Students indicated they were highly satisfied with the workshops provided. Statistically significant differences were observed for seven items relating to student's confidence levels in communicating with patients after they had participated in the workshops and their subsequent clinical placement. Conclusion: The use of communication skills workshops involving actor/patients is an effective method of assisting students to develop their communication and history taking skills. This program has now been implemented into the mentioned undergraduate course and it is recommended that radiography students at other institutions be provided with the opportunity to develop their communication and history taking skills.

Setting Standards for Medically-Based Running Analysis

Science.gov (United States)

Vincent, Heather K.; Herman, Daniel C.; Lear-Barnes, Leslie; Barnes, Robert; Chen, Cong; Greenberg, Scott; Vincent, Kevin R.

2015-01-01

Setting standards for medically based running analyses is necessary to ensure that runners receive a high-quality service from practitioners. Medical and training history, physical and functional tests, and motion analysis of running at self-selected and faster speeds are key features of a comprehensive analysis. Self-reported history and movement symmetry are critical factors that require follow-up therapy or long-term management. Pain or injury is typically the result of a functional deficit above or below the site along the kinematic chain. PMID:25014394

Overcoming strategy to strengthen the History of Medicine in Santiago of Cuba

Directory of Open Access Journals (Sweden)

Ana María Durán-Fonseca

2018-03-01

Full Text Available A strategy of improvement in the Medical Sciences is proposed, integrated to the performance of every teacher that forms part of the Cuban educational system associated with health. The overcoming of the teachers of Medical Sciences in History of Medicine, takes into account the new conceptions and demands of the training of the doctor at present, for what constitutes a challenge from recognizing that the History of Medicine is not a appendix of Medicine, or History, but with its own legitimacy erected in science synthesis with structural and methodological architecture, deduced by the independent position that Medicine occupies in the set of Natural and Humanistic sciences.

Integration of Educational and Research Activities of Medical Students (Experience of the Medical Faculty of Saint Petersburg State University).

Science.gov (United States)

Balakhonov, Aleksei V; Churilov, Leonid P; Erman, Mikhail V; Shishkin, Aleksandr N; Slepykh, Lyudmila A; Stroev, Yuri I; Utekhin, Vladimir J; Basantsova, Natalia Y

2017-12-01

The article is devoted to the role of research activity of the medical students in higher education of physicians. The teaching of physicians in classical universities and specialized medical schools is compared. The history of physicians' training in Russia in imperial, Soviet and post-Soviet periods is reviewed and compared to development of higher medical education in other countries. Article gives the the description of all failed attempts to establish a Medical Faculty within oldest classical university of Russia, crowned by history of last and successful attempt of its establishment. Authors' experience of adjoining education and research in curriculum and extra-curricular life of this Medical Faculty is discussed. The problems of specialization and fundamentalization of medical education are subjected to analysis. Clinical reasoning and reasoning of scholar-experimentalist are compared. The article reviews the role of term and course papers and significance of self-studies and graduation thesis in education of a physician. The paper gives original definition of interactive learning, and discusses the methods and pathways of intermingling the fundamental science and clinical medicine in medical teaching for achievement of admixed competencies of medical doctor and biomedical researcher.

An overview of medical informatics education in China.

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Hu, Dehua; Sun, Zhenling; Li, Houqing

2013-05-01

To outline the history of medical informatics education in the People's Republic of China, systematically analyze the current status of medical informatics education at different academic levels (bachelor's, master's, and doctoral), and suggest reasonable strategies for the further development of the field in China. The development of medical informatics education was divided into three stages, defined by changes in the specialty's name. Systematic searches of websites for material related to the specialty of medical informatics were then conducted. For undergraduate education, the websites surveyed included the website of the Ministry of Education of the People's Republic of China (MOE) and those of universities or colleges identified using the baidu.com search engine. For postgraduate education, the websites included China's Graduate Admissions Information Network (CGAIN) and the websites of the universities or their schools or faculties. Specialties were selected on the basis of three criteria: (1) for undergraduate education, the name of specialty or program was medical informatics or medical information or information management and information system; for postgraduate education, medical informatics or medical information; (2) the specialty was approved and listed by the MOE; (3) the specialty was set up by a medical college or medical university, or a school of medicine of a comprehensive university. The information abstracted from the websites included the year of program approval and listing, the university/college, discipline catalog, discipline, specialty, specialty code, objectives, and main courses. A total of 55 program offerings for undergraduate education, 27 for master's-level education, and 5 for PhD-level education in medical informatics were identified and assessed in China. The results indicate that medical informatics education, a specialty rooted in medical library and information science education in China, has grown significantly in that

The Added Value of Medical Testing in Underwriting Life Insurance.

Directory of Open Access Journals (Sweden)

Jan Bronsema

Full Text Available In present-day life-insurance medical underwriting practice the risk assessment starts with a standard health declaration (SHD. Indication for additional medical screening depends predominantly on age and amount of insured capital. From a medical perspective it is questionable whether there is an association between the level of insured capital and medical risk in terms of mortality. The aim of the study is to examine the prognostic value of parameters from the health declaration and application form on extra mortality based on results from additional medical testing.A history register-based cohort study was conducted including about 15.000 application files accepted between 2007 and 2010. Blood pressure, lipids, cotinine and glucose levels were used as dependent variables in logistic regression models. Resampling validation was applied using 250 bootstrap samples to calculate area under the curves (AUC's. The AUC was used to discriminate between persons with and without at least 25% extra mortality.BMI and the overall assessment of the health declaration by an insurance physician or medical underwriter showed the strongest discrimination in multivariable analysis. Including all variables at minimum cut-off levels resulted in an AUC of 0.710 while by using a model with BMI, the assessment of the health declaration and gender, the AUC was 0.708. Including all variables at maximum cut-off levels lead to an AUC of 0.743 while a model with BMI, the assessment of the health declaration and age resulted in an AUC of 0.741.The outcome of this study shows that BMI and the overall assessment of the health declaration were the dominant variables to discriminate between applicants for life-insurance with and without at least 25 percent extra mortality. The variable insured capital set by insurers as factor for additional medical testing could not be established in this study population. The indication for additional medical testing at underwriting life

Book appraisal: history of dentistry in Nigeria | Michael ... - Ibadan

African Journals Online (AJOL)

The book appraised in this edition of Chronicles of Medical History, History of Dentistry in Nigeria, is a product of many years of painstaking research. The Author, Professor Eyitope Ogunbodede, has put together an excellent book that is a great work of art. Dentistry is one of the first specialties in medicine with a very long ...

Comparison of Unsafe Driving Across Medical Conditions.

Science.gov (United States)

Moon, Sanghee; Ranchet, Maud; Tant, Mark; Akinwuntan, Abiodun E; Devos, Hannes

2017-09-01

To compare risks of unsafe driving in patients with medical conditions. This large population-based study included all patients who were referred for a fitness-to-drive evaluation at an official driving evaluation center in 2013 and 2014. Risks of unsafe driving included physician's fitness-to-drive recommendation, comprehensive fitness-to-drive decision, motor vehicle crash history, and traffic violation history. A total of 6584 patients were included in the study. Risks of unsafe driving were significantly different across medical conditions (Pdriving. Patients with psychiatric conditions or substance abuse did worse on most driving safety outcomes, despite their low representation in the total sample (359 [6%] and 46 [1%], respectively). The risk of unsafe driving varied greatly across medical conditions. Sensitization campaigns, education, and medical guidelines for physicians and driver licensing authorities are warranted to identify patients at risk, especially for those with psychiatric conditions and substance abuse problems. Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

“History, Theory and Ethics of Medicine”: The Last Ten Years. A Survey of Course Content, Methods and Structural Preconditions at Twenty-nine German Medical Faculties

Science.gov (United States)

Schildmann, Jan; Bruns, Florian; Hess, Volker; Vollmann, Jochen

2017-01-01

Objective: “History, Theory, Ethics of Medicine” (German: “Geschichte, Theorie, Ethik der Medizin”, abbreviation: GTE) forms part of the obligatory curriculum for medical students in Germany since the winter semester 2003/2004. This paper presents the results of a national survey on the contents, methods and framework of GTE teaching. Methods: Semi-structured questionnaire dispatched in July 2014 to 38 institutions responsible for GTE teaching. Descriptive analysis of quantitative data and content analysis of free-text answers. Results: It was possible to collect data from 29 institutes responsible for GTE teaching (response: 76%). There is at least one professorial chair for GTE in 19 faculties; two professorial chairs or professorships remained vacant at the time of the survey. The number of students taught per academic year ranges from 350. Teaching in GTE comprises an average of 2.18 hours per week per semester (min: 1, max: 6). Teaching in GTE is proportionally distributed according to an arithmetic average as follows: history: 35.4%, theory 14.7% and ethics 49.9%. Written learning objectives were formulated for GTE in 24 faculties. The preferred themes of teaching in history, theory or ethics which according to respondents should be taught comprise a broad spectrum and vary. Teaching in ethics (79 from a max. of 81 possible points) is, when compared to history (61/81) and theory (53/81), attributed the most significance for the training of medical doctors. Conclusion: 10 years after the introduction of GTE the number of students and the personnel resources available at the institutions vary considerably. In light of the differences regarding the content elicited in this study the pros and cons of heterogeneity in GTE should be discussed. PMID:28584871

A guide for good practices in medical physics - French Society of Medical Physics

International Nuclear Information System (INIS)

Rosenwald, Jean-Claude; Aventin, Christophe; Coste, Frederic; Francois, Pascal; Ginestet, Chantal; Perrin, Benedicte; Salvat, Cecile; Caselles, Olivier; Dedieu, Veronique; Dejean, Catherine; Batalla, Alain; Guillaume, Bonniaud; LeDu, Dominique; Lisbona, Albert; Marchesi, Vincent; Sarrazin, Thierry; Mazeron, Jean-Jacques; Lipinski, Francis; Vera, Pierre; Maximilien Vermandel; Ducou le Pointe, Hubert; Vidal, Vincent; Henry, Cecile; Mazeau-Woynar, Valerie; Prot, Camille; Valero, Marc; Aubert, Bernard; Etard, Cecile; Jimonet, Christine; Roue, Amelie; Sage, Julie; Bardies, Manuel; Beauvais, Helene; Bey, Pierre; Costa, Andre; Desblancs, Claire; Eudaldo, Teresa; Farman, Bardia; Ferrand, Regis; Garcia, Robin; Giraud, Jean-Yves; Husson, Francois; Koulibaly, Malick; Carlan, Loic de; Manens, Jean-Pierre; Naudy, Suzanne; Noel, Alain; Pilette, Pierre; Verdun, Francis

2012-12-01

After a presentation of the methodological approach used to write this book, the first chapter addresses the profession of medical physicist: medical physics in France (history, evolution of the profession, of the education and of regulation), legal framework (related to the medical use of ionizing radiations, legal texts directly concerning medical physics, regulations impacting the professional practice of medical physicists), scopes of intervention of the medical physicist (context, missions, dose management, image quality, quality management and safety, relationship with the patient, education, training and research, relationships with industry, cost management), operating conditions, and good professional practices. The second chapter addresses the principles of management of quality and safety: quality management in medical physics, safety management, quality and safety in health care facilities. The third part addresses good practices in medical physics: general principles of working methods, equipment management, participation to clinic activities

Analysis of medical litigation among patients with medical disputes in cosmetic surgery in Taiwan.

Science.gov (United States)

Lyu, Shu-Yu; Liao, Chuh-Kai; Chang, Kao-Ping; Tsai, Shang-Ta; Lee, Ming-Been; Tsai, Feng-Chou

2011-10-01

This study aimed to investigate the key factors in medical disputes (arguments) among female patients after cosmetic surgery in Taiwan and to explore the correlates of medical litigation. A total of 6,888 patients (3,210 patients from two hospitals and 3,678 patients from two clinics) received cosmetic surgery from January 2001 to December 2009. The inclusion criteria specified female patients with a medical dispute. Chi-square testing and multiple logistic regression analysis were used to analyze the data. Of the 43 patients who had a medical dispute (hospitals, 0.53%; clinics, 0.73%), 9 plaintiffs eventually filed suit against their plastic surgeons. Such an outcome exhibited a decreasing annual trend. The hospitals and clinics did not differ significantly in terms of patient profiles. The Chi-square test showed that most patients with a medical dispute (p stress, had a history of medical litigation, and eventually did not sue the surgeons. The test results also showed that the surgeon's seniority and experience significantly influenced the possibility of medical dispute and nonlitigation. Multiple logistical regression analysis further showed that the patients who did decide to enter into litigation had two main related factors: marital stress (odds ratio [OR], 10.67; 95% confidence interval [CI], 1.20-94.73) and an education level below junior college (OR, 9.33; 95% CI, 1.01-86.36). The study findings suggest that the key characteristics of patients and surgeons should be taken into consideration not only in the search for ways to enhance pre- and postoperative communication but also as useful information for expert testimony in the inquisitorial law system.

[The Theory and Trend of Microhistory: History of Medicine].

Science.gov (United States)

Sul, Heasim

2015-08-01

Microhistory, first developed in the 1970s, is the study of the past on a very small scale applying zoom-in methodology. Although microhistory had been introduced to Korea during the late 1990s, there still exists much of misunderstanding and confusions surrounding its nature. Microhistory is to be distinguished from the monographs which deal with petty subject, or from the history of everyday life, and from the case studies. In the field of the history of medicine, there are not many microhistories proper. Several works that claim to utilize microhistorical approach, could not be categorized as microhistory because they carry strong characteristics of macrohistory, specifically those of the disciplinary history or the case studies. The well known work of Harold J. Cook, Trials of an Ordinary Doctor, is not an exception. These studies fail to materialize the critical mind of microhistory that pursues to write a history from below and to restore the agency of obscure people. However, Guido Ruggiero's "The Strange Death of Margarita Marcellini," David Cressy's Travesties and Transgressions in Tudor and Stuart England, and Laurel Thatcher Ulrich's A Midwife's Tale clearly demonstrate the attributes, characteristics, and methodologies of microhistory. These studies well display the emphasis of microhistory, which reveal the complexity of early modern medicine, and the complicated function of individual relationships within each and every social setting. Recently, some scholars begin to suggest that the rigid definition of microhistory should be softened, arguing that there could be various types of microhistory. The history of medicine has many advantage of aptly applying many virtues of microhistory: the de-territoriality of diseases, the peculiar elements of the training and practice in hospitals and medical schools which call for anthropological survey, and the possibility of utilizing doctor's records that contain the confessions of the patients. Also, medical

The Instructional Model for Using History of Science

Science.gov (United States)

Seker, Hayati

2012-01-01

This paper discusses the levels of The Instructional Model for Using History of Science (UHOS) to explain the relationship between the history of science and science teaching. The UHOS model proposes four levels: Conceptual Level, Epistemological Level, Sociocultural Level, and Interest Level. Each Level has sublevels with regards to types of…

Underutilization of information and knowledge in everyday medical practice: Evaluation of a computer-based solution

Directory of Open Access Journals (Sweden)

Fritz Peter

2008-11-01

Full Text Available Abstract Background The medical history is acknowledged as the sine qua non for quality medical care because recognizing problems is pre-requisite for managing them. Medical histories typically are incomplete and inaccurate, however. We show here that computers are a solution to this issue of information gathering about patients. Computers can be programmed to acquire more complete medical histories with greater detail across a range of acute and chronic issues than physician histories. Methods Histories were acquired by physicians in the usual way and by a computer program interacting directly with patients. Decision-making of what medical issues were queried by computer were made internally by the software, including determination of the chief complaint. The selection of patients was from admissions to the Robert-Bosch-Hospital, Stuttgart, Germany by convenience sampling. Physician-acquired and computer-acquired histories were compared on a patient-by-patient basis for 45 patients. Results The computer histories reported 160 problems not recorded in physician histories or slightly more than 3.5 problems per patient. However, physicians but not the computer reported 13 problems. The data show that computer histories reported problems across a range of organ systems, that the problems detected by computer but not physician histories were both acute and chronic and that the computer histories detected a significant number of issues important for preventing further morbidity. Conclusion A combination of physician and computer-acquired histories, in non-emergent situations, with the latter available to the physician at the time he or she sees the patient, is a far superior method for collecting historical data than the physician interview alone.

The 'medical humanities' in health sciences education in South Africa.

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Reid, S

2014-02-01

A new masters-level course, 'Medicine and the Arts" will be offered in 2014 at the University of Cape Town, setting a precedent for interdisciplinary education in the field of medical humanities in South Africa. The humanities and social sciences have always been an implicit part of undergraduate and postgraduate education in the health sciences, but increasingly they are becoming an explicit and essential component of the curriculum, as the importance of graduate attributes and outcomes in the workplace is acknowledged. Traditionally, the medical humanities have included medical ethics, history, literature and anthropology. Less prominent in the literature has been the engagement with medicine of the disciplines of sociology, politics, philosophy, linguistics, education, and law, as well as the creative and expressive arts. The development of the medical humanities in education and research in South Africa is set to expand over the next few years, and it looks as if it will be an exciting inter-disciplinary journey.

The medical dictionary for regulatory activities (MedDRA).

Science.gov (United States)

Brown, E G; Wood, L; Wood, S

1999-02-01

The International Conference on Harmonisation has agreed upon the structure and content of the Medical Dictionary for Regulatory Activities (MedDRA) version 2.0 which should become available in the early part of 1999. This medical terminology is intended for use in the pre- and postmarketing phases of the medicines regulatory process, covering diagnoses, symptoms and signs, adverse drug reactions and therapeutic indications, the names and qualitative results of investigations, surgical and medical procedures, and medical/social history. It can be used for recording adverse events and medical history in clinical trials, in the analysis and tabulations of data from these trials and in the expedited submission of safety data to government regulatory authorities, as well as in constructing standard product information and documentation for applications for marketing authorisation. After licensing of a medicine, it may be used in pharmacovigilance and is expected to be the preferred terminology for international electronic regulatory communication. MedDRA is a hierarchical terminology with 5 levels and is multiaxial: terms may exist in more than 1 vertical axis, providing specificity of terms for data entry and flexibility in data retrieval. Terms in MedDRA were derived from several sources including the WHO's adverse reaction terminology (WHO-ART), Coding Symbols for a Thesaurus of Adverse Reaction Terms (COSTART), International Classification of Diseases (ICD) 9 and ICD9-CM. It will be maintained, further developed and distributed by a Maintenance Support Services Organisation (MSSO). It is anticipated that using MedDRA will improve the quality of data captured on databases, support effective analysis by providing clinically relevant groupings of terms and facilitate electronic communication of data, although as a new tool, users will need to invest time in gaining expertise in its use.

'The medical' and 'health' in a critical medical humanities.

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Atkinson, Sarah; Evans, Bethan; Woods, Angela; Kearns, Robin

2015-03-01

As befits an emerging field of enquiry, there is on-going discussion about the scope, role and future of the medical humanities. One relatively recent contribution to this debate proposes a differentiation of the field into two distinct terrains, 'medical humanities' and 'health humanities,' and calls for a supersession of the former by the latter. In this paper, we revisit the conceptual underpinnings for a distinction between 'the medical' and 'health' by looking at the history of an analogous debate between 'medical geography' and 'the geographies of health' that has, over the last few years, witnessed a re-blurring of the distinction. Highlighting the value of this debate within the social sciences for the future development of the medical humanities, we call for scholars to take seriously the challenges of critical and cultural theory, community-based arts and health, and the counter-cultural creative practices and strategies of activist movements in order to meet the new research challenges and fulfill the radical potential of a critical medical humanities.

Medication adherence levels and differential use of mental-health services in the treatment of schizophrenia

Directory of Open Access Journals (Sweden)

Furiak Nicolas M

2009-01-01

Full Text Available Abstract Background Adherence to antipsychotics for schizophrenia is associated with favorable clinical outcomes. This study compared annual mental-health service utilization by recent medication adherence levels for patients treated for schizophrenia, and assessed whether adherence levels change from pre- to post-psychiatric hospitalization. Methods We analyzed data from a large prospective, non-interventional study of patients treated for schizophrenia in the United States, conducted between 7/1997 and 9/2003. Detailed mental-health resource utilization was systematically abstracted from medical records and augmented with patients' self report. Medication possession ratio (MPR with any antipsychotic in the 6 months prior to enrollment was used to categorize patients as: adherent (MPR ≥ 80%, N = 1758, partially adherent (MPR ≥ 60% Results Adherent patients had a lower rate of psychiatric hospitalization compared with partially adherent and non-adherent patients (p Conclusion Adherence is associated with lower utilization of acute care services and greater engagement in outpatient mental-health treatment. Adherence is a potentially dynamic phenomenon, which may improve, at least temporarily, following patients' psychiatric hospitalizations.

Retrospective on the construction and practice of a state-level emergency medical rescue team.

Science.gov (United States)

Lei, Zhang; Haitao, Guo; Xin, Wang; Yundou, Wang

2014-10-01

For the past few years, disasters like earthquakes, landslides, mudslides, tsunamis, and traffic accidents have occurred with an ever-growing frequency, coverage, and intensity greatly beyond the expectation of the public. In order to respond effectively to disasters and to reduce casualties and property damage, countries around the world have invested more efforts in the theoretical study of emergency medicine and the construction of emergency medical rescue forces. Consequently, emergency medical rescue teams of all scales and types have come into being and have played significant roles in disaster response work. As the only state-level emergency medical rescue force from the Chinese People's Armed Police Forces, the force described here has developed, through continuous learning and practice, a characteristic mode in terms of grouping methods, equipment system construction, and training.

A history of salt.

Science.gov (United States)

Cirillo, M; Capasso, G; Di Leo, V A; De Santo, N G

1994-01-01

The medical history of salt begins in ancient times and is closely related to different aspects of human history. Salt may be extracted from sea water, mineral deposits, surface encrustations, saline lakes and brine springs. In many inland areas, wood was used as a fuel source for evaporation of brine and this practice led to major deafforestation in central Europe. Salt played a central role in the economies of many regions, and is often reflected in place names. Salt was also used as a basis for population censuses and taxation, and salt monopolies were practised in many states. Salt was sometimes implicated in the outbreak of conflict, e.g. the French Revolution and the Indian War of Independence. Salt has also been invested with many cultural and religious meanings, from the ancient Egyptians to the Middle Ages. Man's innate appetite for salt may be related to his evolution from predominantly vegetarian anthropoids, and it is noteworthy that those people who live mainly on protein and milk or who drink salty water do not generally salt their food, whereas those who live mainly on vegetables, rice and cereals use much more salt. Medicinal use tended to emphasize the positive aspects of salt, e.g. prevention of putrefaction, reduction of tissue swelling, treatment of diarrhea. Evidence was also available to ancient peoples of its relationship to fertility, particularly in domestic animals. The history of salt thus represents a unique example for studying the impact of a widely used dietary substance on different important aspects of man's life, including medical philosophy.

History, Medicine, and Culture: History for Science Students.

Science.gov (United States)

Balog, C. Edward

1980-01-01

Describes college level history course entitled "Healers and Persons" for undergraduate medicine students. Topics include Greek medicine and Hippocrates, Galen of Pergamum, Islamic and Roman culture, medieval medicine, the Renaissance, Harvey, Pasteur, Lister, and Mendel. (KC)

Lack of spirometry use in Danish patients initiating medication targeting obstructive lung disease

DEFF Research Database (Denmark)

Koefoed, Mette; Christensen, René Depont; Søndergaard, Jens

2012-01-01

Research indicates that a large proportion of patients using medication targeting obstructive lung disease have no history of spirometry testing.......Research indicates that a large proportion of patients using medication targeting obstructive lung disease have no history of spirometry testing....

隋前正史医事伦理探骊%Discussion on Medical Ethics Based on the History before the Sui Dynasty

Institute of Scientific and Technical Information of China (English)

赵仁龙; 任杰

2015-01-01

征引隋前正史中医学史料，从高层之医学人文关怀、医学教育及医学传播三个伦理方面进行论述，认为：医与政有着天然紧密相连的渊源关系，医政充分体现了政府有无政治作为和是否实施人文关怀；汉魏南北朝时期太学、地方官学、私学都很活跃，在医学教育方面，也有深刻的进步理念；中医药作为加强民族间交流和融合的友好使者，对当今的中国优秀传统文化对外传播有着重要的引领意义。%Based on the TCM historical information before the history of Sui Dynasty, from the top of the medi-cal humanistic care, medical education and medical communication, the essay discusses three ethical, think: the medical is closely combined with politics have a natural origin, medical administration embodies the government whether any politics as and humanistic care;Jun business, local authority, private and southern and northern dy-nasties period is active, in terms of medical education, also has a profound progress idea; Chinese medicine as strengthen communication and integration between national goodwill ambassador, in today′s Chinese excellent tradi-tional culture of foreign communication has important guide meaning.

Shiraz medical students’ perceptions of their colleagues’ professional behavior

Directory of Open Access Journals (Sweden)

MEHRDAD ASKARIAN

2015-07-01

Full Text Available Introduction: Today, development of professionalism is a critical aim of medical schools. Studies have demonstrated that medical students’ perceived level of professionalism is inadequate worldwide. This study aimed to investigate the medical students’ perceptions of their colleagues’ professional behavior. Methods: This study is a cross-sectional study with 280 medical students at Shiraz University of Medical Sciences in their fifth to seventh year of study as the sample. The study was performed during one month in 2013, using stratified random sampling method. The instrument of the study was the Persian version of the questionnaire of the American Board of Internal Medicine (ABIM.The questionnaire includes demographic information, questions about the meaning of the professionalism, history of medical ethics education programs and 12 behavioral questions. The data were analyzed using student t-test and Pearson correlation test. The significance level was set as 0.05. Results: Forty percent of respondents did not know the meaning of professionalism. The mean±SD score of behavioral questions was 5.91±1.2 on a scale from 0 to 10. The mean±SD score of excellence questions was 4.94±1.7. It was 7.05±1.9 for ‘honor/integrity’, and 6.07±2.1 for ‘altruism/respect’ questions. There was a significant association between gender and excellence score (p=0.007. Conclusion: Medical students assessed their colleagues’ professional behavior as poor. They did not have proper information about professionalism. Medical students are future general practitioners and respecting medical ethics by them is very important in a perfect health system. Universities should emphasize the importance of teaching professionalism to medical students and faculty members, using innovative education methods.

Effect of mobile usage on serum melatonin levels among medical students.

Science.gov (United States)

Shrivastava, Abha; Saxena, Yogesh

2014-01-01

Exposure to extremely low frequency (ELF) electromagnetic radiations from mobile phones may affect the circadian rhythm of melatonin in mobile users. The study was designed with objective to evaluate the influence of mobile phone on circadian rhythm of melatonin and to find the association if any between the hours of mobile usage with serum melatonin levels. All the volunteers medical students using mobiles for > 2 hrs/day were included in high users group and volunteers who used mobile for ≤ 2 hrs where included in low users group. Both high and low users volunteers were sampled three times in the same day (Morning-3-4 am, Noon 1-2 pm, Evening-5-6 pm) for estimation of serum melatonin levels: Comparsion of sernum melatonin levels in high users and low users were done by Mann Whitney "U" Test. Reduced morning melatonin levels (3-4 am) was observed in high users (> 2 hrs/day) i.e high users had a disturbed melatonin circadian rhythm.There was a negative correlation between melatonin secretion and hours of mobile usages.

Collaborative work and medical talk: opportunities for learning through knowledge sharing.

Science.gov (United States)

Nilsen, Line Lundvoll; Ludvigsen, Sten R

2010-01-01

Teleconsultations provide new opportunities for learning in medical settings. This study explores the conditions under which learning among physicians takes place. The empirical context is 47 real-time video conferences carried out to examine collaborative work and the medical talk involved. Sixteen of the observations were consultations wherein general practitioners (GPs) and specialists shared knowledge with the purpose of solving a medical problem related to a patient under treatment. In this exploratory study, the learning opportunities are seen as what medical practitioners with different types of expertise achieve through interaction while working with patients over periods of time. The analysis of medical talk in consultations shows that collaborative work among GPs and specialists creates a shared understanding of the patient's clinical history and treatment trajectory. As knowledge is demanded and attributed and gaps of knowledge become shared, consultations create a work tool that expands the medical work and talk. Collaborative work in and between different levels of the health care service expands knowledge, creates opportunities for learning in everyday settings, and improves the quality of knowledge distribution in the health care system.

Wang Haili, The History of Egypt

Institute of Scientific and Technical Information of China (English)

Han Jianwei[1

2015-01-01

The History of Egypt is the first monograph on Egyptian history written by a single Chinese author. As a comprehensive study both in Egyptology and in Egyptian history, it represents a new level of Egyptian historical research in Chinese academia.

Yang Shengmao and the Development of World History Studies in China

Institute of Scientific and Technical Information of China (English)

Li Jianming[1

2015-01-01

After the adjustment of disciplinary categorization of Chinese colleges in 2011, world history, along with Chinese history and archeology, became the first-level disciplines in history. As a first-level discipline, world history has a meaning clearly different from its western sense: it is not a simply course, nor a single field, but a disciplinary system combined by many second-level disciplines, including ancient world history, modern world history, history of specific nations or regions, and history of specialized subjects.

Psychotropic Medication Use during Inpatient Rehabilitation for Traumatic Brain Injury

Science.gov (United States)

Hammond, Flora M.; Barrett, Ryan S.; Shea, Timothy; Seel, Ronald T.; McAlister, Thomas W.; Kaelin, Darryl; Ryser, David; Corrigan, John D.; Cullen, Nora; Horn, Susan D.

2015-01-01

Objective To describe psychotropic medication administration patterns during inpatient rehabilitation for traumatic brain injury (TBI) and their relationship to patient pre-injury and injury characteristics. Design Prospective observational cohort. Setting multiple acute inpatient rehabilitation units or hospitals. Participants 2,130 individuals with TBI (complicated mild, moderate, or severe) admitted for inpatient rehabilitation. Interventions NA Main Outcome Measure(s) NA Results Most frequently administered was narcotic analgesics (72% of sample) followed by antidepressants (67%), anticonvulsants (47%), antianxiolytics (33%), hypnotics (30%), stimulants (28%), antipsychotics (25%), antiparkinson agents (25%), and miscellaneous psychotropics (18%). The psychotropic agents studied were administered to 95% of the sample with 8.5% receiving only 1 and 31.8% receiving 6 or more. Degree of psychotropic medication administration varied widely between sites. Univariate analyses indicated younger patients were more likely to receive anxiolytics, antidepressants, antiparkinson agents, stimulants, antipsychotics, and narcotic analgesics, while those older were more likely to receive anticonvulsants and miscellaneous psychotropics. Men were more likely to receive antipsychotics. All medication classes were less likely administered to Asians, and more likely to those with more severe functional impairment. Use of anticonvulsants was associated with having seizures at some point during acute care or rehabilitation stays. Narcotic analgesics were more likely for those with history of drug abuse, history of anxiety and depression (premorbid or during acute care), and severe pain during rehabilitation. Psychotropic medication administration increased rather than decreased during the course of inpatient rehabilitation in each of the medication categories except for narcotics. This observation was also true for medication administration within admission functional levels (defined

[Andrologic disease detected during army medical visit].

Science.gov (United States)

Campodonico, Fabio; Michelazzi, Alberto; Capurro, Anna; Carmignani, Giorgio

2003-12-01

Aim of this study is to investigate the prevalence of andrologic diseases in young men (age 18 years) recruited for conscription in a north-western Italian region. A random sample of 1993 young men was evaluated at the Army Medical Visit Center of the Military District of Genoa. The visits were performed by the same doctor. An examination of external genitalia and secondary sex characters was made and the medical history of each conscript was recorded. Investigation procedures were standardized according to the guidelines of the WHO for the diagnosis and management of the infertile male. Andrologic disorders were found in 547 subjects (27.5%) and first diagnosed in 412 (20.7%). Specific acquired or congenital disorders are discussed. Some patients with most significant diseases were referred to the Urologic Department for second level diagnostic exams. This study underlines the role of the army medical visit as a tool for andrologic screening in young males. The military health service may be a relevant institution for postpuberal control and it could be useful to prevent future sexual and fertility problems in adult males.

The Role of Residential Early Parenting Services in Increasing Parenting Confidence in Mothers with A History of Infertility

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Marjan Lynette

2016-07-01

Full Text Available Background Mothers with a history of infertility may experience parenting difficulties and challenges. This study was conducted to investigate the role of residential early parenting services in increasing parenting confidence in mothers with a history of infertility. Materials and Methods This was a retrospective chart review study using the quantitative data from the clients attending the Karitane Residential Units and Parenting Services (known as Karitane RUs during 2013. Parenting confidence (using Karitane Parenting Confidence Scale-KPCS, depression, demographics, reproductive and medical history, as well as child’s information were assessed from a sample of 27 mothers who had a history of infertility and who attended the Karitane RUs for support and assistance. The data were analyzed using SPSS version 19. Results More than half of the women (59.3% reported a relatively low level of parenting confidence on the day of admission. The rate of low parenting confidence, however, dropped to 22.2% after receiving 4-5 days support and training in the Karitane RUs. The mean score of the KPCS increased from 36.9 ± 5.6 before the intervention to 41.1 ± 3.4 after the intervention, indicating an improvement in the parenting confidence of the mothers after attending the Karitane RUs (P<0.0001. No statistically significant association was found between maternal low parenting confidence with parental demographics (including age, country of birth, and employment status, a history of help-seeking, symptoms of depression, as well as child’s information [including gender, age, siblings, diagnosis of gastroesophageal reflux disease (GORD and use of medication]. Conclusion Having a child after a period of infertility can be a stressful experience for some mothers. This can result in low parenting confidence and affect parent-child attachment. Our findings emphasized on the role of the residential early parenting services in promoting the level of

Die Ärztliche Zentralbibliothek des Universitätsklinikums Hamburg-Eppendorf / The Medical Library of the University Medical Center Hamburg-Eppendorf

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Kintzel, Melanie

2009-12-01

Full Text Available This article introduces the Medical Library of the University Medical Center Hamburg-Eppendorf. Firstly, history, role and status of the library within the University Medical Center are illustrated, followed by a description of the library’s facilities and services. Finally, recent projects are presented as well as a selection of key figures.

Assessing accuracy of an electronic provincial medication repository

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Price Morgan

2012-05-01

Full Text Available Abstract Background Jurisdictional drug information systems are being implemented in many regions around the world. British Columbia, Canada has had a provincial medication dispensing record, PharmaNet, system since 1995. Little is known about how accurately PharmaNet reflects actual medication usage. Methods This prospective, multi-centre study compared pharmacist collected Best Possible Medication Histories (BPMH to PharmaNet profiles to assess accuracy of the PharmaNet profiles for patients receiving a BPMH as part of clinical care. A review panel examined the anonymized BPMHs and discrepancies to estimate clinical significance of discrepancies. Results 16% of medication profiles were accurate, with 48% of the discrepant profiles considered potentially clinically significant by the clinical review panel. Cardiac medications tended to be more accurate (e.g. ramipril was accurate >90% of the time, while insulin, warfarin, salbutamol and pain relief medications were often inaccurate (80–85% of the time. 1215 sequential BPMHs were collected and reviewed for this study. Conclusions The PharmaNet medication repository has a low accuracy and should be used in conjunction with other sources for medication histories for clinical or research purposes. This finding is consistent with other, smaller medication repository accuracy studies in other jurisdictions. Our study highlights specific medications that tend to be lower in accuracy.

Humor and Laughter may Influence Health. I. History and Background

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Mary Payne Bennett

2006-01-01

Full Text Available Articles in both the lay and professional literature have extolled the virtues of humor, many giving the impression that the health benefits of humor are well documented by the scientific and medical community. The concept that humor or laughter can be therapeutic goes back to biblical times and this belief has received varying levels of support from the scientific community at different points in its history. Current research indicates that using humor is well accepted by the public and is frequently used as a coping mechanism. However, the scientific evidence of the benefits of using humor on various health related outcomes still leaves many questions unanswered.

The art of history taking.

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Trieger, N; Goldblatt, L

1978-02-01

The art of history taking involves the ability to recognize the interrelationship between the details of the medical history and the patient's personal history. For the oral surgeon, this provides important insights into how the patient has reacted to illness in the past as well as how he is most likely to react to current treatment. Specific problems have been reviewed as well as suggested interview techniques to guide the oral surgeon in his management of his patient's reactions. No one expects the doctor to be an iconoclast. He cannot be all things to all patients. He should recognize a problem, acknowledge it as a problem, and be flexible enough to deal with it or refer the patient to someone who can. This kind of understanding will enable the oral surgeon to fulfill his role with appreciation from his patients and an inner sense of professional and personal achievement.

To determine the level of satisfaction among medical students of a public sector medical university regarding their academic activities

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Manzar Bushra

2011-10-01

Full Text Available Abstract Background An ongoing evaluation system is essential to determine if the academic system in place has worked to produce a better product, hence the objective of our study was to evaluate the satisfaction level among medical students regarding their academic teaching and assessment method and what measures will they suggest for the future to rectify the current situation. This questionnaire based cross sectional study was conducted in a public sector medical university from February to July 2010. A well structured questionnaire was administered to a random sample of 375 final year medical students. However 292 of the students provided informed consent and filled in the questionnaire which included their demographic profile as well as questions in line with the study objective. Data was entered in a Statistical Package for Social Sciences (SPSS version.16 and analyzed using descriptive statistics. Findings The male to female ratio in our study was 1:2. Most of the students (57.2% were dissatisfied with the quality of teaching in the university. Fifty-seven percent of the participants believed that the current standard of their institute were not at par with those of international medical universities. BCQ's were the mode of examination questions preferred by the majority of the students. Most of the students (66.1% wanted the university to conduct career planning seminars to help them plan their career. Conclusions These results suggest that the students of public sector medical universities are unsatisfied from current academic facilities and teaching activities. Students recommend increased emphasis on better lectures and practical training as well as a need to incorporate career planning sessions for the students to help plan them their future career paths.

Lingua patientis: new words for patient communication and history taking.

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Weaver, Donald F

2017-11-01

The English language sometimes fails in its ability to describe the severity or complexity of medical symptoms and complaints. In frustration, patients (or families) occasionally create new words to convey the subtleties of their medical history. Although medicine has created a comprehensive technical lexicon for physicians, we have failed to develop a corresponding patient-centric vocabulary (lingua patientis) that provides more accurate symptom description. The social networking of lingua patientis words might enhance history taking and afford improved appreciation of disease impact on individual patients. The English language is renowned for its capacity for flexibility and adaptability - we need to exploit this capacity for the benefit of our patients.

[Patients' letters and pre-modern medical lay-culture].

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Stolberg, Michael

2007-01-01

Consulting by letter was fairly common practice among the educated, upper classes of early modern Europe. Surviving letters of consultation written by patients, relatives or friends count among the most valuable source for the analysis of pre-modern experiences of disease and the body. This essay gives a brief overview of the various types of consultation letters and related documents which resulted from this practice before tracing the historical development of epistolary consultations from the late Middle Ages through the heyday medical correspondence in the 18th c. before its decline in the 19th c. It presents "experience", "self-fashioning" and "discourse" as three particularly fruitful levels of analysis on which patients' letters can be used within the wider framework of a cultural history of medicine. These three levels of analysis, or three distinct approaches, enable historians to access a greater awareness of the ways in which the experience of illness and the body is culturally framed with an analysis of the performative effects of patients' narratives and the influence of medical discourse among the wider society.

Wie wichtig ist der Unterricht in Medizinethik und Medizingeschichte im Medizinstudium? Eine empirische Studie zu den Einschätzungen Studierender [How Important is Medical Ethics and History of Medicine Teaching in the Medical Curriculum? An Empirical Approach towards Students' Views

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Schulz, Stefan

2012-02-01

Full Text Available [english] Objectives: It was investigated how students judge the teaching of medical ethics and the history of medicine at the start and during their studies, and the influence which subject-specific teaching of the history, theory and ethics of medicine (GTE - or the lack thereof - has on the judgement of these subjects.Methods: From a total of 533 students who were in their first and 5 semester of the Bochum Model curriculum (GTE teaching from the first semester onwards or followed the traditional curriculum (GTE teaching in the 5/6 semester, questionnaires were requested in the winter semester 2005/06 and in the summer semester 2006. They were asked both before and after the 1 and 5 (model curriculum or 6 semester (traditional curriculum. We asked students to judge the importance of teaching medical ethics and the history of medicine, the significance of these subjects for physicians and about teachability and testability (Likert scale from -2 (do not agree at all to +2 (agree completely.Results: 331 questionnaire pairs were included in the study. There were no significant differences between the students of the two curricula at the start of the 1 semester.The views on medical ethics and the history of medicine, in contrast, were significantly different at the start of undergraduate studies: The importance of medical ethics for the individual and the physician was considered very high but their teachability and testability were rated considerably worse. For the history of medicine, the results were exactly opposite. GTE teaching led to a more positive assessment of items previously ranked less favourably in both curricula. A lack of teaching led to a drop in the assessment of both subjects which had previously been rated well.Conclusion: Consistent with the literature, our results support the hypothesis that the teaching of GTE has a positive impact on the views towards the history and ethics of medicine, with a lack of teaching having a

Prevalence of self-reported medical conditions among dental patients

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Mukhatar A Javali

2017-01-01

Conclusion: The results of our study found a high prevalence of medical conditions among patients seeking periodontal treatment, thereby highlighting the need to record patients' medical and dental care history in detail.

A medical social work perspective on rehabilitation.

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Fugl-Meyer, Kerstin Sjögren

2016-10-12

This paper introduces a biopsychosocial model for use as a tool by medical social workers and other rehabilitation professionals for the descriptive analysis of the case history and follow-up of patients needing rehabilitative support. The model is based on action theory and emphasizes the demands on evidence-based clarification of the interplay between a subject's contextual life situation, their ability to act in order to realize their goals, and their emotional adaptation. Using clinical experience and literature searches, a standard operations procedure to adequately document the case history in clinical practice is suggested, thus providing strategies through which the work of medical social workers can be based on evidence. Some specific areas of concern for the medical social worker within the rehabilitation of disabled people are highlighted.

To what extent are medical interviewing skills teachable?

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Kraan, H F; Crijnen, A A; de Vries, M W; Zuidweg, J; Imbos, T; Van der Vleuten, C P

1990-01-01

Growth patterns of medical interviewing skills during a 6-year undergraduate curriculum are assessed by studying 563 medical students taken from five year-groups, interviewing simulated patients. In a cross-sectional, quasi-experimental design their skills are rated by means of the Maastricht History-taking and Advice Checklist (MAAS), an observation instrument which measures five categories of interviewing skills pertaining to initial medical consultations. The findings suggest that the skills for 'history-taking', 'presenting solutions' and 'structuring of the interview' are effectively learned. These learning effects result from a continuous small group teaching program with expert and peer review of videotaped encounters with simulated patients. The teaching effects of this program seem less for the skills pertinent to the phase of 'exploring the reasons for encounter' and to the 'basic interviewing skills', because the students' growing medical knowledge and the increasing ability to solve medical problems exert a counteracting influence on the acquisition of these easily deteriorating skills. The results might be helpful to curriculum planners in order to make their programs for medical interviewing skills more effective.

Application of NCRP REPORT No.151 for evaluating the radiation level at the ambience of megavoltage medical electron linear accelerator treatment room

International Nuclear Information System (INIS)

Yang Haiyou; Yu Shui

2011-01-01

Objective: The estimation model,on radiation level at the ambience of medical electron linear accelerator treatment rooms, is derived on the basis of NCRP REPORT No.151, which presents the calculation model of shielding design about barrier thicknesses of megavoltage medical electron linear accelerator treatment rooms. Methods: The estimation model comes from NCRP REPORT No.151- S tructural Shielding Design and Evaluation for Megavoltage X-and Gamma-Ray Radiotherapy Facilities , which presents the calculation model of shielding design about megavoltage medical electron linear accelerator treatment rooms, and the dose rate at isocenter replaces the workload, and the occupancy factor and the use factor are forsaken, then the converse deduction is done according to barrier thicknesses of shielding materials. Ultimately, the estimation model, on radiation level at the ambience of medical electron linear accelerator treatment rooms, is derived. Results: It can be regarded as a systematic estimation model for calculating the radiation level at the ambience of medical electron linear accelerator treatment room. Conclusion: The estimation model has certain practical value to evaluate the radiation level at the ambience of medical electron linear accelerator treatment room. (authors)

Medical device reliability and associated areas

National Research Council Canada - National Science Library

Dhillon, Balbir S

2000-01-01

.... Although the history of reliability engineering can be traced back to World War II, the application of reliability engineering concepts to medical devices is a fairly recent idea that goes back to the latter part of the 1960s when many publications on medical device reliability emerged. Today, a large number of books on general reliability have been...

The cross-sectional study of anxiety levels and ratio of severity of thirteen symptoms of anxiety among medical students

OpenAIRE

Muhammad Arslan Iqbal; Muhammad Waseem Abbas; Muhammad Zohaib Chaudhary; Muhammad Nouman Iqbal; Mohammad Sami Aleem; Rukhsar Javaid; Hasnain Ahmed; Taleea Younas; Faiza Maqsood; Fiza Fatima; Hafiz Hasnain Ahmed; Sana Mushtaq

2016-01-01

Background: Anxiety is defined as physical, behavioral, social and psychological response to treat self-concept characterized by subjective, consciously perceived feelings of tension. Nowadays anxiety is most commonly found among medical students. This study was conducted to find out the anxiety levels and ratio of severity of thirteen symptoms of anxiety. Methods: A questionnaire based study was conducted among 178 medical students which tests the level of anxiety and severity of symptom...

The IMIA History Working Group: Inception through the IMIA History Taskforce, and Major Events Leading Up to the 50th Anniversary of IMIA.

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Kulikowski, C A; Mihalas, G; Greenes, R A; Yacubsohn, V; Park, H-A

2017-08-01

Background: The 50th Anniversary of IMIA will be celebrated in 2017 at the World Congress of Medical Informatics in China. This takes place 50 years after the International Federation of Information Processing (IFIP) Societies approved the formation of a new Technical Committee (TC) 4 on Medical Information Processing, which was the predecessor of IMIA, under the leadership of Dr. Francois Grémy. The IMIA History Working Group (WG) was approved in 2014 to document and write about the history of the field and its organizations. Objectives: The goals of this paper are to describe how the IMIA History WG arose and developed, including its meetings and projects, leading to the forthcoming 50th Anniversary of IMIA. Methods: We give a chronology of major developments leading up to the current work of the IMIA History WG and how it has stimulated writing on the international history of biomedical and health informatics, sponsoring the systematic compilation and writing of articles and stories from pioneers and leaders in the field, and the organization of workshops and panels over the past six years, leading towards the publication of the contributed volume on the 50th IMIA Anniversary History as an eBook by IOS Press. Conclusions: This article leads up to the IMIA History eBook which will contain original autobiographical retrospectives by pioneers and leaders in the field, together with professional organizational histories of the national and regional societies and working groups of IMIA, with commentary on the main themes and topics which have evolved as scientific and clinical practices have changed under the influence of new insights, technologies, and the changing socio-economic, cultural and professional circumstances around the globe over the past 50 years. Georg Thieme Verlag KG Stuttgart.

Autoimmune progesterone dermatitis: Case report with history of urticaria, petechiae and palpable pinpoint purpura triggered by medical abortion.

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Mbonile, Lumuli

2016-03-17

Autoimmune progesterone dermatitis (APD) is a rare autoimmune response to raised endogenous progesterone levels that occur during the luteal phase of the menstrual cycle. Cutaneous, mucosal lesions and other systemic manifestations develop cyclically during the luteal phase of the menstrual cycle when progesterone levels are elevated. APD symptoms usually start 3 - 10 days before menstruation and resolve 1 - 2 days after menstruation ceases. A 30-year-old woman presented with urticaria, petechiae and palpable pinpoint purpura lesions of the legs, forearms, neck and buttocks 1 week prior to her menses starting and 2 months after a medical abortion. She was diagnosed with allergic contact dermatitis and topical steroids were prescribed. Her skin conditions did not improve and were associated with her menstrual cycle. We performed an intradermal test using progesterone, which was positive. She was treated with oral contraceptive pills and the symptoms were resolved. This is a typical case of APD triggered by increased sensitivity to endogenous progesterone induced a few months after medical abortion.

Medical Robots: Current Systems and Research Directions

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Ryan A. Beasley