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  1. International market research at the Mayo Clinic.

    Science.gov (United States)

    Hathaway, M; Seltman, K

    2001-01-01

    Mayo Clinic has a long international history and has been providing care to international patients since its inception. Despite its history and reputation, however, the marketing staff continues to monitor the international market to gauge the level of awareness, reputation, and attractiveness of Mayo Clinic around the world. Here's a look at how one institution has used word-of-mouth marketing to maintain its global reputation.

  2. The Mayo Clinic Value Creation System.

    Science.gov (United States)

    Swensen, Stephen J; Dilling, James A; Harper, C Michel; Noseworthy, John H

    2012-01-01

    The authors present Mayo Clinic's Value Creation System, a coherent systems engineering approach to delivering a single high-value practice. There are 4 tightly linked, interdependent phases of the system: alignment, discovery, managed diffusion, and measurement. The methodology is described and examples of the results to date are presented. The Value Creation System has been demonstrated to improve the quality of patient care while reducing costs and increasing productivity.

  3. Mayo Clinic Care Network: A Collaborative Health Care Model.

    Science.gov (United States)

    Wald, John T; Lowery-Schrandt, Sherri; Hayes, David L; Kotsenas, Amy L

    2018-01-01

    By leveraging its experience and expertise as a consultative clinical partner, the Mayo Clinic developed an innovative, scalable care model to accomplish several strategic goals: (1) create and sustain high-value relationships that benefit patients and providers, (2) foster relationships with like-minded partners to act as a strategy against the development of narrow health care networks, and (3) increase national and international brand awareness of Mayo Clinic. The result was the Mayo Clinic Care Network. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  4. Empowering Mayo Clinic Individualized Medicine with Genomic Data Warehousing

    Directory of Open Access Journals (Sweden)

    Iain Horton

    2017-08-01

    Full Text Available Individualized medicine enables better diagnoses and treatment decisions for patients and promotes research in understanding the molecular underpinnings of disease. Linking individual patient’s genomic and molecular information with their clinical phenotypes is crucial to these efforts. To address this need, the Center for Individualized Medicine at Mayo Clinic has implemented a genomic data warehouse and a workflow management system to bring data from institutional electronic health records and genomic sequencing data from both clinical and research bioinformatics sources into the warehouse. The system is the foundation for Mayo Clinic to build a suite of tools and interfaces to support various clinical and research use cases. The genomic data warehouse is positioned to play a key role in enhancing the research capabilities and advancing individualized patient care at Mayo Clinic.

  5. Empowering Mayo Clinic Individualized Medicine with Genomic Data Warehousing.

    Science.gov (United States)

    Horton, Iain; Lin, Yaxiong; Reed, Gay; Wiepert, Mathieu; Hart, Steven

    2017-08-22

    Individualized medicine enables better diagnoses and treatment decisions for patients and promotes research in understanding the molecular underpinnings of disease. Linking individual patient's genomic and molecular information with their clinical phenotypes is crucial to these efforts. To address this need, the Center for Individualized Medicine at Mayo Clinic has implemented a genomic data warehouse and a workflow management system to bring data from institutional electronic health records and genomic sequencing data from both clinical and research bioinformatics sources into the warehouse. The system is the foundation for Mayo Clinic to build a suite of tools and interfaces to support various clinical and research use cases. The genomic data warehouse is positioned to play a key role in enhancing the research capabilities and advancing individualized patient care at Mayo Clinic.

  6. Transforming Research Management Systems at Mayo Clinic

    Science.gov (United States)

    Smith, Steven C.; Gronseth, Darren L.

    2011-01-01

    In order for research programs at academic medical centers and universities to survive and thrive in the increasingly challenging economic, political and regulatory environment, successful transformation is extremely important. Transformation and quality management techniques are increasingly well established in medical practice organizations. In…

  7. Optimizing the patient transport function at Mayo Clinic.

    Science.gov (United States)

    Kuchera, Dustin; Rohleder, Thomas R

    2011-01-01

    In this article, we report on the implementation of a computerized scheduling tool to optimize staffing for patient transport at the Mayo Clinic. The tool was developed and implemented in Microsoft Excel and Visual Basic for Applications and includes an easy-to-use interface. The tool allows transport management to consider the trade-offs between patient waiting time and staffing levels. While improved staffing efficiency was a desire of the project, it was important that patient service quality was also maintained. The results show that staffing could be reduced while maintaining historical patient service levels.

  8. Clinical aspects of the Mayo/IBM PACS project

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    Forbes, Glenn S.; Morin, Richard L.; Pavlicek, William

    1991-07-01

    A joint project between Mayo Clinic and IBM to develop a picture archival and communications system has been under development for three years. This project began as a potential solution to a pressing archival problem in magnetic resonance imaging. The project has grown to encompass a much larger sphere of activity including workstations, image retrieval, and report archival. This report focuses on the clinical aspects involved in the design, development, and implementation of such a system. In particular, emphasis is placed on the clinical impact of the system both inside and outside of the radiology department. The primary concerns have centered on fidelity of archival data, ease of use, and diagnostic efficacy. The project to date has been limited to neuroradiology practice. This group consists of nine staff radiologists and fellows. Administrative policy decisions regarding the accessibility and available of digital data in the clinical environment have been much more difficult and complex than originally conceived. Based on the observations thus far, the authors believe the system will become a useful and valuable adjunct to clinical practice of radiology.

  9. Current Perspectives on Desmoid Tumors: The Mayo Clinic Approach

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    Scott Okuno

    2011-08-01

    Full Text Available Desmoid tumors are a rare group of locally aggressive, non malignant tumors of fibroblastic origin that can lead to significant morbidity due to local invasion. Despite advances in the understanding of these tumors, their natural history is incompletely understood and the optimal treatment is still a matter of debate. Local control is the main goal of treatment and there has been a change in philosophy regarding the management of these tumors from aggressive surgical resection to function preservation. A multidisciplinary approach is essential to plan local control with acceptable morbidity. The current Mayo Clinic algorithm for the treatment of these tumors is based on institutional experience and the available evidence in the literature: asymptomatic/non progressive lesions away from vital structures are managed with observation and regular imaging; primary or recurrent desmoid tumors which are symptomatic or progressive or near vital structures are managed with wide surgical resection when wide surgical margins are possible with minimal functional and cosmetic loss. When positive or close surgical margins are likely, surgical resection with adjuvant radiotherapy or definitive radiotherapy is preferred. If likely functional or cosmetic deficit is unacceptable, radiotherapy is the treatment of choice. Unresectable lesions are considered for radiotherapy, chemotherapy or newer modalities however an unresectable lesion associated with a painful, functionless, infected extremity is managed with an amputation.

  10. Current Perspectives on Desmoid Tumors: The Mayo Clinic Approach

    International Nuclear Information System (INIS)

    Joglekar, Siddharth B.; Rose, Peter S.; Sim, Franklin; Okuno, Scott; Petersen, Ivy

    2011-01-01

    Desmoid tumors are a rare group of locally aggressive, non malignant tumors of fibroblastic origin that can lead to significant morbidity due to local invasion. Despite advances in the understanding of these tumors, their natural history is incompletely understood and the optimal treatment is still a matter of debate. Local control is the main goal of treatment and there has been a change in philosophy regarding the management of these tumors from aggressive surgical resection to function preservation. A multidisciplinary approach is essential to plan local control with acceptable morbidity. The current Mayo Clinic algorithm for the treatment of these tumors is based on institutional experience and the available evidence in the literature: asymptomatic/non progressive lesions away from vital structures are managed with observation and regular imaging; primary or recurrent desmoid tumors which are symptomatic or progressive or near vital structures are managed with wide surgical resection when wide surgical margins are possible with minimal functional and cosmetic loss. When positive or close surgical margins are likely, surgical resection with adjuvant radiotherapy or definitive radiotherapy is preferred. If likely functional or cosmetic deficit is unacceptable, radiotherapy is the treatment of choice. Unresectable lesions are considered for radiotherapy, chemotherapy or newer modalities however an unresectable lesion associated with a painful, functionless, infected extremity is managed with an amputation

  11. Postradiation sarcoma of bone: review of 78 Mayo Clinic cases

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    Weatherby, R.P.; Dahlin, D.C.; Ivins, J.C.

    1981-05-01

    Postradiation sarcoma of bone is an uncommon but serious sequela of radiation therapy. Seventy-eight Mayo Clinic patients have been treated for sarcomas arising in irradiated bones. They received their initial radiotherapy for a wide variety of nonneoplastic and neoplastic conditions, both benign and malignant. Thirty-five sarcomas arose in bone that was normal at the time of radiotherapy, and 43 arose in irradiated preexisting osseous lesions. The latent period between radiotherapy and diagnosis of sarcoma averaged 14.3 years. Ninety percent of the postradiation sarcomas were either osteosarcomas or fibrosarcomas; chondrosarcoma, malignant (fibrous) histiocytoma, malignant lymphoma, Ewing's tumor, and metastasizing chondroblastoma also occurred. Prompt radical surgery, when feasible, is usually the treatment of choice for the sarcoma. About 30% of patients with sarcomas of the extremities or craniofacial bones survived 5 years without recurrence; there were no disease-free survivors among patients with tumors of the vertebral column, pelvis, or shoulder girdle. The low risk of sarcoma following radiotherapy for the treatment of cancer should not be a contraindication to its use in these patients; however, radiation therapy for benign bone tumors should be reserved for lesions that are not amenable to surgical treatment. An unusual case is also reported herein in which a fibrosarcoma was discovered in the humerus of a patient who had received radiotherapy 55 years previously for a verified osteosarcoma in the same site.

  12. Postradiation sarcoma of bone: review of 78 Mayo Clinic cases

    International Nuclear Information System (INIS)

    Weatherby, R.P.; Dahlin, D.C.; Ivins, J.C.

    1981-01-01

    Postradiation sarcoma of bone is an uncommon but serious sequela of radiation therapy. Seventy-eight Mayo Clinic patients have been treated for sarcomas arising in irradiated bones. They received their initial radiotherapy for a wide variety of nonneoplastic and neoplastic conditions, both benign and malignant. Thirty-five sarcomas arose in bone that was normal at the time of radiotherapy, and 43 arose in irradiated preexisting osseous lesions. The latent period between radiotherapy and diagnosis of sarcoma averaged 14.3 years. Ninety percent of the postradiation sarcomas were either osteosarcomas or fibrosarcomas; chondrosarcoma, malignant (fibrous) histiocytoma, malignant lymphoma, Ewing's tumor, and metastasizing chondroblastoma also occurred. Prompt radical surgery, when feasible, is usually the treatment of choice for the sarcoma. About 30% of patients with sarcomas of the extremities or craniofacial bones survived 5 years without recurrence; there were no disease-free survivors among patients with tumors of the vertebral column, pelvis, or shoulder girdle. The low risk of sarcoma following radiotherapy for the treatment of cancer should not be a contraindication to its use in these patients; however, radiation therapy for benign bone tumors should be reserved for lesions that are not amenable to surgical treatment. An unusual case is also reported herein in which a fibrosarcoma was discovered in the humerus of a patient who had received radiotherapy 55 years previously for a verified osteosarcoma in the same site

  13. Mayo Alliance Prognostic Model for Myelodysplastic Syndromes: Integration of Genetic and Clinical Information.

    Science.gov (United States)

    Tefferi, Ayalew; Gangat, Naseema; Mudireddy, Mythri; Lasho, Terra L; Finke, Christy; Begna, Kebede H; Elliott, Michelle A; Al-Kali, Aref; Litzow, Mark R; Hook, C Christopher; Wolanskyj, Alexandra P; Hogan, William J; Patnaik, Mrinal M; Pardanani, Animesh; Zblewski, Darci L; He, Rong; Viswanatha, David; Hanson, Curtis A; Ketterling, Rhett P; Tang, Jih-Luh; Chou, Wen-Chien; Lin, Chien-Chin; Tsai, Cheng-Hong; Tien, Hwei-Fang; Hou, Hsin-An

    2018-06-01

    To develop a new risk model for primary myelodysplastic syndromes (MDS) that integrates information on mutations, karyotype, and clinical variables. Patients with World Health Organization-defined primary MDS seen at Mayo Clinic (MC) from December 28, 1994, through December 19, 2017, constituted the core study group. The National Taiwan University Hospital (NTUH) provided the validation cohort. Model performance, compared with the revised International Prognostic Scoring System, was assessed by Akaike information criterion and area under the curve estimates. The study group consisted of 685 molecularly annotated patients from MC (357) and NTUH (328). Multivariate analysis of the MC cohort identified monosomal karyotype (hazard ratio [HR], 5.2; 95% CI, 3.1-8.6), "non-MK abnormalities other than single/double del(5q)" (HR, 1.8; 95% CI, 1.3-2.6), RUNX1 (HR, 2.0; 95% CI, 1.2-3.1) and ASXL1 (HR, 1.7; 95% CI, 1.2-2.3) mutations, absence of SF3B1 mutations (HR, 1.6; 95% CI, 1.1-2.4), age greater than 70 years (HR, 2.2; 95% CI, 1.6-3.1), hemoglobin level less than 8 g/dL in women or less than 9 g/dL in men (HR, 2.3; 95% CI, 1.7-3.1), platelet count less than 75 × 10 9 /L (HR, 1.5; 95% CI, 1.1-2.1), and 10% or more bone marrow blasts (HR, 1.7; 95% CI, 1.1-2.8) as predictors of inferior overall survival. Based on HR-weighted risk scores, a 4-tiered Mayo alliance prognostic model for MDS was devised: low (89 patients), intermediate-1 (104), intermediate-2 (95), and high (69); respective median survivals (5-year overall survival rates) were 85 (73%), 42 (34%), 22 (7%), and 9 months (0%). The Mayo alliance model was subsequently validated by using the external NTUH cohort and, compared with the revised International Prognostic Scoring System, displayed favorable Akaike information criterion (1865 vs 1943) and area under the curve (0.87 vs 0.76) values. We propose a simple and contemporary risk model for MDS that is based on a limited set of genetic and clinical variables

  14. The Enterprise Data Trust at Mayo Clinic: a semantically integrated warehouse of biomedical data.

    Science.gov (United States)

    Chute, Christopher G; Beck, Scott A; Fisk, Thomas B; Mohr, David N

    2010-01-01

    Mayo Clinic's Enterprise Data Trust is a collection of data from patient care, education, research, and administrative transactional systems, organized to support information retrieval, business intelligence, and high-level decision making. Structurally it is a top-down, subject-oriented, integrated, time-variant, and non-volatile collection of data in support of Mayo Clinic's analytic and decision-making processes. It is an interconnected piece of Mayo Clinic's Enterprise Information Management initiative, which also includes Data Governance, Enterprise Data Modeling, the Enterprise Vocabulary System, and Metadata Management. These resources enable unprecedented organization of enterprise information about patient, genomic, and research data. While facile access for cohort definition or aggregate retrieval is supported, a high level of security, retrieval audit, and user authentication ensures privacy, confidentiality, and respect for the trust imparted by our patients for the respectful use of information about their conditions.

  15. Validation of the Mayo Clinic Staging System in Determining Prognoses of Patients With Perihilar Cholangiocarcinoma

    NARCIS (Netherlands)

    Coelen, Robert J. S.; Gaspersz, Marcia P.; Labeur, Tim A.; van Vugt, Jeroen L. A.; van Dieren, Susan; Willemssen, François E. J. A.; Nio, Chung Y.; Ijzermans, Jan N. M.; Klümpen, Heinz-Josef; Groot Koerkamp, Bas; van Gulik, Thomas M.

    2017-01-01

    BACKGROUND & AIMS: Most systems for staging perihilar cholangiocarcinoma (PHC) have been developed for the minority of patients with resectable disease. The recently developed Mayo Clinic system for staging PHC requires only clinical and radiologic variables, but has not yet been validated. We

  16. Dr Albert L. Rhoton Jr's Time at the Mayo Clinic: The Beginnings of a Remarkable Career.

    Science.gov (United States)

    Rayan, Tarek; Carlson, Matthew L; Piepgras, David G; Link, Michael J; Van Gompel, Jamie J

    2017-08-09

    Dr Albert L. Rhoton Jr became the focal point of neurosurgery's evolution in understanding the intricate and complex microanatomy of the human brain over the last 4 decades. His pioneering work on cadaveric specimens proved to be a pivotal endeavor in the pursuit to better understand the complex microsurgical anatomy of cranial surgery. This paper details his early career at the Mayo Clinic in Rochester, Minnesota. A comprehensive review and synthesis of data acquired from the institutional historical archives including the Annual Reports to the Executive Committee, the Reports to the Board of Directors, the MAYOVOX Newsletter, the illustration archives of the Mayo Clinic Division of Creative Media, staff biographies, curriculum vitae, personal interviews, as well as full-text journal articles, and book publications was performed. Dr Rhoton was engaged in a busy clinical practice as a young staff at the Mayo Clinic. Records show he focused on tackling complex intracranial pathologies along with numerous basic research and neuroanatomy projects that became a major part of his life's work and passion. He was a great teacher and friend to countless individuals and his work will continue to impact and improve the care provided to neurosurgery patients for generations to come. Copyright © 2017 by the Congress of Neurological Surgeons.

  17. Patient quality of life in the Mayo Clinic Care Transitions program: a survey study

    Directory of Open Access Journals (Sweden)

    Faucher J

    2016-08-01

    Full Text Available Joshua Faucher,1 Jordan Rosedahl,2 Dawn Finnie,3 Amy Glasgow,3 Paul Takahashi4 1Mayo Medical School, Mayo Clinic College of Medicine, 2Division of Biomedical Statistics and Informatics, Department of Health Science Research, Mayo Clinic, 3Center for the Science of Health Care Delivery, 4Division of Primary Care Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, USA Background: Transitional care programs are common interventions aimed at reducing medical complications and associated readmissions for patients recently discharged from the hospital. While organizations strive to reduce readmissions, another important related metric is patient quality of life (QoL. Aims: To compare the relationship between QoL in patients enrolled in the Mayo Clinic Care Transitions (MCCT program versus usual care, and to determine if QoL changed in MCCT participants between baseline and 1-year follow-up. Methods: A baseline survey was mailed to MCCT enrollees in March 2013. Those who completed a baseline survey were sent a follow-up survey 1 year later. A cross-sectional survey of usual care participants was mailed in November 2013. We included in our analysis 199 participants (83 in the MCCT and 116 in usual care aged over 60 years with multiple comorbidities and receiving primary care. Primary outcomes were self-rated QoL; secondary outcomes included self-reported general, physical, and mental health. Intra- and intergroup comparisons of patients were evaluated using Pearson’s chi-squared analysis. Results: MCCT participants had more comorbidities and higher elder risk assessment scores than those receiving usual care. At baseline, 74% of MCCT participants reported responses of good-to-excellent QoL compared to 64% after 1 year (P=0.16. Between MCCT and usual care, there was no significant difference in self-reported QoL (P=0.21. Between baseline and follow-up in MCCT patients, and compared to usual care, there were no significant

  18. Building a protocol expressway: the case of Mayo Clinic Cancer Center.

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    McJoynt, Terre A; Hirzallah, Muhanad A; Satele, Daniel V; Pitzen, Jason H; Alberts, Steven R; Rajkumar, S Vincent

    2009-08-10

    Inconsistencies and errors resulting from nonstandard processes, together with redundancies, rework, and excess workload, lead to extended time frames for clinical trial protocol development. This results in dissatisfaction among sponsors, investigators, and staff and restricts the availability of novel treatment options for patients. A team of experts from Mayo Clinic formed, including Protocol Development Unit staff and management from the three Mayo Clinic campuses (Florida, Minnesota, and Arizona), a systems and procedures analyst, a quality office analyst, and two physician members to address the identified deficiencies. The current-state process was intensively reviewed, and improvement steps were taken to accelerate the development and approval of cancer-related clinical trials. The primary goal was to decrease the time from receipt of a new protocol through submission to an approving authority, such as the National Cancer Institute or institutional review board. Using the Define, Measure, Analyze, Improve, Control (DMAIC) framework infused with Lean waste-reduction methodologies, areas were identified for improvement, including enhancing first-time quality and processing new studies on a first-in/first-out basis. The project was successful in improving the mean turnaround time for internally authored protocols (P Lean methodologies is an effective tool to structure the definition, planning, analysis, and implementation of significant process changes.

  19. Bringing human resources to the table: utilization of an HR balanced scorecard at Mayo Clinic.

    Science.gov (United States)

    Fottler, Myron D; Erickson, Eric; Rivers, Patrick A

    2006-01-01

    Rather than viewing HR as a critical driver of organizational strategy and outcomes, most health care organizations see HR as a drain on the organization's bottom line. Only by aligning HR with the organizational strategy will HR leaders truly get a seat at the leadership table. HR professionals can overcome impediments and gain a seat at the table by learning the language of business and the ways in which organizational leaders use data to drive their decisions. This article shows how Mayo Clinic uses the popular Balanced Scorecard approach to align its measures of HR performance to the organization's strategic plan.

  20. Strategic performance management: development of a performance measurement system at the Mayo Clinic.

    Science.gov (United States)

    Curtright, J W; Stolp-Smith, S C; Edell, E S

    2000-01-01

    Managing and measuring performance become exceedingly complex as healthcare institutions evolve into integrated health systems comprised of hospitals, outpatient clinics and surgery centers, nursing homes, and home health services. Leaders of integrated health systems need to develop a methodology and system that align organizational strategies with performance measurement and management. To meet this end, multiple healthcare organizations embrace the performance-indicators reporting system known as a "balanced scorecard" or a "dashboard report." This discrete set of macrolevel indicators gives senior management a fast but comprehensive glimpse of the organization's performance in meeting its quality, operational, and financial goals. The leadership of outpatient operations for Mayo Clinic in Rochester, Minnesota built on this concept by creating a performance management and measurement system that monitors and reports how well the organization achieves its performance goals. Internal stakeholders identified metrics to measure performance in each key category. Through these metrics, the organization links Mayo Clinic's vision, primary value, core principles, and day-to-day operations by monitoring key performance indicators on a weekly, monthly, or quarterly basis.

  1. The Prince Edward Island-Mayo Clinic connection: Malcolm B. Dockerty and Lewis B. Woolner.

    Science.gov (United States)

    Wright, James R

    2014-03-01

    Malcolm B. Dockerty and Lewis B. Woolner, 2 preeminent mid-20th-century surgical pathologists, spent their entire careers at the Mayo Clinic. Both were raised in poverty on potato farms only 49 miles apart in Canada's smallest province (Prince Edward Island); both were educated in 1-room schools and graduated as gold medalists from Prince Edward Island's only college and then from Maritime Canada's only medical school; both then trained at the Mayo Clinic. To explore the lives and accomplishments of these 2 important surgical pathologists. Standard historiographic methods were used to explore primary and secondary historical sources. Both became world-renowned general surgical pathologists, one developing subspecialty expertise in gynecologic pathology and the other in cytopathology, pulmonary pathology, and thyroid/parathyroid pathology. Both were prolific authors with h-indices higher than 40, and between them, they published more than 750 peer-reviewed papers and book chapters. As educators, they trained hundreds of pathology and surgery residents/fellows who disseminated their knowledge around the world. Both were fascinated by poetry from childhood and could quote the classics from memory. One wrote poetry throughout his entire life and even used it to teach pathology and serve as his memoir; the other strongly preferred the classics and in jest called his colleague "a (minor) poet." Both received postretirement honorary doctorates from their alma maters. Dockerty died in 1987; Woolner celebrates his 100th birthday on November 17, 2013. Every pathologist should know of these 2 pioneering surgical pathologists.

  2. The conversion to electronic hospital notes at Mayo Clinic. Overcoming barriers and challenges.

    Science.gov (United States)

    Andreen, Debra L; Dobie, Linda J; Jasperson, Jan C; Lucas, Thomas A; Wubbenhorst, Cathryn L

    2010-01-01

    This article describes the conversion to electronic hospital notes at a large, multi-specialty group practice: Mayo Clinic in Rochester, Minnesota. Because of the size of the institution and the barriers to the adoption of electronic notes, the process was a gradual one that took several years. Making a convincing case for change to institutional leaders and maintaining their support was crucial to success. Equally vital was the careful investigation of user requirements and the development of software features that allowed providers to complete their notes quickly in the fast-paced hospital environment. Care providers discovered the value of having immediate access to legible hospital notes throughout the campus and from remote locations.

  3. The Social Media DNA of Mayo Clinic-and Health Care.

    Science.gov (United States)

    Kotsenas, Amy L; Aase, Lee; Arce, Makala; Timimi, Farris K; Dacy, Matthew; Young, Colleen; Wald, John T

    2018-01-01

    Hippocrates' admonition and the medical community's aversion to risk have caused many physicians and institutions to resist participation in modern social media sites such as Facebook (Facebook, Inc, Menlo Park, California, USA), Twitter (Twitter Inc, San Francisco, California, USA), and YouTube (San Mateo, California, USA). However, because Mayo Clinic's founders were champions of analog social networking, it was among the earliest hospitals worldwide to create official accounts on these digital platforms. A proper understanding of the traditional mechanisms of knowledge diffusion in medicine and of the nature of social media sites should help professionals see and embrace the opportunities for positive engagement in social media. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  4. The Mayo Clinic Arizona Spasmodic Dysphonia Experience: A Demographic Analysis of 718 Patients.

    Science.gov (United States)

    Patel, Alpen B; Bansberg, Stephen F; Adler, Charles H; Lott, David G; Crujido, Lisa

    2015-11-01

    Analyze demographic data collected over a 25-year experience of 718 patients with spasmodic dysphonia (SD) who have been treated with botulinum toxin-A (BoNT-A) and compare our data with previously published studies. Seven hundred eighteen patients with SD were treated with 6621 BoNT-A injections at Mayo Clinic Arizona between 1989 and 2014. All patients were treated by the same physician team. Background demographic data for each patient were recorded. Of 718 patients, 557 patients were female (77.6%). Six hundred sixty of 718 (91.8%) patients had adductor SD (AdSD), and 58 of 718 (8.1%) patients had abductor SD (AbSD). Average age of onset was 51 years. Of 718 patients, 378 (52.6%) had vocal tremor (VT); VT was present in 54.4% of AdSD patients and 32.1% of AbSD patients. Thirty-seven of 718 (5.2%) patients had other dystonias, including cervical dystonia (2.3%), blepharospasm (1.4%), limb dystonia (1.1%), and oromandibular dystonia (0.3%). A positive family history of SD was present in only 6 of 718 patients (0.8%) and of other dystonias in 11 of 718 patients (1.5%). Spasmodic dysphonia is a chronic and potentially disabling focal laryngeal dystonia. The Mayo Clinic Arizona SD experience compares to prior reports and reveals a female preponderance, onset in middle age, infrequent hereditary pattern, high co-occurrence of VT, and low co-occurrence of other dystonias. © The Author(s) 2015.

  5. The Minimal Clinically Important Difference for the Mayo-Portland Adaptability Inventory.

    Science.gov (United States)

    Malec, James F; Kean, Jacob; Monahan, Patrick O

    To determine the Minimal Clinically Important Difference (MCID) and Robust Clinically Important Difference (RCID) of the Mayo-Portland Adaptability Inventory-4 (MPAI-4) as measures of response to intervention. Retrospective analysis of existing data. Both distribution- and anchor-based methods were used to triangulate on the MCID and to identify a moderate, that is, more robust, level of change (RCID) for the MPAI-4. These were further evaluated with respect to clinical provider ratings. Data for individuals with acquired brain injury in rehabilitation programs throughout the United States in the OutcomeInfo Database (n = 3087) with 2 MPAI-4 ratings. MPAI-4, Supervision Rating Scale, Clinician Rating of Global Clinical Improvement. Initial analyses suggested 5 T-score points (5T) as the MCID and 9T as the RCID. Eighty-one percent to 87% of clinical raters considered a 5T change and 99% considered a 9T change to indicate meaningful improvement. 5T represents the MCID for the MPAI-4 and 9T, the RCID. Both values are notably less than the Reliable Change Index (RCI). While the RCI indicates change with a high level of statistical confidence, it may be insensitive to change that is considered meaningful by providers and participants as indicated by the MCID.

  6. Mohs micrographic surgery for the treatment of hidradenocarcinoma: the Mayo Clinic experience from 1993 to 2013.

    Science.gov (United States)

    Tolkachjov, Stanislav N; Hocker, Thomas L; Hochwalt, Phillip C; Camilleri, Michael J; Arpey, Christopher J; Brewer, Jerry D; Otley, Clark C; Roenigk, Randall K; Baum, Christian L

    2015-02-01

    Hidradenocarcinoma (HAC) is a rare malignant adnexal neoplasm with reported metastatic potential and undefined optimal treatment. To review clinical characteristics and outcomes of patients with HAC treated with Mohs micrographic surgery (MMS). The authors performed a retrospective chart review of patients with HAC treated by MMS at Mayo Clinic from 1993 to 2013, recording patient demographics, tumor characteristics, MMS stages to clearance, follow-up, recurrence, metastasis, and mortality. Ten patients underwent MMS for HAC more than 20 years. The average age was 62.8 years, with 6 females and 4 males. Occipital scalp was the most common location (40%), followed by extremities (30%) and face (20%). In 5 of 7 cases (71%), "cyst" was the working clinical diagnosis. The average preoperative lesion area was 3.18 cm, with an average of 1.5 MMS stages required for clearance. Mean postoperative follow-up was 7 years (range, 5-205 months). No tumors treated with MMS recurred, metastasized, or led to disease-related mortality. Mohs micrographic surgery seems to be a useful treatment modality for HAC. This is the largest reported series of HAC treated with MMS with long-term follow-up.

  7. Laryngeal Schwannoma: A Case Presentation and Review of the Mayo Clinic Experience.

    Science.gov (United States)

    Romak, Jonathan J; Neel, H Bryan; Ekbom, Dale C

    2017-01-01

    The aim of this study was to clarify the nature of laryngeal schwannomas through review of the experience of a single institution during a 104-year period. This is a retrospective case series. The Mayo Clinic, Rochester, Minnesota clinical and surgical pathology database was reviewed for the years 1985-2011. Four cases of laryngeal schwannoma were identified. These cases were pooled with a previously published series of laryngeal schwannomas treated at our institution between 1907 and 1986. The characteristics of all 11 cases were studied, and relevant literature was reviewed. A total of 11 cases of schwannoma of the larynx were identified. The mean age at presentation was 48 years (range 12-73 years). The most common presenting symptoms were dysphonia and dysphagia. The most frequently involved primary site was the false vocal fold (six patients), followed by the aryepiglottic fold (three), epiglottis (two), subglottis (two), ventricle (one), true vocal fold (one) and postcricoid region (one). The mean maximal tumor diameter was 2.5 cm. In all but one case, surgical excision was curative with no recurrence during recorded follow up ranging from 1 to 17 years. Laryngeal schwannomas, although rare, should be considered in the differential diagnosis of laryngeal tumors. They occur most frequently in the false vocal fold and present most commonly with dysphonia and/or dysphagia. Surgical excision is the treatment of choice. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  8. Lichen planus affecting the female genitalia: A retrospective review of patients at Mayo Clinic.

    Science.gov (United States)

    Fahy, Caoimhe M R; Torgerson, Rochelle R; Davis, Mark D P

    2017-12-01

    Genital or vulval lichen planus (VLP) may have a disabling effect on a patient's quality of life. Evidence-based management guidelines are lacking for VLP. We sought to review clinical presentation and treatment of patients who received a diagnosis of VLP. The 100 consecutive patients who received a diagnosis of VLP at Mayo Clinic between January 1, 1997, and December 31, 2015, were reviewed retrospectively. Descriptive statistics were used for data analysis. Fisher's exact test and the Wilcoxon rank sum test were used for analysis of categorical and continuous variables, respectively. All statistical tests were 2 sided, with the α level set at .05 for statistical significance. The time to diagnosis for 49% of patients was more than 1 year. Three patients (3%) had vulval dysplasia, including invasive squamous cell carcinoma. Sixty-eight patients (68%) had multisite lichen planus disease. Eleven patients (11%) had disease remission. Dermatology was the lead specialty for 9 of these cases of remission. This was a retrospective, small-cohort study. A low frequency of disease remission was seen in patients with VLP. Patients with lichen planus benefit considerably from dermatology consultation. Further research is warranted to establish high-quality, evidence-based guidelines for multidisciplinary management of this challenging disease. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  9. Evaluation of adjuvant chemoradiation therapy for ampullary adenocarcinoma: the Johns Hopkins Hospital - Mayo Clinic collaborative study

    International Nuclear Information System (INIS)

    Narang, Amol K; Haddock, Michael G; Donohue, John H; Schulick, Richard D; Wolfgang, Christopher L; Cameron, John L; Herman, Joseph M; Miller, Robert C; Hsu, Charles C; Bhatia, Sumita; Pawlik, Timothy M; Laheru, Dan; Hruban, Ralph H; Zhou, Jessica; Winter, Jordan M

    2011-01-01

    The role of adjuvant chemoradiation therapy for ampullary carcinoma is unknown. Previous literature suggests that certain populations with high risk factors for recurrence may benefit from adjuvant chemoradiation. We combined the experience of two institutions to better delineate which patients may benefit from adjuvant chemoradiation. Patients who underwent curative surgery for ampullary carcinoma at the Johns Hopkins Hospital (n = 290; 1992-2007) and at the Mayo Clinic (n = 130; 1977-2005) were reviewed. Patients with <60 days of follow-up, metastatic disease at surgery, or insufficient pathologic data were excluded. The final combined study consisted of 186 patients (n = 104 Johns Hopkins, n = 82 Mayo). Most patients received 5-FU based chemoradiation with conformal radiation. Cox proportional hazards models were used for survival analysis. Median overall-survival was 39.9 months with 2- and 5-year survival rates of 62.4% and 39.1%. On univariate analysis, adverse prognostic factors for overall survival included T3/T4 stage disease (RR = 1.86, p = 0.002), node positive status (RR = 3.18, p < 0.001), and poor histological grade (RR = 1.69, p = 0.011). Patients who received adjuvant chemoradiation (n = 66) vs. surgery alone (n = 120) showed a higher rate of T3/T4 stage disease (57.6% vs. 30.8%, P < 0.001), lymph node involvement (72.7% vs. 30.0%, P < 0.001), and close or positive margins (4.6% vs. 0.0%, P = 0.019). Five year survival rates among node negative and node positive patients were 58.7% and 18.4% respectively. When compared with surgery alone, use of adjuvant chemoradiation improved survival among node positive patients (mOS 32.1 vs. 15.7 mos, 5 yr OS: 27.5% vs. 5.9%; RR = 0.47, P = 0.004). After adjusting for adverse prognostic factors on multivariate analysis, patients treated with adjuvant chemoradiation demonstrated a significant survival benefit (RR = 0.40, P < 0.001). Disease relapse occurred in 37.1% of all patients, most commonly metastatic

  10. Brief Report: Cancer Immunotherapy in Patients With Preexisting Rheumatic Disease: The Mayo Clinic Experience.

    Science.gov (United States)

    Richter, Michael D; Pinkston, Olga; Kottschade, Lisa A; Finnes, Heidi D; Markovic, Svetomir N; Thanarajasingam, Uma

    2018-03-01

    To determine the risk of rheumatic disease flare and adverse effects in patients with preexisting rheumatic disease who were receiving immune checkpoint inhibitor (ICI) therapy. A retrospective medical record review was performed to identify all patients who received ICI therapy at Mayo Clinic in Rochester, Minnesota between 2011 and 2016 (~700 patients). Those with a preexisting rheumatic disease were identified using specific diagnostic codes. Sixteen patients were identified (81% female, median age 68.5 years). The most common rheumatic diseases were rheumatoid arthritis (n = 5), polymyalgia rheumatica (n = 5), Sjögren's syndrome (n = 2), and systemic lupus erythematosus (n = 2). Seven patients were receiving immunosuppressive therapy or glucocorticoids for their rheumatic disease at the time of initiation of the ICI. The primary malignancies were melanoma (n = 10), pulmonary (n = 4), or hematologic (n = 2). In most cases, ICIs were offered only after failure of several other therapies. Immune-related adverse effects (IRAEs) occurred in 6 patients, and all were treated successfully with glucocorticoids and discontinuation of the ICI therapy. There were no significant differences in time from cancer diagnosis to immunotherapy, duration of immunotherapy, age, or sex between the patients with and those without IRAEs. To our knowledge, this represents the largest single-center cohort of patients with rheumatic diseases who were exposed to modern cancer immunotherapy. Only a minority of these patients experienced a flare of their preexisting rheumatic disease or any other IRAE. © 2017, American College of Rheumatology.

  11. Nurse practitioners and physician assistants: preparing new providers for hospital medicine at the mayo clinic.

    Science.gov (United States)

    Spychalla, Megan T; Heathman, Joanne H; Pearson, Katherine A; Herber, Andrew J; Newman, James S

    2014-01-01

    Hospital medicine is a growing field with an increasing demand for additional healthcare providers, especially in the face of an aging population. Reductions in resident duty hours, coupled with a continued deficit of medical school graduates to appropriately meet the demand, require an additional workforce to counter the shortage. A major dilemma of incorporating nonphysician providers such as nurse practitioners and physician assistants (NPPAs) into a hospital medicine practice is their varying academic backgrounds and inpatient care experiences. Medical institutions seeking to add NPPAs to their hospital medicine practice need a structured orientation program and ongoing NPPA educational support. This article outlines an NPPA orientation and training program within the Division of Hospital Internal Medicine (HIM) at the Mayo Clinic in Rochester, MN. In addition to a practical orientation program that other institutions can model and implement, the division of HIM also developed supplemental learning modalities to maintain ongoing NPPA competencies and fill learning gaps, including a formal NPPA hospital medicine continuing medical education (CME) course, an NPPA simulation-based boot camp, and the first hospital-based NPPA grand rounds offering CME credit. Since the NPPA orientation and training program was implemented, NPPAs within the division of HIM have gained a reputation for possessing a strong clinical skill set coupled with a depth of knowledge in hospital medicine. The NPPA-physician model serves as an alternative care practice, and we believe that with the institution of modalities, including a structured orientation program, didactic support, hands-on learning, and professional growth opportunities, NPPAs are capable of fulfilling the gap created by provider shortages and resident duty hour restrictions. Additionally, the use of NPPAs in hospital medicine allows for patient care continuity that is otherwise missing with resident practice models.

  12. Delusional infestation is typically comorbid with other psychiatric diagnoses: review of 54 patients receiving psychiatric evaluation at Mayo Clinic.

    Science.gov (United States)

    Hylwa, Sara A; Foster, Ashley A; Bury, Jessica E; Davis, Mark D P; Pittelkow, Mark R; Bostwick, J Michael

    2012-01-01

    Delusional infestation, which encompasses both delusions of parasitosis and delusions of infestation with inanimate objects (sometimes called Morgellons disease), has been said to represent a distinct and encapsulated delusion, that is, a stand-alone diagnosis. Anecdotally, we have observed that patients with delusional infestation often have one or more psychiatric comorbid conditions and that delusional infestation should not be regarded as a stand-alone diagnosis. The purpose of this study was to identify whether patients with delusional infestation have psychiatric comorbid conditions. We therefore identified patients who had been formally evaluated in the Department of Psychiatry during their visit to Mayo Clinic. We retrospectively searched for and reviewed the cases of all patients with delusional infestation seen from 2001 through 2007 at Mayo Clinic, Rochester, Minnesota, and who underwent psychiatric evaluation. The diagnoses resulting from psychiatric evaluation were analyzed. During the 7-year study period, 109 patients seen for delusional infestation at Mayo Clinic were referred to the Department of Psychiatry, 54 (50%) of whom actually followed through with psychiatric consultation. Of these 54 patients, 40 (74%) received additional active psychiatric diagnoses; 14 patients (26%) had delusional infestation alone. Abnormal personality traits were rarely documented. Most patients with delusional infestation have multiple coexisting or underlying psychiatric disorders. Therefore, evaluation by a psychiatrist, when possible, is advised for all patients with delusional infestation. Copyright © 2012 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

  13. Think big, start small, move fast a blueprint for transformation from the Mayo Clinic Center for Innovation

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    LaRusso, Nicholas; Farrugia, Gianrico

    2015-01-01

    The Only Innovation Guide You Will Ever Need--from the Award-Winning Minds at Mayo Clinic. A lot of businesspeople talk about innovation, but few companies have achieved the level of truly transformative innovation as brilliantly--or as famously--as the legendary Mayo Clinic. Introducing Think Big, Start Small, Move Fast, the first innovation guide based on the proven, decade-long program that’s made Mayo Clinic one of the most respected and successful organizations in the world. This essential must-have guide shows you how to: Inspire and ignite trailblazing innovation in your workplace Design a new business model that’s creative, collaborative, and sustainable Apply the traditional scientific method to the latest innovations in "design thinking" Build a customized toolkit of the best practices, project portfolios, and strategies Increase your innovation capacity--and watch how quickly you succeed These field-tested techniques grew out of the health care industry but are designed ...

  14. Outcomes and patterns of failure of sarcomatoid carcinoma of the larynx: The Mayo Clinic experience.

    Science.gov (United States)

    Gamez, Mauricio E; Jeans, Elizabeth; Hinni, Michael L; Moore, Eric; Young, Geoffrey; Ma, Daniel; McGee, Lisa; Buras, Matthew R; Patel, Samir H

    2018-02-01

    Sarcomatoid carcinoma is a rare variant of squamous cell carcinoma of the head and neck. No consensus exists on its management. Our aim was to present our outcomes. Retrospective study. Median follow-up 45 months. There were 38 patients with pathologically confirmed sarcomatoid carcinoma of the larynx treated at the Mayo Clinic from 1990 to 2014. Statistical analysis of overall survival (OS), progression-free survival (PFS), and local control (LC) were conducted using the Kaplan-Meier method. The majority of patients were elderly males (92%) with a smoking history (74%) presenting with early-stage disease (71%). Surgery alone was the primary treatment in 27 patients (71%). Nine patients (25%) were treated with adjuvant radiation due to initial stage or high-risk pathologic features. Median radiation dose to the primary/surgical bed was 65 Gy (range, 60.3-75.0 Gy). A total of 15 patients (39%) had tumor recurrence, majority being local (n = 12). Sixty percent (n = 9) had multiple local recurrences. Five-year OS, PFS, and LC were 63%, 46%, and 72%, respectively. Subgroup analysis by stage I versus higher stages (II-IV) showed an OS of 80% versus 43% (P = .030), PFS of 65% versus 18% (P = .003), and LC of 84% versus 57% (P = .039). Sarcomatoid carcinoma of the larynx is rare, and frequently presents at an early stage in older men with history of smoking. Based on our outcomes and patterns of failure, it appears early-stage tumors are treated appropriately with single-modality therapy, whereas more advanced tumors require multimodality therapy. Validation in a larger cohort is warranted. 4. Laryngoscope, 128:373-377, 2018. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  15. Syndrome of rapid onset end stage renal disease in incident Mayo Clinic chronic hemodialysis patient

    Directory of Open Access Journals (Sweden)

    M. A. C. Onuigbo

    2014-01-01

    Full Text Available Despite decades of research, a full understanding of chronic kidney disease (CKD-end stage renal disease (ESRD progression remains elusive. The common consensus is a predictable, linear, progressive and time-dependent decline of CKD to ESRD. Acute kidney injury (AKI on CKD is usually assumed to be transient, with recovery as the expected outcome. AKI-ESRD association in current nephrology literature is blamed on the so-called "residual confounding." We had previously described a relationship between AKI events and rapid onset yet irreversible ESRD happening in a continuum in a high-risk CKD cohort. However, the contribution of the syndrome of rapid onset-ESRD (SORO-ESRD to incident United States ESRD population remained conjectural. In this retrospective analysis, we analyzed serum creatinine trajectories of the last 100 consecutive ESRD patients in 4 Mayo Clinic chronic hemodialysis units to determine the incidence of SORO-ESRD. Excluding 9 patients, 31 (34% patients, including two renal transplant recipients, had SORO-ESRD: 18 males and 13 females age 72 (range 50-92 years. Precipitating AKI followed pneumonia (8, acutely decompensated heart failure (7, pyelonephritis (4, post-operative (5, sepsis (3, contrast-induced nephropathy (2, and others (2. Time to dialysis was shortest following surgical procedures. Concurrent renin angiotensin aldosterone system blockade was higher with SORO-ESRD - 23% versus 5%, P = 0.0113. In conclusion, SORO-ESRD is not uncommon among the incident general US ESRD population. The implications for ESRD care planning, AV-fistula-first programs, general CKD care and any associations with renal ageing/senescence warrant further study.

  16. Complex Fibroadenoma and Breast Cancer Risk: A Mayo Clinic Benign Breast Disease Cohort Studya

    Science.gov (United States)

    Nassar, Aziza; Visscher, Daniel W.; Degnim, Amy C.; Frank, Ryan D.; Vierkant, Robert A.; Frost, Marlene; Radisky, Derek C.; Vachon, Celine M.; Kraft, Ruth A.; Hartmann, Lynn C.; Ghosh, Karthik

    2015-01-01

    Purpose To examine the breast cancer risk overall among women with simple fibroadenoma or complex fibroadenoma and to examine the association of complex fibroadenoma with breast cancer through stratification of other breast cancer risks. Methods The study included women aged 18 to 85 years from the Mayo Clinic Benign Breast Disease Cohort who underwent excisional breast biopsy from 1967 through 1991. Within this cohort, women who had fibroadenoma were compared to women who did not have fibroadenoma. Breast cancer risk (observed vs expected) across fibroadenoma levels was assessed through standardized incidence ratios (SIRs) by using age- and calendar-stratified incidence rates from the Iowa Surveillance, Epidemiology, and End Results registry. Analyses were performed overall, within subgroups of involution status, with other demographic characteristics (age, year of biopsy, indication for biopsy, and family history), and with histologic characteristics, including overall impression (nonproliferative disease, proliferative disease without atypia [PDWA], or atypical hyperplasia). Results Fibroadenoma was identified in 2,136 women (noncomplex, 1,835 [85.9%]; complex, 301 [14.1%]). SIR for noncomplex fibroadenoma was 1.49 (95% CI, 1.26–1.74); for complex fibroadenoma, it was 2.27 (95% CI, 1.63–3.10) (test for heterogeneity in SIR, P=.02). However, women with complex fibroadenoma were more likely to have other, concomitant high-risk histologic characteristics (eg, incomplete involution and PDWA). In analyses stratified by involution status and PDWA, complex fibroadenoma was not an independent risk marker for breast cancer. Conclusions Complex fibroadenoma does not confer increased breast cancer risk beyond other established histologic characteristics. PMID:26264469

  17. Complex fibroadenoma and breast cancer risk: a Mayo Clinic Benign Breast Disease Cohort Study.

    Science.gov (United States)

    Nassar, Aziza; Visscher, Daniel W; Degnim, Amy C; Frank, Ryan D; Vierkant, Robert A; Frost, Marlene; Radisky, Derek C; Vachon, Celine M; Kraft, Ruth A; Hartmann, Lynn C; Ghosh, Karthik

    2015-09-01

    The purpose of this study is to examine the breast cancer risk overall among women with simple fibroadenoma or complex fibroadenoma and to examine the association of complex fibroadenoma with breast cancer through stratification of other breast cancer risks. The study included women aged 18-85 years from the Mayo Clinic Benign Breast Disease Cohort who underwent excisional breast biopsy from 1967 through 1991. Within this cohort, women who had fibroadenoma were compared to women who did not have fibroadenoma. Breast cancer risk (observed versus expected) across fibroadenoma levels was assessed through standardized incidence ratios (SIRs) by using age- and calendar-stratified incidence rates from the Iowa Surveillance, Epidemiology, and End Results registry. Analyses were performed overall, within subgroups of involution status, with other demographic characteristics (age, year of biopsy, indication for biopsy, and family history), and with histologic characteristics, including overall impression [nonproliferative disease, proliferative disease without atypia (PDWA), or atypical hyperplasia]. Fibroadenoma was identified in 2136 women [noncomplex, 1835 (85.9%); complex, 301 (14.1%)]. SIR for noncomplex fibroadenoma was 1.49 (95% CI 1.26-1.74); for complex fibroadenoma, it was 2.27 (95% CI 1.63-3.10) (test for heterogeneity in SIR, P = .02). However, women with complex fibroadenoma were more likely to have other, concomitant high-risk histologic characteristics (e.g., incomplete involution and PDWA). In analyses stratified by involution status and PDWA, complex fibroadenoma was not an independent risk marker for breast cancer. Complex fibroadenoma does not confer increased breast cancer risk beyond other established histologic characteristics.

  18. Primary hyperparathyroidism surgical management since the introduction of minimally invasive parathyroidectomy: Mayo Clinic experience.

    Science.gov (United States)

    Grant, Clive S; Thompson, Geoffrey; Farley, David; van Heerden, Jon

    2005-05-01

    Minimally invasive parathyroidectomy (MIP) for primary hyperparathyroidism (HPT) has equal cure and recurrence rates as standard cervical exploration. Changes in the management of primary HPT have occurred since introducing MIP including localization, anesthesia, intraoperative parathyroid hormone monitoring, and indications for parathyroidectomy. Cohort analysis of 1361 consecutive patients with primary HPT operated on at the Mayo Clinic, Rochester, Minn, from June 1998 through March 2004. Mean follow-up, 25 months. Tertiary referral center. One thousand three hundred sixty-one patients operated on for primary HPT, excluding 160 patients who were reoperated on. Standard cervical exploration MIP. Cure, recurrence, localization, anesthesia, hospitalization, intraoperative parathyroid hormone level monitoring, contraindications to MIP, surgical indications, assessment of osteoporosis and osteopenia, postoperative patient assessment of general patient health, and operative satisfaction. Cure of primary HPT for both conventional exploration and MIP was 97%; only 1 patient who underwent MIP had a potential recurrence. Imaging sensitivity and positive predictive values were as follows: sestamibi scintigraphy, 86% and 93%; ultrasonography, 61% and 87%, respectively. Usage of general vs local anesthesia with intravenous sedation was 46% and 49%, respectively, in patients w ho underwent MIP; 46% were dismissed as outpatients, 49% had single-night stays. The accuracy of intraoperative parathyroid hormone level monitoring was as follows: 98% (8% had true-negative results); the frequency of multiple gland disease was 13%. Accounting for causes precluding MIP, an estimated 60% to 70% of all patients would be eligible for MIP. By preoperative assessment, 79% had osteoporosis-osteopenia; 58% with postoperative bone mineral density measurements were improved. More than 85% were satisfied with the results of their operation. With high-quality localization and intraoperative

  19. Quality improvement education incorporated as an integral part of critical care fellows training at the Mayo Clinic.

    Science.gov (United States)

    Kashani, Kianoush B; Ramar, Kannan; Farmer, J Christopher; Lim, Kaiser G; Moreno-Franco, Pablo; Morgenthaler, Timothy I; Dankbar, Gene C; Hale, Curt W

    2014-10-01

    The Accreditation Council for Graduate Medical Education emphasizes quality improvement (QI) education in residency/fellowship training programs. The Mayo Clinic Combined Critical Care Fellowship (CCF) program conducted a pilot QI education program to incorporate QI training as a required curriculum for the 2010-2011 academic year. CCF collaborated with the Mayo Quality Academy to customize and teach the existing Mayo Quality Fellows curriculum to the CCF fellows with the help of two quality coaches over five months starting July 2010. All fellows were to achieve Bronze and Silver certification prior to graduation. Silver required passing four written exams and submitting a health care QI project. Five projects were selected on the basis of the Impact-Effort Prioritization matrix, and DMAIC (Define, Measure, Analyze, Improve, and Control) methodology was used to complete the projects. The primary outcome was to assess learners' satisfaction, knowledge, and skill transfer. All 20 fellows were Bronze certified, and 14 (70%) were Silver certified by the time of graduation. All five QI projects were completed and showed positive impacts on patient safety and care. Surveys showed improved learner satisfaction. Graduates felt the QI training improved their QI skills and employment and career advancement. The QI curriculum had appropriate content and teaching pace and did not significantly displace other important clinical core curriculum topics. The pilot was successfully implemented in the CCF program and now is in the fourth academic year as an established and integral part of the fellowship core curriculum.

  20. Decline in Weight and Incident Mild Cognitive Impairment: Mayo Clinic Study of Aging

    Science.gov (United States)

    Alhurani, Rabe E.; Vassilaki, Maria; Aakre, Jeremiah; Mielke, Michelle M.; Kremers, Walter K.; Machulda, Mary M.; Geda, Yonas E.; Knopman, David S.; Peterson, Ronald C.; Roberts, Rosebud O.

    2016-01-01

    IMPORTANCE Unintentional weight loss has been associated with risk of dementia. Since mild cognitive impairment (MCI) is a prodromal stage for dementia, we sought to evaluate whether changes in weight and body mass index (BMI) may predict incident MCI. OBJECTIVE To investigate the association of change in weight and BMI with risk of MCI. DESIGN, SETTING, AND PARTICIPANTS A population-based, prospective study of participants aged 70 years and older from the Mayo Clinic Study of Aging. Maximum weight and height in midlife (aged 40 to 65 years old) were retrospectively ascertained from the medical records of participants using a medical records linkage system. MAIN OUTCOMES MEASURES Participants were evaluated for cognitive outcomes of normal cognition, MCI, or dementia at baseline and prospectively assessed for incident events at each 15-month evaluation. The association of rate of change in weight and body mass index with risk of MCI was investigated using proportional hazards models. RESULTS Over a mean follow-up of 4.4 years, 524 of 1895 cognitively normal participants developed incident MCI. The mean (standard deviation) rate of weight change per decade from midlife to study entry was greater for individuals who developed incident MCI vs. those who remained cognitively normal (−2.0 (5.1) vs. −1.2 (4.9) kg; p = 0.006). A greater decline in weight per decade was associated with an increased risk of incident MCI (hazard ratio [HR] 95% confidence interval [CI], 1.04 [1.02, 1.06], p weight loss of 5 kg/decade corresponds to a 24% increase in risk of MCI (HR=1.24). Higher decline in BMI per decade was also associated with incident MCI (HR, 1.08, 95% CI = [1.03, 1.13], p = 0.003). CONCLUSIONS AND RELEVANCE These findings suggest that declining weight from midlife to late-life is a marker for MCI and may help identify persons at increased risk for MCI. PMID:26831542

  1. Review of Adjuvant Radiochemotherapy for Resected Pancreatic Cancer and Results From Mayo Clinic for the 5th JUCTS Symposium

    International Nuclear Information System (INIS)

    Miller, Robert C.; Iott, Matthew J.; Corsini, Michele M.

    2009-01-01

    Purpose: To present an overview of Phase III trials in adjuvant therapy for pancreatic cancer and review outcomes at the Mayo Clinic after adjuvant radiochemotherapy (RT/CT) for resected pancreatic cancer. Methods and Materials: A literature review and a retrospective review of 472 patients who underwent an R0 resection for T1-3N0-1M0 invasive carcinoma of the pancreas from 1975 to 2005 at the Mayo Clinic, Rochester, MN. Patients with metastatic or unresectable disease at the time of surgery, positive surgical margins, or indolent tumors and those treated with intraoperative radiotherapy were excluded from the analysis. Median radiotherapy dose was 50.4Gy in 28 fractions, with 98% of patients receiving concurrent 5-fluorouracil- based chemotherapy. Results: Median follow-up was 2.7 years. Median overall survival (OS) was 1.8 years. Median OS after adjuvant RT/CT was 2.1 vs. 1.6 years for surgery alone (p = 0.001). The 2-y OS was 50% vs. 39%, and 5-y was 28% vs. 17% for patients receiving RT/CT vs. surgery alone. Univariate and multivariate analysis revealed that adverse prognostic factors were positive lymph nodes (risk ratio [RR] 1.3, p < 0.001) and high histologic grade (RR 1.2, p < 0.001). T3 tumor status was found significant on univariate analysis only (RR 1.1, p = 0.07). Conclusions: Results from recent clinical trials support the use of adjuvant chemotherapy in resected pancreatic cancer. The role of radiochemotherapy in adjuvant treatment of pancreatic cancer remains a topic of debate. Results from the Mayo Clinic suggest improved outcomes after the administration of adjuvant radiochemotherapy after a complete resection of invasive pancreatic malignancies.

  2. Clinical use of the Mayo-Portland Adaptability Inventory in rehabilitation after paediatric acquired brain injury.

    Science.gov (United States)

    Oddson, Bruce; Rumney, Peter; Johnson, Patricia; Thomas-Stonell, Nancy

    2006-11-01

    The Mayo-Portland Adaptability Inventory (MPAI; designed to be administered by clinicians) is a popular measure of disability following head injury in adults. Its acceptability, validity, and reliability were assessed for use with children. There were 335 children and adolescents (215 males, 120 females) aged between 1 and 19 years at injury (median age 9y 8mo [SD 5y]) in our sample. The test was acceptable to respondents, rapidly and easily administered, and required only small modifications. It demonstrated validity against client and parent reports of major symptoms. It demonstrated test-retest reliability within the limitations of our data and excellent interrater accord. Consequently, the MPAI is recommended for paediatric use for evaluating rehabilitation needs and therapy outcome.

  3. Assessment of anosognosia in persons with frontal lobe damage: clinical utility of the Mayo-Portland Adaptability Inventory (MPAI).

    Science.gov (United States)

    Murrey, G J; Hale, F M; Williams, J D

    2005-08-10

    To determine if the Mayo-Portland Adaptability Inventory (MPAI) demonstrates clinical utility in differentiating between persons with severe TBI and frontal lobe damage/anosognosia and persons with mild TBI and no frontal lobe damage. Forty-three persons with TBI and documented frontal lobe damage (mean age = 34; mean time since injury = 5.2 years) and 69 persons with mild TBI and no frontal lobe damage (mean age = 34.3; mean time since injury = 4.8 4.8 years). MPAI. Total inventory and select sub-category difference scores were significantly greater in the frontal lobe group than in the non-frontal lobe group. However, as expected, there was no significant difference between the two groups on the mobility sub-category difference scores. The MPAI appears to be potentially clinically useful in assessing for frontal lobe damage and associated anosognosia in patients with TBI.

  4. Harmonizing and consolidating the measurement of patient-reported information at health care institutions: a position statement of the Mayo Clinic

    Directory of Open Access Journals (Sweden)

    Eton DT

    2014-02-01

    Full Text Available David T Eton,1,2 Timothy J Beebe,1,2 Philip T Hagen,3 Michele Y Halyard,4 Victor M Montori,1,5 James M Naessens,1,2 Jeff A Sloan,6 Carrie A Thompson,7 Douglas L Wood1,81Division of Heath Care Policy and Research, Department of Health Sciences Research, 2Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, 3Department of Preventive, Occupational, and Aerospace Medicine, Mayo Clinic, Rochester, MN, 4Department of Radiation Oncology, Mayo Clinic, Scottsdale, AZ, 5Knowledge and Evaluation Research Unit, 6Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, 7Division of Hematology, Department of Medicine, 8Center for Innovation, Mayo Clinic, Rochester, MN, USAAbstract: Patient-reported outcomes (PROs capture how patients perceive their health and their health care; their use in clinical research is longstanding. Today, however, PROs increasingly are being used to inform the care of individual patients, and document the performance of health care entities. We recently wrote and internally distributed an institutional position statement titled "Harmonizing and Consolidating the Measurement of Patient-Reported Outcomes at Mayo Clinic: A Position Statement for the Center for the Science of Health Care Delivery". The statement is meant to educate clinicians, clinical teams, and institutional administrators about the merits of using PROs in a systematic manner for clinical care and quality measurement throughout the institution. The present article summarizes the most important messages from the statement, describing PROs and their use, identifying practical considerations for implementing them in routine practice, elucidating potential barriers to their use, and formulating strategies to overcome these barriers. The lessons learned from our experience – including pitfalls, challenges, and successes – may inform other health care institutions that are interested in

  5. The state of the science of whole blood: lessons learned at Mayo Clinic.

    Science.gov (United States)

    Stubbs, James R; Zielinski, Martin D; Jenkins, Donald

    2016-04-01

    AABB Standards specify that ABO group-specific whole blood is the only acceptable choice for whole blood transfusions. Although universal donor group O stored whole blood (SWB) was used extensively by the military during the wars of the mid-twentieth century, its use has fallen out of favor and has never been used to great extent in the civilian trauma population. Interest in the use of whole blood has been renewed, particularly in light of its potential value in far-forward military and other austere environments. Evidence of preserved platelet function in SWB has heightened enthusiasm for a "one stop shop" resuscitation product providing volume, oxygen carrying capacity, and hemostatic effects. Experience with universal donor group O SWB is required to ascertain whether its use will be an advance in trauma care. Described here is the process of establishing a universal donor group O SWB at a civilian trauma center in the United States. © 2016 AABB.

  6. Early experience of a fall and fracture prevention clinic at Mayo General Hospital.

    LENUS (Irish Health Repository)

    Hanley, A

    2010-06-01

    Falls in the elderly are a significant public health problem. Previous studies have shown that most falls are multifactorial and an efficacious way of reducing the risk of falling is provided by a falls clinic.

  7. Performance characteristics of the Mayo/IBM PACS

    Science.gov (United States)

    Persons, Kenneth R.; Gehring, Dale G.; Pavicic, Mark J.; Ding, Yingjai

    1991-07-01

    The Mayo Clinic and IBM (at Rochester, Minnesota) have jointly developed a picture archiving system for use with Mayo's MRI and Neuro CT imaging modalities. The communications backbone of the PACS is a portion of the Mayo institutional network: a series of 4-Mbps token rings interconnected by bridges and fiber optic extensions. The performance characteristics of this system are important to understand because they affect the response time a PACS user can expect, and the response time for non-PACS users competing for resources on the institutional network. The performance characteristics of each component and the average load levels of the network were measured for various load distributions. These data were used to quantify the response characteristics of the existing system and to tune a model developed by North Dakota State University Department of Computer Science for predicting response times of more complex topologies.

  8. Patterns in deer-related traffic injuries over a decade: the Mayo clinic experience

    Directory of Open Access Journals (Sweden)

    Smoot Dustin L

    2010-08-01

    Full Text Available Abstract Background Our American College of Surgeons Level 1 Trauma Center serves a rural population. As a result, there is a unique set of accidents that are not present in an urban environment such as deer related motor vehicle crashes (dMVC. We characterized injury patterns between motorcycle/all-terrain vehicles (MCC and automobile (MVC crashes related to dMVC (deer motor vehicle crash with the hypotheses that MCC will present with higher Injury Severity Score (ISS and that it would be related to whether the driver struck the deer or swerved. Methods The records of 157 consecutive patients evaluated at our institution for injury related to dMVC from January 1st, 1997 to December 31st, 2006 were reviewed from our prospectively collected trauma database. Demographic, clinical, and crash specific parameters were abstracted. Injury severity was analyzed by the Abbreviated Injury Scale score for each body region as well as the overall Injury Severity Score (ISS. Results Motorcycle crashes presented with a higher median ISS than MVCs (14 vs 5, p Within the MVC group, there was no difference between swerving and hitting the deer in any AIS group. Forty-seven percent of drivers were not wearing seat belts which resulted in similar median ISS (6 vs 5 and AIS of all body regions. Conclusions Motorcycle operators suffered higher ISS. There were no significant differences in median ISS if a driver involved in a deer-related motor vehicle crash swerved rather than collided, was helmeted, or restrained.

  9. Quantifying the importance of disease burden on perceived general health and depressive symptoms in patients within the Mayo Clinic Biobank.

    Science.gov (United States)

    Ryu, Euijung; Takahashi, Paul Y; Olson, Janet E; Hathcock, Matthew A; Novotny, Paul J; Pathak, Jyotishman; Bielinski, Suzette J; Cerhan, James R; Sloan, Jeff A

    2015-07-03

    Deficits in health-related quality of life (HRQOL) may be associated with worse patient experiences, outcomes and even survival. While there exists evidence to identify risk factors associated with deficits in HRQOL among patients with individual medical conditions such as cancer, it is less well established in more general populations without attention to specific illnesses. This study used patients with a wide range of medical conditions to identify contributors with the greatest influence on HRQOL deficits. Self-perceived general health and depressive symptoms were assessed using data from 21,736 Mayo Clinic Biobank (MCB) participants. Each domain was dichotomized into categories related to poor health: deficit (poor/fair for general health and ≥3 for PHQ-2 depressive symptoms) or non-deficit. Logistic regression models were used to test the association of commonly collected demographic characteristics and disease burden with each HRQOL domain, adjusting for age and gender. Gradient boosting machine (GBM) models were applied to quantify the relative influence of contributors on each HRQOL domain. The prevalence of participants with a deficit was 9.5 % for perception of general health and 4.6 % for depressive symptoms. For both groups, disease burden had the strongest influence for deficit in HRQOL (63 % for general health and 42 % for depressive symptoms). For depressive symptoms, age was equally influential. The prevalence of a deficit in general health increased slightly with age for males, but remained stable across age for females. Deficit in depressive symptoms was inversely associated with age. For both HRQOL domains, risk of a deficit was associated with higher disease burden, lower levels of education, no alcohol consumption, smoking, and obesity. Subjects with deficits were less likely to report that they were currently working for pay than those without a deficit; this association was stronger among males than females. Comorbid health burden has the

  10. The association between peripheral total IGF-1, IGFBP-3, and IGF-1/IGFBP-3 and functional and cognitive outcomes in the Mayo Clinic Study of Aging.

    Science.gov (United States)

    Wennberg, Alexandra M V; Hagen, Clinton E; Machulda, Mary M; Hollman, John H; Roberts, Rosebud O; Knopman, David S; Petersen, Ronald C; Mielke, Michelle M

    2018-06-01

    Levels of insulin-like growth factor (IGF)-1, IGF-binding protein (IGFBP)-3, and their ratio in the blood may be useful for monitoring those at risk of cognitive and functional decline. However, the association between IGF measures and functional and cognitive outcomes has been mixed, and the associations may vary by sex. The present study investigated the cross-sectional, sex-specific associations between serum measures total IGF-1, IGFBP-3, and the IGF-1/IGFBP-3 ratio, gait speed, and cognition in 1320 cognitively unimpaired participants aged 50-95 years enrolled in the Mayo Clinic Study of Aging. We used multivariable linear regression models to determine the association between IGF measures and gait speed or cognitive test performance by sex. IGF measures were not associated with cognitive or functional performance among men. Among women, higher levels of log total IGF-1 and IGFBP-3 were associated with better performance in attention, visuospatial, and global cognitive domains, independent of the gait speed. These findings suggest that among women, IGF measures are associated with cognition, and these associations are independent of function. Copyright © 2018 Elsevier Inc. All rights reserved.

  11. The Prevalence of Cardiovascular Disease Risk Factors and the Framingham Risk Score in Patients Undergoing Percutaneous Intervention Over the Last 17 Years by Gender: Time-trend Analysis From the Mayo Clinic PCI Registry

    Directory of Open Access Journals (Sweden)

    Moo-Sik Lee

    2014-07-01

    Full Text Available Objectives: This study aims to investigate trends of cardiovascular disease (CVD risk factor profiles over 17 years in percutaneous coronary intervention (PCI patients at the Mayo Clinic. Methods: We performed a time-trend analysis within the Mayo Clinic PCI Registry from 1994 to 2010. Results were the incidence and prevalence of CVD risk factors as estimate by the Framingham risk score. Results: Between 1994 and 2010, 25 519 patients underwent a PCI. During the time assessed, the mean age at PCI became older, but the gender distribution did not change. A significant trend towards higher body mass index and more prevalent hypercholesterolemia, hypertension, and diabetes was found over time. The prevalence of current smokers remained unchanged. The prevalence of ever-smokers decreased among males, but increased among females. However, overall CVD risk according to the Framingham risk score (FRS and 10-year CVD risk significantly decreased. The use of most of medications elevated from 1994 to 2010, except for β-blockers and angiotensin converting enzyme inhibitors decreased after 2007 and 2006 in both baseline and discharge, respectively. Conclusions: Most of the major risk factors improved and the FRS and 10-year CVD risk declined in this population of PCI patients. However, obesity, history of hypercholesterolemia, hypertension, diabetes, and medication use increased substantially. Improvements to blood pressure and lipid profile management because of medication use may have influenced the positive trends.

  12. The 2 + 1 paradigm: an efficient algorithm for central reading of Mayo endoscopic subscores in global multicenter phase 3 ulcerative colitis clinical trials.

    Science.gov (United States)

    Ahmad, Harris A; Gottlieb, Klaus; Hussain, Fez

    2016-02-01

    Despite its importance and potential impact in clinical trials, central reading continues to be an under-represented topic in the literature about inflammatory bowel disease (IBD) clinical trials. Although several IBD studies have incorporated central reading to date, none have fully detailed the specific methodology with which the reads were conducted. Here we outline key principles for designing an efficient central reading paradigm for an ulcerative colitis (UC) study that addresses regulatory, operational and clinical expectations. As a step towards standardization of read methodology for the growing number of multicenter phase 3 clinical trials in IBD, we have applied these principles to the design of an optimal read methodology that we call the '2 + 1 paradigm.' The 2 + 1 paradigm involves the use of both site and central readers, validated scoring criteria and multiple measures for blinding readers, all of which contribute to reducing bias and generating a reliable endoscopic subscore that reflects endoscopic disease severity. The paradigm can be utilized while maintaining a practical workflow compatible with an operationally feasible clinical trial. The 2 + 1 paradigm represents a logical approach to endoscopic assessment in IBD clinical trials, one that should be considered attractive to prospective sponsors, contract research organizations, key opinion leaders and regulatory authorities and be ready for implementation and further evaluation. © The Author(s) 2015. Published by Oxford University Press and the Digestive Science Publishing Co. Limited.

  13. Commentary on: "Ipilimumab versus placebo after radiotherapy in patients with metastatic castration-resistant prostate cancer that had progressed after docetaxel chemotherapy (CA184-043): A multicentre, randomised, double-blind, phase 3 trial." Kwon ED, Drake CG, Scher HI, Fizazi K, Bossi A, van den Eertwegh AJ, Krainer M, Houede N, Santos R, Mahammedi H, Ng S, Maio M, Franke FA, Sundar S, Agarwal N, Bergman AM, Ciuleanu TE, Korbenfeld E, Sengeløv L, Hansen S, Logothetis C, Beer TM, McHenry MB, Gagnier P, Liu D, Gerritsen WR, CA184-043 Investigators. Departments of Urology and Immunology and Mayo Clinic Comprehensive Cancer Center, Mayo Clinic, Rochester, MN, USA, Electronic address: kwon.eugene@mayo.edu; Johns Hopkins Sidney Kimmel Comprehensive Cancer Center and Brady Urological Institute, Baltimore, MD, USA; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY, USA; Institut Gustave Roussy, University of Paris-Sud, Villejuif, France; Institut Gustave Roussy, Villejuif, France; VU University Medical Centre, Amsterdam, Netherlands; Vienna General Hospital, Medical University Vienna, Vienna, Austria; Institut Bergonié, Bordeaux, France; CHU Caremeau, Nimes, France; Centro Médico Austral, Buenos Aires, Argentina; Centre Jean Perrin, Clermont-Ferrand, France; St John of God Hospital, Subiaco, WA, Australia; University Hospital of Siena, Istituto Toscano Tumori, Siena, Italy; Hospital de Caridade de Ijuí, Ijuí, Brazil; Nottingham University Hospital, Nottingham, UK; Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA; Netherlands Cancer Institute and Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands; Institute of Oncology Ion Chiricuta and University of Medicine and Pharmacy Iuliu Hatieganu, Cluj-Napoca, Romania; Hospital Británico de Buenos Aires, Buenos Aires, Argentina; Herlev Hospital, Herlev, Denmark; Odense University Hospital, Odense, Denmark; University of Texas MD Anderson Cancer Center, Houston,

    Science.gov (United States)

    Trump, Donald

    2016-05-01

    Ipilimumab is a fully human monoclonal antibody that binds cytotoxic T-lymphocyte antigen 4 to enhance antitumour immunity. Our aim was to assess the use of ipilimumab after radiotherapy in patients with metastatic castration-resistant prostate cancer that progressed after docetaxel chemotherapy. We did a multicentre, randomised, double-blind, phase 3 trial in which men with at least one bone metastasis from castration-resistant prostate cancer that had progressed after docetaxel treatment were randomly assigned in a 1:1 ratio to receive bone-directed radiotherapy (8Gy in one fraction) followed by either ipilimumab 10mg/kg or placebo every 3 weeks for up to four doses. Non-progressing patients could continue to receive ipilimumab at 10mg/kg or placebo as maintenance therapy every 3 months until disease progression, unacceptable toxic effect, or death. Patients were randomly assigned to either treatment group via a minimisation algorithm, and stratified by Eastern Cooperative Oncology Group performance status, alkaline phosphatase concentration, haemoglobin concentration, and investigator site. Patients and investigators were masked to treatment allocation. The primary endpoint was overall survival, assessed in the intention-to-treat population. This trial is registered with ClinicalTrials.gov, number NCT00861614. From May 26, 2009, to Feb 15, 2012, 799 patients were randomly assigned (399 to ipilimumab and 400 to placebo), all of whom were included in the intention-to-treat analysis. Median overall survival was 11.2 months (95% CI: 9.5-12.7) with ipilimumab and 10.0 months (8.3-11.0) with placebo (hazard ratio [HR] = 0.85, 0.72-1.00; P = 0.053). However, the assessment of the proportional hazards assumption showed that it was violated (P = 0.0031). A piecewise hazard model showed that the HR changed over time: the HR for 0-5 months was 1.46 (95% CI: 1.10-1.95), for 5-12 months was 0.65 (0.50-0.85), and beyond 12 months was 0.60 (0.43-0.86). The most common grade 3

  14. Study on Mobile Augmented Reality Adoption for Mayo Language Learning

    OpenAIRE

    Miranda Bojórquez, Erasmo; Vergara Villegas, Osslan Osiris; Cruz Sánchez, Vianey Guadalupe; García-Alcaraz, Jorge Luis; Favela Vara, Jesús

    2016-01-01

    This paper presents the results of a study applied to undergraduates in order to know how the cultural dimensions affect their perceptions of the acceptance and use of new technologies in a student-centered learning environment. A total of 85 undergraduate students from the Autonomous Indigenous University of Mexico (UAIM) participated in the study. Each student was asked to use a mobile augmented reality (MAR) application designed to learn Mayo language (language spoken in Northwestern Mexic...

  15. Burning mouth syndrome: results of screening tests for vitamin and mineral deficiencies, thyroid hormone, and glucose levels-experience at Mayo Clinic over a decade.

    Science.gov (United States)

    Morr Verenzuela, Claudia S; Davis, Mark D P; Bruce, Alison J; Torgerson, Rochelle R

    2017-09-01

    Burning mouth syndrome (BMS) is a disorder characterized by chronic mouth pain in the absence of objective clinical abnormalities. Vitamin or mineral deficiencies may have a role in BMS, but data regarding the prevalence and relevance of hematinic deficiencies are conflicting. We aimed to determine the frequency of specific laboratory abnormalities in patients with BMS. We retrospectively reviewed the results of screening blood tests in patients with BMS at our institution between January 2003 and December 2013. Among 659 patients with BMS, the most common decreased values or deficiencies were vitamin D 3 (15%), vitamin B 2 (15%), vitamin B 6 (5.7%), zinc (5.7%), vitamin B 1 (5.3%), thyrotropin (TSH) (3.2%), vitamin B 12 (0.8%), and folic acid (0.7%). Laboratory values for fasting blood glucose and TSH were increased in 23.7% and 5.2%, respectively. In patients with symptoms of BMS, our results suggest it is reasonable to screen for fasting blood glucose, vitamin D (D 2 and D 3 ), vitamin B 6 , zinc, vitamin B 1 , and TSH. Deficiencies of vitamin B 12 and folic acid were rare (<1% abnormal). © 2017 The International Society of Dermatology.

  16. Elton Mayo and Carl Rogers: A Tale of Two Techniques.

    Science.gov (United States)

    Mahoney, Kevin T.; Baker, David B.

    2002-01-01

    Compares the simultaneous emergence of Mayo's nonauthoritarian interviewing approach and Rogers' nondirective counseling approach. Examines the influence of Piaget on Mayo and reviews the Hawthorne studies. Concludes that differences in the approaches outweigh similarities. (Contains 21 references.) (SK)

  17. Maintenance of Clinical Expertise and Clinical Research by the Clinical Professors at Gifu Pharmaceutical University.

    Science.gov (United States)

    Tachi, Tomoya; Noguchi, Yoshihiro; Teramachi, Hitomi

    2017-01-01

    The clinical professors at Gifu Pharmaceutical University (GPU) provide pharmaceutical services at GPU Pharmacy, Gifu University Hospital, and Gifu Municipal Hospital to keep their clinical skills up-to-date; they also perform clinical research in collaboration with many clinical institutes. The Laboratory of Clinical Pharmacy is part of the Department of Pharmacy Practice and Science, to which the clinical professors belong, and is composed of three clinical professors (a professor, an associate professor, and an assistant professor). The professor administers the GPU Pharmacy as its director, while the associate professor and assistant professor provide pharmaceutical services to patients at Gifu Municipal Hospital, and also provide practical training for students in the GPU Pharmacy. Collectively, they have performed research on such topics as medication education for students, clinical communication education, and analysis of clinical big data. They have also conducted research in collaboration with clinical institutes, hospitals, and pharmacies. Here, we introduce the collaborative research between the Laboratory of Clinical Pharmacy and Gifu Municipal Hospital. These studies include "Risk factors contributing to urinary protein expression resulting from bevacizumab combination chemotherapy", "Hyponatremia and hypokalemia as risk factors for falls", "Economic evaluation of adjustments of levofloxacin dosage by dispensing pharmacists for patients with renal dysfunction", and "Effect of patient education upon discharge for use of a medication notebook on purchasing over-the-counter drugs and health foods". In this symposium, we would like to demonstrate one model of the association and collaborative research between these clinical professors and clinical institutes.

  18. University of Limpopo student nurses' clinical learning experiences ...

    African Journals Online (AJOL)

    University of Limpopo student nurses' clinical learning experiences in a public hospital at ... was applied to explore and describe the experiences of student nurses' clinical learning ... The ethical principles relevant to the study were observed.

  19. The Arabic Version of the Mayo-Portland Adaptability Inventory 4: A Validation Study

    Science.gov (United States)

    Hamed, Razan; Tariah, Hashem Abu; Malkawi, Somaya; Holm, Margo B.

    2012-01-01

    The Mayo-Portland Adaptability Inventory 4 (MPAI-4) is a valid and reliable assessment tool to detect clinical impairments in patients with acquired brain injury. The tool is widely used by rehabilitation therapists worldwide, given its good psychometric properties and its availability in several languages. The purpose of this study was to…

  20. Exploring the uncertainties of early detection results: Model-based interpretation of mayo lung project

    NARCIS (Netherlands)

    L. Shi (Lu); H. Tian (Haijun); W.J. McCarthy (William); B. Berman (Barbara); S. Wu (Shinyi); R. Boer (Rob)

    2011-01-01

    textabstractBackground: The Mayo Lung Project (MLP), a randomized controlled clinical trial of lung cancer screening conducted between 1971 and 1986 among male smokers aged 45 or above, demonstrated an increase in lung cancer survival since the time of diagnosis, but no reduction in lung cancer

  1. Predictors of Early Termination in a University Counseling Training Clinic

    Science.gov (United States)

    Lampropoulos, Georgios K.; Schneider, Mercedes K.; Spengler, Paul M.

    2009-01-01

    Despite the existence of counseling dropout research, there are limited predictive data for counseling in training clinics. Potential predictor variables were investigated in this archival study of 380 client files in a university counseling training clinic. Multinomial logistic regression, predictive discriminant analysis, and classification and…

  2. The Pine Ridge-Mayo National Aeronautics and Space Administration Telemedicine Project: Program Activities and Participant Reactions

    Science.gov (United States)

    Kottke, T. E.; Little Finger, L.; Trapp, M. A.; Panser, L. A.; Novotny, P. J.

    1996-01-01

    OBJECTIVE: To determine the response of participants to the Pine Ridge-Mayo National Aeronautics and Space Administration telemedicine project. DESIGN: We describe a 3-month demonstration project of medical education and clinical consultations conducted by means of satellite transmission. Postparticipation questionnaires and a postproject survey were used to assess the success of the activity. MATERIAL AND METHODS: Patients and employees at the Pine Ridge Indian Health Service Hospital in southwestern South Dakota and employees at Mayo Clinic Rochester participated in a telemedicine project, after which they completed exit surveys and a postproject questionnaire to ascertain the acceptability of this mode of health care. RESULTS: Almost all Pine Ridge and Mayo Clinic participants viewed the project as beneficial. The educational sessions received favorable evaluations, and almost two-thirds of the patients who completed evaluations thought the consultation had contributed to their medical care. More than 90% of the respondents from Pine Ridge and more than 85% of the respondents from Mayo Clinic Rochester said that they would recommend participation in this project to others. More than 90% of respondents from Pine Ridge and 80% of Mayo respondents agreed with the statement that the project should continue. CONCLUSION: These data suggest that a program of clinical consultation services, professional education, and patient education available by telemedicine might be viewed as beneficial.

  3. Against the Corporate Culture Ideology: An Interview with Peter Mayo

    Science.gov (United States)

    Suoranta, Juha

    2010-01-01

    This article presents an interview with Peter Mayo, author and expert in the field of sociology of adult education, on his major influences in this area, his books, and his views on the role of radical adult education and radical scholarship in the future. In the interview, Peter Mayo states that his initial view of adult education was quite a…

  4. Le nonne di Plaza de Mayo

    Directory of Open Access Journals (Sweden)

    Benedetta Calandra

    2006-11-01

    Full Text Available The article is focused on a specific case study of ‘motherist movement’ in Argentina during the last military rule (1976-1983: the Grandmothers of Plaza de Mayo. Blurring the boundaries between public and private realm, these old women, without a previous, soundly-based political conscience, were able to set up a transnational human rights movement, well known all over the world, while looking for their abducted grandchildren. A crucial issue, still, is: how far did this group go in terms of advocating womens’ rights? Could we really find a correspondence, as Jelin puts it, between ‘women for human rights’ and ‘women for women’s rights’? The answer, as the Argentinean case shows, seems to be not so straightforward.

  5. Managing University Clinical Partnership: Learning from International Experience

    Science.gov (United States)

    Davies, Stephen; Smith, Tom

    2004-01-01

    Dialogue between the leaders of academic clinical organisations in different countries has revealed that the core elements of the partnership between universities and health care systems are remarkably consistent across national boundaries. There is now an impetus to move beyond analysis of common challenges and towards strategies for success that…

  6. El paro estudiantil de mayo de 1938

    Directory of Open Access Journals (Sweden)

    Orlando Moreno Martínez

    2009-07-01

    Full Text Available El presente artículo tiene como propósito analizar los sucesos ocurridos en la ciudad de Bogotá durante el paro estudiantil de mayo de 1938, programado para oponerse a algunas medidas de modernización y secularización educativa impuestas por el gobierno liberal del presidente Alfonso López Pumarejo. Específicamente, los estudiantes se levantaron contra el examen de revisión que se aplicaba al terminar la secundaria y el curso preparatorio que era un requisito para poder ingresar a la universidad. El escrito aborda la problemática suscitada por la reforma educativa, el desencadenamiento de la protesta estudiantil, las acciones desarrolladas por los estudiantes en la capital de la República, el impacto del movimiento en otras partes del país y las tendencias ideológicas que apoyaron el paro de estudiantes. A propósito de este último punto, si bien fue evidente el respaldo de la oposición conservadora, muchos estudiantes universitarios y de secundaria lucharon con convicción por lo que consideraron en su momento una arbitrariedad por parte del gobierno liberal.

  7. Brucellosis in Kosovo and Clinical Features of Brucellosis at University clinical center of Kosovo

    OpenAIRE

    Buçaj, Emine; Puca, Edmond; Namani, Sadie; Bajrami, Muharem; Krasniqi, Valbon; Berisha, Lindita; Jakupi, Xhevat; Halili, Bahrie; Kraja, Dhimiter

    2015-01-01

    Objective: Brucellosis became a remarkable disease in Kosovo. But there is not a comprehensive epidemiological study about pidemiology and clinical course of this disease from Kosovo. The aim of our study is to present demographic and clinical data of patients with brucellosis at University Clinical Center of Kosovo.Methods: A retrospective study was performed for the patients with brucellosis treated in our clinic during years 2011- 2012. The data about demography, history of the disease, cl...

  8. Burnout Among the Clinical Dental Students in the Jordanian Universities

    Science.gov (United States)

    Amin, Wala Majid; Al-Ali, Muna H.; Duaibis, Ramzi B.; Oweis, Tamara; Badran, Darwish H.

    2009-01-01

    Background The study aimed to evaluate the level of burnout among the clinical dental students in two Jordanian universities. Methods A total of 307 students from the two schools were surveyed using Maslach Burnout Inventory survey. Scores for the inventory’s subscales were calculated and the mean values for the students’ groups were computed separately. Kruskal-Wallis and Mann-Whitney tests were carried out and the results were compared at 95% confidence level. Results The results showed that the dental students in both Jordanian universities suffered high levels of emotional exhaustion and depersonalization compared to reported levels for dental students in other countries. The dental students of the University of Jordan demonstrated a significantly higher (p < 0.05) level of emotional exhaustion than their counterparts in the Jordan University of Science and Technology. Conclusions The findings indicated that dental students in the Jordanian universities presented considerable degrees of burnout manifested by high levels of emotional exhaustion and depersonalization. Studies targeting students health and psychology should be carried out to determine the causes of burnout among dental students. The curricula of the dental schools in the two universities should be accordingly improved to minimize burnout among the students. Keywords Burnout; Emotional exhaustion; Depersonalization; Personal accomplishment; Maslach Burnout Inventory PMID:22461870

  9. Study on Mobile Augmented Reality Adoption for Mayo Language Learning

    Directory of Open Access Journals (Sweden)

    Erasmo Miranda Bojórquez

    2016-01-01

    Full Text Available This paper presents the results of a study applied to undergraduates in order to know how the cultural dimensions affect their perceptions of the acceptance and use of new technologies in a student-centered learning environment. A total of 85 undergraduate students from the Autonomous Indigenous University of Mexico (UAIM participated in the study. Each student was asked to use a mobile augmented reality (MAR application designed to learn Mayo language (language spoken in Northwestern Mexico. Afterwards, the students responded to a survey with items concerning the use and technology acceptance and about cultural dimensions of individualism and uncertainty avoidance. Structural equation modeling (SEM was used to analyze the data collected from students. Results provide evidence that the individualism contributes positively to perceived ease of use of the MAR app, and uncertainty avoidance has no impact. The findings showed that the MAR system could be easily used if it includes a natural way to promote collaborative work. In addition, to gain the trust of students, the uncertainty avoidance needs to be reduced by enriching the help information offered for app use.

  10. Specialized consultant in radiological safety to the Reforma peripheral clinic, PEMEX. - I. - May-June of 2003; Asesoria especializada en seguridad radiologica a la clinica periferica Reforma, PEMEX.- I.- Mayo-Junio de 2003

    Energy Technology Data Exchange (ETDEWEB)

    Torres P, A.; Garcia A, J.; Rodriguez A, F

    2003-07-15

    The Reforma peripheral clinic, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the clinic can conserve its respective sanitary license.(Author)

  11. Hospital de La Misericordia, 6 de mayo de 1906 - 6 de mayo de 1981

    Directory of Open Access Journals (Sweden)

    Liborio Sánchez Avella

    1981-07-01

    Full Text Available El 6 de mayo de 1981 cumplió el Hospital de La Misericordia 75 años de haber iniciado sus labores. La idea de crear el Hospital se venía gestando desde comienzos de 1890. Obtuvo la Personería Jurídica el 23 de julio de 1897y el 25 de julio del mismo año colocó la primera piedra el Presidente de la República Miguel Antonio Caro. José Ignacio Barberi, su fundador, dejó un escrito en el cual relataba la historia de este Hospital. El mejor homenaje que se le puede hacer al Hospital y a José Ignacio Barberi, es transcribir las palabras que él dejó inéditas en 1940.

  12. [Future roles of clinical laboratories and clinical laboratory technologists in university hospitals].

    Science.gov (United States)

    Yokota, Hiromitsu; Yatomi, Yutaka

    2013-08-01

    Clinical laboratories in university hospitals should be operated with a good balance of medical practice, education, research, and management. The role of a clinical laboratory is to promptly provide highly reliable laboratory data to satisfy the needs of clinicians involved in medical practice and health maintenance of patients. Improvement and maintenance of the quality of the laboratory staff and environment are essential to achieve this goal. In order to implement these requirements efficiently, an appropriate quality management system should be introduced and established, and evaluated objectively by a third party (e.g. by obtaining ISO 15189 certification). ISO 15189 is an international standard regarding the quality and competence of clinical laboratories, and specifies a review of the efficient operational system and technical requirements such as competence in implementing practical tests and calibration. This means the results of laboratory tests reported by accredited laboratories withstand any international evaluation, which is very important to assure the future importance of the existence and management of clinical laboratories as well as internationalization of medical practice. "Education" and "research" have important implications in addition to "medical practice" and "management", as the roles that clinical laboratories should play in university hospitals. University hospital laboratories should be operated by keeping these four factors in good balance. Why are "education" and "research" required in addition to "medical practice" services? If individual clinical laboratory technologists can provide an appropriate response to this question, the importance of the existence of clinical laboratories would be reinforced, without being compromised.

  13. University psychiatry in Italy: organisation and integration of university clinics and the National Health Service

    Directory of Open Access Journals (Sweden)

    Pier Maria Furlan

    2013-09-01

    Full Text Available INTRODUCTION: In the Italian psychiatric system, community-based care has become increasingly important and widespread since the national reform of 1978. This report aims to provide an overview of the involvement of university medical schools in this process, considering their responsibility for teaching and training specialist practitioners and professionals. METHODS: The study was carried out between early 2010 and February 2011. An 18-items, self-administered, questionnaire was designed to investigate the number of faculty members that are responsible both for running a clinical ward and for providing community-based healthcare. RESULTS: Nine out of 53 faculty members (17% manage a Mental Health Department, 9 (17% manage a University Department, and 2 (3.8% manage both types of department. Less than half of the teachers have full responsibility (hospital and community; however the percentage reaches 73.2% if we include the hospital wards open to the community emergencies. The remaining 26.8% have no responsibility for community psychiatry. Moreover there were undoubtedly still too many universities with specialisation schools that are without an appropriate network of facilities enabling them to offer complex psychiatric training. DISCUSSION: As expected, there were several types of healthcare management that were not uniformly distributed throughout Italy and there were also marked differences between mental health care provision in the North, Centre, and South of Italy. The university involvement in clinical responsibility was great, but at the management level there was a lack of equality in terms of clinical care, which risks being reflected also on the institutional functions of teaching and research.

  14. University Clinic of Toxicology--historical note and present work.

    Science.gov (United States)

    Bozinovska, C

    2013-01-01

    The University Clinic of Toxicology (UCT) in Skopje was founded as the Clinic for Toxicology and Emergency Internal Medicine on January 15th 1976. Today UCT has a modern building with office space of 1,300 m2 on 4 floors, 40 hospital beds and 72 employees including 18 doctors. UCT works in accordance with the public healthcare services in the Republic of Macedonia through the use of specialist/consultative and hospital healthcare for people over the age of 14 years. The Clinic also provides services in the field of emergency internal medicine, acute poisoning with medications, pesticides, corrosives, poisonous gases and mushrooms, heavy metals and other chemicals. The Clinic takes an active part in the detoxification programme for users of opiates and psychotropic substances, protocols for enteral and parenteral nutrition and guides for home treatment. Yearly there are more than 14,000 ambulance admissions, over 1,400 hospitalized patients, over 4,000 urgent EHO checks, more than 1,000 urgent upper endoscopies and over 700 other toxicological analyses and other interventions. The educational services and activities are realized through the chair for internal medicine. The Clinic offers undergraduate and graduate level education for medical students and dentists, for medical nurses, radiology technicians, speech therapists and physiotherapists. Over 300 papers and reports have been published to date by the medical staff at the UCT in the form of abstracts and integrated projects in the Republic of Macedonia and aboard. 8 doctorates have been successfully completed by employees from the Clinic as well as 4 master's theses and 1 in-depth project. UCT employees are the authors of some textbooks and monographs. UCT have undertaken some scientific projects. Employees from the Clinic of Toxicology are members taking an active part in many domestic and international associations.

  15. Developing a "clinical presentation" curriculum at the University of Calgary.

    Science.gov (United States)

    Mandin, H; Harasym, P; Eagle, C; Watanabe, M

    1995-03-01

    Currently, medical curricula are structured according to disciplines, body systems, or clinical problems. Beginning in 1988, the faculty of the University of Calgary Faculty of Medicine (U of C) carefully evaluated the advantages and disadvantages of each of these models in seeking to revise their school's curriculum. However, all three models fell short of a curricular structure based on current knowledge and principles of adult learning, clinical problem solving, community demands, and curriculum management. By 1991, the U of C had formulated a strategic plan for a revised curriculum structure based on the way patients present to physicians, and implementation of this plan has begun. In creating the new curriculum, 120 clinical presentations (e.g., "loss of consciousness/syncope") were defined and each was assigned to an individual or small group of faculty for development based on faculty expertise and interest. Terminal objectives (i.e., "what to do") were defined for each presentation to describe the appropriate clinical behaviors of a graduating physician. Experts developed schemes that outlined how they differentiated one cause (i.e., disease category) from another. The underlying enabling objectives (i.e., knowledge, skills, and attitudes) for reaching the terminal objectives for each clinical presentation were assigned as departmental responsibilities. A new administrative structure evolved in which there is a partnership between a centralized multidisciplinary curriculum committee and the departments. This new competency-based, clinical presentation curriculum is expected to significantly enhance students' development of clinical problem-solving skills and affirms the premise that prudent, continuous updating is essential for improving the quality of medical education.

  16. Problems of university-based scientists associated with clinical trials.

    Science.gov (United States)

    Remington, R D

    1979-05-01

    University faculty members who participate in clinical trials face a number of difficulties in connection with this association. Publication opportunities are often limited, and individual scholarship is difficult to express and evaluate within the context of a cooperative trial. Merit increases, promotion, and the award of tenure will usually require evidence of scholarly achievement outside the trial setting. For this reason, it seems inadvisable to recommend that a young investigator devote a major portion of his scholarly and research time to such an activity. A possible exception may be a full-time appointment for 1 to 2 years. Nonetheless, cooperative clinical trials are an important investigative tool and they should continue to be associated with academic centers. If appropriate administrative arrangements can be made, it should be possible to solve the academic problems of the young investigator associated with such trials.

  17. A new universal simplified adhesive: 6-month clinical evaluation.

    Science.gov (United States)

    Mena-Serrano, Alexandra; Kose, Carlos; De Paula, Eloisa Andrade; Tay, Lidia Yileng; Reis, Alessandra; Loguercio, Alessandro D; Perdigão, Jorge

    2013-02-01

    Multimode adhesives, which can be used as etch-and-rinse or as self-etch adhesives, have been recently introduced without clinical data to back their use. To evaluate the 6-month clinical performance of Scotchbond Universal Adhesive (SU; 3M ESPE, St. Paul, MN, USA) in noncarious cervical lesions (NCCLs) using two evaluation criteria. Thirty-nine patients participated in this study. Two hundred restorations were assigned to four groups: SU-TEm: etch-and-rinse + moist dentin; SU-TEd: etch-and-rinse + dry dentin; SU-SEet: selective enamel etching; and SU-SE: self-etch. The composite resin Filtek Supreme Ultra (3M ESPE) was placed incrementally. The restorations were evaluated at baseline and after 6 months using both the World Dental Federation (FDI) and the United States Public Health Service (USPHS) criteria. Statistical analyses were performed with Friedman repeated measures analysis of variance by rank and McNemar test for significance in each pair (α = 0.05). Only four restorations (SU-SE: 3 and SU-TEm: 1) were lost after 6 months (p > 0.05 for either criteria). Marginal discoloration occurred in one restoration in the SU-SE group (p > 0.05 for either criteria). Only 2/200 restorations were scored as bravo for marginal adaptation using the USPHS criteria (one for SU-SE and one for SU-SEet, p > 0.05). However, when using the FDI criteria, the percentage of bravo scores for marginal adaptation at 6 months were 32%, 36%, 42%, and 46% for groups SU-TEm, SU-TEd, SU-SEet, and SU-SE, respectively (p > 0.05). The clinical behavior of the multimode adhesive does not depend on the bonding strategy at 6 months. The FDI evaluation criteria are more sensitive than the USPHS criteria. At 6 months, the clinical behavior of the new multimode adhesive Scotchbond Universal was found to be reliable when used in noncarious cervical lesions and may not depend on the bonding strategy employed. © 2012 Wiley Periodicals, Inc.

  18. Tools in a clinical information system supporting clinical trials at a Swiss University Hospital.

    Science.gov (United States)

    Weisskopf, Michael; Bucklar, Guido; Blaser, Jürg

    2014-12-01

    Issues concerning inadequate source data of clinical trials rank second in the most common findings by regulatory authorities. The increasing use of electronic clinical information systems by healthcare providers offers an opportunity to facilitate and improve the conduct of clinical trials and the source documentation. We report on a number of tools implemented into the clinical information system of a university hospital to support clinical research. In 2011/2012, a set of tools was developed in the clinical information system of the University Hospital Zurich to support clinical research, including (1) a trial registry for documenting metadata on the clinical trials conducted at the hospital, (2) a patient-trial-assignment-tool to tag patients in the electronic medical charts as participants of specific trials, (3) medical record templates for the documentation of study visits and trial-related procedures, (4) online queries on trials and trial participants, (5) access to the electronic medical records for clinical monitors, (6) an alerting tool to notify of hospital admissions of trial participants, (7) queries to identify potentially eligible patients in the planning phase as trial feasibility checks and during the trial as recruitment support, and (8) order sets to facilitate the complete and accurate performance of study visit procedures. The number of approximately 100 new registrations per year in the voluntary trial registry in the clinical information system now matches the numbers of the existing mandatory trial registry of the hospital. Likewise, the yearly numbers of patients tagged as trial participants as well as the use of the standardized trial record templates increased to 2408 documented trial enrolments and 190 reports generated/month in the year 2013. Accounts for 32 clinical monitors have been established in the first 2 years monitoring a total of 49 trials in 16 clinical departments. A total of 15 months after adding the optional feature of

  19. An Academic Healthcare Twitter Account: The Mayo Clinic Experience.

    Science.gov (United States)

    Widmer, R Jay; Engler, Nicole B; Geske, Jeffrey B; Klarich, Kyle W; Timimi, Farris K

    2016-06-01

    With more than 300 million monthly active users, Twitter is a powerful social media tool in healthcare, yet the characterization of an academic healthcare Twitter account remains poor to date. We assessed basic gender and geographic data on the account's "followers," as well as categorization of each tweet based on content type. We analyzed the impressions, engagements, retweets, favorites, replies, hashtag clicks, and detail expansions using both Sprinklr and Twitter Analytics. Over a period of 12 months, the account amassed 1,235 followers, with 54 percent being male and 68 percent residing in the United States. Of the 1,635 tweets sent out over the life of the account, we report more than 382,464 impressions, 6,023 engagements, 1,255 retweets, 776 favorites, and 1,654 embedded media clicks in this period. When broken down by tweet category, publication tweets garnered the highest engagement with an estimated mean number of clicks per tweet of 8.2 ± 81.9. Original content had higher total engagement per tweet than retweeted material (2.8 ± 9.2 vs. 0.2 ± 0.9 engagements per tweet; p < 0.0001). Tweets regarding internal, national, and continuing medical education events had similar engagement. Herein is the first publication within the medical literature describing a "case series" of cardiovascular tweets over 12 months. We highlight a rapidly emerging group of interactive followers, a successful means by which to disseminate and engage in breaking topics throughout the cardiovascular field, and the importance of combining physician-led knowledge with intermittent marketing messages.

  20. Adjuvant therapy for ampullary carcinomas: The Mayo Clinic experience

    International Nuclear Information System (INIS)

    Bhatia, Sumita; Miller, Robert C.; Haddock, Michael G.; Donohue, John H.; Krishnan, Sunil

    2006-01-01

    Purpose: To determine the effects of adjuvant radiotherapy and chemotherapy for carcinoma of the ampulla of Vater. Methods and Materials: We retrospectively reviewed the records of 125 patients who underwent definitive surgery for carcinomas involving the ampulla of Vater between April 1977 and February 2005 and who survived more than 50 days after surgery. Twenty-nine of the patients also received adjuvant radiotherapy (median dose, 50.4 Gy in 28 fractions) with concurrent 5-fluorouracil chemotherapy. Adverse prognostic factors were investigated, and overall survival (OS) and local and distant failure were estimated. Results: Adverse prognostic factors for decreased OS by univariate analysis included lymph node (LN) involvement, locally advanced tumors (T3/T4), and poor histologic grade. By multivariate analysis, positive LN status (p = 0.02) alone was associated with decreased OS. The addition of adjuvant radiotherapy and chemotherapy improved OS for patients with positive LN (p = 0.01). Median survival for positive LN patients receiving adjuvant therapy was 3.4 years, vs. 1.6 years for those with surgery alone. Conclusions: The addition of adjuvant radiotherapy and 5-fluorouracil chemotherapy may improve OS in patients with LN involvement. The effect of adjuvant therapy on outcomes for patients with poor histologic grade or T3/T4 tumors without LN involvement could not be assessed

  1. Adjuvant Therapy for Gallbladder Carcinoma: The Mayo Clinic Experience

    International Nuclear Information System (INIS)

    Gold, Douglas G.; Miller, Robert C.; Haddock, Michael G.; Gunderson, Leonard L.; Quevedo, Fernando; Donohue, John H.; Bhatia, Sumita; Nagorney, David M.

    2009-01-01

    Purpose: To analyze the effect of adjuvant chemoradiotherapy on gallbladder carcinoma. Methods and Materials: We retrospectively reviewed the records from consecutive patients who underwent R0 resection of gallbladder carcinoma between January 1, 1985, and December 31, 2004. Patients had either Stage I (T1-T2N0M0) or Stage II (T3N0M0 or T1-T3N1M0) disease. Patients undergoing adjuvant therapy received 5-fluorouracil chemotherapy concurrently with radiotherapy (median dosage, 50.4 Gy in 28 fractions). Adverse prognostic factors and the effect of adjuvant treatment on overall survival (OS) were evaluated. Results: A total of 73 patients were included in the analysis; of these, 25 received adjuvant chemoradiotherapy. On univariate analysis, no adverse prognostic factors for OS reached statistical significance, but trends were noted for Stage N1 vs. N0 (p = .06), Nx vs. N0 (p = .09), Stage T3 vs. T1-T2 (p = .06), and histologic findings other than adenocarcinoma (p = .13). The median OS for patients receiving adjuvant chemoradiotherapy vs. surgery alone was 4.8 years and 4.2 years, respectively (log-rank test, p = .56). However, a significantly greater percentage of patients receiving adjuvant chemoradiotherapy had Stage II disease (p <.001). In the multivariate Cox model, increasing T and N category and histologic findings other than adenocarcinoma were significant predictors of decreased OS. Additionally, adjuvant chemoradiotherapy was a significant predictor of improved OS after adjusting for these prognostic factors (hazard ratio for death, 0.3; 95% confidence interval, 0.13-0.69; p = .004). Conclusion: After adjusting for the stage parameters and histologic findings, our data suggest that adjuvant chemoradiotherapy might improve OS for patients with gallbladder cancer.

  2. Conservative management of pineal tumors - Mayo clinic experience

    International Nuclear Information System (INIS)

    Laws, E.R.; Abay, E.O.; Forbes, G.S.; Grado, G.L.; Bruckman, J.E.; Scott, M.

    1984-01-01

    The typical pineal tumor occurs in an adolescent boy with subacute increased intracranial pressure and Parinaud's syndrome. Diagnosis is confirmed by CT scanning, and long-term survival usually following shunting and radiation therapy. Direct surgical methods for successful treatment of suitable pineal tumors have evolved and may be utilized with relatively low risk in appropriate cases

  3. Prostate Cancer Clinical Trials Group: The University of Michigan Site

    Science.gov (United States)

    2011-04-01

    2931 alhawary@umich.edu Stephanie Daignault, MS, Biostatistician, Biostatistics Core University of Michigan Comprehensive Cancer Center NI8D11...Consortium; The Cancer Institute of New Jersey/University of Medicine and Dentistry of New Jersey, New Brunswick, NJ; Robert Wood Johnson Medical School...University of Medicine and Dentistry of New Jersey, New Brunswick, NJ; University of Michigan, Ann Arbor, MI; University of Wisconsin Carbone

  4. Enhancing clinical skills education: University of Virginia School of Medicine's Clerkship Clinical Skills Workshop Program.

    Science.gov (United States)

    Corbett, Eugene C; Payne, Nancy J; Bradley, Elizabeth B; Maughan, Karen L; Heald, Evan B; Wang, Xin Qun

    2007-07-01

    In 1993, the University of Virginia School of Medicine began a clinical skills workshop program in an effort to improve the preparation of all clerkship students to participate in clinical care. This program involved the teaching of selected basic clinical skills by interested faculty to small groups of third-year medical students. Over the past 14 years, the number of workshops has increased from 11 to 31, and they now involve clerkship faculty from family medicine, internal medicine, and pediatrics. Workshops include a variety of common skills from the communication, physical examination, and clinical test and procedure domains such as pediatric phone triage, shoulder examination, ECG interpretation, and suturing. Workshop sessions allow students to practice skills on each other, with standardized patients, or with models, with the goal of improving competence and confidence in the performance of basic clinical skills. Students receive direct feedback from faculty on their skill performance. The style and content of these workshops are guided by an explicit set of educational criteria.A formal evaluation process ensures that faculty receive regular feedback from student evaluation comments so that adherence to workshop criteria is continuously reinforced. Student evaluations confirm that these workshops meet their skill-learning needs. Preliminary outcome measures suggest that workshop teaching can be linked to student assessment data and may improve students' skill performance. This program represents a work-in-progress toward the goal of providing a more comprehensive and developmental clinical skills curriculum in the school of medicine.

  5. Existing data sources for clinical epidemiology: Aarhus University Clinical Trial Candidate Database, Denmark.

    Science.gov (United States)

    Nørrelund, Helene; Mazin, Wiktor; Pedersen, Lars

    2014-01-01

    Denmark is facing a reduction in clinical trial activity as the pharmaceutical industry has moved trials to low-cost emerging economies. Competitiveness in industry-sponsored clinical research depends on speed, quality, and cost. Because Denmark is widely recognized as a region that generates high quality data, an enhanced ability to attract future trials could be achieved if speed can be improved by taking advantage of the comprehensive national and regional registries. A "single point-of-entry" system has been established to support collaboration between hospitals and industry. When assisting industry in early-stage feasibility assessments, potential trial participants are identified by use of registries to shorten the clinical trial startup times. The Aarhus University Clinical Trial Candidate Database consists of encrypted data from the Danish National Registry of Patients allowing an immediate estimation of the number of patients with a specific discharge diagnosis in each hospital department or outpatient specialist clinic in the Central Denmark Region. The free access to health care, thorough monitoring of patients who are in contact with the health service, completeness of registration at the hospital level, and ability to link all databases are competitive advantages in an increasingly complex clinical trial environment.

  6. A new universal simplified adhesive: 18-month clinical evaluation.

    Science.gov (United States)

    Perdigão, J; Kose, C; Mena-Serrano, A P; De Paula, E A; Tay, L Y; Reis, A; Loguercio, A D

    2014-01-01

    To evaluate the 18-month clinical performance of a multimode adhesive (Scotchbond Universal Adhesive, SU, 3M ESPE, St Paul, MN, USA) in noncarious cervical lesions (NCCLs) using two evaluation criteria. Thirty-nine patients participated in this study. Two-hundred restorations were assigned to four groups: ERm, etch-and-rinse + moist dentin; ERd, etch-and-rinse + dry dentin; Set, selective enamel etching; and SE, self-etch. The composite resin, Filtek Supreme Ultra (3M ESPE), was placed incrementally. The restorations were evaluated at baseline, and at 18 months, using both the World Dental Federation (FDI) and the United States Public Health Service (USPHS) criteria. Statistical analyses were performed using Friedman repeated-measures analysis of variance by rank and McNemar test for significance in each pair (α=0.05). Five restorations (SE: 3; Set: 1; and ERm: 1) were lost after 18 months (p>0.05 for either criteria). Marginal staining occurred in four and 10% of the restorations evaluated (p>0.05), respectively, for USPHS and FDI criteria. Nine restorations were scored as bravo for marginal adaptation using the USPHS criteria and 38%, 40%, 36%, and 44% for groups ERm, ERd, Set, and SE, respectively, when the FDI criteria were applied (p>0.05). However, when semiquantitative scores (or SQUACE) for marginal adaptation were used, SE resulted in a significantly greater number of restorations, with more than 30% of the total length of the interface showing marginal discrepancy (28%) in comparison with the other groups (8%, 6%, and 8%, respectively, for ERm, ERd, and Set). The clinical retention of the multimode adhesive at 18 months does not depend on the bonding strategy. The only differences between strategies were found for the parameter marginal adaptation, for which the FDI criteria were more sensitive than the USPHS criteria.

  7. Claremount Nursing Home, Claremount, Claremorris, Mayo.

    LENUS (Irish Health Repository)

    Reeves, Emer P

    2012-01-01

    The pathogenesis of lung disease in cystic fibrosis is characterised by decreased airway surface liquid volume and subsequent failure of normal mucociliary clearance. Mucus within the cystic fibrosis airways is enriched in negatively charged matrices composed of DNA released from colonizing bacteria or inflammatory cells, as well as F-actin and elevated concentrations of anionic glycosaminoglycans. Therapies acting against airway mucus in cystic fibrosis include aerosolized hypertonic saline. It has been shown that hypertonic saline possesses mucolytic properties and aids mucociliary clearance by restoring the liquid layer lining the airways. However, recent clinical and bench-top studies are beginning to broaden our view on the beneficial effects of hypertonic saline, which now extend to include anti-infective as well as anti-inflammatory properties. This review aims to discuss the described therapeutic benefits of hypertonic saline and specifically to identify novel models of hypertonic saline action independent of airway hydration.

  8. Remembering Joseph Mayo and His Contributions to Animal Science | Poster

    Science.gov (United States)

    By Carolynne Keenan, Guest Writer In the 1990s, when Joseph Mayo, D.V.M, ran out of gas leading coworkers home from a meeting in Bethesda, he pulled over to the side of the road on I-270 and waited for help. He didn’t have to wait long; within a few minutes a passing motorist took pity on the group of scientists and offered them a lift back to Fort Detrick.

  9. Smoking trends amongst young doctors of a tertiary care hospital - Mayo Hospital, Lahore - Pakistan

    International Nuclear Information System (INIS)

    Chudhary, M.K.; Younis, M.; Bukhari, M.H.

    2011-01-01

    The World Health Organization cites tobacco use as one of the biggest public health threats the world has ever faced. Tobacco is the number one preventable cause of disability and death. Tobacco has many negative health effects which many of the smokers know them well. In Pakistan tobacco use is common in general public and the health professionals don't lack behind this habit. To study the smoking trends amongst young doctors of Mayo Hospital. Questionnaire based descriptive study. This study was conducted at the Institute of Chest Medicine, Mayo Hospital - A tertiary care hospital affiliated with King Edward Medical University, Lahore. Out of 250 doctors, 180 (72%) were males and 70 (28%) were female. Amongst 180 male doctors 97 (53.88%) were smokers and 83 (46.21%) were non smokers. Amongst 70 female doctors 8 (11.43%) were smokers and 62 (88.57%) were non smokers. Smoking is common among male young doctors but it is less common in female doctors. (author)

  10. Brucellosis in Kosovo and Clinical Features of Brucellosis at University clinical center of Kosovo

    Directory of Open Access Journals (Sweden)

    Emine Qehaja Buçaj

    2015-12-01

    Full Text Available Objective: Brucellosis became a remarkable disease in Kosovo. But there is not a comprehensive epidemiological study about epidemiology and clinical course of this disease from Kosovo. The aim of our study is to present demographic and clinical data of patients with brucellosis at University Clinical Center of Kosovo. Methods: A retrospective study was performed for the patients with brucellosis treated in our clinic during years 2011- 2012. The data about demography, history of the disease, clinical presentations, serological test, serum biochemistry and reatment were collected from hospital medical records. The diagnosis of brucellosis based on clinical and laboratory findings. Results: This descriptive study included 47 patients, who 33 of them (70.2% were males. The mean age was 37.9 ± 19.3 years. The route of transmission of the disease was known in 28 59.5% of them. Direct contact with livestock in 22 (46.8% and ingestion of dairy products in six cases (12.7% were reported as the transmission route. The majority of patients (27 patients, 57.4% were from rural area. The main presenting symptoms were atigue, fever and arthralgia. Osteoarticular manifestations were the common forms of localized disease. Regarding to the therapy, 45 (95.7% of patients were treated with streptomycin and doxycycline for the first three weeks. Conclusion: Human brucellosis is not a common in Kosovo but there is a potential risk. Osteoarticular symptoms were the most common presentation reasons. The most effective and preferred treatment regimen was Streptomycin plus Doxycycline for the first three weeks, and Doxycycline plus Rifampicin thereafter. J Microbiol Infect Dis 2015;5(4: 147-150

  11. Occupational Accidents among Clinical Staff of Tabriz University Hospitals

    OpenAIRE

    Leila Sahebi; Rana Gholamzadeh nikjoo; Majid Khalili

    2015-01-01

    ​Background and Objectives : Occupational health and safety is one of the most important issues in the workplace. The purpose of this study was to explore the one –year prevalence of occupational accidents in Tabriz University hospitals. Materials and Methods : A cross-sectional study was conducted on 400 patients of seven university hospitals using researcher made questionnaire. The hospitals were selected based on their specialty of the service. Then, one hospital was selected from each s...

  12. Physiotherapy clinical education at a South African university

    Directory of Open Access Journals (Sweden)

    V Chetty

    2018-04-01

    Full Text Available Background. Clinical education for physiotherapists forms a vital part of undergraduate programmes and equips students with competencies to practise autonomously as qualified health practitioners. However, disparities are evident in approaches to clinical education.Objective. To explore the perceptions of physiotherapy students, community-service physiotherapists and physiotherapy clinical supervisors regarding the clinical education framework at a tertiary institution in South Africa in order to understand preparedness of students for practice.Methods. A case study approach with two focus group discussions with students and interviews with community physiotherapists and clinical supervisors was employed. Data were analysed and categorised into key themes and sub-themes.Results. Five themes emerged from triangulation of data from the three groups: preparedness for professional practice, institutional barriers, curriculum disputes, personal factors and recommendations for physiotherapy clinical education. Students felt inadequately prepared owing to a perceived lack of exposure to certain aspects of physiotherapy, while community therapists believed that reflection on the undergraduate programme after qualifying contributed to their adequate preparation. Clinical supervisors supposed that students would benefit from actively engaging with teaching and learning opportunities, and clinical personnel collaboration was seen as key to facilitate a continuum in clinical education from classroom to healthcare setting.Conclusion. Participants reported that the existing curriculum structure may need to be revisited to address various issues, while holistic collaboration between students, supervisors and clinical personnel is imperative to create a cohesive learning environment.

  13. Clinical improvisation and the universe of musical idioms

    DEFF Research Database (Denmark)

    Bergstrøm-Nielsen, Carl

    2001-01-01

    (please choose Danish language to see a German summary) The music therapy education at Aalborg University, Denmark, takes five years of full-time study to accomplish and contains many special disciplines. One of these is called intuitive music. It deals with improvisation training and with the cr......(please choose Danish language to see a German summary) The music therapy education at Aalborg University, Denmark, takes five years of full-time study to accomplish and contains many special disciplines. One of these is called intuitive music. It deals with improvisation training...

  14. Clinical profile of patients with myasthenia gravis followed at the University Hospital, Federal University of Minas Gerais

    Directory of Open Access Journals (Sweden)

    Aline Mansueto Mourão

    2015-04-01

    Full Text Available Summary Objective: to determine the clinical profile of patients with myasthenia gravis (MG; followed at the Neuromuscular Diseases Clinic of the University Hospital, Federal University of Minas Gerais, Brazil, and to compare it with other Brazilian case series. Methods: sociodemographic and clinical data were collected from patients, and a systematic literature review performed, focusing on national studies on the clinical profile of MG patients. Results: sixty nine patients were enrolled in the study. Fifty five (91% subjects were female and the mean age (SD was 37.6 (±11.4 years. The mean disease duration was 14.1 years. Regarding treatment, prednisone was the most used strategy (64%, followed by the use of azathioprine (43%. There was no difference between thymectomized (42 and non-thymectomized (27 patients regarding disease severity and medication use. Conclusion: clinical and socio-demographic features of this MG sample from a University-based clinic resemble those reported in other Brazilian series and in the international literature.

  15. Third universal definition of myocardial infarction. Implications for clinical practice

    International Nuclear Information System (INIS)

    Bazzino, O.

    2013-01-01

    In general, the conceptual meaning of the term myocardial infarction has not changed, although have developed new sensitive diagnostic methods. In this way the clinical diagnosis is based on patient symptoms, electrocardiogram's (ECG) changes and sensitive biochemical markers, as well as the information obtained from various imaging techniques

  16. Gambling and its clinical correlates in university students.

    Science.gov (United States)

    Grant, Jon E; Lust, Katherine; Christenson, Gary A; Redden, Sarah A; Chamberlain, Samuel R

    2018-02-09

    This study sought to examine the prevalence of gambling disorder (GD) in a university sample and its associated physical and mental health correlates. A 156-item anonymous online survey was distributed via random email generation to a sample of 9449 university students. Current use of alcohol and drugs, psychological and physical status and academic performance were assessed, along with questionnaire-based measures of impulsivity and compulsivity. Positive screens for GD were based upon individuals meeting DSM-5 criteria. A total of 3421 participants (59.7% female) were included in the analysis. The overall prevalence of GD was 0.4%, while an additional 8.4% reported subsyndromal symptoms of GD. GD was significantly associated with past-year use of cocaine, heroin/opiate pain medications, sedatives, alcohol and tobacco. Those with GD were more likely to have generalized anxiety, PTSD and compulsive sexual behavior. Questionnaire-based measures revealed higher levels of both compulsivity and impulsivity associated with disordered gambling. Some level of gambling symptomatology is common in young adults and is associated with alcohol and drug use, as well as impulsive and compulsive behaviors. Clinicians should be aware of the presentation of problematic gambling and screen for it in primary care and mental health settings.

  17. Experience with the Implementation of Clinical Pharmacy Services and Processes in a University Hospital in Belgium.

    Science.gov (United States)

    Somers, Annemie; Claus, Barbara; Vandewoude, Koen; Petrovic, Mirko

    2016-03-01

    This article summarizes the experience with the development of clinical pharmacy services in the Ghent University Hospital in Belgium. Implementation of clinical pharmacy services in Belgian hospitals has not been evident because these activities were initially not structurally financed. The aim is to describe the strengths and weaknesses of the clinical pharmacy development process, and the milestones that enhanced the progress. Furthermore, the organisation of clinical pharmacy in the Ghent University Hospital is explained, including back- and front-office activities, seamless pharmaceutical care and medication safety improvement. Some working methods, procedures and tools are explained for different clinical pharmacy services. In particular, the clinical pharmacy projects for geriatric patients as well as the preparation of clinical pharmacy services for the accreditation process are explained. We also reflect on the organisation model and the future development of clinical pharmacy, taking into consideration facilitators and potential barriers.

  18. Occupational Accidents among Clinical Staff of Tabriz University Hospitals

    Directory of Open Access Journals (Sweden)

    Leila Sahebi

    2015-07-01

    Full Text Available ​Background and Objectives : Occupational health and safety is one of the most important issues in the workplace. The purpose of this study was to explore the one –year prevalence of occupational accidents in Tabriz University hospitals. Materials and Methods : A cross-sectional study was conducted on 400 patients of seven university hospitals using researcher made questionnaire. The hospitals were selected based on their specialty of the service. Then, one hospital was selected from each specialty using random selection method. Univariate and multiple regression analyses were employed. The SPSS version 19 was used for data analysis. Results : The one-year prevalence of workplace accident was %21. Women were encountered in workplace accidents more than men (%31.1 vs. % 26.8. The youngest age group (20-30 years experienced the most workplace accidents (%41.5. Carelessness was the main cause of the workplace accidents (%49.3. Reporting rate of the occupational accidents was% 48.3 and the most common cause for not reporting was the fear of being recognized as a less competent individual. Sick leaves due to the severity of the accident was reported %23 (median: 5 days. Over %90 of the accident victims had experienced severe stress and job pressure within the previous year. In multiple regression models, the young staff (20-30 years with severe stress, job pressure and verbal violence victim had more chance of workplace accident.   Conclusion : In addition to the high prevalence of workplace accidents, intensity and consequences of workplace accidents should be considered as well. Providing appropriate methods including prevention of accidents and education of safety along with the assistance of technical staff, managers and attendants would be helpful.

  19. Radon in dwellings the national radon survey Galway and Mayo

    International Nuclear Information System (INIS)

    McGarry, A.T.; Fennell, S.G.; Mackin, G.M.; Madden, J.S.; O'Colmain, M.

    1999-07-01

    This report presents the results of the final phase of the National Radon Survey carried out by the Radiological Protection Institute of Ireland. The counties included in this phase are Galway and Mayo. The average radon concentrations for the houses measured in these counties were 112 Bq/m 3 and 100 Bq/m 3 , respectively. The measurement data were grouped on the basis of the 10 km grid squares of the Irish National Grid System and used to predict the percentage of dwellings in each grid square which exceeds the Reference Level of 200 Bq/m 3 . Grid squares where this percentage is predicted to be 10% or higher are designated High Radon Areas. The health effects of exposure to high radon levels are discussed and recommendations are made regarding both new and existing dwellings. (author)

  20. Clinical Engeneering Experience at the Hospital of the State University of Londrina

    OpenAIRE

    Ernesto Fernando Ferreyra Ramírez

    2002-01-01

    This paper describes the four-year experience of implementation of Clinical Engineering services at the Hospital of the State University of Londrina (HURNP/UEL). It was performed by the Electrical Engineering Department (DEEL), through a project involving lecturers and students from the Electrical and Civil Engineering Courses of the same university. The main objectives were the formation of human resources in the Clinical Engineering area and a positive contribution to the healthcare service...

  1. [Universal ethical principles and their application in clinical drug trials].

    Science.gov (United States)

    Gonorazky, Sergio Eduardo

    2015-03-01

    Since 1931, and especially since the Nuremberg Code of 1947, an increasing number of declarations, regulations, norms, guidelines, laws, resolutions, and rules intended to create conditions for better protection of subjects participating in research studies have been published, although some have meant setbacks in the human rights of vulnerable populations. As such, violations of the dignity of experimental subjects in clinical trials continue. What researchers investigate and how the research is done, the quality and transparency of the data, and the analysis and the publication of results (of both raw and processed data) respond to the financial interests of the pharmaceutical companies, coming into permanent tension with bioethical principles and the needs of society. The active participation of civil society is necessary to make it so that pharmaceutical research, results and applications subordinate economic benefits to the protection of human rights.

  2. Development of a Clinical Pharmacology Graduate Program at the University of Kentucky.

    Science.gov (United States)

    Blouin, Robert A.; And Others

    1994-01-01

    The structure, components, and anticipated outcomes of a University of Kentucky doctoral program in pharmacology are described. The program is designed to develop pharmacy-trained specialists who are interested in rigorous, intensive clinical experience, state-of-the-art coursework, and integrated laboratory-based and clinical dissertation…

  3. Evaluation of radiological service of Dental Clinic, Uberlandia Federal University (MG-Brazil)

    International Nuclear Information System (INIS)

    Vieira, C.D.V.T.

    1985-01-01

    The management related problems and the quality of dental radiographs of the Radiographic Service of the Dental Clinic, Uberlandia Federal University (MG-Brazil) are evaluated. The results are based on the examinations of 404 dental files from patients atending the Dental Clinic in 1983. Frequency distribution, mean and percentages were computed for the variables studied. (M.A.C.) [pt

  4. IMPACT OF CLINICAL-TRIALS ON THE ADOPTION OF NEW DRUGS WITHIN A UNIVERSITY HOSPITAL

    NARCIS (Netherlands)

    DENIG, P; HAAIJER-RUSKAMP, FM; WESSELING, H

    1991-01-01

    To assess the influence that clinical trials may have on the introduction of new drugs into prescribing routines, the adoption of drugs has been studied in a university hospital in the Netherlands. A significant relation was found between the testing of semi-innovative drugs in clinical trials in

  5. Patient satisfaction and acceptability: a journey through an ambulatory gynaecology clinic in the West of Ireland

    LENUS (Irish Health Repository)

    Uzochukwu, I

    2016-06-01

    Ambulatory Gynaecology allows a “see-and-treat” approach to managing gynaecological conditions, providing a more streamlined, integrated care pathway than the traditional gynaecology clinic and inpatient care model. This study was designed to assess patient satisfaction and acceptability of Ambulatory Gynaecology services in Mayo University Hospital, Castlebar, Ireland. It also provided for feedback from patients as to how the service might be improved. \\r\

  6. [Clinical pharmacy practice education in master's course of Meijo University in affiliation with medical school].

    Science.gov (United States)

    Matsuba, Kazuhisa

    2009-08-01

    In 2003, Meijo University has developed a new program to train students in master's degree in the field of clinical practice. This new curriculum has three big pillars of educational goal: Problem-Based Learning (PBL), communication skill and clinical pharmacy practice training. Before exposing students to clinical training, they must learn first how to solve various patients' problems through PBL and enhance their communication skill. To provide a clinical environment, education and training, the Faculty of Pharmacy cooperated with the School of Medicine of Fujita Health University. Master's students together with other members of the healthcare team observe patient's disease state and most especially monitor pharmacotherapy. At first, students will be trained for a month at the pharmacy division and experience one week-nursing job. Next, they will be trained at the clinical divisions such as General Internal Medicine, Cardiology, Endocrinology, Gastroenterology, Respiratory Medicine, Hematology, Chemotherapy, Gastroenterological Surgery, Psychiatry, and Emergency Unit. Students rotate three-month training on four clinical divisions during one year. The head physicians of the medical department hold concurrent post as professors and share responsibility with the pharmacy faculty in training the students. To have its venue where students, faculty and physicians conduct their discussion on clinical cases, a pharmacy satellite seminar class room was set up at Fujita Health University hospital. Through this, pharmacy students and faculty had more opportunities to exchange knowledge on medicine and pharmacy. Master's students are expected to acquire professionalism, ethical knowledge and pharmaceutical care skills through the clinical pharmacy practice program.

  7. Compare Clinical Competence and Job Satisfaction Among Nurses Working in Both University and Non-University Hospital in Bushehr 2015

    Directory of Open Access Journals (Sweden)

    Abdolrasoul Abbasi

    2017-04-01

    Full Text Available Background: Nurses are the biggest component of the health care system in the world and their job satisfaction and clinical competence affect performance and success of the organization. This study aimed to determine and compare the clinical competence and job satisfaction of nurses in both academic and non-academic hospitals in Bushehr in 2015. Materials & Methods: In this cross-sectional study, 257 nurses were studied in two hospitals of Bushehr city selected by census method. Data was collected by using valid and reliable Nurse Clinical Competence and Job Satisfaction Inventory questionnaires. Data analyzed by using SPSS- 21, and descriptive statistics, t-test, and ANOVA and Pearson correlation coefficient. Statistical significance was set at P< 0.05. Results: Findings showed that there were no significant diffrences between academic hospital nurses' job satisfaction with 126.96±29.34 and non-academic hospital with 128.31±23.26. Also, there were a significant diffrences between total score of nurses' clinical competence in academic hospital 62.18±18.09 and in non-academic hospital 67.78±17.64. There were a significant and direct association between the clinical competence and job satisfaction of nurses in both hospitals (p≤0.05. Conclusion: Although nurses clinical competence and job satisfaction in both hospitals were assessed at desirable level but both criteria were higher in non-university hospital nurses. It is nessessary that Nurse Manager’s of academic hospitals should pay attention to assessment and improvement of nurse clinical competence and job satisfaction

  8. The Anxiety Disorder Clinic for Children and Adolescents (TADCCA) at Aarhus University in Denmark

    DEFF Research Database (Denmark)

    Thastum, Mikael

    2013-01-01

    for children with anxiety problems. The second case study is one of the total group of six families in which Erik was participating; as such it includes a summary of Erik's case in the context of the other five who participated. The group was conducted by a combination of a senior doctoral clinical...... psychologist and eight students. They were part of a training clinic, called The Anxiety Disorder Clinic for Children and Adolescents (TADCCA), in the Educational and Research Clinic of the Department of Psychology at Aarhus University in Aarhus, Denmark. This article describes the background and context...

  9. Clinical Engeneering Experience at the Hospital of the State University of Londrina

    Directory of Open Access Journals (Sweden)

    Ernesto Fernando Ferreyra Ramírez

    2002-01-01

    Full Text Available This paper describes the four-year experience of implementation of Clinical Engineering services at the Hospital of the State University of Londrina (HURNP/UEL. It was performed by the Electrical Engineering Department (DEEL, through a project involving lecturers and students from the Electrical and Civil Engineering Courses of the same university. The main objectives were the formation of human resources in the Clinical Engineering area and a positive contribution to the healthcare services offered by the HURNP for the community in the surroundings of Londrina – Paraná State – Brazil.

  10. Nurse awareness of clinical research: a survey in a Japanese University Hospital

    Science.gov (United States)

    2014-01-01

    Background Clinical research plays an important role in establishing new treatments and improving the quality of medical practice. Since the introduction of the concept of clinical research coordinators (CRC) in Japan, investigators and CRC work as a clinical research team that coordinates with other professionals in clinical trials leading to drug approval (registration trials). Although clinical nurses collaborate with clinical research teams, extended clinical research teams that include clinical nurses may contribute to the ethical and scientific pursuit of clinical research. Methods As knowledge of clinical research is essential for establishing an extended clinical research team, we used questionnaires to survey the knowledge of clinical nurses at Tokushima University Hospital. Five-point and two-point scales were used. Questions as for various experiences were also included and the relationship between awareness and experiences were analyzed. Results Among the 597 nurses at Tokushima University Hospital, 453 (75.9%) responded to the questionnaires. In Japan, registration trials are regulated by pharmaceutical affairs laws, whereas other types of investigator-initiated research (clinical research) are conducted based on ethical guidelines outlined by the ministries of Japan. Approximately 90% of respondents were aware of registration trials and clinical research, but less than 40% of the nurses were aware of their difference. In clinical research terminology, most respondents were aware of informed consent and related issues, but ≤50% were aware of other things, such as the Declaration of Helsinki, ethical guidelines, Good Clinical Practice, institutional review boards, and ethics committees. We found no specific tendency in the relationship between awareness and past experiences, such as nursing patients who were participating in registration trials and/or clinical research or taking a part in research involving patients as a nursing student or a nurse

  11. Mida mõtleb professor Andrew Mayo? / Anne-Mari Ernesaks

    Index Scriptorium Estoniae

    Ernesaks, Anne-Mari

    2005-01-01

    PARE koordinaator tutvustab tuntud inimkapitali ideoloogi Andrew Mayo raamatut "Ettevõtte inimväärtus". Raamatu autori hinnangul on tänapäeva organisatsioonides juhtimise olulisim ülesanne inimese juhtimine varana. Lisa: Konverents

  12. Consultation clinics for complementary and alternative medicine at Japanese university hospitals: An analysis at Tokushima University Hospital

    Science.gov (United States)

    YANAGAWA, HIROAKI; TERAO, JUNJI; TAKEDA, EIJI; TAKAISHI, YOSHIHISA; KASHIWADA, YOSHIKI; KAWAZOE, KAZUYOSHI; FUSHITANI, SHUJI; TSUCHIYA, KOICHIRO; YAMAUCHI, AIKO; SATO, CHIHO; IRAHARA, MINORU

    2010-01-01

    Here, we report on a Consultation Clinic for Complementary and Alternative Medicine (CAM) which we established at Tokushima University Hospital in July of 2007 with the aim of providing person-to-person information on CAM, though not CAM therapy itself. In December of 2008, we received 55 applications for consultation, 37% concerning health foods, 37% Japanese herbal medicine (Kampo), and 26% various other topics. The consultants (nutritionists and pharmacists) communicated individually with 38 applicants; malignancies (26%) and cardiovascular disease (24%) were the main underlying concerns. To promote the quality of consultation, data was collected by means of focus group interviews concerning the perspective of the consultants. Safe and effective use of CAM requires a network of communication linking individuals, consultation teams, physicians, primary care institutions and university hospitals. To advance this goal, we plan to broaden the efforts described herein. Our findings indicate that the specific role of the consultation clinic in promoting the scientific use of CAM merits further study. PMID:22993564

  13. Mapping the Mayo-Portland adaptability inventory to the international classification of functioning, disability and health.

    Science.gov (United States)

    Lexell, Jan; Malec, James F; Jacobsson, Lars J

    2012-01-01

    To examine the contents of the Mayo-Portland Adaptability Inventory (MPAI-4) by mapping it to the International Classification of Functioning, Disability and Health (ICF). Each of the 30 scoreable items in the MPAI-4 was mapped to the most precise ICF categories. All 30 items could be mapped to components and categories in the ICF. A total of 88 meaningful concepts were identified. There were, on average, 2.9 meaningful concepts per item, and 65% of all concepts could be mapped. Items in the Ability and Adjustment subscales mapped to categories in both the Body Functions and Activity/Participation components of the ICF, whereas all except 1 in the Participation subscale were to categories in the Activity/Participation component. The items could also be mapped to 34 (13%) of the 258 Environmental Factors in the ICF. This mapping provides better definition through more concrete examples (as listed in the ICF) of the types of body functions, activities, and participation indicators that are represented by the 30 scoreable MPAI-4 items. This may assist users throughout the world in understanding the intent of each item, and support further development and the possibility to report results in the form of an ICF categorical profile, making it universally interpretable.

  14. THE INCIDENCE OF CAESAREAN SECTIONS IN THE UNIVERSITY CLINICAL CENTER OF KOSOVO

    OpenAIRE

    Elshani, Brikene; Daci, Armond; Gashi, Sanije; Lulaj, Shefqet

    2012-01-01

    Introduction: As in most countries of the world also at Kosovo the rate of Cesarean section from year to year is increasing. Aim: The main purpose of this paper was to present the incidence of births completed by Caesarean section at the Clinic of Gynecology and Obstetrics of University Clinical Center of Kosovo in Prishtin?. Material and methods: This study is retrospective, namely its made by collecting epidemiological data from patients? histories that completed birth by Caesarean section ...

  15. Psychology at Chinese universities and in Chinese society: with special reference to clinical psychology

    OpenAIRE

    Yue, Guoan; Perrez, Meinrad; Han, Xiulan

    2011-01-01

    The following contribution gives a short introduction to Chinese psychology, history, psychological research and teaching institutions and student selection for universities. After a brief overview of the theoretical traditions and contemporary trends in general and experimental psychology it focuses in more detail on the recent developments in clinical and medical psychology. Research domains, academic training in clinical psychology and its applications in modern China are discussed with sp...

  16. Managing out of hours clinical photography at the University Hospitals Bristol.

    Science.gov (United States)

    Brinkworth, Simon; Kenny, Alice; Knights, Christina

    2018-04-01

    In recent years, Medical Illustration at University Hospitals Bristol (UHBristol) NHS Foundation Trust has seen a steady increase in photography requests, including the need for out of hours photography provision. This paper details how Medical Illustration at UHBristol decided to manage an out of hours clinical photography service.

  17. Transition from Clinical Manager to University Lecturer: A Self-Reflective Case Study

    Science.gov (United States)

    Oldland, Elizabeth

    2011-01-01

    This paper is a case study exploring the author's use of reflective practice to facilitate the transition in role from a clinical manager with teaching responsibilities in a critical care unit to university lecturer. The similarities and differences in the roles with respect to learner characteristics, teaching contexts and effective teaching…

  18. Herpes Simplex Virus Infection in a University Health Population: Clinical Manifestations, Epidemiology, and Implications

    Science.gov (United States)

    Horowitz, Robert; Aierstuck, Sara; Williams, Elizabeth A.; Melby, Bernette

    2010-01-01

    Objective: The authors described clinical presentations of oral and genital herpes simplex virus (HSV) infections in a university health population and implications of these findings. Participants and Methods: Using a standardized data collection tool, 215 records of patients with symptomatic culture-positive HSV infections were reviewed. Results:…

  19. Comparing the organisational structure of the preoperative assessment clinic at eight university hospitals

    NARCIS (Netherlands)

    Edward, G. M.; Biervliet, J. D.; Hollmann, M. W.; Schlack, W. S.; Preckel, B.

    2008-01-01

    The preoperative assessment clinic (PAC) has been implemented in most major hospitals. However, there is no uniformity in the way PACs are organised. We compared the organisational structure of the PACs from all eight university hospitals in The Netherlands, looking at the following variables:

  20. Medication therapy management clinic: perception of healthcare professionals in a University medical center setting

    Directory of Open Access Journals (Sweden)

    Shah M

    2013-09-01

    Full Text Available Objective: To determine the overall perception and utilization of the pharmacist managed medication therapy management (MTM clinic services, by healthcare professionals in a large, urban, university medical care setting.Methods: This was a cross-sectional, anonymous survey sent to 195 healthcare professionals, including physicians, nurses, and pharmacists at The University of Illinois Outpatient Care Center to determine their perception and utilization of the MTM clinic. The survey consisted of 12 questions and was delivered through a secure online application. Results: Sixty-two healthcare professionals (32% completed the survey. 82% were familiar with the MTM clinic, and 63% had referred patients to the clinic. Medication adherence and disease state management was the most common reason for referral. Lack of knowledge on the appropriate referral procedure was the prominent reason for not referring patients to the MTM clinic. Of the providers that were aware of MTM services, 44% rated care as ‘excellent’, 44% as ‘good’, 5% as ‘fair’, and 0% stated ‘poor’. Strengths of MTM clinic identified by healthcare providers included in-depth education to patients, close follow-up, and detailed medication reconciliation provided by MTM clinic pharmacists. Of those familiar with MTM clinic, recommendations included; increase marketing efforts to raise awareness of the MTM clinic service, create collaborative practice agreements between MTM pharmacists and physicians, and ensure that progress notes are more concise.Conclusion: In a large, urban, academic institution MTM clinic is perceived as a valuable resource to optimize patient care by providing patients with in-depth education as it relates to their prescribed medications and disease states. These identified benefits of MTM clinic lead to frequent patient referrals specifically for aid with medication adherence and disease state management.

  1. Implementing ward based clinical pharmacy services in an Ethiopian University Hospital

    Directory of Open Access Journals (Sweden)

    Mekonnen AB

    2013-03-01

    Full Text Available Background: Clinical pharmacy practice has developed internationally to expand the role of a pharmacist well beyond the traditional roles of compounding, dispensing and supplying drugs to roles more directly in caring for patients. Studies on the activities of the clinical pharmacist in an inpatient ward in resource constrained settings are scarce, however.Objective: To assess ward based clinical pharmacy services in an internal medicine ward of Jimma University Specialized Hospital. Methods: The study was carried out in the internal medicine ward from March to April, 2011 at Jimma University Specialized Hospital. The study design was a prospective observational study where pharmaceutical care services provided by clinical pharmacists for inpatients were documented over a period of two months. Interventions like optimization of rational drug use and physician acceptance of these recommendations were documented. Clinical significance of interventions was evaluated by an independent team (1 internist, 1 clinical pharmacologist using a standardized method for categorizing drug related problems (DRPs. Results: A total of 149 drug related interventions conducted for 48 patients were documented; among which 133(89.3% were clinical pharmacists initiated interventions and 16(10.7% interventions were initiated by other health care professionals. The most frequent DRPs underlying interventions were unnecessary drug therapy, 36(24.2%; needs additional drug therapy, 34(22.8% and noncompliance, 29(19.5%. The most frequent intervention type was change of dosage/instruction for use, 23(15.4%. Acceptance rate by physicians was 68.4%. Among the interventions that were rated as clinically significant, 46(48.9% and 25(26.6% had major and moderate clinical importance respectively. Conclusion: Involving trained clinical pharmacists in the healthcare team leads to clinically relevant and well accepted optimization of medicine use in a resource limited settings. This

  2. Comparing the organisational structure of the preoperative assessment clinic at eight university hospitals.

    Science.gov (United States)

    Edward, G M; Biervliet, J D; Hollmann, M W; Schlack, W S; Preckel, B

    2008-01-01

    The preoperative assessment clinic (PAC) has been implemented in most major hospitals. However, there is no uniformity in the way PACs are organised. We compared the organisational structure of the PACs from all eight university hospitals in The Netherlands, looking at the following variables: number of patients visiting the PAC, staffing of the PAC, opening hours, scheduling, and additional preoperative diagnostic testing. The number of patients seen yearly varies from 7.000 to 13.500. In all clinics, the preoperative assessment was performed by anaesthetists and residents. In five PACs, preoperative assessment was also performed by physician assistants or nurse practitioners. Opening hours varied. Consultations are by appointment, 'walk-in', or a combination of these two. In four clinics additional testing is performed at the PAC itself. This study shows that the organisational structure of the PAC at similar university hospitals varies greatly; this can have important implications when designing a benchmarking process.

  3. Further psychometric evaluation and revision of the Mayo-Portland Adaptability Inventory in a national sample.

    Science.gov (United States)

    Malec, James F; Kragness, Miriam; Evans, Randall W; Finlay, Karen L; Kent, Ann; Lezak, Muriel D

    2003-01-01

    To evaluate the internal consistency of the Mayo-Portland Adaptability Inventory (MPAI), further refine the instrument, and provide reference data based on a large, geographically diverse sample of persons with acquired brain injury (ABI). 386 persons, most with moderate to severe ABI. Outpatient, community-based, and residential rehabilitation facilities for persons with ABI located in the United States: West, Midwest, and Southeast. Rasch, item cluster, principal components, and traditional psychometric analyses for internal consistency of MPAI data and subscales. With rescoring of rating scales for 4 items, a 29-item version of the MPAI showed satisfactory internal consistency by Rasch (Person Reliability=.88; Item Reliability=.99) and traditional psychometric indicators (Cronbach's alpha=.89). Three rationally derived subscales for Ability, Activity, and Participation demonstrated psychometric properties that were equivalent to subscales derived empirically through item cluster and factor analyses. For the 3 subscales, Person Reliability ranged from.78 to.79; Item Reliability, from.98 to.99; and Cronbach's alpha, from.76 to.83. Subscales correlated moderately (Pearson r =.49-.65) with each other and strongly with the overall scale (Pearson r=.82-.86). Outcome after ABI is represented by the unitary dimension described by the MPAI. MPAI subscales further define regions of this dimension that may be useful for evaluation of clinical cases and program evaluation.

  4. Factor analysis of the Mayo-Portland Adaptability Inventory: structure and validity.

    Science.gov (United States)

    Bohac, D L; Malec, J F; Moessner, A M

    1997-07-01

    Principal-components (PC) factor analysis of the Mayo-Portland Adaptability Inventory (MPAI) was conducted using a sample of outpatients (n = 189) with acquired brain injury (ABI) to evaluate whether outcome after ABI is multifactorial or unifactorial in nature. An eight-factor model was derived which explained 64-4% of the total variance. The eight factors were interpreted as representing Activities of Daily Living, Social Initiation, Cognition, Impaired-Self-awareness/Distress, Social Skills/ Support, Independence, Visuoperceptual, and Psychiatric, respectively. Validation of the Cognition factor was supported when factor scores were correlated with various neuropsychological measures. In addition, 117 patient self-rating total scores were used to evaluate the Impaired Self-awareness/Distress factor. An inverse relationship was observed, supporting this factor's ability to capture the two-dimensional phenomena of diminished self-awareness or enhanced emotional distress. A new subscale structure is suggested, that may allow greater clinical utility in understanding how ABI manifests in patients, and may provide clinicians with a better structure for implementing treatment strategies to address specific areas of impairment and disability for specific patients. Additionally, more precise measurement of treatment outcomes may be afforded by this reorganization.

  5. Exploring the uncertainties of early detection results: model-based interpretation of mayo lung project

    Directory of Open Access Journals (Sweden)

    Berman Barbara

    2011-03-01

    Full Text Available Abstract Background The Mayo Lung Project (MLP, a randomized controlled clinical trial of lung cancer screening conducted between 1971 and 1986 among male smokers aged 45 or above, demonstrated an increase in lung cancer survival since the time of diagnosis, but no reduction in lung cancer mortality. Whether this result necessarily indicates a lack of mortality benefit for screening remains controversial. A number of hypotheses have been proposed to explain the observed outcome, including over-diagnosis, screening sensitivity, and population heterogeneity (initial difference in lung cancer risks between the two trial arms. This study is intended to provide model-based testing for some of these important arguments. Method Using a micro-simulation model, the MISCAN-lung model, we explore the possible influence of screening sensitivity, systematic error, over-diagnosis and population heterogeneity. Results Calibrating screening sensitivity, systematic error, or over-diagnosis does not noticeably improve the fit of the model, whereas calibrating population heterogeneity helps the model predict lung cancer incidence better. Conclusions Our conclusion is that the hypothesized imperfection in screening sensitivity, systematic error, and over-diagnosis do not in themselves explain the observed trial results. Model fit improvement achieved by accounting for population heterogeneity suggests a higher risk of cancer incidence in the intervention group as compared with the control group.

  6. VCT clinic HIV burden and its link with HIV care clinic at the University of Gondar hospital

    Directory of Open Access Journals (Sweden)

    Alemie Getahun

    2012-11-01

    Full Text Available Abstract Background Voluntary Counselling and Testing (VCT is an important component of any HIV/AIDS control and prevention activities. VCT makes people aware of their HIV serostatus and enables early identification of those who need care. It is an important link to HIV care and support. The main aim of this study is to describe the HIV burden at VCT and define the relationship between the VCT Center and the HIV Chronic Care Clinic of the University of Gondar (UoG Hospital. Methods It is a record based descriptive study undertaken by using data collected by health professionals at the VCT center and the HIV chronic care clinic of the UoG Hospital. Patient data collected from 2005/06 to 2008/09 was investigated. Analysis was carried out using the SPSS version 16.0. Results A total of 19,168 people were tested for HIV and a prevalence of 25.4% was obtained. 4298 HIV positive people were referred to the HIV chronic care clinic but only 27% actually registered at the clinic. Chi-square analyses showed residence, age and time of VCT visit showed significant relations with hospital care attendance. Conclusion The overall HIV prevalence is high. The data obtained at the HIV care clinic regarding patients’ clinical conditions at acceptance were incomplete. Improvements are required on the link between VCT and HIV care and documentation of data.

  7. Eighteen-month Clinical Study of Universal Adhesives in Noncarious Cervical Lesions.

    Science.gov (United States)

    Ruschel, V C; Shibata, S; Stolf, S C; Chung, Y; Baratieri, L N; Heymann, H O; Walter, R

    To evaluate the clinical performance of Scotchbond Universal (3M Oral Care) and Prime & Bond Elect (Dentsply Sirona) in the restoration of noncarious cervical lesions (NCCLs). This was a randomized controlled clinical trial involving 63 subjects. Two hundred and three NCCLs were restored using Scotchbond Universal and Prime & Bond Elect using both an etch-and-rinse and a self-etch technique. Lesions were notch-shaped NCCLs, and the restorations were placed without any mechanical retention. Restorations were finished immediately after placement and scored with regard to retention, marginal discoloration, marginal adaptation, and secondary caries. Similar assessment of the restorations was performed 18 months after placement. Logistic regression was performed for each outcome separately with a compound symmetric variance-covariance structure assumed to consider a correlation of restorations within subjects. All analyses were conducted using SAS version 9.4 (SAS Inc). One hundred and fifty-eight teeth (77.8% of the restorations placed) in 46 subjects (73% of subjects enrolled) were available for the 18-month follow-up. A statistically significant difference was reached only for the comparison Scotchbond Universal/self-etch (SU_SE) and Prime & Bond Elect/etch-and-rinse (PBE_E&R) groups ( p=0.01), where a restoration with SU_SE was 66% less likely to maintain a score of Alpha for marginal discoloration than a restoration performed with PBE_E&R. Scotchbond Universal and Prime & Bond Elect presented acceptable clinical performance after 18 months of clinical service. However, Scotchbond Universal, when applied with a self-etch approach, did demonstrate a relatively high level of marginal discoloration when compared to the other groups.

  8. Clinical nurses' attitudes towards research, management and organisational resources in a university hospital: part 1.

    Science.gov (United States)

    Akerjordet, Kristin; Lode, Kirsten; Severinsson, Elisabeth

    2012-09-01

    The aim of this study was to determine clinical nurses' interest in and motivation for research. An additional aim was to identify management and organisational resources in order to improve nurses' research capacity in practice. Clinical nurses find conducting research challenging, which accords with observations of the continuing research-practice gap. This descriptive cross-sectional survey sampled 364 clinical nurses from a university hospital on the west coast of Norway. The response rate was 61%. An increasingly positive attitude towards research emerged (40%), despite the fact that few were engaged in research-based activities. Clinical nurses emphasised that lack of designated time (60%), interest (31%) and knowledge (31%) constituted important research barriers, as did lack of research supervision and support (25%). Research supervision was one of the most significant needs to enhance clinical nurses' research skills, management and organisation of research activities (30%). Conscious efforts strategically built on clinical and academic collaborative networks are required to promote and sustain clinical nurses' research capacity. The findings of this survey should be useful in the building of clinical nurses' research capacity. © 2012 Blackwell Publishing Ltd.

  9. Perceptions of Students and Clinical Instructors of Academic Learning Environments at Yazd University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Hamideh Montazeri

    2012-12-01

    Full Text Available Introduction: The purpose of this cross sectional study is to gain insight into the students and clinical instructors’ perception of learning environments at Yazd medical University in 2012. Various aspects of environment are compared between courses, gender and age. Students and instructors’ perspectives are reported. Methods: The sample consisted of 158 undergraduate students in their final year of graduation in the nursing, anesthesia, operating room, laboratory, radiology, midwifery courses and their 20 clinical instructors at Yazd University. Data were obtained using the Dundee Ready Education Environment Measure (DREEM. Scores were compared across grouping variables identified via demographic information. Results: Scores were fairly high for both students and clinical instructors (M=110.0; SD=21.2 and M=93.1; SD=10.3 respectively, indicating an overall positive perception of learning environments between both groups. The perception of atmosphere subscale (PA received the highest mean grade by both groups. Total DREEM scores didn’t vary significantly between courses (p>0.05 but the results of ANOVA test showed significant differences only for perception of teaching and perception of atmosphere domains. There was not a significant association between females and males regarding total DREEM score (p>0.05. Conclusions: The more positive than negative perception held by the Yazd University health science students and instructors is hopefully indicative of a favorable teaching-learning environment. Overall; teachers’ attention to principles of educational design and setting a favorable environment to promote better learning is recommended.

  10. Universal Versus Targeted Screening for Lynch Syndrome: Comparing Ascertainment and Costs Based on Clinical Experience.

    Science.gov (United States)

    Erten, Mujde Z; Fernandez, Luca P; Ng, Hank K; McKinnon, Wendy C; Heald, Brandie; Koliba, Christopher J; Greenblatt, Marc S

    2016-10-01

    Strategies to screen colorectal cancers (CRCs) for Lynch syndrome are evolving rapidly; the optimal strategy remains uncertain. We compared targeted versus universal screening of CRCs for Lynch syndrome. In 2010-2011, we employed targeted screening (age Lynch syndrome and estimated the 5-year costs of preventing CRC by colonoscopy screening, using a system dynamics model. Using targeted screening, 51/175 (29 %) cancers fit criteria and were tested by immunohistochemistry; 15/51 (29 %, or 8.6 % of all CRCs) showed suspicious loss of ≥1 mismatch repair protein. Germline mismatch repair gene mutations were found in 4/4 cases sequenced (11 suspected cases did not have germline testing). Using universal screening, 17/292 (5.8 %) screened cancers had abnormal immunohistochemistry suspicious for Lynch syndrome. Germline mismatch repair mutations were found in only 3/10 cases sequenced (7 suspected cases did not have germline testing). The mean cost to identify Lynch syndrome probands was ~$23,333/case for targeted screening and ~$175,916/case for universal screening at our institution. Estimated costs to identify and screen probands and relatives were: targeted, $9798/case and universal, $38,452/case. In real-world Lynch syndrome management, incomplete clinical follow-up was the major barrier to do genetic testing. Targeted screening costs 2- to 7.5-fold less than universal and rarely misses Lynch syndrome cases. Future changes in testing costs will likely change the optimal algorithm.

  11. Promoting fundamental clinical skills: a competency-based college approach at the University of Washington.

    Science.gov (United States)

    Goldstein, Erika A; Maclaren, Carol F; Smith, Sherilyn; Mengert, Terry J; Maestas, Ramoncita R; Foy, Hugh M; Wenrich, Marjorie D; Ramsey, Paul G

    2005-05-01

    The focus on fundamental clinical skills in undergraduate medical education has declined over the last several decades. Dramatic growth in the number of faculty involved in teaching and increasing clinical and research commitments have contributed to depersonalization and declining individual attention to students. In contrast to the close teaching and mentoring relationship between faculty and students 50 years ago, today's medical students may interact with hundreds of faculty members without the benefit of a focused program of teaching and evaluating clinical skills to form the core of their four-year curriculum. Bedside teaching has also declined, which may negatively affect clinical skills development. In response to these and other concerns, the University of Washington School of Medicine has created an integrated developmental curriculum that emphasizes bedside teaching and role modeling, focuses on enhancing fundamental clinical skills and professionalism, and implements these goals via a new administrative structure, the College system, which consists of a core of clinical teachers who spend substantial time teaching and mentoring medical students. Each medical student is assigned a faculty mentor within a College for the duration of his or her medical school career. Mentors continuously teach and reflect with students on clinical skills development and professionalism and, during the second year, work intensively with them at the bedside. They also provide an ongoing personal faculty contact. Competency domains and benchmarks define skill areas in which deepening, progressive attention is focused throughout medical school. This educational model places primary focus on the student.

  12. [Effectiveness of cognitive-behavioral therapy in childhood anxiety disorders in a university psychiatric outpatient clinic].

    Science.gov (United States)

    Goletz, Hildegard; Yang, Young-Im; Suhr-Dachs, Lydia; Walter, Daniel; Döpfner, Manfred

    2013-07-01

    Only few studies have examined whether the efficacy of cognitive-behavioral therapy for childhood anxiety disorders as demonstrated in randomized controlled trials (RCTs) generalizes to clinical practice. This study examines the effectiveness of cognitive-behavioral therapy for juvenile anxiety disorders under routine care conditions in a university-based psychiatric outpatient clinic. 92 children and adolescents with parent-ratings regarding anxiety and comorbid symptoms and 61 children and adolescents with self-ratings regarding anxiety and comorbid symptoms were treated with cognitive-behavioral interventions. Pre/post mean comparisons, effect sizes, and the clinical significance of changes in symptoms were examined. The effect size for reduction of anxiety symptoms was .81 for children whose parents had completed the rating scale and .79 for children who had filled in a self-rating scale. Effect sizes for reduction of comorbid symptoms varied between .37 and .84 for parent ratings and between .21 and .62 for self-ratings. The percentage of children and adolescents who achieved clinically significant improvements in anxiety symptoms was 55.1 % according to the parent ratings and 65.7 % according to the children's self-ratings. More than 50 % of parents and children reported clinically significant improvements in comorbid symptoms. Significant reductions in both anxiety and comorbid symptoms were demonstrated over the course of cognitive-behavioral therapy of juvenile anxiety disorders in a university psychiatric outpatient clinic. The effect sizes for anxiety symptoms were found to be comparable to the effect sizes reported in RCTs. Similarly, clinically significant improvements were as frequent as the rates of remission of anxiety symptoms reported in RCTs.

  13. Oral candidiasis as clinical manifestation of HIV/AIDS infection in Airlangga University hospital patients

    Science.gov (United States)

    Putranti, A.; Asmarawati, T. P.; Rachman, B. E.; Hadi, U.; Nasronudin

    2018-03-01

    The purpose of this study was to determine the characteristics of HIV/AIDS patients with oral candidiasis as its clinical manifestation at Airlangga University Hospital Surabaya. This is a descriptive analytic research with cross-sectional design using Chi-Square statistic test. Samples of this study consist of 34 patients using total sampling methods. Those patients were all HIV/AIDS infected patients with oral candidiasis clinical manifestations, who were admitted to Airlangga University Hospital Surabaya from January 2016 to September 2017. Results showed that mostly HIV/AIDS patients with oral candidiasis are male (79.4%), old age (40-75years) total amounted to 58.8%, heterosexual as main risk factor (70%), clinical stadium mostly in stage IV (61.8%), 26% of patients with chronic diarrhea and 56% with pulmonary TB, clinical stages of patients have a significant relation to the incidence of oral candidiasis infection (p=0.024). The most common oral lesions found in people with HIV are Candidiasis. The best management is through routine dental examination and dental precautions to maintain health and achieve a better quality of life.

  14. Job Satisfaction in Basic and Clinical Faculty Members in Shiraz University of Medical Sciences, Iran

    Directory of Open Access Journals (Sweden)

    Mehdi Saberi-Firoozi

    2009-02-01

    Full Text Available Background and Purpose: Shiraz University of Medical Sciences as one of the oldest and largest universities of medicine in Iran with 50 years history has more than 450 faculty members and 5000 students. This study is an attempt to find out the level of job satisfaction among Shiraz University ofMedical Sciences’ faculty members.Methods: In midterm of 2003-2004, data on job satisfaction level among 404 faculty members from all schools of Shiraz University of Medical Sciences were collected. The translation of Spector’s job satisfaction score was used including 34 questions in 9 items of job satisfaction and each one based on Likert’s Scale with score an of 1-5. A question related to overall job satisfaction of faculty members was added.Results: Of all faculties,, 252 responded to the questionnaire and 70.1% expressed satisfaction in response the added question. The mean scores of job satisfaction in items of coworkers, work nature, supervision, management methods, academic relations, promotion, salary and suitable benefits were3.771, 3.265, 2.557, 2.454, 2.395, and 2.376 out of 5 respectively (F=223.8, p=0.0001. In the promotion item, the satisfaction of female faculty was lower than male subjects. The level of job satisfaction was not different between clinical faculty members of Medical School with or without private activity. The results of linear regression analysis between the items of job satisfaction revealed that reimbursement and fringe benefits could predict the overall job satisfaction (r2=0.70, p<0.01.Conclusion: As a whole, the faculty members of the university were satisfied with their jobs, but a correction in reimbursement, benefits and promotion regulations especially in lower academic ranks is needed to improve the level of job satisfaction in this group.Key words: JOB SATISFACTION, FACULTY MEMBER, BASIC AND CLINICAL DEPARTMENTS, FULLTIME, PART-TIME

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

    Directory of Open Access Journals (Sweden)

    Meshkani Z

    2004-07-01

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

  16. Mayo-Portland adaptability inventory: comparing psychometrics in cerebrovascular accident to traumatic brain injury.

    Science.gov (United States)

    Malec, James F; Kean, Jacob; Altman, Irwin M; Swick, Shannon

    2012-12-01

    (1) To evaluate the measurement reliability and construct validity of the Mayo-Portland Adaptability Inventory, 4th revision (MPAI-4) in a sample consisting exclusively of patients with cerebrovascular accident (CVA) using single parameter (Rasch) item-response methods; (2) to examine the differential item functioning (DIF) by sex within the CVA population; and (3) to examine DIF and differential test functioning (DTF) across traumatic brain injury (TBI) and CVA samples. Retrospective psychometric analysis of rating scale data. Home- and community-based brain injury rehabilitation program. Individuals post-CVA (n=861) and individuals with TBI (n=603). Not applicable. MPAI-4. Item data on admission to community-based rehabilitation were submitted to Rasch, DIF, and DTF analyses. The final calibration in the CVA sample revealed satisfactory reliability/separation for persons (.91/3.16) and items (1.00/23.64). DIF showed that items for pain, anger, audition, and memory were associated with higher levels of disability for CVA than TBI patients; whereas, self-care, mobility, and use of hands indicated greater overall disability for TBI patients. DTF analyses showed a high degree of association between the 2 sets of items (R=.92; R(2)=.85) and, at most, a 3.7 point difference in raw scores. The MPAI-4 demonstrates satisfactory psychometric properties for use with individuals with CVA applying for interdisciplinary posthospital rehabilitation. DIF reveals clinically meaningful differences between CVA and TBI groups that should be considered in results at the item and subscale level. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  17. 78 FR 14528 - Mayo Hydropower, LLC, Avalon Hydropower, LLC; Notice of Application for Transfer of License, and...

    Science.gov (United States)

    2013-03-06

    ... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Project No. 11169-029] Mayo Hydropower, LLC, Avalon Hydropower, LLC; Notice of Application for Transfer of License, and Soliciting Comments and Motions To Intervene On November 20, 2012, Mayo Hydropower, LLC (transferor) and Avalon Hydropower...

  18. Certifying a university ENT clinic using the ISO 9001:2000 international standard.

    Science.gov (United States)

    Helbig, Matthias; Helbig, Silke; Kahla-Witzsch, Heike A; Kroll, Tobias; May, Angelika

    2010-01-01

    Against statutory duties to introduce quality management systems, the increased importance of this subject has led to numerous activities in various public health institutions. Following the International Standardization Organization (ISO 9001:2000) prerequisites, Frankfurt Goethe University Hospital ENT clinic staff introduced a quality management system. This paper aims to investigate this process. Designing, planning and implementing the quality management system is described. Under the supervision of an executive quality management board, clinic quality goals were defined. Thereafter, several quality management teams performed an actual state analysis as well as developing and realising improvement proposals. Finally a quality management manual containing binding standards and working instructions concerning all patient care, research and teaching aspects was written. Successful certification by a neutral body ascertained that the clinic's quality management system conformed to current national and international standards while restructuring and reform improved procedural efficiency. The paper shows that mplementing the quality management system requires considerable effort but patients as well as staff profit considerably from the innovation. On the whole, the positive impact on structure and workflow in a specialist clinic predominates. Therefore, implementing a quality management system in all the clinic's wards and departments is recommended.

  19. The etiology and symptoms of endodontic cases treated in a university clinic in Saudi Arabia

    International Nuclear Information System (INIS)

    AlYahya, A. S.; Selirn, H. A.; Guile, E. E.

    1989-01-01

    Endodontic patients treated at a University Dental Clinic over a two year period were studied. A total of 281 patients seen in a beginning endodontic course were analyzed to determine (1) the etiology of the pulpal disease presenting and (2) the signs and symptoms of pulpal disease. Results indicated that caries was the most prevalent reason for endodontic treatment. Most cases (40.6%) were asymptomatic. Lower molars were the most commonly affected and there was no significant difference in endodontic treatment distribution between males and females in the patient population studied. (author)

  20. Measurements of Radon Concentration in Several Wards of the University Clinical Center of Kosovo...

    OpenAIRE

    , Y. Halimi; , S. Kadiri; , G. Hodolli; , B. Xhafa; , A. Jonuzaj

    2016-01-01

    Understanding that what’s the level of environment pollution from radioactive pollutant in some wards of UCCK (University Clinical Center of Kosovo) in Prishtina are made measurements of α radiation which is the product of 222Rn and have been read doses of TLD to some staff workers in three wards of UCCK. All this is done to see the risk level of possible pollution. Concentration of radon 222Rn is measured with device CRM-510 portable instruments. During the measurements the apparatus has rec...

  1. Prácticas de crianza y educación inicial en la etnia Mayo

    Directory of Open Access Journals (Sweden)

    Ángel Vera Noriega

    2010-01-01

    Full Text Available En el artículo se describen las características de las prácticas de crianza en una comunidad mayo y se realiza un análisis documental del Modelo de Educación Inicial no Escolarizada del CONAFE. Ello con la finalidad de contrastar los resultados de la práctica de crianza con las competencias esperadas de los padres y niños que asisten al programa y con base en ello, identificar la eficacia de la implementación del programa para la reproducción social en la etnia mayo. Participaron cincuenta madres y niños de la comunidad indígena mayo "El Júpare" ubicada en el municipio de Huatabampo, al sur de Sonora. Los instrumentos utilizados fueron Índice de Estrés Parental (Abidin, 1990, Interacción Padre-Hijo-Madre (Peña, 2004, Estimulación del Niño en el Hogar (Caldwell y Bradley, 1967 y Escala del Desarrollo Integral del niño (Atkin, 1987. En la evaluación del desarrollo, 54% de los niños presentan un desarrollo normal, 26% rrollo en riesgo y en 20% se detectan problemas. El programa de Educación Inicial no Escolarizado requiere de modificaciones sustantivas para responder a las prácticas de crianza que se desarrollan en la etnia mayo.

  2. A Virtual Mental Health Clinic for University Students: A Qualitative Study of End-User Service Needs and Priorities

    Science.gov (United States)

    Gulliver, Amelia; Chan, Jade KY; Bennett, Kylie; Griffiths, Kathleen M

    2015-01-01

    Background Help seeking for mental health problems among university students is low, and Internet-based interventions such as virtual clinics have the potential to provide private, streamlined, and high quality care to this vulnerable group. Objective The objective of this study was to conduct focus groups with university students to obtain input on potential functions and features of a university-specific virtual clinic for mental health. Methods Participants were 19 undergraduate students from an Australian university between 19 and 24 years of age. Focus group discussion was structured by questions that addressed the following topics: (1) the utility and acceptability of a virtual mental health clinic for students, and (2) potential features of a virtual mental health clinic. Results Participants viewed the concept of a virtual clinic for university students favorably, despite expressing concerns about privacy of personal information. Participants expressed a desire to connect with professionals through the virtual clinic, for the clinic to provide information tailored to issues faced by students, and for the clinic to enable peer-to-peer interaction. Conclusions Overall, results of the study suggest the potential for virtual clinics to play a positive role in providing students with access to mental health support. PMID:26543908

  3. Universe

    CERN Document Server

    2009-01-01

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

  4. NASA/DARPA advanced communications technology satellite project for evaluation of telemedicine outreach using next-generation communications satellite technology: Mayo Foundation participation.

    Science.gov (United States)

    Gilbert, B K; Mitchell, M P; Bengali, A R; Khandheria, B K

    1999-08-01

    To describe the development of telemedicine capabilities-application of remote consultation and diagnostic techniques-and to evaluate the feasibility and practicality of such clinical outreach to rural and underserved communities with limited telecommunications infrastructures. In 1992, Mayo Foundation (Rochester, Minn, Jacksonville, Fla, and Scottsdale, Ariz), the National Aeronautics and Space Administration, and the Defense Advanced Research Projects Agency collaborated to create a complex network of fiberoptic landlines, video recording systems, satellite terminals, and specially developed data translators linking Mayo sites with other locations in the continental United States on an on-demand basis. The purpose was to transmit data via the asynchronous transfer mode (ATM) digital communications protocol over the Advanced Communications Technology Satellite. The links were intended to provide a conduit for transmission of data for patient-specific consultations between physicians, evaluation of medical imagery, and medical education for clinical staffs at remote sites. Low-data-rate (LDR) experiments went live late in 1993. Mayo Clinic Rochester successfully provided medical consultation and services to 2 small regional medical facilities. High-data-rate (HDR) experiments included studies of remote digital echocardiography, store-and-forward telemedicine, cardiac catheterization, and teleconsultation for congenital heart disease. These studies combined landline data transmission with use of the satellite. The complexity of the routing paths and network components, immaturity of available software, and inexperience with existing telecommunications caused significant study delays. These experiments demonstrated that next-generation satellite technology can provide batch and real-time imagery for telemedicine. The first-generation of the ATM and satellite network technology used in these experiments created several technical problems and inconveniences that should

  5. Validation of the Rowland Universal Dementia Assessment Scale for multicultural screening in Danish memory clinics.

    Science.gov (United States)

    Nielsen, T Rune; Andersen, Birgitte Bo; Gottrup, Hanne; Lützhøft, Jan H; Høgh, Peter; Waldemar, Gunhild

    2013-01-01

    The Rowland Universal Dementia Assessment Scale (RUDAS) is a brief cognitive screening test that was developed to detect dementia in multicultural populations. The RUDAS has not previously been validated in multicultural populations outside of Australia. The aim of this study was to evaluate the diagnostic accuracy of the RUDAS in a multicultural sample of patients referred to Danish memory clinics. Data were collected from 137 consecutive patients (34 with an immigrant background) in three Danish memory clinics. All patients were given the RUDAS as a supplement to the standard diagnostic workup. Diagnostic accuracy for the RUDAS [area under the curve (AUC) = 0.838] was similar to that of the Mini-Mental State Examination (MMSE; AUC = 0.840). The cutoff score with the best balance of sensitivity, specificity and accuracy was multicultural patient populations. © 2013 S. Karger AG, Basel.

  6. Bacterial infections in horses: a retrospective study at the University Equine Clinic of Bern.

    Science.gov (United States)

    Panchaud, Y; Gerber, V; Rossano, A; Perreten, V

    2010-04-01

    Bacterial infections present a major challenge in equine medicine. Therapy should be based on bacteriological diagnosis to successfully minimize the increasing number of infections caused by multidrug-resistant bacteria. The present study is a retrospective analysis of bacteriological results from purulent infections in horses admitted at the University Equine Clinic of Bern from 2004 to 2008. From 378 samples analyzed, 557 isolates were identified, of which Staphylococcus aureus, Streptococcus equi subsp. zooepidemicus and coliforms were the most common. Special attention was paid to infections with methicillin-resistant S. aureus (MRSA) ST398 and a non-MRSA, multidrug-resistant S. aureus clone ST1 (BERN100). Screening of newly-admitted horses showed that 2.2 % were carriers of MRSA. Consequent hygiene measures taken at the Clinic helped to overcome a MRSA outbreak and decrease the number of MRSA infections.

  7. Clinical education stressors in medical trainees in Shahid Sadoughi University of Medical Sciences, Yazd

    Directory of Open Access Journals (Sweden)

    MAHDIEH MOMAYYEZI

    2016-01-01

    Full Text Available Introduction: Stress is an important factor in the educational process. Teaching and learning are stressful processes. This stress can affect one’s ability and change his/her performance. The purpose of this study was to investigate stressors of clinical education from the perspective of medical students in Yazd University of Medical Sciences. Methods: This descriptive-analytic study was conducted in Yazd University of Medical Science during year 2014-2015. The sample size was 170 medical students who were selected randomly. The data were collected by a questionnaire including four components: interpersonal relationship, educational environment, clinical experience and the unpleasant emotions. A significance level of 0.05 was considered for analysis. The statistical analyses included descriptive statistics, ANOVA and T-tests, using SPSS software, version 14. Results: The results showed that the highest domain score belonged to interpersonal relationship (3.33±0.3 followed by unpleasant emotions domain (3.3±0.3. The lowest domain score of clinical education stressors was educational environment (3.12±0.1. The results showed that the mean score of interpersonal relationship domain was more in women than in men (p<0.05. Conclusion: The relationship between teachers and students is an effective factor in all dimensions of clinical education stressors. So proper measures such as the promotion of scientific awareness of teachers and educational staff about factors that lead to stress and the best way to communicate with students should be taken to reduce the students’ stress.

  8. Evaluation of factors associated with psychiatric patient dropout at a university outpatient clinic in Japan.

    Science.gov (United States)

    Minamisawa, Atsumi; Narumoto, Jin; Yokota, Isao; Fukui, Kenji

    2016-01-01

    Patient dropout from treatment can lead to a deterioration in clinical condition, thereby increasing the need for more intensive therapy that incurs substantial social and economic losses. The aim of this study was to identify factors related to psychiatric patient dropout at a university outpatient clinic in Japan. We retrospectively examined the medical charts of new psychiatric patients who were diagnosed with either a mood disorder (International Classification of Diseases, 10th revision, code: F3) or an anxiety disorder (F4) in the outpatient clinic at Kyoto Prefectural University of Medicine Hospital in Kyoto, Japan, between April 2010 and March 2013. The baseline characteristics of the patients (age, sex, Global Assessment of Functioning score, Clinical Global Impression-Severity of Illness score, education, occupation, marital status, duration of treatment, and prior treatment history), treating psychiatrist experience in years, and sex concordance between the patients and their treating psychiatrists were analyzed using Cox regression models. From among 1,626 eligible new patients during the study period, 532 patients were enrolled in the study (F3: n=176; F4: n=356). The dropout rate was 35.7%, which was similar to that of previous studies. Higher educational level, being married, and lower Global Assessment of Functioning scores were associated with a lower dropout rate. Although psychiatrist experience was not significantly associated with patient dropout in the multivariate analysis, patients treated by less experienced psychiatrists had a higher hazard ratio for dropout (1.31; 95% confidence interval: 0.94-1.85). In order to reduce the dropout rate, special focus should be placed on patients with the factors identified in this study, and young psychiatrists should undergo further education to foster adherence.

  9. Depression in diabetic patients attending University of Gondar Hospital Diabetic Clinic, Northwest Ethiopia

    Directory of Open Access Journals (Sweden)

    Birhanu AM

    2016-05-01

    Full Text Available Anteneh Messele Birhanu,1 Fekadu Mazengia Alemu,2 Tesfaye Demeke Ashenafie,3 Shitaye Alemu Balcha,4 Berihun Assefa Dachew5 1School of Medicine, College of Medicine and Health Sciences, Wollo University, Dessie, 2Department of Midwifery, 3Department of Nursing, 4Department of Internal Medicine, College of Medicine and Health Sciences, 5Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Gondar, Ethiopia Background: Diabetes mellitus, frequently associated with comorbid depression, contributes to the double burden of individual patients and community. Depression remains undiagnosed in as many as 50%–75% of diabetes cases. This study aimed to determine the prevalence and associated factors of depression among diabetic patients attending the University of Gondar Hospital Diabetic Clinic, Northwest Ethiopia. Methods: An institution-based cross-sectional study was conducted from March to May 2014 among 422 sampled diabetic patients attending the University of Gondar Hospital Diabetic Clinic. The participants were selected using systematic random sampling. Data were collected by face-to-face interview using a standardized and pretested questionnaire linked with patient record review. Depression was assessed using the Patient Health Questionnaire-9. Data were entered to EPI INFO version 7 and analyzed by SPSS version 20 software. Binary logistic regression analysis was performed to identify factors associated with depression. Results: A total of 415 diabetic patients participated in the study with a response rate of 98.3%. The prevalence of depression among diabetic patients was found to be 15.4% (95% confidence interval (CI: 11.7–19.2. Only religion (adjusted odds ratio [AOR] =2.65 and 95% CI: 1.1–6.0 and duration of diabetes (AOR =0.27 and 95% CI: 0.07–0.92 were the factors associated with depression among diabetic patients. Conclusion: The prevalence of depression was low as compared to other

  10. [Self perception of clinical competences declared by recently graduated physicians of the University of Chile].

    Science.gov (United States)

    Millán K, Teresa; Ercolano F, Mariely; Pérez A, Marcela; Fuentes F, Cristián

    2007-11-01

    The new curriculum of the University of Chile School of Medicine includes the evaluation not only of knowledge and skills, but also abilities and attitudes. To measure the self perceived level of basic clinical competences (BCC) declared by recently graduated physicians. A self evaluation survey was designed, based on the proposed objectives of the Faculty Curriculum Committee and on an instrument used in Spanish Universities. It contained 194 questions and the possible answers were: 1.1 know what it is and it has been explained to me; 2.1 have seen it done; 3.1 have done it before under supervision; 4. I would be capable to do it under any circumstance. It was applied confidentially to 50 of a total of 170 recently graduated physicians. Perception of BCC for the diagnosis of most common diseases was felt as satisfactory. History taking and physical examination were also considered as achieved skills. Deficiencies were found in practical aspects of nursing care, obstetric and gynecological abilities and reanimation procedures. Answers may be biased considering that the survey was a self assessment procedure. However, results provide sound orientation to detect strengths and weaknesses of delivered education. Achievement of BCC is proportional to clinical practice opportunities as a student.

  11. Feasibility of iFISH patterns in hematologic malignancies among Congolese patients at Kinshasa University clinics

    Directory of Open Access Journals (Sweden)

    Mireille Solange Nganga Nkanga

    2017-12-01

    Full Text Available Objective: To analyze the feasibility of detecting Ph1 in leukemia patients in the Kinshasa University Clinics in the Democratic Republic of Congo, at KU Leuven, Belgium. Methods: Bone marrow and peripheral blood samples with chronic myeloid leukemia, acute myeloid leukemia or acute leukocytes leukemia were obtained from 32 patients in Kinshasa University clinics in the Democratic Republic of Congo and transferred to KU Leuven in Belgium for iFISH feasibility. Ph1 was detected by using a remote analysis of interphase fluorescence in situ hybridization (iFISH. Results: Out of the 32 patients involved in this study, 65.6% (n = 21 of the cases were successfully tested, of which 52.4% (n = 11 were iFISH positives for the variant t(9;22 (presence of Ph1 in chronic myeloid leukemia samples and 47.6% (n = 10 negatives in all subtypes of hematological malignancies. However, there was a female predominance in chronic myeloid leukemia samples Ph1-positives by iFISH, whereas no sexual influence was observed on acute subtypes of leukemia. Conclusions: iFISH analysis is feasible on samples obtained from remote sites in the Democratic Republic of Congo. However, the optimization of the sample storage is necessary to further improve iFISH's performance. Keywords: iFISH, Ph1, Democratic Republic of Congo, Leukemia, Bone marrow, Blood

  12. St. Augustine's Community Nursing Unit, Cathedral Road, Ballina, Mayo.

    LENUS (Irish Health Repository)

    Nicholl, Honor

    2014-04-01

    In 2010\\/12 an innovative children\\'s palliative care interprofessional educational project funded by the Irish Hospice Foundation was undertaken in a University faculty (Trinity College Dublin). This initiative responded to international educational recommendations to meet the palliative care needs of children. The project involved the development and delivery of 3 standalone modules at Master\\'s level and a substantive research evaluation of the project to examine stakeholders and students perspectives to provide an insight into their experiences and to gather data for future developments. The research evaluation was conducted in two parts, part one sought students\\' evaluation and part two sought stakeholders\\

  13. Revitalization of clinical skills training at the University of the Western Cape

    Directory of Open Access Journals (Sweden)

    J.D. Jeggels

    2010-09-01

    Full Text Available Most educational institutions that offer health related qualifications make use of clinical skills laboratories. These spaces are generally used for the demonstration and assessment of clinical skills. The purpose of this paper is to share our experiences related to the revitalization of skills training by introducing the skills lab method at the School of Nursing (SoN, University of the Western Cape (UWC. To accommodate the contextual changes as a result of the restructuring of the higher education landscape in 2003, the clinical skills training programme at UWC had to be reviewed. With a dramatic increase in the student numbers and a reduction in hospital beds, the skills lab method provided students with an opportunity to develop clinical skills prior to their placement in real service settings. The design phase centred on adopting a skills training methodology that articulates with the case-based approach used by the SoN. Kolb’s, experiential learning cycle provided the theoretical underpinning for the methodology. The planning phase was spent on the development of resources. Eight staff members were trained by our international higher education collaborators who also facilitated the training of clinical supervisors and simulated patients. The physical space had to be redesigned to accommodate audio visual and information technology to support the phases of the skills lab method. The implementation of the skills lab method was phased in from the first-year level. An interactive seminar held after the first year of implementation provided feedback from all the role players and was mostly positive. The results of introducing the skills lab method include: a move by students towards self-directed clinical skills development, clinical supervisors adopting the role of facilitators of learning and experiential clinical learning being based on, amongst others, the students’ engagement with simulated patients. Finally, the recommendations relate

  14. Evaluation of factors associated with psychiatric patient dropout at a university outpatient clinic in Japan

    Directory of Open Access Journals (Sweden)

    Minamisawa A

    2016-09-01

    Full Text Available Atsumi Minamisawa,1 Jin Narumoto,1 Isao Yokota,2 Kenji Fukui1 1Department of Psychiatry, 2Department of Biostatistics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan Background: Patient dropout from treatment can lead to a deterioration in clinical condition, thereby increasing the need for more intensive therapy that incurs substantial social and economic losses. The aim of this study was to identify factors related to psychiatric patient dropout at a university outpatient clinic in Japan.Methods: We retrospectively examined the medical charts of new psychiatric patients who were diagnosed with either a mood disorder (International Classification of Diseases, 10th revision, code: F3 or an anxiety disorder (F4 in the outpatient clinic at Kyoto Prefectural University of Medicine Hospital in Kyoto, Japan, between April 2010 and March 2013. The baseline characteristics of the patients (age, sex, Global Assessment of Functioning score, Clinical Global Impression–Severity of Illness score, education, occupation, marital status, duration of treatment, and prior treatment history, treating psychiatrist experience in years, and sex concordance between the patients and their treating psychiatrists were analyzed using Cox regression models.Results: From among 1,626 eligible new patients during the study period, 532 patients were enrolled in the study (F3: n=176; F4: n=356. The dropout rate was 35.7%, which was similar to that of previous studies. Higher educational level, being married, and lower Global Assessment of Functioning scores were associated with a lower dropout rate. Although psychiatrist experience was not significantly associated with patient dropout in the multivariate analysis, patients treated by less experienced psychiatrists had a higher hazard ratio for dropout (1.31; 95% confidence interval: 0.94–1.85.Conclusion: In order to reduce the dropout rate, special focus should be placed on

  15. Combining clinical practice and academic work in nursing: a qualitative study about perceived importance, facilitators and barriers regarding clinical academic careers for nurses in university hospitals.

    NARCIS (Netherlands)

    Oostveen, C.J. van; Goedhart, N.S.; Francke, A.L.; Vermeulen, H.

    2017-01-01

    Aims and objectives: To obtain in-depth insight into the perceptions of nurse aca- demics and other stakeholders regarding the importance, facilitators and barriers for nurses combining clinical and academic work in university hospitals. Background: Combining clinical practice and academic work

  16. Utility of the Mayo-Portland adaptability inventory-4 for self-reported outcomes in a military sample with traumatic brain injury.

    Science.gov (United States)

    Kean, Jacob; Malec, James F; Cooper, Douglas B; Bowles, Amy O

    2013-12-01

    To investigate the psychometric properties of the Mayo-Portland Adaptability Inventory-4 (MPAI-4) obtained by self-report in a large sample of active duty military personnel with traumatic brain injury (TBI). Consecutive cohort who completed the MPAI-4 as a part of a larger battery of clinical outcome measures at the time of intake to an outpatient brain injury clinic. Medical center. Consecutively referred sample of active duty military personnel (N=404) who suffered predominantly mild (n=355), but also moderate (n=37) and severe (n=12), TBI. Not applicable. MPAI-4 RESULTS: Initial factor analysis suggested 2 salient dimensions. In subsequent analysis, the ratio of the first and second eigenvalues (6.84:1) and parallel analysis indicated sufficient unidimensionality in 26 retained items. Iterative Rasch analysis resulted in the rescaling of the measure and the removal of 5 additional items for poor fit. The items of the final 21-item Mayo-Portland Adaptability Inventory-military were locally independent, demonstrated monotonically increasing responses, adequately fit the item response model, and permitted the identification of nearly 5 statistically distinct levels of disability in the study population. Slight mistargeting of the population resulted in the global outcome, as measured by the Mayo-Portland Adaptability Inventory-military, tending to be less reflective of very mild levels of disability. These data collected in a relatively large sample of active duty service members with TBI provide insight into the ability of patients to self-report functional impairment and the distinct effects of military deployment on outcome, providing important guidance for the meaningful measurement of outcome in this population. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  17. Clinical Assessment and Diagnosis of Germline Predisposition to Hematopoietic Malignancies: The University of Chicago Experience

    Directory of Open Access Journals (Sweden)

    Ami V. Desai

    2017-12-01

    Full Text Available With the increasing use of clinical genomics to guide cancer treatment and management, there is a rise in the identification of germline cancer predisposition syndromes and a critical need for patients with germline findings to be referred for surveillance and care. The University of Chicago Hematopoietic Malignancies Cancer Risk Team has established a unique approach to patient care for individuals with hereditary hematologic malignancies through close communication and coordination between our pediatric and adult programs. Dedicated program members, including physicians, nurses, genetic counselors, and clinical research assistants, screen individuals for cancer predisposition at initial diagnosis through survivorship, in addition to testing individuals with an established family history of a cancer predisposition syndrome. Sample procurement, such as a skin biopsy at the time of bone marrow aspirate/biopsy in individuals with a positive screen, has facilitated timely identification of clinical germline findings or has served as a pipeline for translational research. Our integrated translational research program has led to the identification of novel syndromes in collaboration with other investigators, which have been incorporated iteratively into our clinical pipeline. Individuals are referred for clinical assessment based on personal and family history, identification of variants in susceptibility genes via molecular tumor testing, and during evaluation for matched related allogeneic stem cell transplantation. Upon referral, genetic counseling incorporates education with mindfulness of the psychosocial issues surrounding germline testing at different ages. The training and role of genetic counselors continues to grow, with the discovery of new predisposition syndromes, in the age of improved molecular diagnostics and new models for service delivery, such as telemedicine. With the identification of new syndromes that may predispose individuals

  18. Comparison of the EZ-Cap recapper with the Mayo recapper for the prevention of needlesticks.

    Science.gov (United States)

    Dewhirst, Chad A; Hung, Joseph C

    2008-09-01

    The purpose of this project was the development of a device that improves the design of our current capping block, the Mayo recapper. The major challenges for design and improvement included creating a device that is simple to use and can be applied throughout our department. We wanted a recapper device that increased safety and minimized the potential for needlesticks. Simplicity was another important factor, along with versatility and low cost. A new recapper, called EZ-Cap, was developed, and a comparison study was conducted to evaluate the pros and cons of the EZ-Cap recapper and the Mayo recapper. Nuclear medicine technologists (n = 10) in our department used each device when administering patient injections. At the conclusion of their patient injection rotation, they recorded on a survey sheet the pros and cons of each device. The results of this survey were used to evaluate the effectiveness, comfort level during use, and safety of each recapping device. We used a 2-level scoring system to help determine which device was more favorable. The first level focused on comfort and convenience and was given a score of +1 or -1. The second level focused on safety and was given a score of +2 or -2. Because we believed that safety was a high priority for our capping blocks, this level received a higher score than the first level. The Mayo recapper was the device preferred by 9 of 10 technologists surveyed. The EZ-Cap recapper had several technical issues that made it difficult to use and that could potentially lead to safety concerns. According to our scoring system, the Mayo recapper received a score of +9 for its pros and -4 for its cons. By comparison, the EZ-Cap recapper received a score of +7 for its pros and -16 for its cons. Our results show that the Mayo recapper was the device of choice because its pros outweighed its cons. However, we will continually improve the effectiveness of the Mayo recapper to prevent needlesticks.

  19. Using Computers for Intervention and Remediation of Severely Reading-Impaired Children in a University Literacy Clinic.

    Science.gov (United States)

    Balajthy, Ernest; Reuber, Kristin; Damon, Corrine J.

    A study investigated software choices of graduate-level clinicians in a university reading clinic to determine computer use and effectiveness in literacy instruction. The clinic involved students of varying ability, ages 7-12, using 24 Power Macintosh computers equipped with "ClarisWorks,""Kid Pix,""Student Writing…

  20. D'Alton Community Nursing Unit, Claremorris, Mayo.

    LENUS (Irish Health Repository)

    Hurley, Deirdre A

    2009-01-01

    BACKGROUND: Chronic low back pain (CLBP) is a persistent disabling condition with rising significant healthcare, social and economic costs. Current research supports the use of exercise-based treatment approaches that encourage people with CLBP to assume a physically active role in their recovery. While international clinical guidelines and systematic reviews for CLBP support supervised group exercise as an attractive first-line option for treating large numbers of CLBP patients at low cost, barriers to their delivery include space and time restrictions in healthcare settings and poor patient attendance. The European Clinical Guidelines have identified the need for research in the use of brief\\/minimal contact self-activation interventions that encourage participation in physical activity for CLBP. Walking may be an ideally suited form of individualized exercise prescription as it is easy to do, requires no special skills or facilities, and is achievable by virtually all ages with little risk of injury, but its effectiveness for LBP is unproven. METHODS AND DESIGN: This study will be an assessor-blinded randomized controlled trial that will investigate the difference in clinical effectiveness and costs of an individualized walking programme and a supervised general exercise programme compared to usual physiotherapy, which will act as the control group, in people with chronic low back pain. A sample of 246 patients will be recruited in Dublin, Ireland through acute general hospital outpatient physiotherapy departments that provide treatment for people with CLBP. Patients will be randomly allocated to one of the three groups in a concealed manner. The main outcomes will be functional disability, pain, quality of life, fear avoidance, back beliefs, physical activity, satisfaction and costs, which will be evaluated at baseline, and 3, 6 and 12 months [follow-up by pre-paid postage]. Qualitative telephone interviews and focus groups will be embedded in the research

  1. Routine clinical heart examinations using SQUID magnetocardiography at University of Tsukuba Hospital

    Science.gov (United States)

    Inaba, T.; Nakazawa, Y.; Yoshida, K.; Kato, Y.; Hattori, A.; Kimura, T.; Hoshi, T.; Ishizu, T.; Seo, Y.; Sato, A.; Sekiguchi, Y.; Nogami, A.; Watanabe, S.; Horigome, H.; Kawakami, Y.; Aonuma, K.

    2017-11-01

    A 64-channel Nb-based DC-SQUID magnetocardiography (MCG) system was installed at the University of Tsukuba Hospital (UTH) in March 2007 after obtaining Japanese pharmaceutical approval and insurance reimbursement approval. In the period between 2008 and 2016, the total number of patients was 10 085. The heart diseases diagnosed in fetuses as well as adults are mainly atrial arrhythmia, abnormal repolarization, ventricular arrhythmia, and fetal arrhythmia. In most cases of insufficient diagnostic accuracy with electrocardiography, SQUID MCG precisely revealed these heart diseases as an abnormal electrical current distribution. Based on success in routine examinations, SQUID MCG is now an indispensable clinical instrument with diagnostic software tuned up during routine use at UTH.

  2. A new universal simplified adhesive: 36-Month randomized double-blind clinical trial.

    Science.gov (United States)

    Loguercio, Alessandro D; de Paula, Eloisa Andrade; Hass, Viviane; Luque-Martinez, Issis; Reis, Alessandra; Perdigão, Jorge

    2015-09-01

    It is still debatable which technique should be used with universal adhesives, either etch-and-rinse (wet or dry) or self-etch strategy (with or without selective enamel etching). To evaluate the 36-month clinical performance of Scotchbond Universal Adhesive (SU, 3M ESPE) in non-carious cervical lesions (NCCLs) using two evaluation criteria. Thirty-nine patients participated in this study. Two-hundred restorations were assigned to four groups: ERm: etch-and-rinse+moist dentin; ERd: etch-and-rinse+dry dentin; Set: selective enamel etching; and SE: self-etch. The same composite resin was inserted for all restorations in up to 3 increments. The restorations were evaluated at baseline and at 6-, 18-, and 36-months using both the FDI and the USPHS criteria. Statistical analyses were performed with Friedman repeated measures ANOVA by rank and McNemar test for significance in each pair (α=0.05). Eight restorations (ERm: 1; ERd: 1; Set: 1 and SE: 5) were lost after 36 months, but only significant for SE when compared with baseline (p=0.02 for either criteria). Marginal staining occurred in 6.8% of the restorations (groups ERm, ERd, and Set) and 17.5% of the restorations (group SE), with significant difference for each group when compared with baseline using the FDI criteria (puniversal adhesive was used, there were signs of degradation when the universal adhesive was applied in SE mode. The FDI criteria remain more sensitive than the USPHS criteria, especially for the criteria marginal staining and marginal adaptation. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Clinical profile of hypertension at a University Teaching Hospital in Nigeria

    Directory of Open Access Journals (Sweden)

    Arthur C Onwuchekwa

    2010-07-01

    Full Text Available Arthur C Onwuchekwa, Sunday ChinenyeDepartment of Internal Medicine, University of Port Harcourt Teaching Hospital, NigeriaBackground: Hypertension in Nigeria is a widespread problem of immense social and economic importance because of its high prevalence and the severity of its complications.Aim: To define the morbidity and mortality pattern of hypertension at the University of Port Harcourt Teaching Hospital (UPTH.Method: Records of all patients admitted to the medical wards of the UPTH over a 5-year period with essential hypertension or any of its complications were retrieved from the ward and medical records and reviewed.Result: A total of 780 hypertensive patients were reviewed, constituting 28.2% of all ­medical admissions. Only 424 (15.2% had complete records and were analyzed. Record keeping was poor. There were 173 (41% males and 251 (59% females with a male to female ratio of 1:1.5. The ages ranged from 18 years to 100 years with a mean of 56.5 ± 16.2. Stroke was responsible for 169 (39.9% hypertensive complications. Heart failure occurred in 97 (22% cases while renal failure and encephalopathy accounted for 40 (9.4% and 7 (1.7% hypertensive complications respectively. There were 99 deaths out of which 51 (51.5% were due to stroke, 14 (14.12% were due to heart failure, and 12 (12.1% were due to renal failure.Conclusion: The contribution of systemic hypertension to the morbidity and mortality of adults at UPTH is quite significant.Keywords: clinical profile, hypertension, University of Port Harcourt Teaching Hospital

  4. Perceptions of clients on awareness and the geographical location of a South African university sexual health clinic.

    Science.gov (United States)

    Adams, Rukshana; Van Der Heever, Mariana M; Damons, Anneleen

    2017-09-27

    The Campus Health Service at Stellenbosch University has a sub-division, a sexual health clinic, which provides sexual health services. The clients of the sexual health clinic consist of staff members and students. This article reports on the perceptions of clients that relate to awareness and the geographical location of the clinic. The Campus Health Service at Stellenbosch University's main campus. A descriptive qualitative approach was applied utilising in-depth interviews. A sample of n = 15 was drawn through purposive sampling and data saturation was achieved with the sample. The following themes emerged from the data: location of the clinic, awareness of sexual health services and marketing and advertising. The findings of the study revealed that accessibility of the clinic is influenced by the geographical location of the clinic and that marketing and awareness of services require attention.

  5. Privacy Issues in the Development of a Virtual Mental Health Clinic for University Students: A Qualitative Study.

    Science.gov (United States)

    Gulliver, Amelia; Bennett, Kylie; Bennett, Anthony; Farrer, Louise M; Reynolds, Julia; Griffiths, Kathleen M

    2015-01-01

    There is a growing need to develop online services for university students with the capacity to complement existing services and efficiently address student mental health problems. Previous research examining the development and acceptability of online interventions has revealed that issues such as privacy critically impact user willingness to engage with these services. To explore university student perspectives on privacy issues related to using an online mental health service within the context of the development of an online, university-based virtual mental health clinic. There were two stages of data collection. The first stage consisted of four 1.5-hour focus groups conducted with university students (n=19; 10 female, 9 male, mean age = 21.6 years) to determine their ideas about the virtual clinic including privacy issues. The second stage comprised three 1-hour prototype testing sessions conducted with university students (n=6; 3 male, 3 female, mean age = 21.2 years) using participatory design methods to develop and refine a service model for the virtual clinic and determine student views on privacy within this context. The students raised a number of issues related to privacy in relation to the development of the university virtual clinic. Major topics included the types of personal information they would be willing to provide (minimal information and optional mental health data), concern about potential access to their personal data by the university, the perceived stigma associated with registering for the service, and privacy and anonymity concerns related to online forums contained within the virtual clinic. Students would be more comfortable providing personal information and engaging with the virtual clinic if they trust the privacy and security of the service. Implications of this study include building the clinic in a flexible way to accommodate user preferences.

  6. The clinical pattern of diabetes Insipidus in a large university hospital in the Middle East.

    Science.gov (United States)

    Babiker, Amir M I; Al Jurayyan, Nasir A M; Al Jurayyan, Rushaid N A; Al Gadi, Iman; Drop, Stenvert L S

    2015-04-01

    Diabetes insipidus is a rare but serious endocrine disorder. Paediatric patients were evaluated for polyuria at King Khalid University Hospital, Riyadh, Saudi Arabia, over a decade (2000-13). Relevant clinical examination and/or a triad of high serum osmolality, hypernatremia and low urine osmolality due to increased urine output confirmed the diagnosis. Water deprivation test was required in some cases with non-classic presentations. Appropriate brain imaging was performed whenever central diabetes insipidus (CDI) was suspected. Twenty-eight patients, 15 males (53.6%) and 13 females (46.4%), aged 0-17 years (mean: 6 years) were included. The calculated period prevalence was 7 in 10,000. In our cohort, 60.7% (17 of 28 patients) had CDI, 21.4% (6 of 28) were diagnosed with nephrogenic diabetes insipidus (NDI) and 17.9% (5 of 30) had psychogenic polydipsia. CDI was due to variable aetiology. Though CDI was the commonest, NDI was not a rare encounter in our community, possibly because of high consanguineous marriages. © The Author [2015]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  7. The Assessment of the Applications to University Hospital Urology Outpatient Clinic

    Directory of Open Access Journals (Sweden)

    Adnan Gucuk

    2013-04-01

    Full Text Available Introduction: Provision of health care services to persons where it is needed required for the production of quality service in the organization of health services. The purpose of this study, determine the reason for admission and factors affecting admission and evaluate the current status for the patients admitted to a tertiary health care center. Materials and methods: The study was planned descriptive. Participants were determined among the patients were admitted to urology clinic between December 2011-March 2012 for any reason on a voluntary basis. Fourteen item questionnaire was completed by the physician. The survey asked the age, educational status, initial complaint, elapsed time from the beginning of complaints, whether was the previous treatment from another institution, reasons for choosing a university hospital polyclinics for participants. Results: A total of 337 participants attended, and their gender were 23.7% female, 76.3% male. 61.7% participants had received earlier medical attention because of complaints, 38.3% of had not received previously medical attention in any health institution and had to apply directly to the tertiary health care center. Apply directly to the university hospital outpatient clinic was significantly higher in men (p:0.11(table 1. Direct applications are increasing significantly in participant has higher education level. Compared to complexity of required investigations for patients had received and had not received earlier medical attention were no significant differences (p:0.134. Conclusion: For more effective use of health resources and results-oriented, training must be relevant to users of health care services to increase health literacy as well as a number of legal arrangements. [TAF Prev Med Bull 2013; 12(2.000: 165-168

  8. Friars Lodge Nursing Home, Convent Road, Ballinrobe, Mayo.

    LENUS (Irish Health Repository)

    Murphy, JFA

    2011-01-01

    Lack of sleep has well established effects on physiological, cognitive and behavioural functionality. Sleep deprivation can adversely affect clinical performance as severely as alcohol according to some sources. Sleep deficiency may be due to loss of one night’s sleep or repeated interruptions of sleep. Chronic sleep degrades the ability to recognise one’s ability to recognise the impairments induced by sleep loss. The problem of sleep deprivation has vexed acute medical practice for decades. Improvement has been painfully slow. The problem is that all 168 hours throughout every week of every year have to be covered and there are a finite number of doctors to shoulder the burden. There are many strongly held views about how best to provide night-time and week-end care. Constructive innovations are thin on the ground. The biggest gap is between administration and doctors with financial considerations being the limiting factor. It is, however, generally accepted on all sides that sleep loss and fatigue can have adverse effects on both patients and doctors.

  9. Evaluating laboratory key performance using quality indicators in Alexandria University Hospital Clinical Chemistry Laboratories.

    Science.gov (United States)

    Rizk, Mostafa M; Zaki, Adel; Hossam, Nermine; Aboul-Ela, Yasmin

    2014-12-01

    The performance of clinical laboratories plays a fundamental role in the quality and effectiveness of healthcare. To evaluate the laboratory performance in Alexandria University Hospital Clinical Laboratories using key quality indicators and to compare the performance before and after an improvement plan based on ISO 15189 standards. The study was carried out on inpatient samples for a period of 7 months that was divided into three phases: phase I included data collection for evaluation of the existing process before improvement (March-May 2012); an intermediate phase, which included corrective, preventive action, quality initiative and steps for improvement (June 2012); and phase II, which included data collection for evaluation of the process after improvement (July 2012-September 2012). In terms of the preanalytical indicators, incomplete request forms in phase I showed that the total number of received requests were 31 944, with a percentage of defected request of 33.66%; whereas in phase II, there was a significant reduction in all defected request items (Plaboratories.

  10. Concordance Between Clinical Practice and Published Evidence: Findings From Virginia Commonwealth University School of Dentistry.

    Science.gov (United States)

    Chiang, Harmeet K; Best, Al M; Sarrett, David C

    2017-09-01

    To evaluate the concordance between clinical practice and published evidence by dental faculty and graduating students of the Virginia Commonwealth University School of Dentistry. A questionnaire previously developed by the National Dental Practice-Based Research Network with 12 clinical scenarios was administered to VCU faculty and graduating students. Responses were scored as either consistent or inconsistent with published evidence and then analyzed for differences between dental faculty, graduating students, and the national results. There were 43 dental faculty members with at least half-time student contact who responded to the survey. Faculty concordance ranged from 33% to 100%, and general practice faculty had the highest concordance (82%). Eighty-five of the graduating class of 98 responded to the survey, and student concordance ranged from 18% to 92% and averaged 67%. General practice faculty had higher concordance with published evidence than recently graduated dental students. Graduating students and dental faculty demonstrated higher concordance with evidence-based practice than practitioners in the National Dental Practice-Based Research Network. General practice dental faculty demonstrated adequate concordance, but students demonstrated only a medium-level concordance. Practitioners involved in teaching dental students are better able to keep up with evolving evidence and are better able to demonstrate evidence-based practice. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. [Urological emergencies at the Dakar university teaching hospital: epidemiological, clinical and therapeutic features].

    Science.gov (United States)

    Fall, B; Diao, B; Fall, P A; Diallo, Y; Sow, Y; Ondongo, A A M; Diagana, M; Ndoye, A K; Ba, M; Diagne, B A

    2008-11-01

    To present the epidemiological, clinical and therapeutic features of the urological emergencies in Senegal, West Africa. The authors conducted a 20 months retrospective study that analyzed the epidemiological, clinical and therapeutic features of all urological emergencies admitted to the urology department of the university teaching hospital Aristide-Le-Dantec (Dakar). There were 1237 urological emergencies. The mean age of the patients was 58.8 years (range one month-94 years). The sex ratio (M/F) was 20.32. These patients had an age equal to or higher than 60 years in 50.7% of the cases. The most frequent illness was urinary retention (53%) and genitor-urinary system infectious, which represented as a whole 16.4% of the cases. The gangrenes of male external genitalia (Fournier's gangrene) accounted for 4.1% of the cases and the priapism 1.3%. In emergency, 331 surgical operations were performed. The most performed procedures were the installation of a suprapubic catheter (59.8%) and debridement of a gangrene of male external genitalia (15.4%). The most frequent urological emergency in our country was the acute urinary retention. Some serious illness like gangrene of male external genitalia (Fournier's gangrene) and priapism are not rare there.

  12. Satisfaction With Medication Therapy Management Services at a University Ambulatory Care Clinic.

    Science.gov (United States)

    Kim, Shiyun; Martin, Michelle T; Pierce, Andrea L; Zueger, Patrick

    2016-06-01

    A survey was issued to patients enrolled in the Medication Therapy Management Clinic (MTMC) at University of Illinois Hospital and Health Sciences (June 2011-January 2012) in order to assess satisfaction with pharmacy services provided by pharmacists. A 23-item survey was offered to 65 patients in the MTMC program before or after clinic visits. Since there is a paucity of data indicating the level of satisfaction with MTM services provided by pharmacists, this survey may contribute to the process of building a greater collaboration between the pharmacist and patient. Sixty-two of 65 patients completed the survey; satisfaction with MTMC pharmacists was demonstrated to be significantly positively correlated with overall satisfaction with the MTMC. Patient satisfaction is not significantly different according to age, gender, ethnicity, or number of disease states. Satisfaction with the pillbox service is not significantly different between younger and older patients. It was also noted that patients taking a greater number of medications had higher levels of satisfaction. Most patients indicated that they were satisfied with the MTMC pharmacists and services; further study linking patient satisfaction with MTM services to improved patient outcomes may allow our MTMC to serve as a model for other pharmacist-managed MTMCs serving similar patient populations. © The Author(s) 2014.

  13. First clinical and microbiological characterization of Clostridium difficile infection in a Croatian University Hospital.

    Science.gov (United States)

    Novak, Anita; Spigaglia, Patrizia; Barbanti, Fabrizio; Goic-Barisic, Ivana; Tonkic, Marija

    2014-12-01

    Clinical background and molecular epidemiology of Clostridium difficile infection (CDI) in the University Hospital Centre Split were investigated from January 2010 to December 2011. In total, 54 patients with first episode of CDI were consecutively included in the study based on the positive EIA test specific for A and B toxins. Demographic and clinical data were prospectively analyzed from medical records. CDI incidence rate was 0.6 per 10,000 patient-days. Thirty six cases (70.6%) were healthcare-associated, twelve cases (23.5%) were community-associated and three (5.9%) were indeterminate. Six patients (11.7%) had suffered one or more recurrences and 37 patients (72.5%) showed severe CDI. Prior therapy with third generation cephalosporin was significantly associated with severe CDI (Pdifficile strains were isolated and 50 of them were available for PCR-ribotyping. Sixteen different PCR-ribotypes were identified. The most prevalent were PCR-ribotype 001 (27.8%) and 014/020 (24.1%). Twenty three strains were resistant to at least one of the antibiotics tested. Among resistant strains, three (13.0%)--all PCR-ribotype 001--were multi-resistant. Resistance to fluoroquinolones was significantly higher in strains that caused infection after previous use of fluoroquinolones (P=0.04). Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. A survey of dental treatment under general anesthesia in a Korean university hospital pediatric dental clinic.

    Science.gov (United States)

    Shin, Bisol; Yoo, Seunghoon; Kim, Jongsoo; Kim, Seungoh; Kim, Jongbin

    2016-09-01

    In South Korea, the number of cases of dental treatment for the disabled is gradually increasing, primarily at regional dental clinics for the disabled. This study investigated pediatric patients at a treatment clinic for the disabled within a university hospital who received dental treatment under general anesthesia. This data could assist those that provide dental treatment for the disabled and guide future treatment directions and new policies. This study was a retrospective analysis of 263 cases in which patients received dental treatment under general anesthesia from January 2011 to May 2016. The variables examined were gender, age, reason for anesthesia, type of disability, time under anesthesia, duration of treatment, type of procedure, treatment details, and annual trends in the use of general anesthesia. Among pediatric patients with disabilities who received dental treatment under general anesthesia, the most prevalent age group was 5-8 years old (124 patients, 47.1%), and the primary reason for administering anesthesia was dental anxiety or phobia. The mean time under anesthesia was 132.7 ± 77.6 min, and the mean duration of treatment was 101.9 ± 71.2 min. The most common type of treatment was restoration, accounting for 158 of the 380 treatments performed. Due to increasing demand, the number of cases of dental treatment performed under general anesthesia is expected to continue increasing, and it can be a useful method of treatment in patients with dental anxiety or phobia.

  15. Health and mood among HIV-positive outpatients attending an ART Clinic of a University Hospital.

    Science.gov (United States)

    Costa, Dilar; Mendes, Aida; Abreu, Wilson

    2016-11-01

    To evaluate how individuals at different stages of infection with HIV perceive their health status and its association with mood states. With the introduction of Highly Active Antiretroviral Therapy in 1996, the quality of life of people living with HIV has improved. However, the literature emphasises the negative effects of the disease on the mental health of individuals suffering from this condition and the high incidence of depression among infected individuals. Although people diagnosed and living with HIV are overwhelmed by emotions, we found that various emotional manifestations are understudied within this group of patients. A cross-sectional study was conducted in an outpatient unit of a University Hospital (antiretroviral therapy clinic), with a consecutive sample composed of 152 patients. Data were collected through a questionnaire used to assess the sociodemographic and clinical characteristics, the Short Form (36) Health Survey, and the Profile of Mood States scale. The health status negatively affects the role at the emotional and mental health dimensions. The participants showing a worse health condition than in the previous year had higher levels of tension/anxiety, depression/dejection, fatigue/inertia and confusion/bewilderment. The stage of disease and the profile of mood state emerged as independent phenomena. The results of this study indicate that nurses worldwide should be aware of the emotional aspects (negative emotions strongly impact health) related to the subjective perception of a worsening health status, regardless of the stage of the disease. © 2016 John Wiley & Sons Ltd.

  16. Quality of Diabetes Care at Outpatient Clinic, Sultan Qaboos University Hospital

    Directory of Open Access Journals (Sweden)

    Sawsan Al-Sinani

    2015-01-01

    Full Text Available Objective: To assess the clinical care of type 2 diabetes mellitus (T2D patients at Sultan Qaboos University Hospital (SQUH, a countrywide tertiary referral center in Muscat, Oman.  Methods: We performed a retrospective, observational, cross-sectional study using a total of 673 Omani T2D patients from the Diabetes and Family Medicine Clinics at SQUH. We collected patient data from June 2010 to February 2012 from the Hospital Information System (HIS. Patients had to be Omani, aged more than 18 years old, and have T2D with active follow-up and at least three visits within one year to be included in the study. Ninety-three percent of the patients (n=622 were on oral hypoglycemic drugs and/or insulin, and 70% were on statins. Patients’ anthropometric data, biochemical investigations, blood pressure, and duration of diabetes were recorded from the HIS.  Results: Using the recommended standards and guidelines of medical care in diabetes (American Diabetes Association and the American National Cholesterol Education Program III NCDP NIII standards, we observed that 22% of the patients achieved a HbA1C goal of 1.0; females >1.3mmol/L. Almost 60% of the patients had urinary microalbumin/creatinine ratio within the normal range.  Conclusions: The clinical outcomes of the care that T2D patients get at SQUH were lower than those reported in Europe and North America. However, it is similar to those reported in other countries in the Arabian Gulf.

  17. The incidence of caesarean sections in the university clinical center of kosovo.

    Science.gov (United States)

    Elshani, Brikene; Daci, Armond; Gashi, Sanije; Lulaj, Shefqet

    2012-12-01

    As in most countries of the world also at Kosovo the rate of Cesarean section from year to year is increasing. The main purpose of this paper was to present the incidence of births completed by Caesarean section at the Clinic of Gynecology and Obstetrics of University Clinical Center of Kosovo in Prishtinë. This study is retrospective, namely its made by collecting epidemiological data from patients' histories that completed birth by Caesarean section for the period 2000-2006 in this clinic. During this period, 14 maternal deaths were recorded during or after Caesarean section. Besides this, 14 lethal outcomes, the object of our study was 84 mothers which completed birth by Caesarean section and which are best used as a control group. The average age of mothers who died during or after Caesarean section was 32.1 years (SD ± 4.9). Youngest in this group was 24 years old and oldest 42 years. While the average age of mothers from the control group was 30.6 years (SD ± 5.9). Youngest was 19 and oldest 43 years, without significant difference. Most mothers included in the survey had more than one indication for Caesarean section. The most frequent indication was PIH syndrome with 33.7% and previous Caesarean section in 32.7%. Then with the participation of 12.2% were abruption of the placenta and disproportio feto pelvinea, 11.2% pelvinea and placenta praevia presentation, 10.2% parturiens while other indications were much rarer with less than 10% participation. Based on this we can conclude that the risk of the Caesarean section is high.

  18. Clinical profile and aetiology of optic neuritis in Hospital Universiti Sains Malaysia--5 years review.

    Science.gov (United States)

    Ismail, Shatriah; Wan Hazabbah, Wan Hitam; Muhd-Nor, Nor-Idahriani; Daud, Jakiyah; Embong, Zunaina

    2012-04-01

    Although few studies concerning optic neuritis (ON) in Asian countries have been reported, there is no report about ON in Malaysia particularly within the Malay population. We aimed to determine the clinical manifestation, visual outcome and aetiology of ON in Malays, and discussed the literature of ON studies in other Asian populations. This was a retrospective study involving 31 consecutive patients (41 eyes) with ON treated at Hospital Universiti Sains Malaysia commencing from July 2005 till January 2010 with a period of follow-up ranging from 18-60 months. The clinical features, laboratory results, possible aetiology, and visual acuity after one year were analysed. Females were the predominant group. The age of the patients ranged between 3-55 years and peaked between 21-30 years old. 67.7% of the patients had unilateral involvement. Pain on ocular movement was observed in 31.7% of the affected eyes. 73.3% of 41 involved eyes showed visual acuity equal 6/60 or worse on presentation. Paracentral scotoma was the most common visual field defect noted. Optic disc papillitis proved more widespread compared to the retrobulbar type of ON. The aetiology was idiopathic in more than 50%, while the risk of multiple sclerosis was extremely low (3.2%) in our series. 66.0% demonstrating visual acuity improved to 6/12 or better at one year after the attack. 16.1% showed evidence of recurrence during follow-up. In conclusion, the clinical profile and aetiology of ON in Malay patients are comparable to other ON studies reported by other Asian countries.

  19. Clinical outcome of protein-energy malnourished patients in a Brazilian university hospital

    Energy Technology Data Exchange (ETDEWEB)

    Pasquini, T.A.S. [Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Uberlândia, Uberlândia, MG (Brazil); Neder, H.D. [Instituto de Economia, Universidade Federal de Uberlândia, Uberlândia, MG (Brazil); Araújo-Junqueira, L. [Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Uberlândia, Uberlândia, MG (Brazil); De-Souza, D.A. [Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Uberlândia, Uberlândia, MG (Brazil); Departamento de Clínica Médica e Curso de Nutrição, Faculdade de Medicina, Universidade Federal de Uberlândia, Uberlândia, MG (Brazil)

    2012-12-17

    Protein-energy malnutrition (PEM) is a treatable disease with high prevalence among hospitalized patients. It can cause significant increases in the duration of hospitalization and costs. PEM is especially important for health systems since malnourished patients present higher morbidity and mortality. The objective of the present study was to assess the evolution of nutritional status (NS) and the effect of malnutrition on clinical outcome of patients at a public university hospital of high complexity in Brazil. Patients hospitalized in internal medicine (n = 54), oncology (n = 43), and infectious diseases (n = 12) wards were included. NS was evaluated using subjective global assessment up to 48 h after admission, and thereafter at intervals of 4-6 days. On admission, patients (n = 109) were classified as well-nourished (n = 73), moderately malnourished or at risk of malnutrition (n = 28), and severely malnourished (n = 8). During hospitalization, malnutrition developed or worsened in 11 patients. Malnutrition was included in the clinical diagnosis of only 5/36 records (13.9% of the cases, P = 0.000). Nutritional therapy was administered to only 22/36 of the malnourished patients; however, unexpectedly, 6/73 well-nourished patients also received commercial enteral diets. Complications were diagnosed in 28/36 malnourished and 9/73 well-nourished patients (P = 0.000). Death occurred in 12/36 malnourished and 3/73 well-nourished patients (P = 0.001). A total of 24/36 malnourished patients were discharged regardless of NS. In summary, malnutrition remains a real problem, often unrecognized, unappreciated, and only sporadically treated, even though its effects can be detrimental to the clinical course and prognosis of patients. The amount of public and private funds unnecessarily dispersed because of hospital malnutrition is significant.

  20. Clinical characteristics of lung abscess in children: 15-year experience at two university hospitals.

    Science.gov (United States)

    Choi, Mi Suk; Chun, Ji Hye; Lee, Kyung Suk; Rha, Yeong Ho; Choi, Sun Hee

    2015-12-01

    Information on the clinical features of lung abscess, which is uncommon in children, at hospitalizationis helpful to anticipate the disease course and management. There is no report concerning lung abscess in Korean children. We aimed to identify the clinical characteristics of pediatric lung abscess and compare the difference between primary and secondary abscess groups. The medical records of 11 lung abscess patients (7 males and 4 females) from March 1998 to August 2011 at two university hospitals were retrospectively reviewed. The clinical characteristics, symptoms, underlying disease, laboratory and radiologic findings, microbiological results, and treatments were examined. Six patients had underlying structural-related problems (e.g., skeletal anomalies). No immunologic or hematologic problem was recorded. The mean ages of the primary and secondary groups were 2.4 and 5.3 years, respectively, but the difference was not statistically significant. The mean length of hospital stay was similar in both groups (22.8 days vs. 21.4 days). Immunologic studies were performed in 3 patients; the results were within the normal range. Most patients had prominent leukocytosis. Seven and 4 patients had right and left lung abscess, respectively. Staphylococcus aureus, Streptococcus pneumoniae, and antimycoplasma antibodies were detected in both groups. Two patients with primary lung abscess were administered antibiotics in the absence of other procedures, while 8 underwent interventional procedures, including 5 with secondary abscess. The most common symptoms were fever and cough. All patients in the primary group were younger than 3 years. Structural problems were dominant. Most patients required interventional procedures and antibiotics.

  1. Clinical outcome of protein-energy malnourished patients in a Brazilian university hospital

    International Nuclear Information System (INIS)

    Pasquini, T.A.S.; Neder, H.D.; Araújo-Junqueira, L.; De-Souza, D.A.

    2012-01-01

    Protein-energy malnutrition (PEM) is a treatable disease with high prevalence among hospitalized patients. It can cause significant increases in the duration of hospitalization and costs. PEM is especially important for health systems since malnourished patients present higher morbidity and mortality. The objective of the present study was to assess the evolution of nutritional status (NS) and the effect of malnutrition on clinical outcome of patients at a public university hospital of high complexity in Brazil. Patients hospitalized in internal medicine (n = 54), oncology (n = 43), and infectious diseases (n = 12) wards were included. NS was evaluated using subjective global assessment up to 48 h after admission, and thereafter at intervals of 4-6 days. On admission, patients (n = 109) were classified as well-nourished (n = 73), moderately malnourished or at risk of malnutrition (n = 28), and severely malnourished (n = 8). During hospitalization, malnutrition developed or worsened in 11 patients. Malnutrition was included in the clinical diagnosis of only 5/36 records (13.9% of the cases, P = 0.000). Nutritional therapy was administered to only 22/36 of the malnourished patients; however, unexpectedly, 6/73 well-nourished patients also received commercial enteral diets. Complications were diagnosed in 28/36 malnourished and 9/73 well-nourished patients (P = 0.000). Death occurred in 12/36 malnourished and 3/73 well-nourished patients (P = 0.001). A total of 24/36 malnourished patients were discharged regardless of NS. In summary, malnutrition remains a real problem, often unrecognized, unappreciated, and only sporadically treated, even though its effects can be detrimental to the clinical course and prognosis of patients. The amount of public and private funds unnecessarily dispersed because of hospital malnutrition is significant

  2. Clinical profile of newly presenting diabetic patients at the University of Uyo Teaching Hospital, Nigeria

    International Nuclear Information System (INIS)

    Unadike, B.C.; Akpan, N.A.; Essien, I.O.

    2010-01-01

    Diabetes Mellitus is emerging as a major health challenge with the incidence and prevalence of the disease on the increase. It also contributes to overall morbidity and mortality with complications like cardiovascular disease, neuropathy, nephropathy, retinopathy and lower extremity amputation. There are few local studies on the clinical characteristics of the disease in our wet up and this study therefore set out to characterize the clinical profile of newly presenting diabetic patients in a health facility in Nigeria. It is a cross sectional, descriptive study carried out at the diabetes clinic of the University of Uyo Teaching Hospital between January 2007 and September 2008. Data obtained included age, sex, anthropometric indices, symptomatology, co-morbidities, complications and treatment of diabetes. Data was analyzed using SPSS version 10. A total of two hundred and seventy patients were studied (120 males, 150 females). About 89.2% were Type 2 DM patients and majority of the study subjects were overweight. Diabetic neuropathy was the commonest complication present in 38.8% of the subjects. Polyuria was the commonest symptom and hypertension the commonest comorbidity. Majority of the subjects were on oral hypolgycaemic agents for the management of their disease with the sulphonyureas and biguanides being the most common medication that was taken by them. A few of the patients were also taking herbal medication for treatment of their disease. Majority of the patients presenting in our facility have Type 2 diabetes, were hypertensive and overweight. Hypertension was the commonest co-morbidity and diabetic neuropathy the commonest complication. Adequate health education, subsidies on medications and proper funding of the health sector is necessary to stem the tide of the burden attributable to the disease. (author)

  3. Fragile X checklists: A meta-analysis and development of a simplified universal clinical checklist.

    Science.gov (United States)

    Lubala, Toni Kasole; Lumaka, Aimé; Kanteng, Gray; Mutesa, Léon; Mukuku, Olivier; Wembonyama, Stanislas; Hagerman, Randi; Luboya, Oscar Numbi; Lukusa Tshilobo, Prosper

    2018-04-06

    has identified the highest risk features for patients with Fragile X syndrome that have been used to design a universal clinical checklist. © 2018 The Authors. Molecular Genetics & Genomic Medicine published by Wiley Periodicals, Inc.

  4. Rasch measurement analysis of the Mayo-Portland Adaptability Inventory (MPAI-4) in a community-based rehabilitation sample.

    Science.gov (United States)

    Kean, Jacob; Malec, James F; Altman, Irwin M; Swick, Shannon

    2011-05-01

    The precise measurement of patient outcomes depends upon clearly articulated constructs and refined clinical assessment instruments that work equally well for all subgroups within a population. This is a challenging task in those with acquired brain injury (ABI) because of the marked heterogeneity of the disorder and subsequent outcomes. Although essential, the iterative process of instrument refinement is often neglected. This present study was undertaken to examine validity, reliability, dimensionality and item estimate invariance of the Mayo-Portland Adaptability Inventory - 4 (MPAI-4), an outcome measure for persons with ABI. The sampled population included 603 persons with traumatic ABI participating in a home- and community-based rehabilitation program. Results indicated that the MPAI-4 is a valid, reliable measure of outcome following traumatic ABI, which measures a broad but unitary core construct of outcome after ABI. Further, the MPAI-4 is composed of items that are unbiased toward selected subgroups except where differences could be expected [e.g., more chronic traumatic brain injury (TBI) patients are better able to negotiate demands of transportation than more acute TBI patients]. We address the trade-offs between strict unidimensionality and clinical applicability in measuring outcome, and illustrate the advantages and disadvantages of applying single-parameter measurement models to broad constructs.

  5. Relatively High Complication and Revision Rates of the Mayo® Metaphysical Conservative Femoral Stem in Young Patients.

    Science.gov (United States)

    Rutenberg, Tal Frenkel; Warshevski, Yaniv; Gold, Aviram; Shasha, Nadav; Snir, Nimrod; Chechik, Ofir; Dolkart, Oleg; Eilig, Dynai; Herman, Amir; Rath, Ehud; Kramer, Moti; Drexler, Michael

    2018-05-08

    The Mayo metaphysical conservative femoral stem (Zimmer, Warsaw, Indiana) is a wedge-shaped implant designed to transfer loads proximally, reduce femoral destruction, and enable the preservation of bone stock in the proximal femur. Thus, it is a potentially preferred prosthesis for active, non-elderly patients who may require additional future surgeries. This retrospective case study analyzed the outcomes of consecutive patients who underwent total hip replacements with this stem between May 2001 and February 2013. All patients underwent clinical assessment, radiological evaluation for the presence and development of radiolucent lines, and functional assessment (numerical analog scale, Harris hip score, and Short Form-12 questionnaire). Ninety-five hips (79 patients) were available for analysis. The patients' mean age was 43 years (range, 18-64 years), and the mean follow-up was 97 months (range, 26.9-166 months). The postoperative clinical assessments and functional assessments revealed significant improvements. Sixteen patients (20.3%) had 18 orthopedic complications, the most common of which were an intraoperative femoral fracture and implant dislocation requiring revision surgeries in 10 hips (10.5%). Radiological analysis revealed evidence of femoral remodeling in 64 (67.4%) implants, spot welds (neocortex) in 35 (36.8%), and osteolysis in 3 (3.2%). These results suggest that the conservative hip femoral implant has an unacceptable complication rate for non-elderly patients. [Orthopedics. 201x; xx(x):xx-xx.]. Copyright 2018, SLACK Incorporated.

  6. Expansive learning in the university setting: the case for simulated clinical experience.

    Science.gov (United States)

    Haigh, Jacquelyn

    2007-03-01

    This paper argues that simulated practice in the university setting is not just a second best to learning in the clinical area but one which offers the potential for deliberation and deep learning [Eraut, M., 2000. Non-formal learning, implicit learning and tacit knowledge in professional work. Journal of Educational Psychology, 70, 113-136]. The context of student learning in an undergraduate midwifery programme is analysed using human activity theory [Engeström, Y., 2001. Expansive learning at work: toward an activity theoretical reconceptualization. Journal of Education and Work, 14, 133-156]. The advantages of this approach to student learning as opposed to situated learning theory and the concept of legitimate peripheral participation [Lave, J., Wenger, E., 1991. Situated Learning: Legitimate Peripheral Participation. Cambridge University Press, New York] are discussed. An activity system changes as a result of contradictions and tensions between what it purports to produce and the views of stakeholders (multi-voicedness) as well as its historical context (Historicity of activity). A focus group with students highlights their expressed need for more simulated practice experience. The views of midwifery lecturers are sought as an alternative voice on this tension in the current programme. Qualitative differences in types of simulated experience are explored and concerns about resources are raised in the analysis. Discussion considers the value of well planned simulations in encouraging the expression of tacit understanding through a group deliberative learning process [Eraut, M., 2000. Non-formal learning, implicit learning and tacit knowledge in professional work. Journal of Educational Psychology, 70, 113-136].

  7. State University of New York, University of Stoney Brook, University and Clinical Practice Management Plan Space Leasing Practices. Report 96-S-36.

    Science.gov (United States)

    New York State Office of the Comptroller, Albany. Div. of Management Audit.

    This audit report assesses the propriety and economy of space leasing practices of the State University of New York at Stony Brook (SUNY-SB) for the period July 1, 1994 through December 31, 1996, specifically those related to a health center that includes five professional schools, a 536-bed teaching hospital, and a 350-bed veterans' home. Some of…

  8. The need for reviewing log books in Birjand University of Medical Sciences clinical wards: Letter to Editor

    Directory of Open Access Journals (Sweden)

    Zoya Tahergorabi

    2017-08-01

    Furthermore, due to the pervasive use of electronic log books in recent years in medical universities across the country that are in line with developments and innovations in medical education, it is recommended that the log books at this university too, should be presented and evaluated electronically. Electronic log books with ongoing record of activities and clinical techniques based on educational objectives, in addition to learning consolidation, determine unavailable measures to achieve clinical objectives and, thus, cause regular monitoring and evaluation on the part of students.

  9. Depression and anxiety in patients on chronic hemodialysis in University Clinical Hospital Mostar.

    Science.gov (United States)

    Klarić, Miro; Letica, Ivona; Petrov, Bozo; Tomić, Monika; Klarić, Branka; Letica, Ludvig; Francisković, Tanja

    2009-12-01

    Depression and anxiety are prevailing mental problem in patients on chronic hemodialysis and they have great influence on outcome of illness. Additionally, these disorders are rarely identified in that population of patients and they are insufficiently treated. The aim of this study was to assess the prevalence of depression and anxiety in patients on chronic hemodialysis in University Clinical Hospital Mostar and to examine the correlation between the demographic variables and the time spent on dialysis with depression and anxiety levels. The experimental group consisted of 56 patients on chronic hemodialysis in Mostar Clinical Hospital. The control group 1 consisted of 53 patients diagnosed with a chronic illness and treated for at least a year, while the control group 2 consisted of 51 persons who were not diagnosed with any chronic somatic or mental illness. Demographic data were collected using the constructed questionnaire. The Beck Depression Inventory-BDI was used to determine depression, while the Spielberger State-Trait Anxiety Inventory-STAI was used to determine anxiety. We recorded significantly higher prevalence of depression in patients on chronic dialysis (51.8%) than in patients with a chronic illness (41.5%) and persons without chronic illnesses (9.8%; p < 0.001). Trait anxiety level was significantly higher in hemodialysed patients compared to the other two groups (p = 0.006) but there were no significant differences in state anxiety level. The study has not shown any significant difference in the prevalence of depression and anxiety level regarding the differences in sex, gender and education level, apart from a higher level of state anxiety in patients with a lower education level (p = 0.032). These results indicate that patients on hemodialysis have a significantly higher level of depression and a higher level of trait anxiety compared to patients with chronic illnesses and especially compared to general population.

  10. Barking, Havering and Redbridge University Hospitals NHS Trust Fellowships in Clinical Leadership Programme: An Evaluation.

    Science.gov (United States)

    Miani, Celine; Marjanovic, Sonja; Jones, Molly Morgan; Marshall, Martin; Meikle, Samantha; Nolte, Ellen

    2013-01-01

    Leadership is seen to be central to improving the quality of healthcare and existing research suggests that absence of leadership is related to poor quality and safety performance. Leadership training might therefore provide an important means through which to promote quality improvement and, more widely, performance within the healthcare environment. This article presents an evaluation of the Fellowships in Clinical Leadership Programme, which combines leadership training and quality improvement initiatives with the placement of temporary external clinical champions in Barking, Havering and Redbridge University Hospitals NHS Trust. We assessed impacts of the Programme on individual and organisational change, alongside core enablers and barriers for Programme success. Analyses drew on the principles of a theory-of-change-led realist evaluation, using logic modelling to specify the underlying causal mechanisms of the Programme. Data collection involved a stakeholder workshop, online questionnaires of programme participants, senior managers and support staff (n=114), and follow-up in-depth semi-structured interviews with a subsample of survey participants (n=15). We observed that the Programme had notable impacts at individual and organisational levels. Examples of individual impact included enhanced communication and negotiation skills or increased confidence as a result of multi-modal leadership training. At the organisational level, participants reported indications of behaviour change among staff, with evidence of spill-over effects to non-participants towards a greater focus on patient-centred care. Our findings suggest that there is potential for combined leadership training and quality improvement programmes to contribute to strengthening a culture of care quality in healthcare organisations. Our study provides useful insights into strategies seeking to achieve sustainable improvement in NHS organisations.

  11. Barking, Havering and Redbridge University Hospitals NHS Trust Fellowships in Clinical Leadership Programme

    Science.gov (United States)

    Miani, Celine; Marjanovic, Sonja; Jones, Molly Morgan; Marshall, Martin; Meikle, Samantha; Nolte, Ellen

    2013-01-01

    Abstract Leadership is seen to be central to improving the quality of healthcare and existing research suggests that absence of leadership is related to poor quality and safety performance. Leadership training might therefore provide an important means through which to promote quality improvement and, more widely, performance within the healthcare environment. This article presents an evaluation of the Fellowships in Clinical Leadership Programme, which combines leadership training and quality improvement initiatives with the placement of temporary external clinical champions in Barking, Havering and Redbridge University Hospitals NHS Trust. We assessed impacts of the Programme on individual and organisational change, alongside core enablers and barriers for Programme success. Analyses drew on the principles of a theory-of-change-led realist evaluation, using logic modelling to specify the underlying causal mechanisms of the Programme. Data collection involved a stakeholder workshop, online questionnaires of programme participants, senior managers and support staff (n=114), and follow-up in-depth semi-structured interviews with a subsample of survey participants (n=15). We observed that the Programme had notable impacts at individual and organisational levels. Examples of individual impact included enhanced communication and negotiation skills or increased confidence as a result of multi-modal leadership training. At the organisational level, participants reported indications of behaviour change among staff, with evidence of spill-over effects to non-participants towards a greater focus on patient-centred care. Our findings suggest that there is potential for combined leadership training and quality improvement programmes to contribute to strengthening a culture of care quality in healthcare organisations. Our study provides useful insights into strategies seeking to achieve sustainable improvement in NHS organisations. PMID:28083304

  12. Clinical usefulness of therapeutic drug monitoring of voriconazole in a university hospital.

    Science.gov (United States)

    Cabral-Galeano, Evelyn; Ruiz-Camps, Isabel; Len-Abad, Oscar; Pou-Clavé, Leonor; Sordé-Masip, Roger; Meije-Castillo, Yolanda; Blanco-Grau, Albert; Barba-Suñol, Pere; Monforte-Torres, Victor; Román-Broto, Antonio; Pahissa-Berga, Albert; Gavaldà-Santapau, Joan

    2015-05-01

    The aim of this study was to assess the clinical usefulness of therapeutic drug monitoring (TDM) of voriconazole (VOR) in a university hospital. A retrospective review was conducted on the clinical records of 52 patients treated with VOR and on whom TDM was performed. Steady-state trough plasma VOR concentration was measured at least 5 days after starting treatment. The therapeutic range of plasma VOR concentration was defined as 1-5.5μg/mL. The most frequent underlying conditions in the study population were lung transplant (48.1%) and hematological malignancies (26.9%). At the first TDM in each patient, VOR levels were outside the therapeutic range in 16 (30.7%) cases: 5.5μg/mL in 6 (11.5%). Eleven patients (21.2%) experienced severe muscle weakness and had considerable difficulty walking. All these patients were receiving concomitant treatment with corticosteroids. Age younger than 30 years (p=.005) and cystic fibrosis as the underlying disease (p=.04) were factors associated with low VOR levels. Almost all patients who had VOR concentrations >1μg/mL at the first TDM had a successful outcome (96%). Plasma VOR concentrations were outside the therapeutic range at the first TDM in 30% (16/52) of patients. Age younger than 30 years and cystic fibrosis were factors associated with low VOR levels. The potential interactions between corticosteroids and VOR should be highlighted, as they could be responsible for a high rate of muscle weakness observed in our patients. Prospective trials are needed to investigate VOR TDM and corticosteroid pharmacokinetics. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  13. Combining clinical practice and academic work in nursing: A qualitative study about perceived importance, facilitators and barriers regarding clinical academic careers for nurses in university hospitals.

    Science.gov (United States)

    van Oostveen, Catharina J; Goedhart, Nicole S; Francke, Anneke L; Vermeulen, Hester

    2017-12-01

    To obtain in-depth insight into the perceptions of nurse academics and other stakeholders regarding the importance, facilitators and barriers for nurses combining clinical and academic work in university hospitals. Combining clinical practice and academic work facilitates the use of research findings for high-quality patient care. However, nurse academics move away from the bedside because clinical academic careers for nurses have not yet been established in the Netherlands. This qualitative study was conducted in two Dutch university hospitals and their affiliated medical faculties and universities of applied sciences. Data were collected between May 2015 and August 2016. We used purposive sampling for 24 interviews. We asked 14 participants in two focus groups for their perceptions of importance, facilitators and barriers in nurses' combined clinical and academic work in education and research. We audiotaped, transcribed and thematically analysed the interviews and focus groups. Three themes related to perceived importance, facilitators and barriers: culture, leadership and infrastructure. These themes represent deficiencies in facilitating clinical academic careers for nurses. The current nursing culture emphasises direct patient care, which is perceived as an academic misfit. Leadership is lacking at all levels, resulting in the underuse of nurse academics and the absence of supporting structures for nurses who combine clinical and academic work. The present nursing culture appears to be the root cause of the dearth of academic positions and established clinical academic posts. A culture change would require a show of leadership that would promote and enable combined research, teaching and clinical practice and that would introduce clinical academic career pathways for nurses. Meanwhile, nurse academics should collaborate with established medical academics for whom combined roles are mainstream, and they should take advantage of their established infrastructure

  14. Clinical information system post-adoption evaluation at the georges pompidou university hospital.

    Science.gov (United States)

    Palm, Jean-Marc; Dart, Thierry; Dupuis, Isabelle; Leneveut, Laurence; Degoulet, Patrice

    2010-11-13

    The evaluation of a clinical information system (CIS) at different stages of deployment and routine use is a key factor to improve acceptability and use by health professionals. This paper examines on an expectation-confirmation model (ITPAM) the relationships between the determinants of success of a CIS in a cross-sectional survey performed at the Georges Pompidou University Hospital (HEGP). Results for the groups of physicians and nurses that replied to the survey (n=312) suggest that health professional satisfaction (overall R(2)=0.60) is determined by the quality of user support (r=.21, p=<0001), ease of use (r=.19, p=<0001), confirmation of expectations (r=.15, p=.0037), usefulness (r=.12, p=.0068), and compatibility (r=.10, p=.0206). The best predictor of physician satisfaction (R(2)=0.71) was compatibility (r=.21, p=.0072) whereas for nurses (R(2)=0.52) it was user support (r=.22, p=<0001) and ease of use (r=.22, p=.0001). Confirmation of expectations had an impact on post-adoption expectation and user's satisfaction, and confirms its importance for CIS evaluation studies.

  15. Perceptions of Ghanaian medical students completing a clinical elective at the University of Michigan Medical School.

    Science.gov (United States)

    Abedini, Nauzley C; Danso-Bamfo, Sandra; Moyer, Cheryl A; Danso, Kwabena A; Mäkiharju, Heather; Donkor, Peter; Johnson, Timothy R B; Kolars, Joseph C

    2014-07-01

    International medical electives typically represent a unidirectional flow of students from economically advantaged countries in the global "North" to resource-poor nations in the global "South." Little is known about the impact of bilateral exchanges on students from less affluent nations. Since 2007, students from the University of Michigan Medical School (UMMS) and medical schools in Ghana have engaged in a bilateral clinical exchange program. A 45-item online survey was distributed to all 73 Ghanaian medical students who had rotated at UMMS from 2008 to 2010 to assess perspectives on the value and impact of their participation. Incoming Ghanaian students outnumbered outgoing UMMS students 73 to 33 during the study period. Of eligible Ghanaian students, 70% (51/73) participated in the survey, with 40 of 51 providing valid data on at least 50% of questions. Ninety-seven percent (37/38) reported that the UMMS rotation was valuable to their medical training, 90% (35/39) reported changes in how they approach patient care, and 77% (24/31) reported feeling better equipped to serve patients in their home community. Eighty-five percent of students (28/33) felt more inclined to pursue training opportunities outside of their home country after their rotation at UMMS. More studies are needed to determine the feasibility of bidirectional exchanges as well as the short-term and long-term impact of rotations on students from underresourced settings and their hosts in more resource-rich environments.

  16. [Pediatric victims of traffic accidents admitted to a university hospital: epidemiological and clinical aspects].

    Science.gov (United States)

    Feitas, Juliana Pontes Pinto; Ribeiro, Lindioneza Adriano; Jorge, Miguel Tanús

    2007-12-01

    This study analyzes epidemiological and clinic characteristics of victims of traffic accidents. Data were obtained from medical records of children under 15 years of age (n = 1,123) admitted to a university hospital in Uberlândia, Minas Gerais State, Brazil, from 1999 to 2003. Mean age was eight years, 65.7% were boys, 76.6% were cyclists or pedestrians, 45.9% suffered head injuries, and 9% remained in hospital for more than two weeks. Fourteen (1.2%) died, 78.6% of these within 48 hours of hospitalization, and 85.7% with brain injuries. Among the passengers of motorcycles and larger vehicles, 58.8% were not using security devices properly at the time of the accident. Among the cyclists, 61% suffered isolated limb injuries. Meanwhile, pedestrians tended to suffer multiple lesions (57.5%) and be admitted to intensive care (7.1%), and represented 66.7% of the deaths. Epidemiological data on pediatric traffic victims can be useful for accident prevention programs.

  17. Comparability of Mayo-Portland Adaptability Inventory ratings by staff, significant others and people with acquired brain injury.

    Science.gov (United States)

    Malec, James F

    2004-06-01

    To determine the internal consistency, reliability and comparability of the Mayo-Portland Adaptability Inventory (MPAI-4) and sub-scales completed by people with acquired brain injury (ABI), family and significant others (SO) and rehabilitation staff. 134 people with ABI consecutively seen for outpatient rehabilitation evaluation. MPAI-4 protocols based on independent ratings by the people with ABI undergoing evaluation, SO and rehabilitation staff were submitted to Rasch Facets analysis to determine the internal consistency of the overall measure and sub-scales (Ability, Adjustment and Participation indices) for each rater group and for a composite measure based on all rater groups. Rater agreement for individual items was also examined. Rasch indicators of internal consistency were entirely within acceptable limits for 3-rater composite full scale and sub-scale measures; these indicators were generally within acceptable limits for measures based on a single rater group. Item agreement was generally acceptable; disagreements suggested various sources of bias for specific rater groups. The MPAI-4 possesses satisfactory internal consistency regardless of rating source. A composite measure based on ratings made independently by people with ABI, SO and staff may serve as a 'gold standard' for research purposes. In the clinical setting, assessment of varying perspectives and biases may not only best represent outcome as evaluated by all parties involved but be essential to developing effective rehabilitation plans.

  18. Anesthesia Practice in Pediatric Radiation Oncology: Mayo Clinic Arizona's Experience 2014-2016.

    Science.gov (United States)

    Khurmi, Narjeet; Patel, Perene; Koushik, Sarang; Daniels, Thomas; Kraus, Molly

    2018-02-01

    Understanding the goals of targeted radiation therapy in pediatrics is critical to developing high quality and safe anesthetic plans in this patient population. An ideal anesthetic plan includes allaying anxiety and achieving optimal immobilization, while ensuring rapid and efficient recovery. We conducted a retrospective chart review of children receiving anesthesia for radiation oncology procedures from 1/1/2014 to 7/31/2016. No anesthetics were excluded from the analysis. The electronic anesthesia records were analyzed for perianesthetic complications along with efficiency data. To compare our results to past and current data, we identified relevant medical literature covering a period from 1984-2017. A total of 997 anesthetic procedures were delivered in 58 unique patients. The vast majority of anesthetics were single-agent anesthesia with propofol. The average duration of radiation treatment was 13.24 min. The average duration of anesthesia was 37.81 min, and the average duration to meet discharge criteria in the recovery room was 29.50 min. There were seven instances of perianesthetic complications (0.7%) and no complications noted for the 80 CT simulations. Two of the seven complications occurred in patients receiving total body irradiation. The 5-year survival rate for pediatric cancers has improved greatly in part due to more effective and targeted radiation therapy. Providing an anesthetic with minimal complications is critical for successful daily radiation treatment. The results of our data analysis corroborate other contemporary studies showing minimal risk to patients undergoing radiation therapy under general anesthesia with propofol. Our data reveal that single-agent anesthesia with propofol administered by a dedicated anesthesia team is safe and efficient and should be considered for patients requiring multiple radiation treatments under anesthesia.

  19. Comparative analysis of fracture characteristics of the developing mandible: the Mayo Clinic experience.

    Science.gov (United States)

    Siwani, Rizwan; Tombers, Nicole M; Rieck, Kevin L; Cofer, Shelagh A

    2014-07-01

    To review and compare the epidemiology and treatment of mandibular fractures in subgroups of a pediatric population. We conducted a retrospective review of pediatric patients (age, ≤18 years) with mandibular fractures treated at our institution from January 1996 through November 2011. We identified 122 patients (93 [76%] male) with 216 mandibular fractures. The prevalent mechanisms of injury were motor vehicle accidents (n=52 [43%]), sports injuries (n=24 [20%]), and assault (n=13 [11%]). The most common fracture sites were subcondylar, parasymphyseal, angle, and body. Two patients (2%) were treated conservatively by observation only, 67 (55%) underwent maxillomandibular fixation alone, 41 (34%) underwent maxillomandibular fixation with plate fixation, and 7 (5.7%) underwent plate fixation only. The average duration of maxillomandibular fixation was 26 days (range, 7-49 days). Complications occurred in 11 patients (9.0%) over a mean follow-up of 92 days (range, 21-702 days). Fifty patients (41.0%) had comorbid conditions or a history of mental illness at the time of injury, including attention deficit hyperactivity disorder (n=11 [9%]), mental disorders other than attention deficit hyperactivity disorder (n=23 [19%]), and asthma (n=17 [14%]). Twenty-six patients (21%) had a history of substance use, the most common being tobacco (n=18 [15%]), alcohol (n=13 [11%]), and marijuana (n=11 [9%]). Treatment approach and outcomes were affected by age and fracture characteristics. In addition, a marked proportion of this cohort had preexisting mental disorders and history of substance use, which may have implications on treatment approach. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  20. Catheter-based intervention for pulmonary vein stenosis due to fibrosing mediastinitis: The Mayo Clinic experience

    Directory of Open Access Journals (Sweden)

    Shiva P. Ponamgi

    2015-09-01

    Conclusions: We describe the largest reported case series of catheter-based intervention for PV stenosis in FM. Although catheter-based therapy improved hemodynamics, short-term vascular patency, and patient symptoms, the rate of life-threatening complications, restenosis, and mortality associated with these interventions was found to be high. Despite these associated risks, catheter-based intervention is the only palliative option available to improve quality of life in severely symptomatic patients with PV stenosis and FM. Patients with PV stenosis and FM (especially those with bilateral disease have an overall poor prognosis in spite of undergoing these interventions due to the progressive and recalcitrant nature of the disease. This underscores the need for further innovative approaches to manage this disease.

  1. Radiotherapy for malignancy in patients with scleroderma: The Mayo Clinic experience

    International Nuclear Information System (INIS)

    Gold, Douglas G.; Miller, Robert C.; Petersen, Ivy A.; Osborn, Thomas G.

    2007-01-01

    Purpose: To determine the frequency of acute and chronic adverse effects in patients with scleroderma who receive radiotherapy for treatment of cancer. Methods and Materials: Records were reviewed of 20 patients with scleroderma who received radiotherapy. Acute and chronic toxic effects attributable to radiotherapy were analyzed, and freedom from radiation-related toxicity was calculated. Results: Of the 20 patients, 15 had acute toxic effects, with Grade 3 or higher toxicity for 3 patients. Seven patients had self-limited Grade 1 or 2 radiation dermatitis, and no patient had Grade 3 or higher radiation dermatitis. Thirteen patients had chronic toxic effects, with Grade 3 or higher chronic toxicity for 3 patients. The median estimated time to any grade chronic toxicity was 0.4 years, and the median estimated time to Grade 3 or higher chronic toxicity has not been reached. Conclusions: The results suggest that although some patients with scleroderma treated with radiation experience considerable toxic effects, the occurrence of Grade 3 or higher toxicity may be less than previously anticipated

  2. Multiple sclerosis, brain radiotherapy, and risk of neurotoxicity: The Mayo Clinic experience

    International Nuclear Information System (INIS)

    Miller, Robert C.; Lachance, Daniel H.; Lucchinetti, Claudia F.; Keegan, B. Mark; Gavrilova, Ralitza H.; Brown, Paul D.; Weinshenker, Brian G.; Rodriguez, Moses

    2006-01-01

    Purpose: The aim of this study was a retrospective assessment of neurotoxicity in patients with multiple sclerosis (MS) receiving external beam radiotherapy (EBRT) to the brain. Methods and Materials: We studied 15 consecutively treated patients with MS who received brain EBRT. Neurologic toxicity was assessed with the Common Toxicity Criteria v.3.0. Results: Median follow-up for the 5 living patients was 6.0 years (range, 3.3-27.4 years). No exacerbation of MS occurred in any patient during EBRT. Five patients had Grade 4 neurologic toxicity and 1 had possible Grade 5 toxicity. Kaplan-Meier estimated risk of neurotoxicity greater than Grade 4 at 5 years was 57% (95% confidence interval, 27%-82%). Toxicity occurred at 37.5 to 54.0 Gy at a median of 1.0 year (range, 0.2-4.3 years) after EBRT. Univariate analysis showed an association between opposed-field irradiation of the temporal lobes, central white matter, and brainstem and increased risk of neurotoxicity (p < 0.04). Three of 6 cases of toxicity occurred in patients treated before 1986. Conclusions: External beam radiotherapy of the brain in patients with MS may be associated with an increased risk of neurotoxicity compared with patients without demyelinating illnesses. However, this risk is associated with treatment techniques that may not be comparable to modern, conformal radiotherapy

  3. The U.S. Role in Global Security: The Mayo Clinic, Not the Emergency Room

    National Research Council Canada - National Science Library

    Hillen, John

    1998-01-01

    While many different proposals have been put forward outlining a post-Cold War security identity for the United States, most do not characterize an American role in terms of either excessive activism...

  4. Stress Induced Cardiomyopathy Triggered by Acute Myocardial Infarction: A Case Series Challenging the Mayo Clinic Definition.

    Science.gov (United States)

    Christodoulidis, Georgios; Kundoor, Vishwa; Kaluski, Edo

    2017-08-28

    BACKGROUND Various physical and emotional factors have been previously described as triggers for stress induced cardiomyopathy. However, acute myocardial infarction as a trigger has never been reported. CASE REPORT We describe four patients who presented with an acute myocardial infarction, in whom the initial echocardiography revealed wall motion abnormalities extending beyond the coronary distribution of the infarct artery. Of the four patients identified, the mean age was 59 years; three patients were women and two patients had underlying psychiatric history. Electrocardiogram revealed ST elevation in the anterior leads in three patients; QTc was prolonged in all cases. All patients had ≤ moderately elevated troponin. Single culprit lesion was found uniformly in the proximal or mid left anterior descending artery. Initial echocardiography revealed severely reduced ejection fraction with relative sparing of the basal segments, whereas early repeat echocardiography revealed significant improvement in the left ventricular function in all patients. CONCLUSIONS This is the first case series demonstrating that acute myocardial infarction can trigger stress induced cardiomyopathy. Extensive reversible wall motion abnormalities, beyond the ones expected from angiography, accompanied by modest elevation in troponin and marked QTc prolongation, suggest superimposed stress induced cardiomyopathy.

  5. Systemic Lupus Erythematosus, Radiotherapy, and the Risk of Acute and Chronic Toxicity: The Mayo Clinic Experience

    International Nuclear Information System (INIS)

    Pinn, Melva E.; Gold, Douglas G. M.; Petersen, Ivy A.; Osborn, Thomas G.; Brown, Paul D.; Miller, Robert C.

    2008-01-01

    Purpose: To determine the acute and chronic toxic effects of radiotherapy in patients with systemic lupus erythematosus (SLE). Methods and Materials: Medical records of 21 consecutive patients with SLE, who had received 34 courses of external beam radiotherapy and one low-dose-rate prostate implant, were retrospectively reviewed. Patients with discoid lupus erythematosus were excluded. Results: Median survival was 2.3 years and median follow-up 5.6 years. Eight (42%) of 19 patients evaluable for acute toxicity during radiotherapy experienced acute toxicity of Grade 1 or greater, and 4 (21%) had acute toxicity of Grade 3 or greater. The 5- and 10-year incidence of chronic toxicity of Grade 1 or greater was 45% (95% confidence interval [CI], 22-72%) and 56% (95% CI, 28-81%), respectively. The 5- and 10-year incidence of chronic toxicity of Grade 3 or greater was 28% (95% CI, 18-60%) and 40% (95% CI, 16-72%), respectively. Univariate analysis showed that chronic toxicity of Grade 1 or greater correlated with SLE renal involvement (p < 0.006) and possibly with the presence of five or more American Rheumatism Association criteria (p < 0.053). Chronic toxicity of Grade 3 or greater correlated with an absence of photosensitivity (p < 0.02), absence of arthritis (p < 0.03), and presence of a malar rash (p < 0.04). Conclusions: The risk of acute and chronic toxicity in patients with SLE who received radiotherapy was moderate but was not prohibitive of the use of radiotherapy. Patients with more advanced SLE may be at increased risk for chronic toxicity

  6. Animal-assisted therapy at Mayo Clinic: The time is now.

    Science.gov (United States)

    Creagan, Edward T; Bauer, Brent A; Thomley, Barbara S; Borg, Jessica M

    2015-05-01

    The animal-human bond refers to an emotional, almost existential, relationship between animals and people. From the time of antiquity, domestic animals were an important source of economic vitality, but with the changing cultural landscape, the companion animal has become a faithful friend. Overwhelming anecdotal evidence supports the healing power of this relationship. We summarize the emerging literature on the neurobiochemical and cardiovascular benefits of companion pet ownership. We address the peer-reviewed data from myriad journal articles assessing the impact of the companion animal on the quality and often the length of life of select patients. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Psychosocial problems of pre-clinical students in the University of Ibadan Medical School.

    Science.gov (United States)

    Omokhodion, F O

    2003-06-01

    Recent changes in the psychosocial environment of the university campus such as the steep rise in student numbers, the high cost of living standards and the increase in violence and cult activities has prompted the need to assess the impact of these changes on the students. A cross sectional study was carried out among pre-clinical medical students to identify their psychosocial problems. A self-administered questionnaire was used to collect information about socio-demographic variables including age, sex, sources of financial support, type of accommodation, smoking and drinking habits and use of recreational facilities. Causes of insecurity and depression among students were also recorded. The General Health Questionnaire GHQ-12 was used to assess their mental health status. One hundred and seventy-six students responded to the enquiry, 94 males (53%) and 80 females (45%). One hundred and thirty-seven (79%) live on the campus while 37 (21%) live off campus. Only 9 of the students (5%) were smokers and 28 (16%) were drinkers. Monthly pocket money ranged from Naira 1,000 to Naira 25,000. Forty-one (23%) thought their pocket money was adequate, 92 (52%) thought it was fair and 39 (22%) thought it was inadequate. Causes of insecurity on the campus were cultism 34 (19%), lack of money 27 (15%), lack of textbooks 13 (7%) and stealing 10 (6%). Causes of depression include fear of failure of examinations, 62 (35%), lack of money, 48 (27%) and family problems 17 (10%). Mental health scores ranged from 1 to 10. Using a cut off point of 3 to delineate those with traits of poor mental health, 35 (21%) fell into the category 15 boys and 20 girls. Mean mental health score were higher for females, those living on campus, smokers and drinkers but this was not statistically significant. Fear of failure of examinations, cultism and lack of money are major concerns among medical students on the main university campus. Counselling services should be provided to assist students with

  8. Empirical Correlates of Low Scores on MMPI-2/MMPI-2-RF Restructured Clinical Scales in a Sample of University Students

    Science.gov (United States)

    Avdeyeva, Tatyana V.; Tellegen, Auke; Ben-Porath, Yossef S.

    2012-01-01

    In the present study, the authors explored the meaning of low scores on the MMPI-2/MMPI-2-RF Restructured Clinical (RC) scales. Using responses of a sample of university students (N = 811), the authors examined whether low (T less than 39), within-normal-limits (T = 39-64), and high (T greater than 65) score levels on the RC scales are…

  9. [Development, problems and results of specialty-specific genetic counseling at the Neurology Clinic of the Karl Marx University].

    Science.gov (United States)

    Bachmann, H

    1987-11-01

    Genetic counselling for inherited neurological diseases has been established at the Clinic for Neurology of Karl Marx University. Comprehensive experiences have been got with the specific and sometimes markedly different problems and aims of counselling in Wilsons disease, X-linked recessive muscular dystrophies, myotonic dystrophy and other neuromuscular disorders, Huntingtons chorea and hereditary ataxias.

  10. Pharmacy Students’ Knowledge and Attitude toward Registration Trials and Clinical Research: A Survey in a Japanese University Hospital

    Directory of Open Access Journals (Sweden)

    Natsuko Ise

    2017-12-01

    Full Text Available Clinical research plays a fundamental role in establishing new treatments. Clinical research coordinators are considered essential in clinical research, and medical professionals such as pharmacists often take on this role. Pharmacy students can be considered future candidates for this task. We used questionnaires to survey the knowledge of and attitudes toward registration trials and clinical research of pharmacy students at Tokushima University Hospital. All pharmacy students (103 to whom questionnaires were sent responded. Almost all respondents were aware of registration trials and clinical research. More than 90% were aware of the existence of clinical research coordinators, and about half (48.6% understood their role. In clinical research terminology, most respondents were aware of informed consent and related issues, but fewer than 20% were aware of more practical things. In total, 29.1% and 40.8% of the respondents were willing to carry out and coordinate research. These findings suggest that pharmacy students have basic knowledge of clinical research and that many students are willing to carry out and coordinate clinical research. More practical exposure to clinical research may help to strengthen their future contribution. Further studies may help to determine how to provide education on registration trials and clinical research to pharmacy students.

  11. Which Obstacles Prevent Us from Recruiting into Clinical Trials: A Survey about the Environment for Clinical Studies at a German University Hospital in a Comprehensive Cancer Center

    Directory of Open Access Journals (Sweden)

    Christoph Straube

    2017-08-01

    Full Text Available BackgroundProspective clinical studies are the most important tool in modern medicine. The standard in good clinical practice in clinical trials has constantly improved leading to more sophisticated protocols. Moreover, translational questions are increasingly addressed in clinical trials. Such trials must follow elaborate rules and regulations. This is accompanied by a significant increase in documentation issues which require substantial manpower. Furthermore, university-based clinical centers are interested in increasing the amount of patients treated within clinical trials, and this number has evolved to be a key quality criterion. The present study was initiated to elucidate the obstacles that limit clinical scientists in screening and recruiting for clinical trials.MethodsA specific questionnaire with 28 questions was developed focusing on all aspects of clinical trial design as well as trial management. This included questions on organizational issues, medical topics as well as potential patients’ preferences and physician’s goals. The questionnaire was established to collect data anonymously on a web-based platform. The survey was conducted within the Klinikum rechts der Isar, Faculty of Medicine, Technical University of Munich; physicians of all levels (Department Chairs, attending physicians, residents, as well as study nurses, and other study-related staff were addressed. The answers were analyzed using the Survio analyzing tool (http://www.survio.com/de/.ResultsWe collected 42 complete sets of answers; in total 28 physicians, 11 study nurses, and 3 persons with positions in administration answered our survey. The study centers reported to participate in a range of 3–160 clinical trials with a recruitment rate of 1–80%. Main obstacles were determined: 31/42 (74% complained about limited human resources and 22/42 (52% reported to have a lack on technical resources, too. 30/42 (71% consented to the answer, that the documentation

  12. Antimicrobial susceptibility of clinically isolated anaerobic bacteria in a University Hospital Centre Split, Croatia in 2013.

    Science.gov (United States)

    Novak, Anita; Rubic, Zana; Dogas, Varja; Goic-Barisic, Ivana; Radic, Marina; Tonkic, Marija

    2015-02-01

    Anaerobic bacteria play a significant role in many endogenous polymicrobial infections. Since antimicrobial resistance among anaerobes has increased worldwide, it is useful to provide local susceptibility data to guide empirical therapy. The present study reports recent data on the susceptibility of clinically relevant anaerobes in a University Hospital Centre (UHC) Split, Croatia. A total of 63 Gram-negative and 59 Gram-positive anaerobic clinical isolates from various body sites were consecutively collected from January to December 2013. Antimicrobial susceptibility testing was performed using standardized methods and interpreted using EUCAST criteria. Patient's clinical and demographic data were recorded by clinical microbiologist. Among 35 isolates of Bacteroides spp., 97.1% were resistant to penicillin (PCN), 5.7% to amoxicillin/clavulanic acid (AMC), 8.6% to piperacillin/tazobactam (TZP), 29.0% to clindamycin (CLI) and 2.9% to metronidazole (MZ). Percentages of susceptible strains to imipenem (IPM), meropenem (MEM) and ertapenem (ETP) were 94.3. Resistance of other Gram-negative bacilli was 76.0% to PCN, 8.0% to AMC, 12.0% to TZP, 28.0% to CLI and 8% to MZ. All other Gram-negative strains were fully susceptible to MEM and ETP, while 96.0% were susceptible to IPM. Clostridium spp. isolates were 100% susceptible to all tested antibiotics except to CLI (two of four tested isolates were resistant). Propionibacterium spp. showed resistance to CLI in 4.3%, while 100% were resistant to MZ. Among other Gram-positive bacilli, 18.2% were resistant to PCN, 9.1% to CLI and 54.5% to MZ, while 81.8% of isolates were susceptible to carbapenems. Gram-positive cocci were 100% susceptible to all tested antimicrobials except to MZ, where 28.6% of resistant strains were recorded. Abdomen was the most common source of isolates (82.5%). The most prevalent types of infection were abscess (22.1%), sepsis (14.8%), appendicitis (13.9%) and peritonitis (6.6%). Twenty four patients (19

  13. Salida de campo a Etang de Fournelet (Francia) el 1 de mayo de 1954

    OpenAIRE

    Valverde Gómez, José Antonio, 1926-2003

    2008-01-01

    Salida de campo a Etang de Fournelet, seguramente cerca a la reserva natural de La Camarga, en el delta del río Ródano (Provenza), el 1 de mayo de 1954, de la que se anotaron observaciones sobre las siguientes aves: Actitis hypoleucos (Andarríos chico, llamado Actynioides hypoleucus por el autor), Circus aeruginosus (Aguilucho lagunero occidental), Himantopus himantopus (Cigüeñuela común), Motacilla flava (Lavandera boyera), Saxicola rubetra (Tarabilla norteña), Sylvia conspicillata (Curruca ...

  14. Antimycobacterial activity of medicinal plants used by the Mayo people of Sonora, Mexico.

    Science.gov (United States)

    Coronado-Aceves, Enrique Wenceslao; Sánchez-Escalante, José Jesús; López-Cervantes, Jaime; Robles-Zepeda, Ramón Enrique; Velázquez, Carlos; Sánchez-Machado, Dalia Isabel; Garibay-Escobar, Adriana

    2016-08-22

    Tuberculosis (TB) is an infectious disease mainly caused by Mycobacterium tuberculosis (Mtb), which generates 9 million new cases worldwide each year. The Mayo ethnicity of southern Sonora, Mexico is more than 2000 years old, and the Mayos possess extensive knowledge of traditional medicine. To evaluate the antimycobacterial activity levels of extracts of medicinal plants used by the Mayos against Mtb and Mycobacterium smegmatis (Msm) in the treatment of TB, respiratory diseases and related symptoms. A total of 34 plant species were collected, and 191 extracts were created with n-hexane, dichloromethane, ethyl acetate (EtOAc), methanol and water. Their minimum inhibitory concentrations (MICs) and minimum bactericidal concentrations (MBCs) were determined against Mtb H37Rv using the microplate alamar blue assay (MABA) and against Msm using the resazurin microplate assay (REMA) at 6 and 2 days of exposure, respectively, and at concentrations of 250-1.9µg/mL (n-hexane extracts) and 1000-7.81µg/mL (extracts obtained with dichloromethane, EtOAc, methanol and water). Rhynchosia precatoria (Willd.) DC. (n-hexane root extract), Euphorbia albomarginata Torr. and A. Gray. (EtOAc shoot extract) and Helianthus annuus L. (n-hexane stem extract) were the most active plants against Mtb H37Rv, with MICs of 15.6, 250, 250µg/mL and MBCs of 31.25, 250, 250µg/mL, respectively. R. precatoria (root) was the only active plant against Msm, with MIC and MBC values of ≥250µg/mL. None of the aqueous extracts were active. This study validates the medicinal use of certain plants used by the Mayo people in the treatment of TB and related symptoms. R. precatoria, E. albomarginata and H. annuus are promising plant sources of active compounds that act against Mtb H37Rv. To our knowledge, this is the first time that their antimycobacterial activity has been reported. Crude extracts obtained with n-hexane, EtOAc and dichloromethane were the most active against Mtb H37Rv. Copyright © 2016

  15. 8 de Mayo ... día internacional de la mujer

    OpenAIRE

    Gutiérrez González, Acela Elena

    1987-01-01

    Al movimiento feminista lo podemos dividir en dos etapas. La primera corresponde a su lucha por la igualdad de derechos civiles que concluye en los países europeos y Norteamérica con la finalización de la segunda guerra mundial. La segunda etapa es política. En Latinoamérica surge con el nacimiento de la revolución cubana. En los países europeos, como consecuencia de la Primavera de Praga, el Mayo Francés y la oposición de los jóvenes norteamericanos a intervenir militarmente en la autodeterm...

  16. Evaluation of Dental Status of Adolescents at Kuwait University Dental Clinic.

    Science.gov (United States)

    Ali, Dena A

    2016-01-01

    This study was designed to evaluate the dental status of adolescents initially presenting at Kuwait University Dental Clinic (KUDC). The purpose of this cross-sectional study was to evaluate (a) the prevalence of unrestored caries dentin among 12- to 16-year-old Kuwaiti residents, (b) the frequency of restorations extending into the inner half of the dentin, and (c) tooth loss pattern among this age group. Twelve- to 16-year-old patients who attended KUDC during the period January 2009 to December 2012 were included in this study. The total number of patients included in the study was 486; however, only 409 panoramic radiographs were available for evaluation. The Student t-test and one-way ANOVA were used for statistical analysis. The prevalence of unrestored dentin caries among 12- to 16-year-old patients was 52%. The frequency of deep restorations extending into the inner half of the dentin was 33%. Tooth loss was found in 8.0% of the sampled population. The most common missing tooth was the mandibular first molar followed by the mandibular second premolar and the maxillary first molar. There were no statistical differences between Kuwaiti and non-Kuwaiti residents regardless of gender; however, males had a slightly higher DMFT. The DMFT and DMFS values in this study were higher than in other studies. Despite the tremendous effort by the Kuwaiti government to improve oral health, comprehensive preventive strategies, dental treatment and maintenance of oral health are still necessary and must be reinforced in this age group.

  17. Pediatric chronic patients at outpatient clinics: a study in a Latin American University Hospital.

    Science.gov (United States)

    Alveno, Renata A; Miranda, Caroline V; Passone, Caroline G; Waetge, Aurora R; Hojo, Elza S; Farhat, Sylvia C L; Odone-Filho, Vicente; Tannuri, Uenis; Carvalho, Werther B; Carneiro-Sampaio, Magda; Silva, Clovis A

    2017-10-02

    To describe the characteristics of children and adolescentes with chronic diseases of outpatient clinics at a tertiary university hospital. A cross-sectional study was performed with 16,237 patients with chronic diseases followed-up in one year. The data were collected through the electronic system, according to the number of physician appointments in 23 pediatric specialties. Patients were divided in two groups: children (0-9 years) and adolescents (10-19 years). Early (10-14 years) and late (15-19 years) adolescent groups were also analyzed. Of the total sample, 56% were children and 46% were adolescents. The frequencies of following pediatric specialties were significantly higher in adolescents when compared with children: cardiology, endocrinology, hematology, nephrology/renal transplantation, neurology, nutrology, oncology, palliative and pain care, psychiatry, and rheumatology (p<0.05). The frequencies of emergency service visits (30% vs. 17%, p<0.001), hospitalizations (23% vs. 11%, p<0.001), intensive care unit admissions (6% vs. 2%, p<0.001), and deaths (1% vs. 0.6%, p=0.002) were significantly lower in adolescents than in children. However, the number of physician appointments (≥13) per patient was also higher in the adolescent group (5% vs. 6%, p=0.018). Further analysis comparison between early and late adolescents revealed that the first group had significantly more physician appointments (35% vs. 32%, p=0.025), and required more than two pediatric specialties (22% vs. 21%, p=0.047). Likewise, the frequencies of emergency service visits (19% vs. 14%, p<0.001) and hospitalizations (12% vs. 10%, p=0.035) were higher in early adolescents. This study evaluated a large population in a Latin American hospital and suggested that early adolescents with chronic diseases required many appointments, multiple specialties and hospital admissions. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  18. Quality of life Among Women who were Attending to Trakya University Hospital Menopause clinic

    Directory of Open Access Journals (Sweden)

    B. Tokuç

    2006-12-01

    Full Text Available OBJECTIVE: To asses the menopause symptoms and the impact of menopause and some socio-demographic variables and the hormon replacement therapy on quality of life among women who were attending to a menopause\tMatreial and METHOD: The study was a cross-sectional and descriptive study which was conducted on 299 women who were\tattending to Trakya University Hospital Menopause Clinic, between February –September 2005. After applying a questionnaire about socio-demographic characteristics of respondents, Menopause Rating Scale (MRS, SF-36 Health Survey and Hospital\tAnxiety and Depression Scale were applied by trained interns respectively.\tRESULTS: The mean age of respondents was 52.07±6.12 r(36.0 – 76.0. The mean age of menopause was 45.8±5.1 (26.0 – 56.0. 18.9 % of women were still using HRT, 37.0% have used in the past and 44.1% of them have never used HRT. Women who were stil using HRT, who were stil working, who were educated more than 8 years and who have had no problems in the family have had significantly lower MRS scores and significantly higher SF-36 scores than the others. While MRS scores and SF-36 scores were increasing, the HAD scores were decreasing significantly.\tCONCLUSION: We could say that the menopause symptoms effected the women’s health and quality of life, negatively. But it was\tnot the only determinant of health perception and quality of life. The socio-economic, environmental and cultural factors and life style were also effective in menopause period like the other periods of life.

  19. [Clinical and epidemiological profile of tuberculosis in a university hospital in Santiago, Chile].

    Science.gov (United States)

    Morgado, Alvaro; Köhnenkampf, Ruth; Navarrete, Pablo; García, Patricia; Balcells, M Elvira

    2012-07-01

    The incidence and epidemiological profile of tuberculosis (TB) has changed significantly in the recent years in Chile. To evaluate the clinical and epidemiological characteristics of TB cases diagnosed in the last decade at a university hospital in Santiago. The Mycobacterium tuberculosis culture registry of the microbiology laboratory was reviewed. Medical records of patients with a positive culture registered between 2000 and 2010 were retrieved and analyzed. Two hundred forty positive Mycobacterium tuberculosis cultures were identified and the medical records of 158 of these patients were accessed for analysis. The median age was 53 years (range: 3 to 89), 55.1% were female and nearly 42% had extra-pulmonary TB. Among known risk factors, 32.9% of patients were older than 65 years, 4.4% were health care workers and 3.9% immigrants. Twenty eight percent (41/145) had some type of immunosuppression at diagnosis: 11.7% HIV infection and 16.6% were using immunosuppressive drugs. In this group, a previous tuberculin skin test was done in only 5 cases (12.2%). Adverse events related to TB treatment were reported in 21.3% of cases (17/80). No cases of fulminant hepatitis or death from this cause were identified. Four of 92 patients that had a complete follow up during treatment, died. Two of these patients were receiving steroids. Almost one third of TB cases occurred among immunosuppressed patients and 42% were extra-pulmonary forms. The prevention of TB reactivation in this group should be strengthened.

  20. Assessing nursing clinical skills competence through objective structured clinical examination (OSCE) for open distance learning students in Open University Malaysia.

    Science.gov (United States)

    Oranye, Nelson Ositadimma; Ahmad, Che'an; Ahmad, Nora; Bakar, Rosnida Abu

    2012-06-01

    The objective structured clinical skills examination (OSCE) has over the years emerged as a method of evaluating clinical skills in most medical and allied professions. Although its validity and objectivity has evoked so much debate in the literature, little has been written about its application in non-traditional education systems such as in distance learning. This study examined clinical skills competence among practising nursing students who were enrolled in a distance learning programme. The study examined the effect of work and years of nursing practice on nurses' clinical skills competence. This study used observational design whereby nursing students' clinical skills were observed and scored in five OSCE stations. Two instruments were used for the data collection - A self-administered questionnaire on the students' bio-demographic data, and a check list on the clinical skills which the examiners rated on a four point scale. The findings revealed that 14% of the nurses had level four competence, which indicated that they could perform the tasks correctly and complete. However, 12% failed the OSCE, even though they had more than 10 years experience in nursing and post basic qualifications. Inter-rater reliability was 0.92 for the five examiners. Factor analysis indicated that five participant factors accounted for 74.1% of the variations in clinical skills performance. An OSCE is a necessary assessment tool that should be continuously applied in nursing education, regardless of the mode of the education program, the student's years of experience or his/her clinical placement. This study validates the need for OSCE in both the design of tertiary nursing degree programs and the assessment of nurses' clinical competency level.

  1. Does clinical experience affect knowledge regarding hepatitis-B among male medical students at a private university

    International Nuclear Information System (INIS)

    Nisar, N.

    2009-01-01

    To assess the knowledge of male medical students about Hepatitis-B in their preclinical and clinical years and to investigate the self reported vaccination status of these students. In the year of 2007, 187 male students of Isra University Hyderabad Sindh Pakistan were selected by convenient sampling and surveyed with a self reported questionnaire comprising of questions regarding knowledge about hepatitis B. Data gathered was analyzed by SPSS V. 16. Knowledge between preclinical and clinical students were compared by Pearson's coefficient chi square test, p value < 0.005 was considered significant. Out of 187 students interviewed, 73 (39%) and 114 (61%) were from preclinical and clinical years respectively. Significant difference was found in clinical and preclinical students regarding basic knowledge about hepatitis B. and mode of transmission of disease (P= 0.004) and (P=< 0.001) respectively. Significant difference was found in the knowledge of both preclinical and clinical male medical students. (JPMA 59:808; 2009). (author)

  2. Prevalence of Body Dysmorphic Disorder Symptoms and Associated Clinical Features among Australian University Students

    Science.gov (United States)

    Bartsch, Dianna

    2007-01-01

    The current study addressed the frequency of body dysmorphic disorder (BDD) symptoms among university students and investigated the predictors of dysmorphic concern. Six hundred and nineteen Australian university students completed measures assessing BDD, dysmorphic concern, self-esteem, depression, life satisfaction, self-oriented and socially…

  3. Factors Enhancing Manpower Efficiency from the Viewpoint of Clinical and Non-clinical Faculty Members at Guilan University of Medical Sciences in 2011

    Directory of Open Access Journals (Sweden)

    Fardin Mehrabian

    2012-11-01

    Full Text Available Introduction: There are various factors that affect manpower efficiency. Identification of the most important and influential factors on efficiency is quite essential. Analysis of factors affecting manpower efficiency from the viewpoint of clinical and non-clinical faculty members at Guilan University of Medical Sciences in 2011.Methods: This descriptive, analytical, cross-sectional study was performed in October and November in 2011. The study sample consisted of 186 faculty members, including 128 clinical and 58 non-clinical. Instruments used to collect library data were questionnaire and field studies. Exploratory factor analysis with Varimax rotation was utilized to determine the factors influencing manpower efficiency as well as loading level of each of the variables. Results: Among clinical faculty members, 70.66% of changes in manpower efficiency, and among non-clinical faculty members, 79.57% of changes in manpower efficiency were explained by 9 and 8 factors, respectivelyConclusion: Staff empowerment and organizational culture were recognized as the most important factors enhancing manpower efficiency from the viewpoint of clinical and non-clinical faculty members, respectively.

  4. Demographic characteristics and clinical predictors of patients discharged from university hospital-affiliated pain clinic due to breach in narcotic use contract.

    Science.gov (United States)

    Chakrabortty, Shushovan; Gupta, Deepak; Rustom, David; Berry, Hussein; Rai, Ajit

    2014-01-01

    The current retrospective study was completed with the aim to identify demographic characteristics and clinical predictors (if any) of the patients discharged from our pain clinic due to breach in narcotic use contract (BNUC). Retrospective patient charts' review and data audit. University hospital-affiliated pain clinic in the United States. All patient charts in our pain clinic for a 2-year period (2011-2012). The patients with BNUC were delineated from the patients who had not been discharged from our pain clinic. Pain characteristics, pain management, and substance abuse status were compared in each patient with BNUC between the time of admission and the time of discharge. The patients with BNUC discharges showed significant variability for the discharging factors among the pain physicians within a single pain clinic model with this variability being dependent on their years of experience and their proactive interventional pain management. The patients with BNUC in our pain clinic setting were primarily middle-aged, obese, unmarried males with nondocumented stable occupational history who were receiving only noninterventional pain management. Substance abuse, doctor shopping, and potential diversion were the top three documented reasons for BNUC discharges. In 2011-2012, our pain clinic discharged 1-in-16 patients due to breach in narcotic use contract.

  5. MCNP6 model of the University of Washington clinical neutron therapy system (CNTS).

    Science.gov (United States)

    Moffitt, Gregory B; Stewart, Robert D; Sandison, George A; Goorley, John T; Argento, David C; Jevremovic, Tatjana

    2016-01-21

    A MCNP6 dosimetry model is presented for the Clinical Neutron Therapy System (CNTS) at the University of Washington. In the CNTS, fast neutrons are generated by a 50.5 MeV proton beam incident on a 10.5 mm thick Be target. The production, scattering and absorption of neutrons, photons, and other particles are explicitly tracked throughout the key components of the CNTS, including the target, primary collimator, flattening filter, monitor unit ionization chamber, and multi-leaf collimator. Simulations of the open field tissue maximum ratio (TMR), percentage depth dose profiles, and lateral dose profiles in a 40 cm × 40 cm × 40 cm water phantom are in good agreement with ionization chamber measurements. For a nominal 10 × 10 field, the measured and calculated TMR values for depths of 1.5 cm, 5 cm, 10 cm, and 20 cm (compared to the dose at 1.7 cm) are within 0.22%, 2.23%, 4.30%, and 6.27%, respectively. For the three field sizes studied, 2.8 cm × 2.8 cm, 10.4 cm × 10.3 cm, and 28.8 cm × 28.8 cm, a gamma test comparing the measured and simulated percent depth dose curves have pass rates of 96.4%, 100.0%, and 78.6% (depth from 1.5 to 15 cm), respectively, using a 3% or 3 mm agreement criterion. At a representative depth of 10 cm, simulated lateral dose profiles have in-field (⩾ 10% of central axis dose) pass rates of 89.7% (2.8 cm × 2.8 cm), 89.6% (10.4 cm × 10.3 cm), and 100.0% (28.8 cm × 28.8 cm) using a 3% and 3 mm criterion. The MCNP6 model of the CNTS meets the minimum requirements for use as a quality assurance tool for treatment planning and provides useful insights and information to aid in the advancement of fast neutron therapy.

  6. Medical Students’ Clinical Skills Do Not Match Their Teachers’ Expectations: Survey at Zagreb University School of Medicine, Croatia

    Science.gov (United States)

    Sičaja, Mario; Romić, Dominik; Prka, Željko

    2006-01-01

    Aim To evaluate self-assessed level of clinical skills of graduating medical students at Zagreb University School of Medicine and compare them with clinical skill levels expected by their teachers and those defined by a criterion standard. Method The study included all medical students (n = 252) graduating from the Zagreb University School of Medicine in the 2004-2005 academic year and faculty members (n = 129) teaching clinical skills. The participants completed anonymous questionnaire listing 99 clinical skills divided into nine groups. Students were asked to assess their clinical skills on a 0-5 scale, and faculty members were asked to assess the minimum necessary level of clinical skills expected from graduating medical students, using the same 0-5 scale. We compared the assessment scores of faculty members with students’ self-assessment scores. Participants were grouped according to their descriptive characteristics for further comparison. Results The response rate was 91% for students and 70% for faculty members. Students’ self-assessment scores in all nine groups of clinical skills ranged from 2.2 ± 0.8 to 3.8 ± 0.5 and were lower than those defined by the criterion standard (3.0-4.0) and those expected by teachers (from 3.1 ± 1.0 to 4.4 ± 0.5) (P<0.001 for all). Students who had additional clinical skills training had higher scores in all groups of skills, ranging from 2.6 ± 0.9 to 4.0 ± 0.5 (P<0.001 for all). Male students had higher scores than female students in emergency (P<0.001), neurology (P = 0.017), ear, nose, and throat (P = 0.002), urology (P = 0.003), and surgery skills (P = 0.002). Teachers’ expectations did not vary according to their sex, academic position, or specialty. Conclusion Students’ self-assessed level of clinical skills was lower than that expected by their teachers. Education during clinical rotations is not focused on acquiring clinical skills, and additional clinical

  7. Medical genetic issues in clinical of pediatric neurology practice:a history of pediatrics in Peking University First Hospital.

    Science.gov (United States)

    Wu, Xi-ru

    2006-02-18

    The Department of Pediatrics of Peking University First Hospital has a long term of outstanding history. It was established about 60 years ago. After the division of pediatric neurology (DPN) had been established in 1960s, it had been assigned to cover genetic disorders. During the recent 20 years, efforts have been put on three aspects: (1) Pediatric neurology clinical service and education; (2) research studies of childhood epilepsies and pediatric neurogenetic disorders; and (3) development of a strong DPN team to establish a comprehensive pediatric neurological program. In this paper, we reviewed the history of the pediatric neurology division in our department, our clinical and research work and achievements for neurogenetic diseases.

  8. [Clinical electro-ophthalmology at the Max Planck Institute of the Frankfurt University Ophthalmology Clinic 1970-1991].

    Science.gov (United States)

    Lorenz, R; Baier, M; Eckl, G; Raile, A

    1996-07-01

    The survey shows the frequency and distribution of diseases evaluated by electroophthalmological methods. Patients with retinal diseases (51.2%) and those with diseases of the optic nerve (21.8%) were examined most frequently. In a high percentage these investigations lead to a clinically useful assessment: described as confirmation or exclusion of a clinical diagnosis, as establishing a possible differential diagnosis or clearing up formerly unknown aspects of a disease. In cases of hereditary retinal disorders only 11% remained unclear, with presumed optic neuritis only 6%. The importance of electroophthalmological investigations is there ability to assess functional deficits in the visual system especially in somehow more rare retinal and centrally located disorders, functional deficits of unknown origins or in general diseases including the visual system.

  9. [Publication performances of university clinics for anesthesiology: Germany, Austria and Switzerland from 2001 to 2010].

    Science.gov (United States)

    Putzer, G; Ausserer, J; Wenzel, V; Pehböck, D; Widmann, T; Lindner, K; Hamm, P; Paal, P

    2014-04-01

    This study assessed the publication performance of university departments of anesthesiology in Austria, Germany and Switzerland. The number of publications, original articles, impact factors and citations were evaluated. A search was performed in PubMed to identify publications related to anesthesiology from 2001 to 2010. All articles from anesthesiology journals listed in the fields of anesthesia/pain therapy, critical care and emergency medicine by the "journal citation report 2013" in Thomson Reuters ISI web of knowledge were included. Articles from non-anaesthesiology journals, where the stem of the word anesthesia (anes*, anaes*, anäst*, anast*) appears in the affiliation field of PubMed, were included as well. The time periods 2001-2005 and 2006-2010 were compared. Articles were allocated to university departments in Austria, Germany and Switzerland via the affiliation field. A total of 45 university departments in Austria, Germany and Switzerland and 125,979 publications from 2,863 journals (65 anesthesiology journals, 2,798 non-anesthesiology journals) were analyzed. Of the publications 23 % could not be allocated to a given university department of anesthesiology. In the observation period the university department of anesthesiology in Berlin achieved most publications (n = 479) and impact points (1,384), whereas Vienna accumulated most original articles (n = 156). Austria had the most publications per million inhabitants in 2006-2010 (n=50) followed by Switzerland (n=49) and Germany (n=35). The number of publications during the observation period decreased in Germany (0.5 %), Austria (7 %) and Switzerland (8 %). Tables 2 and 4-8 of this article are available at Springer Link under Supplemental. The research performance varied among the university departments of anesthesiology in Germany, Austria and Switzerland whereby larger university departments, such as Berlin or Vienna published most. Publication output in Germany, Austria and

  10. Attitude of clinical faculty members in Shiraz Medical University towards private practice physicians' participation in ambulatory care education

    Directory of Open Access Journals (Sweden)

    Khatereh Mahori

    2002-04-01

    Full Text Available Background: Improvement of medical education is necessary for meeting health care demands. Participation of private practice physicians in ambulatory care training is an effective method for enhancing medical students' skills. Purpose This study was undertaken to determine clinical professors' views about participation of physicians with private office in ambulatory care training. Methods: Participants composed of 162 Shiraz Medical University faculty members from 12 disciplines. A questionnaire requesting faculty members' views on different aspects of ambulat01y care teaching and interaction of community-based organizations was distributed. Results: Of 120 (74.1% respondents, 64 (54.2% believed that clinical settings of medical university are appropriate for ambulatory care training. Private practice physicians believed more than academic physicians without private office that private offices have wider range of patients, more common cases, and better follow up chance; and is also a better setting for learning ambulatory care compared with medical university clinical centers. Overall, 32 (29.1% respondent’s found the participation of physicians with private practice on medical education positive. Key words medical education, ambulatory medicine, private practice

  11. Stereotactic Body Radiation Therapy (SBRT) for clinically localized prostate cancer: the Georgetown University experience

    International Nuclear Information System (INIS)

    Chen, Leonard N; Lei, Siyuan; Batipps, Gerald P; Kowalczyk, Keith; Bandi, Gaurav

    2013-01-01

    Stereotactic body radiation therapy (SBRT) delivers fewer high-dose fractions of radiation which may be radiobiologically favorable to conventional low-dose fractions commonly used for prostate cancer radiotherapy. We report our early experience using SBRT for localized prostate cancer. Patients treated with SBRT from June 2008 to May 2010 at Georgetown University Hospital for localized prostate carcinoma, with or without the use of androgen deprivation therapy (ADT), were included in this retrospective review of data that was prospectively collected in an institutional database. Treatment was delivered using the CyberKnife® with doses of 35 Gy or 36.25 Gy in 5 fractions. Biochemical control was assessed using the Phoenix definition. Toxicities were recorded and scored using the CTCAE v.3. Quality of life was assessed before and after treatment using the Short Form-12 Health Survey (SF-12), the American Urological Association Symptom Score (AUA) and Sexual Health Inventory for Men (SHIM) questionnaires. Late urinary symptom flare was defined as an AUA score ≥ 15 with an increase of ≥ 5 points above baseline six months after the completion of SBRT. One hundred patients (37 low-, 55 intermediate- and 8 high-risk according to the D’Amico classification) at a median age of 69 years (range, 48–90 years) received SBRT, with 11 patients receiving ADT. The median pre-treatment prostate-specific antigen (PSA) was 6.2 ng/ml (range, 1.9-31.6 ng/ml) and the median follow-up was 2.3 years (range, 1.4-3.5 years). At 2 years, median PSA decreased to 0.49 ng/ml (range, 0.1-1.9 ng/ml). Benign PSA bounce occurred in 31% of patients. There was one biochemical failure in a high-risk patient, yielding a two-year actuarial biochemical relapse free survival of 99%. The 2-year actuarial incidence rates of GI and GU toxicity ≥ grade 2 were 1% and 31%, respectively. A median baseline AUA symptom score of 8 significantly increased to 11 at 1 month (p = 0.001), however returned to

  12. Redesign of a university hospital preanesthesia evaluation clinic using a queuing theory approach

    NARCIS (Netherlands)

    Zonderland, Maartje Elisabeth; Boer, Fredrik; Boucherie, Richardus J.; de Roode, Annemiek; van Kleef, Jack W.

    2009-01-01

    BACKGROUND: Changes in patient length of stay (the duration of 1 clinic visit) as a result of the introduction of an electronic patient file system forced an anesthesia department to change its outpatient clinic organization. In this study, we sought to demonstrate how the involvement of essential

  13. CLINIC-LABORATORY DESIGN BASED ON FUNCTION AND PHILOSOPHY AT PURDUE UNIVERSITY.

    Science.gov (United States)

    HANLEY, T.D.; STEER, M.D.

    THIS REPORT DESCRIBES THE DESIGN OF A NEW CLINIC AND LABORATORY FOR SPEECH AND HEARING TO ACCOMMODATE THE THREE BASIC PROGRAMS OF--(1) CLINICAL TRAINING OF UNDERGRADUATE AND GRADUATE STUDENT MAJORS, (2) SERVICES MADE AVAILABLE TO THE SPEECH AND HEARING HANDICAPPED, AND (3) RESEARCH IN SPEECH PATHOLOGY, AUDIOLOGY, PSYCHO-ACOUSTICS, AND…

  14. Nurse-delivered universal point-of-care testing for HIV in an open-access returning traveller clinic.

    Science.gov (United States)

    Herbert, R; Ashraf, A N; Yates, T A; Spriggs, K; Malinnag, M; Durward-Brown, E; Phillips, D; Mewse, E; Daniel, A; Armstrong, M; Kidd, I M; Waite, J; Wilks, P; Burns, F; Bailey, R; Brown, M

    2012-09-01

    Early diagnosis of HIV infection reduces morbidity and mortality associated with late presentation. Despite UK guidelines, the HIV testing rate has not increased. We have introduced universal HIV screening in an open-access returning traveller clinic. Data were prospectively recorded for all patients attending the open-access returning traveller clinic between August 2008 and December 2010. HIV testing was offered to all patients from May 2009; initially testing with laboratory samples (phase 1) and subsequently a point-of-care test (POCT) (phase 2). A total of 4965 patients attended the clinic; 1342 in phase 0, 792 in phase 1 and 2831 in phase 2. Testing rates for HIV increased significantly from 2% (38 of 1342) in phase 0 to 23.1% (183 of 792) in phase 1 and further increased to 44.5% (1261 of 2831) during phase 2 (P travelling to the Middle East and Europe were less likely to accept an HIV test with POCT. A nurse-delivered universal point-of-care HIV testing service has been successfully introduced and sustained in an acute medical clinic in a low-prevalence country. Caution is required in communicating reactive results in low-prevalence settings where there may be alternative diagnoses or a low population prevalence of HIV infection. © 2012 British HIV Association.

  15. Expansion of the consultation-liaison psychiatry paradigm at a university medical center: integration of diversified clinical and funding models.

    Science.gov (United States)

    Bourgeois, James A; Hilty, Donald M; Klein, Sally C; Koike, Alan K; Servis, Mark E; Hales, Robert E

    2003-01-01

    The perspective of the contemporary Consultation-Liason Service (CLS) psychiatrist is increasingly one of consultant to medical and surgical colleagues in models other than inpatient medical and surgical units. Simultaneously, the need for a clinically and educationally robust inpatient CLS persists despite funding pressures. The University of California, Davis Medical Center Department of Psychiatry has made use of creative organizational and financial models to accomplish the inpatient CLS clinical and educational missions in a fiscally responsible manner. In addition, the department has in recent years expanded the delivery of psychiatry consultation-liaison clinical and educational services to other models of care delivery, broadening the role and influence of the CLS. Several of the initiatives described in this paper parallel an overall evolution of the practice of consultation-liaison psychiatry in response to managed care influences and other systems pressures. This consultation-liaison paradigm expansion with diversified sources of funding support facilitates the development of consultation-liaison psychiatry along additional clinical, administrative, research, and educational dimensions. Other university medical centers may consider adaptation of some of the initiatives described here to their institutions.

  16. Mary as Mother in the Flores de Mayo in Poblacion, Oslob

    Directory of Open Access Journals (Sweden)

    Patricia Marion Y. Lopez

    2016-06-01

    Full Text Available The paper reflects on the meanings of the Flores de Mayo ritual as performed in a town on the southeastern coast of Cebu through the examination of Mary as a “semantically open” symbol. The essay illustrates how ideas about Mary are constructed through the discourse of the Church and are in turn, reinforced through a Church-instituted and regulated ritual. An analysis of selected elements of the ritual however, reveals that the symbol of Mary has the potential to hold “other” kinds of meanings that slip in between “official” and “unofficial” discourses, highlighting how Mary continues to be a negotiated field between church authorities and the popular faithful.

  17. [Skills lab training in veterinary medicine. Effective preparation for clinical work at the small animal clinic of the University for Veterinary Medicine Hannover, Foundation].

    Science.gov (United States)

    Engelskirchen, Simon; Ehlers, Jan; Kirk, Ansgar T; Tipold, Andrea; Dilly, Marc

    2017-09-20

    During five and a half years of studying veterinary medicine, students should in addition to theoretical knowledge acquire sufficient practical skills. Considering animal welfare and ethical aspects, opportunities for hands-on learning on living animals are limited because of the high annual number of students. The first German veterinary clinical-skills lab, established in 2013 at the University for Veterinary Medicine Hannover, Foundation (TiHo), offers opportunities for all students to learn, train and repeat clinical skills on simulators and models as frequently as they would like, until they feel sufficiently confident to transfer these skills to living animals. This study describes the establishment of clinical-skills lab training within the students' practical education, using the example of the small-animal clinic of the TiHo. Two groups of students were compared: without skills lab training (control group K) and with skills lab training (intervention group I). At the end of both the training and a subsequent 10-week clinical rotation in different sections of the clinic, an objective structured clinical examination (OSCE) was performed, testing the students' practical skills at 15 stations. An additional multiple-choice test was performed before and after the clinical rotation to evaluate the increased theoretical knowledge. Students of group I achieved significantly (p ≤ 0.05) better results in eight of the 15 tested skills. The multiple-choice test revealed a significant (p ≤ 0.05) gain of theoretical knowledge in both groups without any differences between the groups. Students displayed a high degree of acceptance of the skills lab training. Using simulators and models in veterinary education is an efficient teaching concept, and should be used continually and integrated in the curriculum.

  18. Validation of the Rowland Universal Dementia Assessment Scale for Multicultural Screening in Danish Memory Clinics

    DEFF Research Database (Denmark)

    Nielsen, Thomas Rune; Andersen, Birgitte Bo; Gottrup, Hanne

    2013-01-01

    Background/Aims: The Rowland Universal Dementia Assessment Scale (RUDAS) is a brief cognitive screening test that was developed to detect dementia in multicultural populations. The RUDAS has not previously been validated in multicultural populations outside of Australia. The aim of this study...

  19. University Counseling Center Use of Prolonged Exposure Therapy: In-Clinic Treatment for Students with PTSD

    Science.gov (United States)

    Bonar, Ted C.

    2015-01-01

    Students utilize university counseling center services to address distress related to post-traumatic stress disorder (PTSD). Since counseling centers services such as group work or general psychotherapy may not address specific PTSD-symptom reduction, centers often give community referrals in such cases. Evidence-based therapies (EBTs), including…

  20. Surgical treatment of 137 cases with chronic subdural hematoma at the university clinical center of Kosovo during the period 2008?2012

    OpenAIRE

    Mekaj, Agon Y.; Morina, Arsim A.; Mekaj, Ymer H.; Manxhuka-Kerliu, Suzana; Miftari, Ermira I.; Duci, Shkelzen B.; Hamza, Astrit R.; Gashi, Musli M.; Xhelaj, Mentor R.; Kelmendi, Fatos M.; Morina, Qamile Sh.

    2015-01-01

    Background: Chronic subdural hematoma (CSDH) is frequent pathology in neurosurgical practice. The aim of this study is to present the first series of patients with CSDH, who got surgically treated in Clinic of Neurosurgery, University Clinical Center of Kosovo. Materials and Methods: This is a retrospective study that included 137 patients with CSDH who had been treated during the period 2008-2012. The data were collected and analyzed from the archives and protocols of the University Clinical...

  1. Major clinical events, signs and severity assessment scores related to actual survival in patients who died from primary biliary cirrhosis. A long-term historical cohort study

    NARCIS (Netherlands)

    van Dam, GM; Gips, CH; Reisman, Y; Maas, KW; Purmer, IM; Huizenga, [No Value; Verbaan, BW

    1999-01-01

    BACKGROUND/AIMS: One of the prognostic methods for survival in primary biliary cirrhosis (PBC) is the Mayo model, with a time-scale limited to 7 years. The aim of our study was to assess how major clinical events, signs, several severity assessment methods and Mayo survival probabilities fit in with

  2. The US Supreme Court in Mayo v. Prometheus - Taking the fire from or to biotechnology and personalized medicine?

    DEFF Research Database (Denmark)

    Minssen, Timo; Nilsson, David

    2012-01-01

    On 20 March 2012, the US Supreme Court handed down its much awaited patent eligibility- ruling in the dispute between Prometheus Laboratories Inc (“Prometheus”), acting as plaintiffs, and Mayo Medical Laboratories (“Mayo”), as alleged infringers of Prometheus’ licensed patents. This case review w...

  3. [Preconception counseling: evaluation of an outpatient clinic at a university hospital

    NARCIS (Netherlands)

    Weerd, S. de; Wouters, M.G.A.J.; Mom-Boertjens, J.; Bos, K.L.; Steegers, E.A.P.

    2001-01-01

    OBJECTIVE: To provide an overview of the outcomes from an outpatients' clinic for preconceptional counselling in the Netherlands and to assess its activities in terms of referrals, referral indications, supplementary investigations, treatment policy and a possible future pregnancy. DESIGN:

  4. Achieving Educational Goals in Neurology Ward from the Viewpoint of Clinical Clerkship at Kermanshah University of Medical Sciences in 2012

    Directory of Open Access Journals (Sweden)

    Nazanin Razazian

    2012-11-01

    Full Text Available In medical education, setting goals for clinical clerkship is the responsibility of educational groups. Taking the students' opinions into account, it is possible to study the efficacy of education in terms of learning and achieving educational goals. (1In periodontics and restorative departments of Shahed and Tehran University of Medical Sciences, it is reported that, achieving educational goals is not poss-ible (2. Also, some studies have reported the inadequacy of educational objectives in anesthesia clerkship from the viewpoint of medical students (3. In this descriptive-analytic study, 166 medical students of neurology wards at Imam Reza Hospital in Kermanshah during 2011- 2012 were selected via a survey to study the achievement rate of educational goals. We used a questionnaire to collect data. Reliability of the questionnaire (including content and face validity was obtained via consulting with ten faculty members of Kermanshah University of Medical Sciences.The mean age of the participants was 21.34 (±1.43 years. 60.5% of them were females. 3.6% were freshmen and 49.9% were sophomores. 79.5% knew the goals before the start of clinical clerkship and 76.5% took part in the justification session in which their responsibility and method of evaluation were presented. 78.3% of them received the emergency protocol of Neurology. Overall, the participants ranked the goal achievement as high (41.6%, well (45.2% and medium (23.3%. There was no statistically significantly association between achieving educational goals and age and clinical clerkship period. However, there was a statis¬tically significantly association between the increase rate of achieving educational goals and introducing the objectives at the beginning of clinical clerkship period (p=0.011, justification session at the beginning of clinical clerkship (p=0.019 being familiar with emergency protocols of Neurology (p=0.04 and the season (winter in comparison with fall and spring in

  5. Performance of Universal Adhesive in Primary Molars After Selective Removal of Carious Tissue: An 18-Month Randomized Clinical Trial.

    Science.gov (United States)

    Lenzi, Tathiane Larissa; Pires, Carine Weber; Soares, Fabio Zovico Maxnuck; Raggio, Daniela Prócida; Ardenghi, Thiago Machado; de Oliveira Rocha, Rachel

    2017-09-15

    To evaluate the 18-month clinical performance of a universal adhesive, applied under different adhesion strategies, after selective carious tissue removal in primary molars. Forty-four subjects (five to 10 years old) contributed with 90 primary molars presenting moderately deep dentin carious lesions on occlusal or occluso-proximal surfaces, which were randomly assigned following either self-etch or etch-and-rinse protocol of Scotchbond Universal Adhesive (3M ESPE). Resin composite was incrementally inserted for all restorations. Restorations were evaluated at one, six, 12, and 18 months using the modified United States Public Health Service criteria. Survival estimates for restorations' longevity were evaluated using the Kaplan-Meier method. Multivariate Cox regression analysis with shared frailty to assess the factors associated with failures (Padhesion strategy did not influence the restorations' longevity (P=0.06; 72.2 percent and 89.7 percent with etch-and-rinse and self-etch mode, respectively). Self-etch and etch-and-rinse strategies did not influence the clinical behavior of universal adhesive used in primary molars after selective carious tissue removal; although there was a tendency for better outcome of the self-etch strategy.

  6. The Georges Pompidou University Hospital Clinical Data Warehouse: A 8-years follow-up experience.

    Science.gov (United States)

    Jannot, Anne-Sophie; Zapletal, Eric; Avillach, Paul; Mamzer, Marie-France; Burgun, Anita; Degoulet, Patrice

    2017-06-01

    When developed jointly with clinical information systems, clinical data warehouses (CDWs) facilitate the reuse of healthcare data and leverage clinical research. To describe both data access and use for clinical research, epidemiology and health service research of the "Hôpital Européen Georges Pompidou" (HEGP) CDW. The CDW has been developed since 2008 using an i2b2 platform. It was made available to health professionals and researchers in October 2010. Procedures to access data have been implemented and different access levels have been distinguished according to the nature of queries. As of July 2016, the CDW contained the consolidated data of over 860,000 patients followed since the opening of the HEGP hospital in July 2000. These data correspond to more than 122 million clinical item values, 124 million biological item values, and 3.7 million free text reports. The ethics committee of the hospital evaluates all CDW projects that generate secondary data marts. Characteristics of the 74 research projects validated between January 2011 and December 2015 are described. The use of HEGP CDWs is a key facilitator for clinical research studies. It required however important methodological and organizational support efforts from a biomedical informatics department. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Patient characteristics upon initial presentation to chiropractic teaching clinics: A descriptive study conducted at one university

    Science.gov (United States)

    Kaeser, Martha A.; Hawk, Cheryl; Anderson, Michelle

    2014-01-01

    Objective The purpose of this study was to compare demographics and chief complaints of the new patient population at our institution's fee-for-service clinics to the patient population of practicing chiropractors in the United States. We also compared the prevalence of obesity and hypertension to reference standards for the adult population. Methods Patient data were obtained from the electronic health records. All records identified as new patients during October 2013 were included. Variables of interest were clinic site, patient demographics, blood pressure, body mass index (BMI), chief complaint, and ICD-9 codes. Descriptive statistics were computed and compared to reference standards from previous reports. Results During October 2013, there were 224 new patients that entered the clinics. The average patient was a 31- to 50-year-old white male. Our clinic patients differed from those seen by US chiropractors in the distribution of all demographic variables. For adult patients, 31.4% were overweight, 29% were obese, and 8% stage 1 or 2 hypertension. Conclusion New patients in the fee-for-service teaching clinics appear to be dissimilar to those of US practicing chiropractors in several important demographics, characteristics, and types of complaints. The new patients had lower levels of overweight, obesity, and hypertension compared to US reference standards. PMID:25162982

  8. Epidemiological profile of patients seen in the pre-anesthetic assessment clinic of a university hospital

    Directory of Open Access Journals (Sweden)

    Monica Loureiro Santos

    Full Text Available Abstract Objective Assess the demographic and clinical characteristics of surgical patients seen in the Pre-anesthetic Assessment Clinic of the Hospital Universitário Gaffrée e Guinle (APA/HUGG, in order to assist in the pursuit for quality, effectiveness, and resource rationalization of hospital management. Method Cross-sectional descriptive study with 491 patients undergoing elective surgery, treated at APA/HUGG Clinic from March to December 2014. The following variables were assessed: sex, age, BMI, smoking status, associated diseases, classification of MET's and ASA, presence of decompensated disease, medical associated appointments interconsultation, specialty and surgical risk, history of prior anesthetic-surgical procedure, and complications. Results There was a predominance of female (64.8% and overweight patients (55.9%, aged 18-59 years. The prevalence of associated diseases was high (71.3%, with hypertension pressure prevailing (50.1%. Most patients had clinically compensated morbidity (96.3% and long-term use of medication (77.4%. Regarding the surgical characteristics, the most frequent specialty was general and medium risk surgeries. The analysis of the characteristics by age showed that the elderly have more associated diseases and long-term use of medication, in addition to predominance of ASA II-III. Conclusion The epidemiological profile of surgical patients seen at the APA/HUGG was female, age 18-59 years, overweight, with associated diseases, long-term use of medication, without clinical decompensation, ASA II and MET's ≥4. Knowledge of the clinical characteristics of surgical patients is critical to schedule the perioperative care, allowing the improvement of quality and safety in anesthesia and surgery.

  9. Analysis of health services cost at the dental clinic of the San Marcos University.

    OpenAIRE

    Madrid Chumacero, Marco Tulio; Echeandía Arellano, Juana V.

    2014-01-01

    The objectives of this study were: To establish the unitary services cost in Dentistry, To describe simplest way to determine the costs structure approximated for each dental service offered at the clinic. They it was compared with the welfare rates at the dental clinic of the UNMSM, the results were the following ones: 1. Diagnosis: in the four cost activities is higher compared with the official rates, demonstrating "minimum utilities" that goes up from 0,21 to s. 15.96. 2. Radiology: in th...

  10. Assessment of Clinical Stressful Factors Among Academic Students of Nursing and Operating Room of Dezful University of Medical Sciences (2015

    Directory of Open Access Journals (Sweden)

    Mojtaba Raji

    2016-07-01

    Full Text Available Background and Objective: Nursing students are exposed to clinical environmental stresses in addition to educational environmental stresses. The aim of this study was to assessment of clinical stressful factors among Academic Students of Nursing and Operating Room of Dezful University of Medical Sciences in 2015.Materials and Methods: This study was a description-analytical study with 234 students of nursing and operation room up to two semesters for enrolled. Data was using a self-made researcher Questionnaire consisted of demographic information and clinical stressful factors. Data analysis was performed by descriptive and inferential statistics using SPSS-PC (v.20.Results: The findings showed that the main stressors in students of nursing and operation room were unpleasant emotions and least stressful areas were interpersonal communication in a clinical environment. The results showed that the average score of the field of education and humiliating experiences using Spearman correlation test (P=0/045 (r=0/16.Conclusion: Study showed, the mean stress is the moderate level. Stressful areas obtained in the four areas of personal communication, clinical practice stressful, unpleasant feelings and humiliating experience that fortunately, in many cases reform and change.

  11. [Laboratory medicine in the obligatory postgraduate clinical training system--common clinical training program in the department of laboratory medicine in our prefectural medical university hospital].

    Science.gov (United States)

    Okamoto, Yasuyuki

    2003-04-01

    I propose a postgraduate common clinical training program to be provided by the department of laboratory medicine in our prefectural medical university hospital. The program has three purposes: first, mastering basic laboratory tests; second, developing the skills necessary to accurately interpret laboratory data; third, learning specific techniques in the field of laboratory medicine. For the first purpose, it is important that medical trainees perform testing of their own patients at bedside or in the central clinical laboratory. When testing at the central clinical laboratory, instruction by expert laboratory technicians is helpful. The teaching doctors in the department of laboratory medicine are asked to advise the trainees on the interpretation of data. Consultation will be received via interview or e-mail. In addition, the trainees can participate in various conferences, seminars, and meetings held at the central clinical laboratory. Finally, in order to learn specific techniques in the field of laboratory medicine, several special courses lasting a few months will be prepared. I think this program should be closely linked to the training program in internal medicine.

  12. Clinical reliability and validity of elbow functional assessment in rheumatoid arthritis.

    NARCIS (Netherlands)

    Boer, Y.A. de; Ende, C.H.M. van den; Eygendaal, D.; Jolie, I.M.M.; Hazes, J.M.W.; Rozing, P.M.

    1999-01-01

    OBJECTIVES: (1) To investigate the measurement characteristics of the Hospital for Special Surgery (HSS) and Mayo Clinic elbow assessment instruments, utilizing methodological criteria including feasibility, reliability, validity, and discriminative ability; and (2) to develop an efficient and

  13. Clinical analysis of oral carcinoma treated in the department of otolaryngology, Niigata University Hospital

    International Nuclear Information System (INIS)

    Sato, Katsuro; Takahashi, Sugata; Tomita, Masahiko; Watanabe, Jun; Matsuyama, Hiroshi

    2007-01-01

    One hundred and thirty-five sites of oral carcinoma (118 patients) treated in our department during 15 years (1991 to 2005) were clinically analyzed. Multiple carcinomas within the oral cavity arose in 17 sites. In our department, tongue and oral floor were common subsites, followed by buccal mucosa, gingiva, lip, and hard palate. The number of patients increased according to the elevation of clinical stage. Since the subsites and stage characteristics of our department might be due to patients' distribution among medical and dental clinics, correlation of information among medical and dental schools was considered important The significance of multiple malignancies in patients with oral carcinoma was confirmed since multiple malignancies within and outside of the oral cavity occurred at a high rate. The five-year survival rate was 73.8% in tongue carcinoma patients and 58.9% in oral floor carcinoma patients, and the prognosis of patients was fair with positive application of surgery. Since the prognosis of patients without surgery was poor, it is important to consider the treatment strategy for patients who reject surgery and to recommend that they visit a clinic before the tumor advances to an unresectable stage. (author)

  14. Redesign of a University Hospital Preanesthesia Evaluation Clinic Using a Queuing Theory Approach

    NARCIS (Netherlands)

    Zonderland, Maartje Elisabeth; de Boer, F.; Boucherie, Richardus J.; de Roode, A.; van Kleef, J.W.

    Background Changes in patient length of stay (the duration of one visit) as a result of the introduction of an electronic patient file system forced an anesthesia department to change their outpatient clinic organization. The aim of this study is to demonstrate how the involvement of essential

  15. Clinical experience of therapy with cyclotron neutrons at the University of Washington

    International Nuclear Information System (INIS)

    Parker, R.G.; Gerdes, A.J.; Berry, H.C.; Soronen, M.D.

    1975-01-01

    Proper clinical evaluation of fast neutron teletherapy of human cancers will be difficult and time-consuming and will require extension over many years. Fast neutron teletherapy may not have significant advantage over modern conventional supervoltage/megavoltage radiation therapy. A negative answer will be acceptable only if based on sound evidence. If fast neutron teletherapy has an advantage over modern conventional radiation therapy, the advantage may be small and tumor- and site-specific. Detection of a small advantage will require study of a large number of patients and this will be possible only in carefully planned cooperative clinical trials. The study of a large number of patients over a long period will require installation of dedicated neutron generators in research-oriented medical centers. Cooperative clinical trials must be preceded by careful definition of target tumors, normal tissue tolerances, reasonable doses and advantageous patterns of application. Any improvement in local tumor control attributed to fast neutron teletherapy might be dissipated by a concurrent increase in treatment-related sequelae. Much related physics and radiobiology remains to be done and must be supported concurrent with the clinical programs

  16. The clinical feature of HIV/AIDS at presentation at the Jos University ...

    African Journals Online (AJOL)

    Each qualified patient had a comprehensive history taken with emphasis on the clinical symptoms and detailed physical examination performed by the researchers. The data collected were analyzed using a multipurpose computer programme, Epi-info 2000 version 1.1.3 (Atlanta GA, USA). Results: There were 86(43.0%) ...

  17. Treatment of the carcinoma of the vulva at the 1st University-Clinic of Gynaecology in Vienna (386 cases)

    International Nuclear Information System (INIS)

    Kucera, H.

    1980-01-01

    In the department of radiotherapy of the 1st University-Clinic of Gynaecology and Obstetrics in Vienna the electroresection and electrocoagulation is practiced with good success in the treatment of carcinoma of the vulva. Of 386 treated cases with vulvar carcinoma, 234 (60,6%) were alive after five years. After surgical treatment the inguinal lymphonodes were irradiated (6000 rad). In comparison with the international statistic of the Annual Report of the results of treatment in gynaecological cancer (1979) the results obtained in Vienna are much better than the international average. (orig.) [de

  18. Factors influencing patients seeking oral health care in the oncology dental support clinic at an urban university dental school setting.

    Science.gov (United States)

    Corrigan, Dale M; Walker, Mary P; Liu, Ying; Mitchell, Tanya Villalpando

    2014-01-01

    The purpose of this study was to identify predictors and/or factors associated with medically compromised patients seeking dental care in the oncology dental support clinic (ODSC) at the University of Missouri-Kansas City (UMKC) School of Dentistry. An 18-item survey was mailed to 2,541 patients who were new patients to the clinic from 2006 to 2011. The response rate was approximately 18% (n = 450). Analyses included descriptive statistics of percentages/frequencies as well as predictors based on correlations. Fifty percent of participants, 100 females and 119 males, identified their primary medical diagnosis as cancer. Total household income (p dental care (p dental health. Perceived overall health (p Care Dentistry Association and Wiley Periodicals, Inc.

  19. Pilot Design and Implementation of an Innovative Mental Health and Wellness Clinic at a Historically Black College/University.

    Science.gov (United States)

    Moore, Jessica R; Pollio, David E; Hong, Barry A; Valencia, Celeste; Sorrell, Michael; North, Carol S

    2018-05-01

    A pilot mental health and wellness clinic was developed and implemented on the campus of Paul Quinn College, a small Historically Black College and University (HBCU) in Dallas, TX, to address mental health disparities in an African-American student population. Additionally, a series of student engagement activities was developed and implemented to address stigma and enhance linkage to the clinic. The student engagement activities were well attended. In all, 14 students requested a total of 97 appointments during the spring 2016 semester, but attended only 41 appointments. Students sought treatment of a variety of psychiatric disorders, most commonly major depressive disorder and adjustment disorder. A model based on this program could conceivably be extended to serve students more broadly in other HBCUs as well as in community colleges.

  20. Tumors and tumor - like lesions of the oro - facial region at Mayo hospital, Lahore - a five year study

    International Nuclear Information System (INIS)

    Riaz, N.; Warriach, R.A.

    2011-01-01

    The oro-facial region including the oral cavity, the maxilla and mandible and related tissues can be the site of a multitude of neoplastic conditions. These tumours have a predilection for the entire facial region; however, odontogenic tumours tend to affect the mandible more than the maxilla. We report results from a retrospective study spanning five years on the frequency, clinical presentation, sites and character of orofacial tumors seen in the main referral hospital of Pakistan. Patients and Methods: Records of consecutive patients of all age and sex seen by the author's team at the Department of Oral and Maxillofacial Surgery, Mayo Hospital with tumours affecting the oro-facial region from January 2005 to December 2009 were retrieved, coded and entered into a database. The data were then analyzed by age, sex, presenting signs and symptoms, site of lesion, and their histology. Results: A total of 237 patients with oro-facial swellings were retrieved from the registry. The complete data set was obtained for 189 patients, comprising 108 (57.9%) males and 81 (42%) females. The most common clinical presenting features were mandibular facial swelling (63%), intra-oral swelling (55%), and ulceration (29%). The tumors were found in the mandible 67 (35%), buccal mucosa 33 (17%), floor of the mouth 22 (11%) and tongue 29 (15%). The remainder making up almost 20% was found in the palate, submandibular region, pre auricular region and lips. Ninety three (49.2%) of the patients presented with lesions that were classified as malignant of which 64 (69%) were diagnosed as squamous cell carcinoma (SCC). seventy (37.0%) had benign odontogenic tumors and twenty six (13.7%) had non-odontogenic tumor - like lesions. Sixty - four (69%) of malignant tumors were squamous cell carcinoma; sixty four (86.4%) of the benign odontogenic tumors were classified as ameloblastoma. The mean age at presentation of all lesions was 40.4 years with over 50% of benign lesions in patients aged

  1. Determining nurses\\' clinical competence in hospitals of Bushehr University of Medical Sciences by self assessment method

    Directory of Open Access Journals (Sweden)

    Masood mahreini

    2008-09-01

    Full Text Available Background: Nurses’ self awareness of their own level of clinical competence is essential in maintaining high standards of care and identifying areas of educational need and professional development. Self-assessment is a method for measuring clinical competence, and encourages nurses to use reflective thinking and take an active part in the learning process. Although nurse competence may vary between hospitals, very few studies have been done on this subject. Methods: In this cross sectional study, we analyzed clinical competency of 190 registered nurses working in different hospitals in Bushehr by self assessment method. The instrument for data collection was a valid and reliable questionnaire consisting of 73 items from seven categories which were devised from Benner's “from Novice to Expert” framework. The level of competence was assessed on a scale of 0-100 and the frequency of using the competencies was assessed on a Likert scale. Results: the nurses reported their overall level of competence as “good” (51-75. They felt more competent in the categories of “managing situations” and “helping role” (with maximum score of 79.54 and least competent in “teaching – coaching” and “ensuring quality” categories (with minimum score of 61.15. The frequency of practicing competencies had a positive correlation with the level of nursing clinical competence. Conclusion: The level of nursing competence and frequency of using competencies varied in different hospitals. Although the nurses reported their overall level of competence as good, we should be concerned about 24% of competencies which are not used by the nurses, especially in "teaching – coaching" and "ensuring quality" categories.

  2. [Is autonomy a universal value principle? The study of concrete clinical cases in perinatology].

    Science.gov (United States)

    Tilmans-Cabiax, Chantal

    2007-09-01

    Certain perinatalogy situations make one confront cultural differences and, in particular, the relative importance of the value of female autonomy. This leads to the following question: should autonomy have as much weight everywhere as it is given in Western health ethics? The passionate, philosophical and historical work by J.B. Schneewind, The Invention of Autonomy: A History of Modern Moral Philosophy, is used to assist in the understanding of the important cultural evolutions which have interacted to support the idea of moral autonomy in the West. This return to our roots brings us, not to question moral autonomy through its claim to universality, but to dare to relativize the modalities according to cultural contexts. And especially to rehabilitate other values--for example caring for one another--prominent in other more community orientated societies in which the West can be inspired.

  3. Mini clinical evaluation exercise in undergraduate dermatovenereology education: an experience of University of Pamukkale, Medical Faculty

    Directory of Open Access Journals (Sweden)

    Şeniz Ergin

    2013-03-01

    Full Text Available Background and Design: Mini Clinical Evaluation Exercise (Mini-CEX is being widely used in medical education and is a reliable and valid method for the assessment of residents’ competency in medical interviewing, physical examination, humanistic qualities/professionalism, clinical judgment, counseling skills, organization, and efficiency. In order to enhance formative evaluation methods in our faculty, we planned to apply the method to students on dermatovenereology training. Materials and Methods: The Mini-CEX was performed by residents to 42 medical students. At first, 5 residents were evaluated by a faculty member with Mini-CEX and were informed about their application-oriented evaluator roles. The students were informed prior to conducting the assessment. Standard Mini-CEX form was used for the assessment. The participants were rated in 7 competencies and each was rated using a 9-point Likert scale. At the end of each encounter, students and evaluators rated their satisfaction with Mini-CEX using a 9-point Likert scale. Student’s t-test and one-way ANOVA were used for statistical analysis. Student feedback was evaluated with “grounded theory”. Results: A total of 50 assessments, 44 in outpatient and 6 in inpatient clinic, were performed. Satisfaction with the Mini-CEX was rated by the evaluators and the students as 7,16 and 7,98, respectively. There was no significant difference between the evaluators in terms of student satisfaction. Average time spent on observing the encounter and in giving feedback was 16.5 and 6.5 minutes, respectively. There was no significant difference between assessors in terms of time spent observing and giving feedback. Average scores of assessed clinical competencies were between 4,28 and 8,14. The highest scores were reported on humanistic qualities/ professionalism whereas the lowest were reported on clinical judgment skills. Discussion: According to our data, we believe that Mini-CEX may be used as an

  4. Morbidity and mortality pattern of hospitalized children with measles at mayo hospital, lahore (epidemic 2013)

    International Nuclear Information System (INIS)

    Javed, T.; Bibi, A.

    2014-01-01

    Major outbreak of measles took place in Punjab recently (2013), leading on to increase in hospitalized cases of measles in children wards, with unacceptably high morbidity and mortality. The aim of this study was to find out morbidity and mortality pattern of hospitalized cases of measles and associated factors. Design: Prospective case series conducted at Pediatric Department Mayo Hospital, Lahore for 7 months, i.e. from 1st Jan to 31st Jul 2013 Methods:A total of 628 cases of measles were admitted in the children ward, Unit II, Mayo Hospital, Lahore from Jan-Jul 2013. The diagnosis was assigned using WHO criteria. Cases were admitted through emergency on 24 hour basis and managed in HDU and Measles isolation section. Chest X-Ray and blood complete examination was done in all cases. Complications were noted and managed along with eye consultations where necessary. Data was recorded in a predesigned proforma and entered in computer. Results: 628 admitted cases were enrolled, with comparable sex distribution, having mean age 30.8+-26.25 months and mean weight 9.69+-4.14 Kg. Eighty three percent cases were below 6 years of age (33% <1 year), 71% cases were under weight and 68% were wasted (WHO classification). Sixty six percent cases had not received measles vaccination, 144 (23%) cases had received a single dose and 71 cases (12.2%) had received two doses before admission. Majority of cases belonged to Lahore city and its peri-urban areas (83%). Pneumonia (80%), diarrhea (37%), and encephalitis (7.7%) were common complications. Eye complications (corneal ulcers, keratitis, perforation and blindness) were seen in 7.3% cases. Being under weight, H/O improper measles immunization, presence of anemia, pneumonia and encephalitis were statistically significant risk factors for mortality. The case fatality rate was 8.76%. Conclusion:Recent Measles outbreak further highlights the importance of strengthening the need for routine and mass vaccination for all children. In a

  5. Clinical experiences of undergraduate dental students in pediatric dentistry at Cork University Dental School and Hospital, Ireland.

    LENUS (Irish Health Repository)

    Stewart, Christopher J

    2010-03-01

    The objectives of this study were to evaluate the number and range of clinical procedures completed by undergraduate dental students in pediatric dentistry in Cork University Dental School and Hospital, Ireland, and to compare the number of procedures undertaken with the subsequent examination scores. The work comprised a retrospective audit of clinical logbooks for all of the undergraduate dental students in one cohort through their fourth and fifth clinical years between 2004 and 2006. Thirty-four quantitative logbooks were audited. Students had seen a total of 1,031 patients, and each student had completed a full course of dental treatment for an average of twenty-two children. Students completed means of 30.2 restorative procedures for children, fourteen in deciduous dentition (range six to twenty-eight), and seventeen in permanent dentition (range seven to twenty-eight). Continuity of education and care (measured through children having their treatment fully completed by the same student) was 72 percent. A moderate positive correlation between levels of clinical experience and exam score was identified. All students gained experience in management of child patients with students providing care for an average of thirty children and a minimum of nineteen.

  6. A New Approach for Education and Training of Medical Physicists in Cuba: From University to Clinical Training

    International Nuclear Information System (INIS)

    Alfonso-Laguardia, R.; Rivero Blanco, J.M.

    2016-01-01

    Full text: According to the international recommendations of IAEA and the International Organization for Medical Physics (IOMP), the education and training of clinically qualified medical physicists (CQMP) should include three main academic and professional elements: a university level education, a postgraduate education specific in medical physics (MP) and a supervised clinical training. In Cuba, most of the medical physicists working in radiation oncology (RO) or nuclear medicine (NM) services have graduated from nuclear related programmes of the High Institute on Applied Technologies and Sciences (InSTEC), who further perform a postgraduate study in medical physics (MP), at the level of a so-called Diploma course or a Master in Sciences. Nevertheless, the third level of education, namely the supervised clinical training has not yet been established, due to the lack of official recognition of the profession of MP by the health authorities. A new approach for comprehensive training of CQMP is presented, where, by maintaining the three elements of education, the process is optimized so that a medical physicist is prepared with the highest level of theoretical and clinical training, in agreement with the current demand of the advanced technologies put in service in Cuban hospitals. (author

  7. Impact of the University of Colorado's Advanced Clinical Training and Service (ACTS) Program on dental students' clinical experience and cognitive skills, 1994-2006.

    Science.gov (United States)

    Berg, Rob; Call, Richard L; Maguire, Kerry; Berkey, Douglas B; Karshmer, Bernard A; Guyton, Brad; Tawara-Jones, Karen

    2010-04-01

    The University of Colorado Denver School of Dental Medicine has operated a community-based dental education program for all of its students since 1985. A database of student productivity has been maintained in a standardized format, capable of multiyear compilation, since 1994. This study utilizes twelve years of these data to profile the type and amount of clinical treatment that can be provided by a typical fourth-year dental student during a 100-day community-based training experience. Between 1994 and 2006, the school's 423 graduates provided a mean of 922 treatment procedures per student at a mean of 498 patient visits per student. During a typical four-week clinical affiliation, each student provided a mean of approximately twenty-seven restorations on permanent teeth, sixteen restorations on primary teeth, and twenty-four oral surgery procedures (extractions). Students also gained considerable experience in periodontics, fixed and removable prosthodontics, and endodontics. Self-assessed competency ratings tended to increase after completing the program, as did willingness to treat underserved populations after graduation. About 16 percent of graduates reported planning to practice in the public sector after completing dental school. A community-based experience such as this appears to offer an opportunity to substantially augment dental students' clinical training experiences.

  8. Agreement between Cochrane Neonatal Group reviews and clinical guidelines for newborns at a Copenhagen University Hospital - a cross-sectional study

    DEFF Research Database (Denmark)

    Brok, Jesper; Greisen, Gorm; Jacobsen, Robert Thorkild

    2007-01-01

    To assess the agreement between Cochrane Neonatal Group reviews and clinical guidelines of a University Neonatology Department, to evaluate the reasons for potential disagreements and to ascertain whether Cochrane reviews were considered for the guidelines development.......To assess the agreement between Cochrane Neonatal Group reviews and clinical guidelines of a University Neonatology Department, to evaluate the reasons for potential disagreements and to ascertain whether Cochrane reviews were considered for the guidelines development....

  9. Electronic health record in the internal medicine clinic of a Brazilian university hospital: Expectations and satisfaction of physicians and patients.

    Science.gov (United States)

    Duarte, Jurandir Godoy; Azevedo, Raymundo Soares

    2017-06-01

    To evaluate the satisfaction and expectations of patients and physicians before and after the implementation of an electronic health record (EHR) in the outpatient clinic of a university hospital. We conducted 389 interviews with patients and 151 with physicians before and after the implementation of a commercial EHR at the internal medicine clinic of Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo (HC-FMUSP), Brazil. The physicians were identified by their connection to the outpatient clinic and categorized by their years since graduation: residents and preceptors (with 10 years or less of graduation) or assistants (with more than 10 years of graduation). The answers to the questionnaire given by the physicians were classified as favorable or against the use of EHR, before and after the implementation of this system in this clinic, receiving 1 or 0 points, respectively. The sum of these points generated a multiple regression score to determine which factors contribute to the acceptance of EHR by physicians. We also did a third survey, after the EHR was routinely established in the outpatient clinic. The degree of patient satisfaction was the same before and after implementation, with more than 90% positive evaluations. They noted the use of the computer during the consultation and valued such use. Resident (younger) physicians had more positive expectations than assistants (older physicians) before EHR implementation. This optimism was reduced after implementation. In the third evaluation the use of EHR was higher among resident physicians. Resident physicians perceived and valued the EHR more and used it more. In 28 of the 57 questions on performance of clinical tasks, resident physicians found it easier to use EHR than assistant physicians with significant differences (pclinical setting should be preceded by careful planning to improve physician's adherence to the use of EHR. Patients do not seem to notice much difference to the

  10. Analysis of clinical records of dental patients attending Jordan University Hospital: Documentation of drug prescriptions and local anesthetic injections

    Directory of Open Access Journals (Sweden)

    Najla Dar-Odeh

    2008-08-01

    Full Text Available Najla Dar-Odeh1, Soukaina Ryalat1, Mohammad Shayyab1, Osama Abu-Hammad21Department of Oral and Maxillofacial Surgery Oral Medicine and Periodontics, Faculty of Dentistry, University of Jordan, Jordan; 2Department of Prosthetic Dentistry, Faculty of Dentistry, University of Jordan, JordanObjectives: The aim of this study was to analyze clinical records of dental patients attending the Dental Department at the University of Jordan Hospital: a teaching hospital in Jordan. Analysis aimed at determining whether dental specialists properly documented the drug prescriptions and local anesthetic injections given to their patients.Methods: Dental records of the Dental Department at the Jordan University Hospital were reviewed during the period from April 3rd until April 26th 2007 along with the issued prescriptions during that period.Results: A total of 1000 records were reviewed with a total of 53 prescriptions issued during that period. Thirty records documented the prescription by stating the category of the prescribed drug. Only 13 records stated the generic or the trade names of the prescribed drugs. Of these, 5 records contained the full elements of a prescription. As for local anesthetic injections, the term “LA used” was found in 22 records while the names and quantities of the local anesthetics used were documented in only 13 records. Only 5 records documented the full elements of a local anesthetic injection.Conclusion: The essential data of drug prescriptions and local anesthetic injections were poorly documented by the investigated group of dental specialists. It is recommended that the administration of the hospital and the dental department implement clear and firm guidelines for dental practitioners in particular to do the required documentation procedure.Keywords: dental records, documentation, prescriptions, local anesthesia

  11. Interactive tele-education applied to a distant clinical microbiology specialization university course.

    Science.gov (United States)

    Andreazzi, Denise B; Rossi, Flávia; Wen, Chao L

    2011-09-01

    The microbiology laboratory provides a strategic support for infectious disease diagnosis and also alerts the medical community about bacterial resistance to antibiotics. The microbiologists' training is a challenge in Brazil, a country with an extensive territory, a diverse population, and disparity of resource allocation. The aim of this study was to implement an interactive tele-educational course in clinical microbiology to reach distant laboratory workers and to improve their professional skills. The course scientific content was defined according to competences associated, distributed in 560 h, with laboratory practices (knowledge matrix-contextual education). The 11-module course structure comprised 70% distance learning, 22% on campus (integrated modules), and 8% monographs. The group included 7 physicians and 21 microbiologists from 20 different Brazilian cities. The time flexibility and location were the two main reasons for student participation, thus decreasing absences to the workplace, different from the traditional teaching methodologies. The group performance was measured by monthly evaluations, and 1 year postcourse, the researcher visited their workplace. There was significant improvement in microbiological practices performed before compared with after group participation. Therefore, 76.9% of laboratory practices were modified because of the knowledge acquired in the course. Students showed behavioral changes in relation to performance in infection control as well as on the dissemination of their knowledge. This specialization course using distance education did not compromise the quality. This educational methodology represents an alternative to teach clinical microbiology to laboratory workers from remote hospitals, as a nationwide continuing educational strategy.

  12. Histopathological Study of Hysterectomy Operations in A University Clinic in Tehran From 2005 to 2009

    Directory of Open Access Journals (Sweden)

    Mahmoud Khaniki

    2011-06-01

    Full Text Available Objective: We intended to determine causes and histological pattern of hysterectomies in an Iranianpopulation.Materials and methods: Archived reports of pathology department of a university hospital dated March2005 to March 2009 were retrospectively reviewed. Age, chief complaint, type of operation includingabdominal, vaginal and subtotal hysterectomy, the indication of the operation and the pathology of thespecimen were retrieved from the records.Results: The average rate of hysterectomy was 219 per year. The average age of the patients was49.6±11.3. About 40% of cases aged 45-54 years. The main chief compliant was abnormal uterinebleeding (62.2%. The leading preoperative indication for hysterectomy operations were uterineleiomyoma (24.8% and then abnormal uterine bleeding and abdominal/pelvic mass. The most frequentpathologic findings were leiomyoma (22.0% and adenomyosis (12.1%. In 11.8% of hysterectomyspecimens no pathologic lesion was found.Conclusion: The hysterectomy is rather common in Iran with age dependent pattern of indications andcorresponding pathologies.

  13. Pattern of clinical presentation of eclampsia at Nnamdi Azikiwe University Teaching Hospital, Nnewi, Southeastern Nigeria.

    Science.gov (United States)

    Adinma, E D; Echendu, D A

    2012-01-01

    Eclampsia contributes significantly to maternal and perinatal mortalities globally. The objective of this study is to review the pattern of Eclampsia in Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Nigeria. A retrospective study that reviewed records from labour ward and the Medical Records Department, of cases of Eclampsia managed at NAUTH over a ten year period 1st January-31st December, 2009. There were 57 cases of Eclampsia out of a total of 6,262 deliveries within the study period, giving a prevalence of 0.91%. The highest prevalence of 0.24% occurred in 2009. It was most common, 14 (30.4%), in the 25-29 year age group. The nulliparous women, 28 (61%) were more commonly affected. The prevalence was higher in the un-booked patients (89%), and antepartum Eclampsia was the commonest type (76%). Twenty one (45.7%) patients had three or more convulsions prior to the institution of therapy. Headache, oedema, and blurring of vision were the commonest symptoms, 74%, 71%, and 65% respectively. Eclampsia occurred mainly in un-booked and primigravid patients in this study. Early registration of pregnant women, especially primigravid, in health facilities for effective antenatal care and supervised hospital delivery will significantly reduce the prevalence and complications of Eclampsia.

  14. Environmental iodine intake and pattern of thyroid diseases: experience at nuclear medicine centre, Mayo Hospital (abstract)

    International Nuclear Information System (INIS)

    Elahi, S.; Khan, M.; Rasool, S.; Khalid, A.; Tasneem, A.

    2011-01-01

    To know level of iodine intake in women residing in Lahore and correlate it with pattern of thyroid diseases found in women referred to Centre for Nuclear Medicine (CENUM), Mayo Hospital. Iodine intake status was determined by urinary iodine (UI) excretion by Sandell-Kolthoff reaction. Thyroid related hormones (FT4, FT3 and TSH) were measured by radioimmunoassay. In 110 non-pregnant euthyroid women (age 20-36 year) average iodine intake was 66.3 +- 14.4 mu g/L (range: 30-98 mu g/dL). All women were iodine deficient (UI 22.0 pmol/L and TSH greater or equal to 0.1mIU/L) was detected in 580(10.8%) women and hypothyroidism (FT4 0.4mIU/L) was found in 271(5.1%) women. Thus incidence of hyperthyroidism was almost double than that of hypothyroidism. Low iodine intake is manifested as increased incidence of hyperthyroidism. (author)

  15. The Mayo-Portland Participation Index: A brief and psychometrically sound measure of brain injury outcome.

    Science.gov (United States)

    Malec, James F

    2004-12-01

    To evaluate the internal consistency, interrater agreement, concurrent validity, and floor and ceiling effects of the 8-item Participation Index (M2PI) of the Mayo-Portland Adaptability Inventory (MPAI). M2PI data derived from MPAIs completed independently by the people with acquired brain injury undergoing evaluation, their significant others, and rehabilitation staff were submitted to Rasch Facets analysis to determine the internal consistency of each independent rater group and of composite measures that combined rater groups. Correlations with the full-scale MPAI were examined to assess concurrent validity, as was interrater agreement. Outpatient rehabilitation in academic physical medicine and rehabilitation department. People with acquired brain injury (N=134) consecutively seen for evaluation, significant others, and evaluating staff. Not applicable. The MPAI and M2PI. The M2PI showed satisfactory internal consistency, concurrent validity, interrater agreement, and minimal floor and ceiling effects, although evidence of rater bias was also apparent. Composite indices showed more desirable psychometric properties than ratings by individual rater groups. The M2PI, particularly in composite indices and with attention to rater biases, provides an outcome measure with satisfactory psychometric qualities and the potential to represent the varying perspectives of people with acquired brain injury, significant others, and rehabilitation staff.

  16. Elemental composition of Usnea sp lichen from Potter Peninsula, 25 de Mayo (King George) Island, Antarctica

    International Nuclear Information System (INIS)

    Bubach, Débora; Catán, Soledad Perez; Di Fonzo, Carla; Dopchiz, Laura

    2016-01-01

    Several pollutants, which include metals, are present in the Antarctic atmosphere, snow, marine and terrestrial organisms. This work reports the elements incorporated by Usnea sp thalli in Potter Peninsula, 25 de Mayo (King George) Island, South Shetlands, Antarctica. Geological origin was analyzed as possible sources of elements. For this purpose, correlations were done using a geochemical tracer, principal component analysis and enrichment factors were computed. Lithophile elements from particulate matter were present in most of the sampling sites. Bromine, Se and Hg showed the highest enrichment factors suggesting other sources than the particulate matter. Mercury values found in Usnea sp were in the same range as those reported for Deception Island (South Shetlands) and remote areas from the Patagonia Andes. - Highlights: • Hg enrichment factor was higher in ASPA than in human settlements area. • The elemental composition in Usnea sp from Antarctica reflected the human influence. • Bromine, Ca, Sr, Se, Fe, Hg and K contents indicated origins natural and anthropic. • The data will be considered as baselines for Potter Peninsula, King George Island. - This study provides recent element contents in Usnea sp from Potter Peninsula, South Shetland Islands, Antarctica. Some of them are the first concentration reported by Argentina.

  17. El valor de los servicios ambientales en la cuenca baja del río Mayo

    Directory of Open Access Journals (Sweden)

    Alma Angelina Haro Martínez

    2015-01-01

    Full Text Available en este trabajo se presentan los resultados de la valora-ción económica de los servicios ambientales, para la cuencabaja del río Mayo, en Sonora, en el noroeste de México,donde las actividades económicas han impactado severa-mente y sustituido los ecosistemas naturales en la mayorparte del territorio. La metodología utilizada consistió en ladelimitación de los servicios en función de su distribuciónespacial y, en algunos casos, se usaron componentes de losecosistemas como proxy. Se compararon nueve servicios,que abarcan los cuatro grupos de funciones ecosistémicas(regulación, soporte, provisión y cultural. Los cálculos sebasaron en valores estimados de mercado por servicio y porunidad de área. Esto generó nueve mapas individuales y unodonde se integra el valor total por unidad de área.

  18. Polyphenolic substrates and dyes degradation by yeasts from 25 de Mayo/King George Island (Antarctica).

    Science.gov (United States)

    Rovati, José I; Pajot, Hipólito F; Ruberto, Lucas; Mac Cormack, Walter; Figueroa, Lucía I C

    2013-11-01

    Antarctica offers a range of extreme climatic conditions, such as low temperatures, high solar radiation and low nutrient availability, and constitutes one of the harshest environments on Earth. Despite that, it has been successfully colonized by ’cold-loving’ fungi, which play a key role in decomposition cycles in cold ecosystems. However, knowledge about the ecological role of yeasts in nutrient or organic matter recycling/mineralization remains highly fragmentary. The aim of this work was to study the yeast microbiota in samples collected on 25 de Mayo/King George Island regarding the scope of their ability to degrade polyphenolic substrates such as lignin and azo dyes. Sixty-one yeast isolates were obtained from 37 samples, including soil, rocks, wood and bones. Molecular analyses based on rDNA sequences revealed that 35 yeasts could be identified at the species level and could be classified in the genera Leucosporidiella, Rhodotorula, Cryptococcus, Bullera and Candida. Cryptococcus victoriae was by far the most ubiquitous species. In total, 33% of the yeast isolates examined showed significant activity for dye decolorization, 25% for laccase activity and 38% for ligninolytic activity. Eleven yeasts did not show positive activity in any of the assays performed and no isolates showed positive activity across all tested substrates. A high diversity of yeasts were isolated in this work, possibly including undescribed species and conspicuous Antarctic yeasts, most of them belonging to oligotrophic, slow-growing and metabolically diverse basidiomycetous genera.

  19. [Effectiveness and difficulty of education on nosocomial infection control for pre-clinical practice in the clinic, so-called inclusive clinical practice phase I, for students in the Faculty of Dentistry, Tokyo Medical and Dental University].

    Science.gov (United States)

    Sunakawa, Mitsuhiro; Matsumoto, Hiroyuki

    2009-03-01

    It has been planned to give pre-clinical practice in the clinic, so-called inclusive clinical practice phase I, for fifth-grade students in the School of Dentistry, Faculty of Dentistry, Tokyo Medical and Dental University, to give them the clinical training needed to perform dental practice and clinical practicum for comprehensive patient care, namely inclusive clinical practice phase II. This study analyzed the educative efficiency of the class on nosocomial infection control (NIC) by comparing achievements pre- and post-test, and discussed appropriate education planning on the NIC for dental students. Sixty-two fifth-grade students in the 2007 academic year sat the pre- and post-tests; the mean score and standard deviation of these tests were 5.30 +/- 1.26 (n = 56) and 8.59 +/- 1.18 (n = 59), respectively. There was a statistically significant difference between them (paired t-test, p < 0.01). Another finding was that students with high scores in the post-test did not necessarily achieve high ratings in the pre-test. It is suggested that the introduction of pre- and post-tests and the clarification of main points in the class as a theme of NIC could be a useful tool for increasing the comprehension of students on the theme. Since students at lower grades will attend clinical practice in the university hospital, it is thought that students should be given NIC training early in the clinical course, and the current curriculum should be improved to increase the opportunity for students to study this important issue.

  20. Overview of two years of clinical experience of chest tomo-synthesis at Sahlgrenska university hospital

    International Nuclear Information System (INIS)

    Johnsson, Aa. A.; Vikgren, J.; Svalkvist, A.; Zachrisson, S.; Flinck, A.; Boijsen, M.; Kheddache, S.; Maansson, L. G.; Baath, M.

    2010-01-01

    Since December 2006, ∼ 3800 clinical chest tomo-synthesis examinations have been performed at our department at Sahlgrenska Univ. Hospital. A subset of the examinations has been included in studies of the detectability of pulmonary nodules, using computed tomography (CT) as the gold standard. Visibility studies, in which chest tomo-synthesis and CT have been compared side-by side, have been used to determine the depiction potential of chest tomo-synthesis. Comparisons with conventional chest radiography have been made. In the clinical setting, chest tomo-synthesis has mostly been used as an additional examination. The most frequent indication for chest tomo-synthesis has been suspicion of a nodule or tumour. In visibility studies, tomo-synthesis has depicted over 90% of the nodules seen on the CT scan. The corresponding figure for chest radiography has been <30%. In the detection studies, the lesion-level sensitivity has been ∼ 60% for tomo-synthesis and 20% for chest radiography. In one of the detection studies, an analysis of all false-positive nodules was performed. This analysis showed that all findings had morphological correlates on the CT examinations. The majority of the false-positive nodules were localised in the immediate sub-pleural region. In conclusion, chest tomo-synthesis is an improved chest radiography method, which can be used to optimise the use of CT resources, thereby reducing the radiation dose to the patient population. However, there are some limitations with chest tomo-synthesis. For example, patients undergoing tomo-synthesis have to be able to stand still and hold their breath firmly for 10 s. Also, chest tomo-synthesis has a limited depth resolution, which may explain why pathology in the sub-pleural region is more difficult to interpret and artefacts from medical devices may occur. (authors)

  1. Clinical and Biological Insights from the University of California San Francisco Prospective and Longitudinal Cohort.

    Science.gov (United States)

    Benn, Bryan S; Lehman, Zoe; Kidd, Sharon A; Ho, Melissa; Sun, Sara; Ramstein, Joris; Arger, Nicholas K; Nguyen, Christine P; Su, Robert; Gomez, Antonio; Gelfand, Jeffrey M; Koth, Laura L

    2017-10-01

    Sarcoidosis is a systemic inflammatory disease characterized by non-necrotizing granulomas in involved organs, most commonly the lung. Description of patient characteristics in the Western United States is limited. Furthermore, blood-based measures that relate to clinical sarcoidosis phenotypes are lacking. We present an analysis of a prospective, longitudinal sarcoidosis cohort at a Northern Californian academic medical center. We enrolled 126 sarcoidosis subjects and 64 healthy controls and recorded baseline demographic and clinical characteristics. We used regression models to identify factors independently associated with pulmonary physiology. We tested whether blood transcript levels at study entry could relate to longitudinal changes in pulmonary physiology. White, non-Hispanics composed ~70% of subjects. Hispanics and Blacks had a diagnostic biopsy at an age ~7 years younger than whites. Obstructive, but not restrictive, physiology characterized Scadding Stage IV patients. Subjects reporting use of immunosuppression had worse FEV1%p, FVC%p, and DLCO%p compared to subjects never treated, regardless of Scadding stage. We defined sarcoidosis disease activity by a drop in pulmonary function over 36 months and found that subjects meeting this definition had significant repression of blood gene transcripts related to T cell receptor signaling pathways, referred to as the "TCR factor." Obstructive pulmonary physiology defined Stage IV patients which were mostly white, non-Hispanics. Genes comprising the composite gene expression score, TCR factor, may represent a blood-derived measure of T-cell activity and an indirect measure of active sarcoidosis inflammation. Validation of this measure could translate into individualized treatment for sarcoidosis patients.

  2. Psychosocial problems of clinical students in the University of Ibadan Medical School.

    Science.gov (United States)

    Omokhodion, F O; Gureje, O

    2003-03-01

    A cross sectional study was carried out among medical students in the University of Ibadan to identify their socio economic and psychological problems. Three hundred and sixteen students, 159 males and 157 females participated in the study. The questionnaire, which was self-administered, sought information about sources of financial support, type of accommodation, use of recreational facilities, smoking and drinking habits and sources of stress and insecurity on the campus. The GHQ-12 was used to assess their mental status. Ninety-four percent of students were sponsored by their parents. Average monthly income as pocket money ranged from N800-N15,000. Sixty-three (20%) reported that their pocket money was inadequate and 11 (3.5%) engage in business ventures to supplement their income. Two hundred and fifty-seven (81%) live on the campus, 11 (3.5%) were current smokers and 54 (18%) were current drinkers. Stealing and lack of money were the commonest causes of insecurity on the campus. Lack of money, fear of failure of examinations, family problems and broken relationships were reported as causes of depression among this study population. GHQ scores ranged from 1 to 9 using a cut-off point of 3 scores, 38 students (12.0%) were categorised as having traits of poor mental health. GHQ scores were not associated with age, sex, smoking or drinking status or students' assessment of the adequacy of their pocket money. However, living off campus and poor self-perception were associated with poor mental health (p < 0.01). Counseling services should be provided in the medical school to assist students to handle issues that constitute a source of stress in their psychosocial environment.

  3. Quality of clinical supervision as perceived by attending doctors in university and district teaching hospitals.

    Science.gov (United States)

    Busari, Jamiu O; Koot, Bart G

    2007-10-01

    Attending doctors (ADs) play important roles in the supervision of specialist registrars. Little is known, however, about how they perceive the quality of their supervision in different teaching settings. We decided to investigate whether there is any difference in how ADs perceive the quality of their supervision in university teaching hospital (UTH) and district teaching hospital (DTH) settings. We used a standardised questionnaire to investigate the quality of supervision as perceived by ADs. Fifteen items reflecting good teaching ability were measured on a 5-point Likert scale (1-5: never-always). We investigated for factors that influenced the perceived quality of supervision using Likert scale items (1-5: totally disagree-totally agree) and open-ended questionnaires. A total of 83 ADs (UTH: 51; DTH: 32) were eligible to participate in the survey. Of these, 43 (52%) returned the questionnaire (UTH: 25; DTH: 18). There was no difference in the overall mean of the 15 items between the UTH (3.67, standard deviation [SD] 0.35) and DTH (3.73, SD 0.31) ADs. Attending doctors in the DTH group rated themselves better at 'teaching technical skills' (mean 3.50, SD 0.70), compared with their UTH counterparts (mean 3.0, SD 0.76) (P = 0.03). Analysis of variance of the overall means revealed no significant difference between the different hospital settings. The results suggest that teaching hospital environments do not influence how ADs perceive the quality of their supervision. Lack of time for teaching was perceived as responsible for poor supervision. Other factors found to influence AD perceptions of good supervision included effective teaching skills, communication skills and provision of feedback.

  4. Clinical and Demographic Features of Pseudotumor Cerebri Syndrome Diagnosed in a University Hospital

    Directory of Open Access Journals (Sweden)

    Demet Arslan

    2017-06-01

    Full Text Available Objective: Pseudotumor cerebri syndrome (PTCS is characterized by symptoms and signs of increased intracranial pressure without ventriculomegaly, intracranial tumor or mass. This study aimed to explore and analyze 34 patients with PTCS according to age, sex, symptoms of the disorder, cranial magnetic resonance images findings, etiology, and treatment. Materials and Methods: A total of 34 patients who were diagnosed as having PTCS and followed up between January 2011 and August 2016 by Dicle University Medical School Neurology Department were included in this study. PTCS was diagnosed in accordance with the modified Dandy criteria. Results: Thirty-four patients were identified as having PTCS. Twenty-one (91.2% had headache, 19 (55.9% had blurred vision, 6 (17.6% had diplopia, 2 (5.9% had vertigo, 1 (2.9% had tinnitus, and 1 (2.9% had numbness of the face. Twenty-seven patients were diagnosed as having idiopathic intracranial hypertension, 21 (61.8% had no etiologic factors. Six (17.6% patients were obese, one of whom had recently gained weight and another had polycystic ovary syndrome. Seven patients were thought to have secondary PTCS with the following etiologic factors: 2 (5.9% patients had Hashimoto’s thyroiditis, 1 (2.9% had a history of all-trans retinoic acid intake due to a malignancy, 1 (2.9% had choroid plexus granuloma, 2 (5.9% had sinus venous thrombosis, and 1 (2.9% had Familial Meditteranian Fever. Conclusion: Although PTCS was described many years ago, its physiopathology and exact treatment procedures are not clearly understood. The most important target of its treatment is to prevent loss of vision and improve symptoms. With a better understanding of its pathophysiology, effective treatment protocols will be developed

  5. Determining the association between retinopathy and metabolic syndrome in patients with type 2 diabetes mellitus visiting Mayo Hospital, Lahore

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    Ghani, U; Niaz, Z; Cheema, T M; Abaidullah, S; Salman, S; Latif, F [King Edward Medical University, Mayo Hospital, Lahore (Pakistan). Dept. of Diabetic Mellitus

    2010-04-15

    Introduction: The metabolic syndrome is a cluster of metabolic abnormalities including abdominal obesity, glucose intolerance, hypertension and dyslipidemia. Diabetic retinopathy is common sequel of diabetes. Objective: To determine the frequency of retinopathy in patients of type 2 diabetes metabolic syndrome. Study Design; Descriptive study. This study was conducted in diabetic clinic of Mayo Hospital, Lahore, from January 17, 2007 to July 16,2007. Methods; Three hundred and sixty patients fulfilling the inclusion criteria were selected for this study and divided into two groups. (Diabetes and with metabolic syndrome) Demographic data of each patient including age, sex, height and weight were collected. Each patient was interviewed about the duration, treatment and complications of diabetes. Data were analyzed by SPSS. P value was calculated by Chi Square test. Results; In group I, the mean height was 1.60 +- 0.08 meters, mean weight was 68.82 +- 7.36 kilograms and mean BMI was 26.38 +- 1.10 kg/m2 and In group II, the mean height was 1.56 +- 0.12 meters, mean weight was 81.58 +- 9.85 kilograms and mean BMI was 33.80 +- 3.61 kg/m/sup 2/. In group I micro aneurysms, dot hemorrhages, blot hemorrhages and hard exudates were found in 12.22% patients. In group II, micro aneurysms, dot hemorrhages, blot hemorrhages and hard exudates were found in 25% patients (p 0.0028). In group I, there were 10.56% patients in which cotton wool spots were found and in group II there were 11.67% patients in which cotton wool spots were found (p 0.0358). In group I, there were 2.78% patients in which new blood vessel formation were found and in group II there were 4.44% patients in which new blood vessel formation was found (p 0.625). Conclusion; It is concluded from this study that frequency of retinopathy is high in patients with metabolic syndrome as compared to patients without metabolic syndrome. (author)

  6. Determining the association between retinopathy and metabolic syndrome in patients with type 2 diabetes mellitus visiting Mayo Hospital, Lahore

    International Nuclear Information System (INIS)

    Ghani, U.; Niaz, Z.; Cheema, T.M.; Abaidullah, S.; Salman, S.; Latif, F.

    2010-01-01

    Introduction: The metabolic syndrome is a cluster of metabolic abnormalities including abdominal obesity, glucose intolerance, hypertension and dyslipidemia. Diabetic retinopathy is common sequel of diabetes. Objective: To determine the frequency of retinopathy in patients of type 2 diabetes metabolic syndrome. Study Design; Descriptive study. This study was conducted in diabetic clinic of Mayo Hospital, Lahore, from January 17, 2007 to July 16,2007. Methods; Three hundred and sixty patients fulfilling the inclusion criteria were selected for this study and divided into two groups. (Diabetes and with metabolic syndrome) Demographic data of each patient including age, sex, height and weight were collected. Each patient was interviewed about the duration, treatment and complications of diabetes. Data were analyzed by SPSS. P value was calculated by Chi Square test. Results; In group I, the mean height was 1.60 +- 0.08 meters, mean weight was 68.82 +- 7.36 kilograms and mean BMI was 26.38 +- 1.10 kg/m2 and In group II, the mean height was 1.56 +- 0.12 meters, mean weight was 81.58 +- 9.85 kilograms and mean BMI was 33.80 +- 3.61 kg/m/sup 2/. In group I micro aneurysms, dot hemorrhages, blot hemorrhages and hard exudates were found in 12.22% patients. In group II, micro aneurysms, dot hemorrhages, blot hemorrhages and hard exudates were found in 25% patients (p 0.0028). In group I, there were 10.56% patients in which cotton wool spots were found and in group II there were 11.67% patients in which cotton wool spots were found (p 0.0358). In group I, there were 2.78% patients in which new blood vessel formation were found and in group II there were 4.44% patients in which new blood vessel formation was found (p 0.625). Conclusion; It is concluded from this study that frequency of retinopathy is high in patients with metabolic syndrome as compared to patients without metabolic syndrome. (author)

  7. Now What? Think Fast: Using Healthcare Clinics as Universal Language to Maximize Learning for International Students in a Graduate Classroom

    Directory of Open Access Journals (Sweden)

    Sanda Katila

    2016-12-01

    Full Text Available International students in Masters programs come to the US optimistic and willing to learn. Upon arrival and entrance into programs, they often encounter unexpected environments. Culture shock and language barriers may seem like obvious hurdles, but work ethic and scope of visual knowledge also pose unique challenges for both students and design educators. Although all students share new challenges in graduate school, international students face tougher impediments in studio environments where they express themselves both visually and verbally. Additionally, much of design uses humor, idioms, and visual clues only understood in English. So how do educators help international students build on what they already know? How do educators break barriers between domestic and international students so they may teach one another through a shared language? In fall 2015, my Conceptual Development and Implementation class was struggling to exchange ideas in the classroom. We moved through that struggle by developing a shared language around each student's experiences with healthcare clinics in their country of origin. Students explained what makes healthcare clinics reputable; how people access information in India, China, small towns and larger urban areas; and where people look for trustworthy information. This paper discusses how one educator used student experience of healthcare clinics to find a universal language to maximize learning for international students in design education.

  8. Clinical audit teaching in record-keeping for dental undergraduates at International Medical University, Kuala Lumpur, Malaysia.

    Science.gov (United States)

    Chong, Jun A; Chew, Jamie K Y; Ravindranath, Sneha; Pau, Allan

    2014-02-01

    This study investigated the impact of clinical audit training on record-keeping behavior of dental students and students' perceptions of the clinical audit training. The training was delivered to Year 4 and Year 5 undergraduates at the School of Dentistry, International Medical University, Kuala Lumpur, Malaysia. It included a practical audit exercise on patient records. The results were presented by the undergraduates, and guidelines were framed from the recommendations proposed. Following this, an audit of Year 4 and Year 5 students' patient records before and after the audit training was carried out. A total of 100 records were audited against a predetermined set of criteria by two examiners. An email survey of the students was also conducted to explore their views of the audit training. Results showed statistically significant improvements in record-keeping following audit training. Responses to the email survey were analyzed qualitatively. Respondents reported that the audit training helped them to identify deficiencies in their record-keeping practice, increased their knowledge in record-keeping, and improved their record-keeping skills. Improvements in clinical audit teaching were also proposed.

  9. Case Study in Designing a Research Fundamentals Curriculum for Community Health Workers: A University - Community Clinic Collaborative

    Science.gov (United States)

    Dumbauld, Jill; Kalichman, Michael; Bell, Yvonne; Dagnino, Cynthia; Taras, Howard

    2014-01-01

    Introduction Community health workers are increasingly incorporated into research teams. Training them in research methodology and ethics, while relating these themes to a community’s characteristics, may help to better integrate these health promotion personnel into research teams. Approach and Strategies This pilot project involved the design and implementation of an interactive training course on research fundamentals for community health workers from clinics in a rural, predominately Latino setting. Curriculum development was guided by collaborative activities arising from a university - clinic partnership, a community member focus group, and the advice of community-based researchers. The resulting curriculum was interactive and stimulated dialogue between trainees and academic researchers. Discussion and Conclusions Collaboration between researchers and health agency professionals proved to be a practical method to develop curriculum for clinic staff. An interactive curriculum allowed trainees to incorporate community-specific themes into the discussion. This interaction educated course instructors from academia about the community as much as it educated course participants about research. The bidirectional engagement that occurs during the development and teaching of this course can potentially lead to research partnerships between community agencies and academia, better-informed members of the public, and research protocols that accommodate community characteristics. PMID:24121537

  10. Septic arthritis: a 12 years retrospective study in a rheumatological university clinic

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    L. Riato

    2011-09-01

    Full Text Available Background: Septic arthritis is a disabling and potentially life-threatening condition that requires prompt diagnosis and treatment. The most important risk factors are joint prosthesis, pre-existing joint disease and immunosuppressive drugs. The aim of our study therefore was to revaluate all septic arthritis cases discharged from our Rheumatologic Unit in the last 12 years, to assess the risk factors, the clinical and laboratory characteristics, the causative microorganisms and its possible increase in frequency. Methods: The medical records of 42 consecutive patients with septic arthritis discharged from our Rheumatology Unit between January 1995 and December 2006 were reviewed. The patients ranged in age from 23 to 90 and there isn’t gender predominance. Septic arthritis was diagnosed based on the finding of purulent material in the joint space and/or the isolation of a bacterial pathogen from joint fluid. Demographic data, risk factors, co-morbidity, clinical manifestations, time interval between symptoms onset and diagnosis, treatment and laboratory data including serum white blood cell count, erythrocyte sedimentation rate (ESR, C reactive protein (CRP, synovial white blood cells and culture results were analysed. We considered these parameters in the whole population and in two different age groups (≤60, >60 and tried to determine if there was a change of microorganisms involved in septic arthritis during the years. Results: Of 42 patients, 47% were aged 60 and younger. Only 10 patients were admitted to our unit before 2001. A predisposing factor was recorded in 90,5% of cases: 15 patients had rheumatoid arthritis, 8 were diabetic, 6 had seronegative arthritis, 4 had a connective tissue disease, 8 patients had a prosthetic infection and 3 were subjected recently to arthrocentesis. We found that patients aged 60 and younger were more frequently affected by joint disease and had a synovial white blood cell count lower than patients

  11. Clinical Benefit of Ablating Localized Sources for Human Atrial Fibrillation: The Indiana University FIRM Registry.

    Science.gov (United States)

    Miller, John M; Kalra, Vikas; Das, Mithilesh K; Jain, Rahul; Garlie, Jason B; Brewster, Jordan A; Dandamudi, Gopi

    2017-03-14

    Mounting evidence shows that localized sources maintain atrial fibrillation (AF). However, it is unclear in unselected "real-world" patients if sources drive persistent atrial fibrillation (PeAF), long-standing persistent atrial fibrillation (LPeAF), or paroxysmal atrial fibrillation (PAF); if right atrial sites are important; and what the long-term success of source ablation is. The aim of this study was to analyze the role of rotors and focal sources in a large academic registry of consecutive patients undergoing source mapping for AF. One hundred seventy consecutive patients (mean age 59 ± 12 years, 79% men) with PAF (37%), PeAF (31%), or LPeAF (32%). Of these, 73 (43%) had undergone at least 1 prior ablation attempt (mean 1.9 ± 0.8; range: 1 to 4). Focal impulse and rotor modulation (FIRM) with an endocardial basket catheter was used in all cases. FIRM analysis revealed sources in the right atrium in 85% of patients (1.8 ± 1.3) and in the left atrium in 90% of patients (2.0 ± 1.3). FIRM ablation terminated AF to sinus rhythm or atrial flutter or tachycardia in 59% (PAF), 37% (PeAF), and 19% (LPeAF) of patients, with 15 of 67 terminations due to right atrial ablation. On follow-up, freedom from AF after a single FIRM procedure for the entire series was 95% (PAF), 83% (PeAF), and 82% (LPeAF) at 1 year and freedom from all atrial arrhythmias was 77% (PAF), 75% (PeAF), and 57% (LPeAF). In the Indiana University FIRM registry, FIRM-guided ablation produced high single-procedure success, mostly in patients with nonparoxysmal AF. Data from mapping, acute terminations, and outcomes strongly support the mechanistic role of biatrial rotors and focal sources in maintaining AF in diverse populations. Randomized trials of FIRM-guided ablation and mechanistic studies to determine how rotors form, progress, and regress are needed. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  12. ACUTE RENAL FAILURE IN THE NEWBORNS HOSPITALIZED AT THE INTENSIVE CARE UNIT, UNIVERSITY CLINICAL CENTRE TUZLA

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    Zulić Evlijana

    2015-03-01

    Full Text Available Introduction: Reasons for acute renal failure in hospitalized infants were sepsis, hypovolemia, asphyxia, respiratory distress syndrome, surgical interventions and congenital heart defects. The aim of this study was to determine the frequency and and main etiologies, and early outcome of neonatal acute renal failure. Materials and Methods: At Intensive Care Unit, Clinical Center Tuzla, from 15. 01. 2013 to 15. 01. 2015 in 21 newborn was diagnosed renal failure, based on the amount of excreted urine and serum creatinine. Results: The prevalence of renal failure was 6.84%, with a higher incidence of female. 33.3% of infants were term neonates. Oliguria was diagnosed in 71.4% of newborns. Sepsis was the most common predisposing factor for the development of renal failure, associated with high mortality. Other causes of renal failure were perinatal hypoxia, RDS, surgical interventions and congenital heart defects. There was a positive correlation between the gestational age of the newborn and serum creatinine. Discussion: Early prevention of risk factors with rapid diagnosis and effective treatment, can affect further outcome of acute renal failure in infants.

  13. Epidemiological observations in the AIDS clinic at the Hadassah University Hospital in Jerusalem.

    Science.gov (United States)

    Maayan, S; Engelhard, D; Boger, S; Ganer, A; Morag, A; Shapiro, M; Sacks, T

    1989-06-01

    Of the first 395 attendees at the AIDS clinic in Jerusalem, 32% were homo/bisexuals, 4% i.v. drug abusers (IVDAs), 24% persons with minimal risk for AIDS and 38% were persons having no risk. Human immunodeficiency virus (HIV) antibody rates were 7% for homosexuals, 29% for IVDAs, 1% for persons with minimal risk and 0% for persons at no risk. Israeli homosexuals had a significantly greater risk for HIV infection (9 of 35) if they had sexual contact with non-Israelis as compared with homosexuals who had contact with local partners only (0/91, P less than 0.001). The mean number of attendees per month increased by 431% during the 4 months following the first prime-time television program on AIDS. The largest mean increases occurred among persons at no risk (1 to 27.2), those with minimal risk (2.5 to 16.5), and among women (1.25 to 20.0). This report indicates that HIV infection among Israeli homosexuals has not yet reached U.S. proportions. It also shows that the TV program raised anxiety concerning AIDS among the general public, and probably encouraged the public to use HIV testing as part of a general health screening program.

  14. The knowledge and attitude about HIV/AIDS among Jordanian dental students: (Clinical versus pre clinical students at the University of Jordan

    Directory of Open Access Journals (Sweden)

    Shayyab Mohammad H

    2011-06-01

    Full Text Available Abstract Background The present study aimed to address the suspected deficiency in the level of understanding of HIV/AIDS among clinical and pre clinical dental students at the University of Jordan. In this cross-sectional study, structured questionnaires were distributed to fifth year dental students (n = 121 and to third year dental students (n = 144 in the academic year 2008/2009. Findings Significantly higher percentage of fifth-year students compared to third-year students felt that the teaching they received on cross-infection precautions and barrier dentistry was adequate (P Significantly higher proportion of third-year students compared to fifth-year (39.2% vs. 26.3% thought that HIV patients should be referred to other centers or support groups for treatment (P = 0.04. Conclusions The level of knowledge of Jordanian dental students about HIV and AIDS was generally acceptable; there were inadequacies, however, in their understanding regarding some aspects of AIDS epidemic which demands that dental school curriculum needs some improvement.

  15. The Mayo Dysphagia Questionnaire-30: documentation of reliability and validity of a tool for interventional trials in adults with esophageal disease.

    Science.gov (United States)

    McElhiney, Judith; Lohse, Matthew R; Arora, Amindra S; Peloquin, Joanna M; Geno, Debra M; Kuntz, Melissa M; Enders, Felicity B; Fredericksen, Mary; Abdalla, Adil A; Khan, Yulia; Talley, Nicholas J; Diehl, Nancy N; Beebe, Timothy J; Harris, Ann M; Farrugia, Gianrico; Graner, Darlene E; Murray, Joseph A; Locke, G Richard; Grothe, Rayna M; Crowell, Michael D; Francis, Dawn L; Grudell, April M B; Dabade, Tushar; Ramirez, Angelica; Alkhatib, MhdMaan; Alexander, Jeffrey A; Kimber, Jessica; Prasad, Ganapathy; Zinsmeister, Alan R; Romero, Yvonne

    2010-09-01

    The aim of this study was to develop the Mayo Dysphagia Questionnaire-30 Day (MDQ-30), a tool to measure esophageal dysphagia, by adapting items from validated instruments for use in clinical trials, and assess its feasibility, reproducibility, and concurrent validity. Outpatients referred to endoscopy for dysphagia or seen in a specialty clinic were recruited. Feasibility testing was done to identify problematic items. Reproducibility was measured by test-retest format. Concurrent validity reflects agreement between information gathered in a structured interview versus the patients' written responses. The MDQ-30, a 28-item instrument, took 10 min (range = 5-30 min) to complete. Four hundred thirty-one outpatients [210 (49%) men; mean age = 61 years] participated. Overall, most concurrent validity kappa values for dysphagia were very good to excellent with a median of 0.78 (min 0.28, max 0.95). The majority of reproducibility kappa values for dysphagia were moderate to excellent with a median kappa value of 0.66 (min 0.07, max 1.0). Overall, concurrent validity and reproducibility kappa values for gastroesophageal reflux disease (GERD) symptoms were 0.81 (95% CI = 0.72, 0.91) and 0.66 (95% CI = 0.55, 0.77), respectively. Individual item percent agreement was generally very good to excellent. Internal consistency was excellent. We conclude that the MDQ-30 is an easy-to-complete tool to evaluate reliably dysphagia symptoms over the last 30 days.

  16. The role of the Oregon State University Endophyte Service Laboratory in diagnosing clinical cases of endophyte toxicoses.

    Science.gov (United States)

    Craig, A Morrie; Blythe, Linda L; Duringer, Jennifer M

    2014-07-30

    The Oregon State University Colleges of Veterinary Medicine and Agricultural Sciences instituted the Endophyte Service Laboratory to aid in diagnosing toxicity problems associated with cool-season grasses in livestock. The endophyte (Neotyphodium coenophalum) present in tall fescue (Festuca arundinacea) produces ergopeptine alkaloids, of which ergovaline is the molecule used to determine exposure and toxicity thresholds for the vasoconstrictive conditions "fescue foot" and "summer slump". Another vasoconstrictive syndrome, "ergotism," is caused by a parasitic fungus, Claviceps purpurea, and its primary toxin, ergotamine. "Ryegrass staggers" is a neurological condition that affects livestock consuming endophyte (Neotyphodium lolii)-infected perennial ryegrass (Lolium perenne) with high levels of lolitrem B. HPLC-fluorescent analytical methods for these mycotoxins are described and were used to determine threshold levels of toxicity for ergovaline and lolitrem B in cattle, sheep, horses, and camels. In addition, six clinical cases in cattle are presented to illustrate diagnosis of these three diseases.

  17. Building leadership among laboratory-based and clinical and translational researchers: the University of California, San Francisco experience.

    Science.gov (United States)

    Wides, Cynthia; Mertz, Elizabeth; Lindstaedt, Bill; Brown, Jeanette

    2014-02-01

    In 2005 the University of California, San Francisco (UCSF) implemented the Scientific Leadership and Management (SLM) course, a 2-day leadership training program to assist laboratory-based postdoctoral scholars in their transition to independent researchers managing their own research programs. In 2011, the course was expanded to clinical and translational junior faculty and fellows. The course enrollment was increased from approximate 100 to 123 participants at the same time. Based on course evaluations, the number and percent of women participants appears to have increased over time from 40% (n = 33) in 2007 to 53% (n = 58) in 2011. Course evaluations also indicated that participants found the course to be relevant and valuable in their transition to academic leadership. This paper describes the background, structure, and content of the SLM and reports on participant evaluations of the course offerings from 2007 through 2011. © 2014 Wiley Periodicals, Inc.

  18. Neurosurgery clinical registry data collection utilizing Informatics for Integrating Biology and the Bedside and electronic health records at the University of Rochester.

    Science.gov (United States)

    Pittman, Christine A; Miranpuri, Amrendra S

    2015-12-01

    In a population health-driven health care system, data collection through the use of clinical registries is becoming imperative to continue to drive effective and efficient patient care. Clinical registries rely on a department's ability to collect high-quality and accurate data. Currently, however, data are collected manually with a high risk for error. The University of Rochester's Department of Neurosurgery in conjunction with the university's Clinical and Translational Science Institute has implemented the integrated use of the Informatics for Integrating Biology and the Bedside (i2b2) informatics framework with the Research Electronic Data Capture (REDCap) databases.

  19. Surgent University : The Establishment and Evaluation of a National Online Clinical Teaching Repository for Surgical Trainees and Students.

    LENUS (Irish Health Repository)

    2012-02-01

    Introduction. The aim of this study was to develop a new teaching strategy for medical students while creating a national online repository system (Surgent University). Then, the potential of this e-learning modality to facilitate learning of clinical surgery was evaluated. Methods. An online repository and Internet-based interface was designed and hosted on the medical education Web site, www.surgent.ie. Participation was by medical students across 3 Irish universities. Student use of the repository was quantitatively assessed over an 8-week period. They were then invited to complete an anonymous survey assessing the effectiveness of the online repository. Statistical analysis was performed using SPSS version 15, with P < .05 considered significant. Results. Over the study period, the online repository received 6105 uploaded facts by 182 final-year medical students from 3 different universities. The repository Web pages were accessed 54 061 times with 4609 individual searches of the repository. Of the 60 participating students invited to provide survey-based feedback, there were 40 respondents, giving a 66.7% response rate. Of those surveyed, 70% (n = 28) rated the online repository as highly beneficial and 75% (n = 30) as highly relevant. Overall, 87.5% (n = 35) felt that it should be continued, and 70% (n = 28) felt that it should be expanded beyond surgery to include other hospital specialties. Those finding the program interface user-friendly were more likely to find it beneficial (P = .031) and relevant to their ongoing education (P = .002). Conclusions. A user-friendly interface allows for high levels of usage, whereas a "student-centered" structure ensures that the facts uploaded are beneficial and relevant to medical students\\' education.

  20. [Systematic Readability Analysis of Medical Texts on Websites of German University Clinics for General and Abdominal Surgery].

    Science.gov (United States)

    Esfahani, B Janghorban; Faron, A; Roth, K S; Grimminger, P P; Luers, J C

    2016-12-01

    Background: Besides the function as one of the main contact points, websites of hospitals serve as medical information portals. As medical information texts should be understood by any patients independent of the literacy skills and educational level, online texts should have an appropriate structure to ease understandability. Materials and Methods: Patient information texts on websites of clinics for general surgery at German university hospitals (n = 36) were systematically analysed. For 9 different surgical topics representative medical information texts were extracted from each website. Using common readability tools and 5 different readability indices the texts were analysed concerning their readability and structure. The analysis was furthermore stratified in relation to geographical regions in Germany. Results: For the definite analysis the texts of 196 internet websites could be used. On average the texts consisted of 25 sentences and 368 words. The reading analysis tools congruously showed that all texts showed a rather low readability demanding a high literacy level from the readers. Conclusion: Patient information texts on German university hospital websites are difficult to understand for most patients. To fulfill the ambition of informing the general population in an adequate way about medical issues, a revision of most medical texts on websites of German surgical hospitals is recommended. Georg Thieme Verlag KG Stuttgart · New York.

  1. Oral health knowledge among pre-clinical students of International Branch of Shiraz University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    2015-01-01

    Full Text Available   Background and Aims: Oral health is an important issue in public health with a great impact on individuals’ general health status. A good access to oral healthcare services and a good knowledge of it play a key role in the oral disease prevention. A better health attitude and practice require a better knowledge. The aims of this study was to evaluate the oral health knowledge among the International students branch (Kish of Shiraz University of Medical Sciences in 2011-12.   Materials and Methods: 159 pre-clinical students in medicine (54 students, dentistry (69 students and pharmacy (36 students participated in this research. A standard questionnaire was used as the main tool of research to evaluate the attitude and knowledge of students about the oral health. Data were analyzed using Chi-square test.   Results: According to the results, dental students had the best level of knowledge and pharmacy students had a better knowledge level compared to the medical students. The results also showed a significant relationship between students’ oral health knowledge and their field and duration of study and the place of their secondary school (P0.05.   Conclusion: The results showed that the students at the International Branch of Shiraz University of Medical Sciences had a relatively good knowledge of oral health. Students’ knowledge level can be improved by providing students with educational materials, organized workshops and seminars.

  2. Antibiotic prescribing and resistance: knowledge level of medical students of clinical years of University Sultan Zainal Abidin, Malaysia

    Directory of Open Access Journals (Sweden)

    Haque M

    2016-03-01

    Full Text Available Mainul Haque, Nor Iza A Rahman, Zainal Zulkifli, Salwani Ismail Faculty of Medicine, Universiti Sultan Zainal Abidin, Kuala Terengganu, Terengganu, Malaysia Abstract: The innovation of penicillin by Dr Alexander Fleming in 1928 and its use in clinical practice saved many lives, especially during the Second World War. Tuberculosis still carries a significant public health threat and has re-emerged over the past two decades, even in modern countries where tuberculosis was thought to be eliminated. The World Health Organization defines antimicrobial resistance as the resistance of a microorganism to an antimicrobial drug that was initially effective for treatment of infections caused by the microbe. Therefore, the findings of the current study will provide data to enable the design of a new educational program to better equip our students in confronting antimicrobial resistance. This study was a cross-sectional, questionnaire-based survey, which was undertaken in the Faculty of Medicine, Universiti Sultan Zainal Abidin, Kuala Terengganu, Malaysia. The study participants were students of the Bachelor of Medicine and Bachelor of Surgery program (MBBS of Year III, IV, and V. A total of 142 out of 164 (86% medical students returned the questionnaire. Specifically, the year-wise breakdown of responses was 29% (41, 39% (55, and 32% (45 for Year III, IV, and V, respectively. Among the study respondents, 28% (40 were male, and the remaining 72% (102 were female. In all, 67% of the participants felt more confident in “making an accurate diagnosis of infection/sepsis.” The majority (88% of the study participants stated that they would like more training on antibiotic selection. This research has found that there is a gap between theoretical input and clinical practice; the students are demanding more educational intervention to face the threat of antimicrobial resistance. Keywords: antibiotic, prescribing, resistance, medical students, knowledge

  3. Systematic implementation of clinical risk management in a large university hospital: the impact of risk managers.

    Science.gov (United States)

    Sendlhofer, Gerald; Brunner, Gernot; Tax, Christa; Falzberger, Gebhard; Smolle, Josef; Leitgeb, Karina; Kober, Brigitte; Kamolz, Lars Peter

    2015-01-01

    For health care systems in recent years, patient safety has increasingly become a priority issue. National and international strategies have been considered to attempt to overcome the most prominent hazards while patients are receiving health care. Thereby, clinical risk management (CRM) plays a dominant role in enabling the identification, analysis, and management of potential risks. CRM implementation into routine procedures within complex hospital organizations is challenging, as in the past, organizational change strategies using a top-down approach have often failed. Therefore, one of our main objectives was to educate a certain number of risk managers in facilitating CRM using a bottom-up approach. To achieve our primary purpose, five project strands were developed, and consequently followed, introducing CRM: corporate governance, risk management (RM) training, CRM process, information, and involvement. The core part of the CRM process involved the education of risk managers within each organizational unit. To account for the size of the existing organization, we assumed that a minimum of 1 % of the workforce had to be trained in RM to disseminate the continuous improvement of quality and safety. Following a roll-out plan, CRM was introduced in each unit and potential risks were identified. Alongside the changes in the corporate governance, a hospital-wide CRM process was introduced resulting in 158 trained risk managers correlating to 2.0 % of the total workforce. Currently, risk managers are present in every unit and have identified 360 operational risks. Among those, 176 risks were scored as strategic and clustered together into top risks. Effective meeting structures and opportunities to share information and knowledge were introduced. Thus far, 31 units have been externally audited in CRM. The CRM approach is unique with respect to its dimension; members of all health care professions were trained to be able to identify potential risks. A network of risk

  4. Los acontecimientos de mayo del 68 y la lucha antipsiquiátrica

    Directory of Open Access Journals (Sweden)

    Valentín Galván García

    2009-12-01

    Full Text Available Los movimientos de detracción a la psiquiatría clásica no nacieron hasta la década de los años 60. Las reflexiones comunes de sociólogos, filósofos, políticos, psiquiatras y enfermos mentales coincidieron en un severo replanteamiento del saber psiquiátrico y de las prácticas propugnadas. El término propuesto en 1967 por David Cooper fue el estandarte de estos nuevos planteamientos. Con anterioridad al movimiento psiquiátrico, en 1961, se publicaron dos textos fundamentales: Internados de Erving Goffman y la Historia de la locura de Michel Foucault. Ambas obras, hasta entonces, conocidas exclusivamente en el ámbito académico, por lo que sus enfoques y problemáticas tuvieron escasa repercusión hasta los acontecimientos de Mayo del 68, los cuales propiciaron unas condiciones más favorables para su discurso.________________________ABSTRACT:The movements back to the classical psychiatry weren’t born until the 60 ths decade. The common thoughts of sociologists, philosophers, politicians, psychiatrists and mentally sick people joined together a strict reconsideration of the phychiatric knowledge and the proposed training. The word “antipsychiatry” proposed in 1967 by David Cooper was the flagship of these new thoughts. Before the psychiatric movement, in 1961, two main books were published: Asylums by Erving Goffman and History of mandess by Michel Foucault. Both books, until then, were known exclusively in the academic field, for its focus and problems had little repercussion until the May 68 events, which encouraged more favourable conditions for its speech.  

  5. Cigarette smoking and health care professionals at Mayo Hospital, Lahore, Pakistan

    International Nuclear Information System (INIS)

    Malik, A.K.; Chaudhry, A.; Karamat, A.; Arif, N.; Cheema, M.A.; Rauf, A.

    2010-01-01

    Objectives: To observe the frequency of cigarette smoking in doctors and paramedics and study various variables associated with it. Methods: An anonymous questionnaire was given to randomly selected 250 Doctors and 250 Paramedics at Mayo Hospital in 2009. Information about demographic characteristics, smoking status in family, number of cigarettes smoked per day, influence for starting smoking, reason for continuation of smoking and use of nicotine replacement therapy was obtained. Results: A total of 234 questionnaires from doctors and 207 from paramedics were received back (88.2% response rate). There were 280 males (163 Doctors; 117 Paramedics) and 161 females (71 Doctors; 90 Paramedics). Eighty seven (37.18%) Doctors and 74 (35.74%) Paramedics were smokers with 82 (50.31%) male doctors and 5 (7.04%) females. Similar results were obtained in Paramedics 72 (61.53%) males and 2 (2.22%) females. Of the smokers, majority started smoking between 11-20 years age with 39 (44.83%) Doctors and 48 (64.86%) Paramedics. Twenty three (26.44%) Doctors and 31 (41.89%) Paramedics smoked 11-20 cigarettes per day. Smoking was initiated due to the influence of friends by 48 (55.17%) Doctors and 56 (75.68%) Paramedics. Most smokers, 29 (33.33%) Doctors and 33 (44.59%) Paramedics found use of cigarette smoking as 'Relaxing'. Addiction was the main reason for difficulty in quitting cigarette smoking as reported by 33 (37.93%) Doctors and 31 (41.89%) Paramedics. Of the smokers, 61(70.11%) doctors and 50 (32.43%) paramedics had no intention to quit smoking in the next 6 months. Conclusion: A significant number of doctors and paramedics, especially males, in Pakistan smoke cigarettes, which requires proper attention. (author)

  6. Recursos florísticos de la cuenca baja del río mayo, Sonora

    Directory of Open Access Journals (Sweden)

    Julio César Duarte Ruiz

    2014-06-01

    Full Text Available En México se presentan prácticamente todos los grandes tipos de vegetación que existen en el mundo y su distribución a menudo es compleja. El objetivo del trabajo consistió en realizar un listado de la flora silvestre ribereña del Río Mayo, localizado en el sur del estado de Sonora, para conocer su composición. La recolección de especímenes se realizó mediante la técnica de intercepción o línea de Canfield (1941, en 15 sitios con dos repeticiones sumando 30 transectos. Se encontraron un total de 40 familias, 79 géneros y 99 especies. Las familias mejor representadas fueron: Leguminoseae, Cactaceae, Gramineae, Compositae, Chenopodiaceae, Salicaceae, Solanaceae, Euphorbiaceae, Amaranthaceae y Asteraceae. La dominante fue Leguminoseae con vegetación de bosque espinoso compuesta por Acacia cymbispina, Acacia farnesiana, Parkinsonia aculeata y Prosopis juliflora. Resulta perceptible la pérdida de flora debido al cambio de uso de suelo. Especies representativas de la zona riparia como Populus fremontii y Salix bonplandiana están desapareciendo por alteración del ecosistema. Poblaciones de mangle como Rhizophora mangle y Conocarpus erectus están disminuidas. El área estudiada es rica en especies a pesar de la perturbación. La diversidad varía de acuerdo al gradiente altitudinal y el número de especies guarda relación con los géneros y familias recolectadas. La agricultura, acuicultura, ganadería, la industria pesquera y la urbanización, son los giros que causan mayor afectación en los ecosistemas

  7. Reliability and Validity of Objective Structured Clinical Examination for Residents of Obstetrics and Gynecology at Kermanshah University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Nasrin Jalilian

    2012-11-01

    Full Text Available Introduction: Objective structured clinical examination (OSCE is used for the evaluation of the clinical competence in medicine for which it is essential to measure validity and reliability. This study aimed to investigate the validity and reliability of OSCE for residents of obstetrics and gynecology at Kermanshah University of Medical Sciences in 2011.Methods: A descriptive-correlation study was designed and the data of OSCE for obstetrics and gynecology were collected via learning behavior checklists in method stations and multiple choice questions in question stations. The data were analyzed through Pearson correlation coefficient and Cronbach's alpha, using SPSS software (version 16. To determine the criterion validity, correlation of OSCE scores with scores of resident promotion test, direct observation of procedural skills, and theoretical knowledge was determined; for reliability, however, Cronbach's alpha was used. Total sample consisted of 25 participants taking part in 14 stations. P value of less than 0.05 was considered as significant.Results: The mean OSCE scores was 22.66 (±6.85. Criterion validity of the stations with resident promotion theoretical test, first theoretical knowledge test, second theoretical knowledge, and direct observation of procedural skills (DOPS was 0.97, 0.74, 0.49, and 0.79, respectively. In question stations, criterion validity was 0.15, and total validity of OSCE was 0.77.Conclusion: Findings of the present study indicated acceptable validity and reliability of OSCE for residents of obstetrics and gynecology.

  8. Study of H. pylori infection in children with recurrent abdominal pain attending the pediatrics outpatient clinic of Zagazig University Hospitals.

    Science.gov (United States)

    Badr, M A; El-Saadany, Hosam F; Ali, Adel S A; Abdelrahman, D

    2012-12-01

    This study assessed the prevalence of H. pylori infection in children with recurrent abdominal pain attending the Outpatient Pediatric Clinic of Zagazig University Hospitals. The study was conducted on 100 children suffering from different GIT symptoms mainly recurrent abdominal pain, they were categorized into 3 categories according to their ages. First category below 5 years, second category between 5 and 10 years and last category above 10 years. All subjects underwent full history taking, clinical examination and laboratory investigations. Protozoa infection was in 29% of patients, helminthes 10%, chronic constipation 4% and UTI 4%. The patients with apparent etiology were excluded. The data do not support the hypothesis that there is a direct role for H. pylori infection as a causative agent for Recurrent Abdominal Pain (RAP) in children. The mean +/- SD of age of patients were 5.7 +/- 3.7, with range of 1:18 years. Male to female ratio was 1:1.1. H. pylori serum IgG antibodies were in 26 patients (43.3%) and 24 controls (p = 0.71), and H. pylori stool Ag in stool of 22 cases and 20 controls (p = 0.7).

  9. Recent diagnostic and therapeutic approaches to prenatally and perinatally diagnosed hydronephrosis and their implementation in the University Clinical Hospital Mostar.

    Science.gov (United States)

    Mandić, Vjekoslav; Martinović, Vlatka; Kvesić, Ante; Bukvić, Nado; Skitarelić, Nataša; Brekalo, Zdrinko; Ivanković, Krunoslav; Šetka, Violeta

    2015-03-01

    A shift of the diagnostics of urological malformations towards the fetal age by means of ultrasound, especially hydronephrosis which, apart from reflux, is the most frequent developmental urological disorder, opened many dilemmas and debates. In the course of more than three decades the application of this diagnostic approach to the problem of hydrone- phrosis became a routine clinical practice in all modern clinics. In this paper we present the problems related to this diagnostic method and its delayed application in the Mostar University Clinical Hospital. Along with the exposition of a general approach to the problem of hydronephrosis we briefly present our modest collection of cases which points to the most recent trend of a vigorous medical development in this region, despite unfavorable overall conditions which prevailed so far. The observation included 56 children with prenatal, perinatal and early age determination of pyelon dilatation by means of ultrasonic exploration who were treated surgically. Of this number 32 (57.14%) were male, and 24 (42.86%) female children. Of the observed patients 56 had unilateral and 6 had bilateral pyelon dilatation so that 62 kidneys in all were observed and treated. The dilatation was determined prenatally in 24 (38.7%) out of 62 kidneys observed in all, in 7 (11.29%) the disorder was observed perinatally and in remaining 31 cases (49.9%) it manifested during early childhood, school age, even at the age of pre-puberty. Of the children with prenatally and perinatally determined dilatation, in 14 (45.16%) out of 31 (100.0%) observed kidneys the ap radius of the dilated pyelon was between 10-15 mm, and in 17 (54.84%) more than 15 mm. Along with other examinations (MAG3 and DMSA) the patients were followed-up by ultrasonic exploration of the observed kidney for 6 to 30 (average 18) months after postnatal diagnosis; the ultrasonic exploration was repeated in intervals of 6 months. Within 12 months of birth surgical intervention

  10. Primary myelofibrosis with or without mutant MPL: comparison of survival and clinical features involving 603 patients.

    Science.gov (United States)

    Pardanani, A; Guglielmelli, P; Lasho, T L; Pancrazzi, A; Finke, C M; Vannucchi, A M; Tefferi, A

    2011-12-01

    MPL and JAK2V617F mutation analysis was performed in 603 patients with primary myelofibrosis (PMF) seen at the Mayo Clinic, USA (n=329) or University of Florence, Italy (n=274). Mutant MPL was detected in 49 (8.1%) patients and JAK2V617F in 350 (58%); 4 patients showed both mutations. MPLW515L/K was the commonest mutation; 2 patients showed novel mutations (L513ins and Q516-P518insAAAA). The US and Italy patient cohorts were separately analyzed for comparison of survival and clinical features between MPL-mutated, JAK2-mutated and JAK2/MPL-unmutated cases. JAK2/MPL-unmutated patients were significantly younger than their JAK2-mutated counterparts, in both patient cohorts (PMPL was associated with older age (PMPL has narrow and inconsistent phenotypic effect in PMF and does not influence overall or leukemia-free survival.

  11. Three-year randomized controlled clinical study of a one step universal adhesive and a two-step self-etch adhesive in Class II resin composite restorations

    DEFF Research Database (Denmark)

    van Dijken, Jan WV; Pallesen, Ulla

    2017-01-01

    Purpose: To evaluate in a randomized clinical evaluation the 3-year clinical durability of a one-step universal adhesive bonding system and compare it intraindividually with a 2-step self-etch adhesive in Class II restorations. Materials and Methods: Each of 57 participants (mean age 58.3 yr......) received at least two, as similar as possible, extended Class II restorations. The cavities in each of the 60 individual pairs of cavities were randomly distributed to the 1-step universal adhesive (All Bond Universal: AU) and the control 2-step self-etch adhesive (Optibond XTR: OX). A low shrinkage resin......) success rates (p>0.05). Annual failure rates were 1.8% and 2.6%, respectively.The main reason for failure was resin composite fracture. Conclusion: Class II resin composite restorations placed with a one-step universal adhesive showed good short time effectiveness....

  12. Clinical characteristics of dental emergencies and prevalence of dental trauma at a university hospital emergency center in Korea.

    Science.gov (United States)

    Bae, Ji-Hyun; Kim, Young-Kyun; Choi, Yong-Hoon

    2011-10-01

    The aim of this study was to examine the clinical characteristics of dental emergency patients who visited a university hospital emergency center and to evaluate the incidence of dental trauma. A retrospective chart review of patients with dental complaints and who visited the Seoul National University Bundang Hospital (SNUBH) emergency center in Gyeonggi-do, Korea, from January 2009 to December 2009 was conducted. Information regarding age, gender, the time, day, and month of presentation, diagnosis, treatment, and follow up was collected and analyzed. One thousand four hundred twenty-five patients with dental problems visited the SNUBH emergency center. Dental patients accounted for 1.47% of the total 96,708 patients at the emergency center. The male-to-female ratio was 1.68:1, with a considerably larger number of male patients (62.7%). The age distribution peak was at 0-9 years (27.5%), followed by patients in their forties (14.1%). The number of patients visiting the dental emergency center peaked in May (14.2%), on Sundays (22.4%), and between 2100 and 2400 h (20.8%). The patients' chief complaints were as follows: dental trauma, dental infection, oral bleeding, and temporomandibular joint disorder (TMD). The prevalence of dental trauma was 66%. The reasons for dental emergency visits included the following: dental trauma, dental infection, oral bleeding, and TMD, with 66% of the patients requiring management of dental trauma. It is important that dentists make a prompt, accurate diagnosis and initiate effective treatment in case of dental emergencies, especially dental trauma. © 2011 John Wiley & Sons A/S.

  13. The Utility of the Mayo-Portland Adaptability Inventory Participation Index (M2PI) in US Military Veterans With a History of Mild Traumatic Brain Injury.

    Science.gov (United States)

    OʼRourke, Justin; Critchfield, Edan; Soble, Jason; Bain, Kathleen; Fullen, Chrystal; Eapen, Blessen

    2018-05-31

    To examine the utility of the Mayo-Portland Adaptability Inventory-4th Edition Participation Index (M2PI) as a self-report measure of functional outcome following mild traumatic brain injury (mTBI) in US Military veterans. Department of Veterans Affairs Polytrauma Rehabilitation Center specialty hospital. On hundred thirty-nine veterans with a history of self-reported mTBI. Retrospective cross-sectional examination of data collected from regular clinical visits. M2PI, Neurobehavioral Symptoms Inventory with embedded validity measures, Posttraumatic Stress Disorder Checklist-Military Version. Forty-one percent of the sample provided symptom reports that exceeded established cut scores on embedded symptom validity tests. Invalid responders had higher levels of unemployment and endorsed significantly greater functional impairment, posttraumatic stress symptoms, and postconcussive complaints. For valid responders, regression analyses revealed that self-reported functioning was primarily related to posttraumatic stress complaints, followed by postconcussive cognitive complaints. For invalid responders, posttraumatic stress complaints also predicted self-reported functioning. Caution is recommended when utilizing the M2PI to measure functional outcome following mTBI in military veterans, particularly in the absence of symptom validity tests.

  14. Controlled, prospective, randomized, clinical split-mouth evaluation of partial ceramic crowns luted with a new, universal adhesive system/resin cement: results after 18 months.

    Science.gov (United States)

    Vogl, Vanessa; Hiller, Karl-Anton; Buchalla, Wolfgang; Federlin, Marianne; Schmalz, Gottfried

    2016-12-01

    A new universal adhesive with corresponding luting composite was recently marketed which can be used both, in a self-etch or in an etch-and-rinse mode. In this study, the clinical performance of partial ceramic crowns (PCCs) inserted with this adhesive and the corresponding luting material used in a self-etch or selective etch approach was compared with a self-adhesive universal luting material. Three PCCs were placed in a split-mouth design in 50 patients. Two PCCs were luted with a combination of a universal adhesive/resin cement (Scotchbond Universal/RelyX Ultimate, 3M ESPE) with (SB+E)/without (SB-E) selective enamel etching. Another PCC was luted with a self-adhesive resin cement (RelyX Unicem 2, 3M ESPE). Forty-eight patients were evaluated clinically according to FDI criteria at baseline and 6, 12 and 18 months. For statistical analyses, the chi-square test (α = 0.05) and Kaplan-Meier analysis were applied. Clinically, no statistically significant differences between groups were detected over time. Within groups, clinically significant increase for criterion "marginal staining" was detected for SB-E over 18 months. Kaplan-Meier analysis revealed significantly higher retention rates for SB+E (97.8 %) and SB-E (95.6 %) in comparison to RXU2 (75.6 %). The 18-month clinical performance of a new universal adhesive/composite combination showed no differences with respect to bonding strategy and may be recommended for luting PCCs. Longer-term evaluation is needed to confirm superiority of SB+E over SB-E. At 18 months, the new multi-mode adhesive, Scotchbond Universal, showed clinically reliable results when used for luting PCCs.

  15. Student travel health and the role of universities and health clinics in New Zealand to prevent imported infections: a cross-sectional study.

    Science.gov (United States)

    Neave, Penny E; Nair, Balakrishnan; Heywood, Anita E

    2017-05-01

    Tertiary students are at risk of acquiring infectious diseases during overseas travel as they visit low-income countries, have low perceptions of risk and are unlikely to access travel health advice. Some will visit friends and relatives abroad, a group identified as disproportionately affected by imported infections. There is no national student travel health policy in NZ. This study aimed to explore travel health training of university-based health providers; academics' practices and perceptions of travel health; reasons for travel and countries visited by NZ university students, their travel health uptake and factors affecting decision making about this. A cross-sectional study consisting of surveys sent in 2014 to university clinics, senior academics and students. Surveys were completed by 251 respondents. Three of nine clinicians had only undertaken a short course in travel health. Competing resources and time constraints in health clinics were amongst the barriers to providing optimal services. Of the senior academics, only 14% were able to confirm their university collaborated with health clinics. Sixty seven percent of students were unaware that clinics provided travel health services and 19% had or intended to seek professional travel health advice. A national policy is warranted involving all stakeholders, utilizing innovative technologies to increase uptake of student travel health services. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

  16. RELACIONES HÍDRICAS Y TEMPERATURAS ALTAS EN FRIJOL DEL TIPO "FLOR DE MAYO"

    Directory of Open Access Journals (Sweden)

    Edwin Javier Barrios-Gómez

    2011-01-01

    Full Text Available Se estudió el efecto del déficit hídrico del suelo y temperatura alta del aire en las relaciones hídricas y temperatura del dosel del cultivo (Tc, rendimiento de semilla (RS y sus componentes en 8 variedades de frijol del tipo "Flor de Mayo" (FM y una variedad criolla. Se realizaron 3 experimentos de campo; Montecillo en riego (MR con la aplicación de agua de la siembra a la madurez, Montecillo en secano (MS con la lluvia como fuente única de humedad y Celaya en secano (CS con lluvia y 2 riegos suplementarios en floración. Se utilizó una dosis de fertilización de 80 kg.ha-1 de nitrógeno y 40 kg.ha-1 de fósforo. En MR el potencial hídrico foliar ( =-0,33 Mpa, osmótico ( =-1,26 Mpa y de turgencia y (P=0,93 Mpa fue más alto que en CS ( =-0,77, =-1,36 y P=0,59 Mpa y MS ( =-1,22, =-1,57 y P=0,35 Mpa; MS, con mayor deficiencia hídrica del suelo, tuvo mayor reducción en y , y mayor grado de ajuste osmótico (AO=0,70 Mpa. El AO estuvo positiva y significativamente asociado con RS y biomasa aérea final (BMAF en los 2 ambientes de secano. La Tc en MR (26,7°C fue más baja que en CS (30,8°C y MS (36,6°C; el estrés por calor se agudizó con el descenso en el contenido hídrico de las plantas en el ambiente más seco (MS; Tc se relacionó negativa y significativamente con y en MS. La alta Tc también tuvo efecto significativo en la producción de BMAF y RS y sus componentes; la alta Tc redujo el RS, BMAF, número de vainas normales.m-2 (VN.m-2 y peso de 100 semillas (P100S en 12,5, 10,7, 10,2 y 3,4% por cada ºC (-1 ºC de aumento en la Tc, respectivamente.

  17. Environmental pollution in Mayo area and its impact on people health

    International Nuclear Information System (INIS)

    Omer, N. H.

    2003-04-01

    The study undertook the pollution problem in Mayo area, south of the Green Belt. This is considered to have come about as a result of legal and illegal planning and the re-planning of the squatter settlements, plus the area that lies in the vicinity of the sanitary drainage pool. The study identified the factors and causes of the pollutants.The study also studied the effects of these pollutants on health. The objectives of the study were to identify the factors of environmental pollution in the area, the role of the people in the environmental pollution, the negative consequences of this pollution on people in the area, the attempts of the local authorities in fighting the area's pollution and improving the habitat. The study depended on some scientific approaches such as the historic method and the descriptive statistics method. Information was collected from primary and secondary sources. The researcher depended on field work such as direct observation, personal interviews and filling questionnaire which were prepared for data allocation. The study concluded that the environmental pollution is an out come of many factors that inter link with each other. One of the most important factors is the low economic level of the people, and its effects on the poor and deteriorating living environment and the planning of the area placing it near the sources of environmental pollution at the green belt. In addition to the negative role played by the areas inhabitants in relation to getting rid of environmental pollutants of the area, which has in turn led to the outbreak of environmental diseases that reside in the area, specially malaria and diarrhea. The researcher views that one of the most important recommendations that this study has come out of with is the general planning that takes into consideration the health, economic natural and environmental aspects. These are necessities that will participate in the decline and end of the spreading of these pollutants and what

  18. La jornada de reconciliación nacional del 5 de mayo de 1958

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    Félix Hernández

    2008-01-01

    Full Text Available En la segunda mitad de la década de los cincuenta la dictadura franquista atravesaba un período de crisis, ante la gravedad de la situación socio-económica que atravesaba el país, es en este contexto en el que el Partido Comunista de España decidió convocar una jornada de movilización contra la dictadura, a la que denominó Jornada de Reconciliación Nacional, para el 5 de mayo de 1958, pese a estar precedida de un período de fuertes protestas sociales los resultados de la misma fueron muy modestos, en este hecho influyeron el propio aislamiento en que se encontraban los comunistas dentro de la oposición antifranquista, como el miedo a la represión, mientras el franquismo continuaría recibiendo el apoyo de las instituciones políticas y grupos sociales sobre las que se asentaba asi como sus apoyos exteriores, lo que le permitiría imponer sus propias soluciones y sobrevivir hasta la muerte del dictador.In the second half of the fifties, the Franco dictatorship was going through a period of crisis given the gravity of the socioeconomic situation that the country was facing. It is in this context that the Spanish Communist Party decided to call mobilization day against dictatorship, which he called National Reconciliation Day, for the 5th of May 1958. Although it was preceded by a period of strong social protest, the results of it were very modest.In this event influenced the isolation itself in which the Communists were inside the anti-Franco opposition, as the fear of repression. While the Franco´s regime would continue receiving the support of political institutions and social groups on which was laid down as well as their external supports, which would enable it to impose its own solutions and survive until the dictator’s death.

  19. Perceptions of pharmacy clerkship students and clinical preceptors regarding preceptors’ teaching behaviors at Gondar University in Ethiopia

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    Tadesse Melaku

    2016-02-01

    Full Text Available This study aimed to compare the perceptions of pharmacy clerkship students and clinical preceptors of preceptors’ teaching behaviors at Gondar University. A cross-sectional study was conducted among pharmacy clerkship students and preceptors during June 2014 and December 2015. A 52-item structured questionnaire was self-administered to 126 students and 23 preceptors. The responses are presented using descriptive statistics. The Mann-Whitney U test was applied to test the significance of differences between students and preceptors. The response rate was 89.4% for students and 95.6% for preceptors. Statistically significant differences were observed in the responses regarding two of the five communication skills that were examined, six of the 26 clinical skills, and five of the 21 parameters involving feedback. The mean scores of preceptors (2.6/3 and students (1.9/3 regarding instructors’ ability to answer questions were found to be significantly different (P= 0.01. Students and preceptors gave mean scores of 1.9 and 2.8, respectively, to a question regarding preceptors’ application of appropriate up-to-date knowledge to individual patients (P= 0.00. Significant differences were also noted between students and instructors regarding the degree to which preceptors encouraged students to evaluate their own performance (P= 0.01. Discrepancies were noted between students and preceptors regarding preceptors’ teaching behaviors. Preceptors rated their teaching behaviors more highly than students did. Short-term training is warranted for preceptors to improve some aspects of their teaching skills.

  20. Seroprevalence and determinants of toxoplasmosis in pregnant women attending antenatal clinic at the university teaching hospital, Lusaka, Zambia.

    Science.gov (United States)

    Frimpong, Christiana; Makasa, Mpundu; Sitali, Lungowe; Michelo, Charles

    2017-01-05

    Toxoplasmosis is a neglected zoonotic disease which is prevalent among pregnant women especially in Africa. This study aimed to determine the seroprevalence and determinants of the disease among pregnant women attending antenatal clinic at the University Teaching Hospital (UTH). A cross-sectional study was employed where 411 pregnant women attending antenatal clinic at UTH were interviewed using closed ended questionnaires. Their blood was also tested for Toxoplasma gondii IgG and IgM antibodies using the OnSite Toxo IgG/IgM Combo Rapid test cassettes by CTK Biotech, Inc, USA. The overall seroprevalence of the infection (IgG) was 5.87%. There was no seropositive IgM result. Contact with cats showed 7.81 times the risk of contracting the infection in the pregnant women and being a farmer/being involved in construction work showed 15.5 times likelihood of contracting the infection. Socio-economic status of the pregnant women also presented an inverse relationship (showed association) with the infection graphically. However, though there were indications of association between contact with cats, employment type as well as socioeconomic status of the pregnant women with the infection, there was not enough evidence to suggest these factors as significant determining factors of Toxoplasma gondii infection in our study population. There is a low prevalence of Toxoplasma gondii infection among pregnant women in Lusaka, Zambia. Screening for the infection among pregnant women can be done once or twice during pregnancy to help protect both mother and child from the disease. Health promotion among women of child bearing age on the subject is of immense importance in order to help curb the situation. Further studies especially that of case-control and cohort studies should be carried out in the country in order to better ascertain the extent of the condition nationwide.

  1. Deluges of Grandeur: Water, Territory, and Power on Northwest Mexico’s Río Mayo, 1880-1910

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    Jeffrey M. Banister

    2011-02-01

    Full Text Available Northwest Mexico’s irrigation landscape, known today as El Distrito de Riego 038, or El Valle del Mayo, issues from historical struggles to build an official order out of a diverse world of signs, symbols, processes, places, and peoples. It is the ancestral home of the Yoreme (Mayo, an indigenous group for whom colonisation and agricultural development have meant the loss of autonomy and of the seasonal mobility required to subsist in an arid land. It is also the birthplace of President Álvaro Obregón, a one-time chickpea farmer who transformed late-19th century irrigation praxis into the laws and institutions of 20th century water management. Reshaping territory for the ends of centralising ('federalising' water resources has always proved exceedingly difficult in the Mayo. But this was particularly so in the beginning of the federalisation process, a time of aggressive modernisation under the direction of President Porfirio Díaz (1876-1910. Research on Mexican hydraulic politics and policy, with some important exceptions, has tended to focus on the scale and scope of centralisation. Scholars have paid less attention to the moments and places where water escapes officials’ otherwise ironclad grasp. This paper explores water governance (and state formation more broadly in the late 19th century, on the eve of Mexico’s 1910 Revolution, as an ongoing, ever-inchoate series of territorial claims and projects. Understanding the weaknesses and incompleteness of such projects offers critical insight into post-revolutionary and/or contemporary hydraulic politics.

  2. Reconstrucción de la memoria Colectiva: Madres y Abuelas de Plaza de Mayo : Relatos del Futuro

    OpenAIRE

    Coria, Carla

    2013-01-01

    El Proyecto de Extensión Universitaria "Madres y Abuelas de Plaza de Mayo" fue realizado por el Taller de Producción Audiovisual I de la Facultad de Periodismo y Comunicación Social de la Universidad Nacional de La Plata. Su objetivo fue relevar y compilar relatos audiovisuales de las madres y abuelas víctimas del terrorismo de Estado en la Argentina para socializar sus experiencias de vida, fomentar la participación política y el compromiso de la comunidad universitaria. El present...

  3. Las madres de Plaza de Mayo: à memória do sangue, o legado ao revés

    OpenAIRE

    Maria Fernanda Garbero de Aragão Ponzio

    2009-01-01

    O contexto da Argentina da década de setenta é o cenário de personagens e narrativas que emergem do medo e permanecem, até os dias atuais, em posições de resistência e enfrentamento. Nessa paisagem marcada pela opressão do Estado militar, nascem as Madres de Plaza de Mayo, originadas pela tragédia do desaparecimento forçado de seus filhos. Investidas pela maternidade, elas rompem com a esfera privada para desestabilizar a esfera pública e questionar a memória de um país maculad...

  4. Streptococo del grupo B en mujeres embarazadas atendidas en el Centro de Salud Primero de Mayo. Abril-Agosto 2007

    OpenAIRE

    Dubón Méndez, Nancy; Altamirano González, Marjorie del Socorro; Alemán Rivera, Teresa de Jesús

    2008-01-01

    Streptococos del grupo B (SGB) es una de las principales causas de muertes neonatales en todo el mundo y esta directamente relacionada con la colonización materna al momento del parto. Se realizó un estudio descriptivo de corte transversal que incluyó un total de 120 mujeres embarazadas atendidas en el Centro de Salud 1ro. de mayo-León, con el objetivo de identificar la frecuencia de streptococo del grupo B, debido a que la identificación de esta bacteria influye positivamente en la prevenció...

  5. Phenotypic Detection of Genitourinary Candidiasis among Sexually Transmitted Disease Clinic Attendees in Ladoke Akintola University Teaching Hospital, Osogbo, Nigeria

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    Oluranti J. Obisesan

    2015-01-01

    Full Text Available The management of genitourinary candidiasis (GC is fraught with challenges, especially, in an era of increasing antifungal resistance. This descriptive cross-sectional study conducted between May 2013 and January 2014 determined the prevalence and characteristics of GC and the species of Candida among 369 attendees of a Sexually Transmitted Disease (STD clinic of Ladoke Akintola University Teaching Hospital, Osogbo, Nigeria. Appropriate urogenital specimen collected from each attendee was examined by microscopy and culture for Candida, with preliminary species identification by CHROMAgar Candida and confirmation by Analytical Profile Index (API 20C AUX. The age range of attendees was 1-80 years, mean age was 36.32±11.34 years, and male to female ratio was 1 to 3. The prevalence of genitourinary candidiasis was 47.4%, with 4.9% in males and 42.5% in females (p<0.0001. The age groups 31–45 and 16–30 have the highest prevalence of 23.3% and 16.8%, respectively. The species of Candida recovered include Candida glabrata 46.9%, Candida albicans 33.7%, Candida dubliniensis 9.7%, Candida tropicalis 5.7%, Candida krusei 1.7%, Candida lusitaniae 1.7%, and Candida utilis 0.6%. This study reported non-C. albicans Candida, especially C. glabrata, as the most frequently isolated species in GC, contrary to previous studies in this environment and elsewhere.

  6. Determining the agent factors related with time management of responsible doctors and nurses in clinics at Ankara University hospitals.

    Science.gov (United States)

    Acuner, Ahmet Munir; Nilgun, Sarp; Cifteli, F Gulay

    2006-01-01

    This research has been planned and conducted as a descriptive scanning model field study in order to determine the agent factors related with time management of doctors and nurses in positions of responsibility at Ankara University hospitals. As data collection instruments; the "Personal Information Form" which has been developed to determine the socio-demographical characteristics of the research group, the questionnaire of "Determining the Time Management Attitudes and Behaviour of Managers, Time Management Opportunities of the Managers, Prodcutive Working Times of the Managers and the Factors Causing Them to Lose Time", developed by Erdem has been used. It has been determined that the time management attitudes and behaviour of doctors, nurses and nurse assistants responsible for clinics are all different. It was found that nurse assistants graduated from pre-undergraduate or high schools are the least conscious of time management. In particular, nurse assistants of 36 years old and over with 21 years of work experience and 11 years of management experience show little awareness of time management. The time losing factors of the research group were found to be unnecessary visitors, lack of materials and the excessive amount of time spent on obtaining the necessary equipment.

  7. Comparing comprehensive care and departmental clinical education models: students' perceptions at the University of Tennessee College of Dentistry.

    Science.gov (United States)

    Dehghan, Mojdeh; Harrison, Janet; Langham, Sue; Scarbecz, Mark; Amini, Mehdi

    2015-02-01

    In summer 2012, the University of Tennessee Health Science Center College of Dentistry transitioned from a departmental clinical education model to a comprehensive care/group leader model. The aim of this study was to investigate the perspectives of the fourth-year class of dental students who, because the transition took place during their training, had experienced treating patients under both educational models. To achieve this objective, a questionnaire was designed to assess the students' opinions on the efficiency of their effort, availability of specialty faculty, stress, collaboration with classmates, and availability of exposure to different practice styles and techniques under the two systems. The students were also given an opportunity to provide open-ended feedback on the shortcomings and advantages of the systems. The Class of 2013 had 81 students, 55 of whom participated in the survey for a response rate of 67.9%. The majority (86%) of the respondents preferred the comprehensive care model and reported feeling that, in it, they were able to accomplish more comprehensive dentistry with greater consistency of supervision from faculty in a more patient-centered environment than in the departmental model. However, 56 percent considered having the same group leader for two years a disadvantage and recommended rotation of at least one group leader every six months. The results of this survey can help this college and other dental schools that are seeking to optimize their educational model to best serve students' educational experience and the dental needs of their patient population.

  8. Trichomonas vaginalis infection in a low-risk women attended in Obstetrics and Gynaecology Clinic, Universiti Kebangsaan Malaysia Medical Centre

    Institute of Scientific and Technical Information of China (English)

    Norhayati Moktar; Nor Liyana Ismail; Phoy Cheng Chun; Mohamad Asyrab Sapie; Nor Farahin Abdul Kahar; Yusof Suboh; Noraina Abdul Rahim; Nor Azlin Mohamed Ismail; Tengku Shahrul Anuar

    2016-01-01

    Objective: To investigate the presence of trichomoniasis among women attending the Obstetrics and Gynaecology Clinic, Universiti Kebangsaan Malaysia Medical Centre.Methods: A total of 139 high vaginal swabs were taken from the subjects and sent to the laboratory in Amies gel transport media. The specimens were examined for the presence of Trichomonas vaginalis using wet mount, Giemsa staining and cultured in Diamond’s medium. Sociodemographic characteristics and gynaecological complaints were obtained in private using structured questionnaire applied by one investigator.Results: The median age was 32 years, with an interquartile interval of 9.96. Most of the subjects were Malays(76.9%) and the remaining were Chinese(15.1%), Indians(2.2%)and other ethnic groups(5.8%). One hundred and thirty eight(99.3%) of the women were married and 98.6% had less than 6 children. More than half(75.5%) of the women’s last child birth was less than 6 years ago. Forty seven percent of them were involved in supporting administrative work and 64.7% of the women gave a history of previous or current vaginal discharge.Conclusions: The present study reported zero incidence rate of trichomoniasis. The low incidence rate was postulated due to all women who participated in this study were categorized into a low-risk group.

  9. Trichomonas vaginalis infection in a low-risk women attended in Obstetrics and Gynaecology Clinic, Universiti Kebangsaan Malaysia Medical Centre

    Institute of Scientific and Technical Information of China (English)

    Norhayati Moktar; Nor Liyana Ismail; Phoy Cheng Chun; Mohamad Asyrab Sapie; Nor Farahin Abdul Kahar; Yusof Suboh; Noraina Abdul Rahim; Nor Azlin Mohamed Ismail; Tengku Shahrul Anuar

    2016-01-01

    Objective: To investigate the presence of trichomoniasis among women attending the Obstetrics and Gynaecology Clinic, Universiti Kebangsaan Malaysia Medical Centre. Methods: A total of 139 high vaginal swabs were taken from the subjects and sent to the laboratory in Amies gel transport media. The specimens were examined for the presence of Trichomonas vaginalis using wet mount, Giemsa staining and cultured in Diamond's medium. Sociodemographic characteristics and gynaecological complaints were obtained in private using structured questionnaire applied by one investigator. Results: The median age was 32 years, with an interquartile interval of 9.96. Most of the subjects were Malays (76.9%) and the remaining were Chinese (15.1%), Indians (2.2%) and other ethnic groups (5.8%). One hundred and thirty eight (99.3%) of the women were married and 98.6%had less than 6 children. More than half (75.5%) of the women's last child birth was less than 6 years ago. Forty seven percent of them were involved in supporting administrative work and 64.7% of the women gave a history of previous or current vaginal discharge. Conclusions: The present study reported zero incidence rate of trichomoniasis. The low incidence rate was postulated due to all women who participated in this study were categorized into a low-risk group.

  10. Phenotypic Detection of Genitourinary Candidiasis among Sexually Transmitted Disease Clinic Attendees in Ladoke Akintola University Teaching Hospital, Osogbo, Nigeria

    Science.gov (United States)

    Obisesan, Oluranti J.; Olowe, Olugbenga A.; Taiwo, Samuel S.

    2015-01-01

    The management of genitourinary candidiasis (GC) is fraught with challenges, especially, in an era of increasing antifungal resistance. This descriptive cross-sectional study conducted between May 2013 and January 2014 determined the prevalence and characteristics of GC and the species of Candida among 369 attendees of a Sexually Transmitted Disease (STD) clinic of Ladoke Akintola University Teaching Hospital, Osogbo, Nigeria. Appropriate urogenital specimen collected from each attendee was examined by microscopy and culture for Candida, with preliminary species identification by CHROMAgar Candida and confirmation by Analytical Profile Index (API) 20C AUX. The age range of attendees was 1-80 years, mean age was 36.32 ± 11.34 years, and male to female ratio was 1 to 3. The prevalence of genitourinary candidiasis was 47.4%, with 4.9% in males and 42.5% in females (p < 0.0001). The age groups 31–45 and 16–30 have the highest prevalence of 23.3% and 16.8%, respectively. The species of Candida recovered include Candida glabrata 46.9%, Candida albicans 33.7%, Candida dubliniensis 9.7%, Candida tropicalis 5.7%, Candida krusei 1.7%, Candida lusitaniae 1.7%, and Candida utilis 0.6%. This study reported non-C. albicans Candida, especially C. glabrata, as the most frequently isolated species in GC, contrary to previous studies in this environment and elsewhere. PMID:26064140

  11. Prevalence of depression and its associated factors among elderly patients in outpatient clinic of Universiti Sains Malaysia Hospital.

    Science.gov (United States)

    Imran, A; Azidah, A K; Asrenee, A R; Rosediani, M

    2009-06-01

    Depression among elderly primary care patients is a serious problem with significant morbidity and mortality. This is a cross sectional study to determine the prevalence of depression and its associated factors among the elderly patients attending the outpatient clinic, Universiti Sains Malaysia Hospital. This study utilized Malay version Geriatric Depression Scale 14 (M-GDS 14) to screen for elderly depression among Malaysian population. It also looked into associated risk factors for elderly depression using sociodemographic, family dynamics, and medically related questionnaires. Out of 244 subjects, 34 or 13.9% were found to have depression. Three variables were found to be significantly associated with depression. Elderly patient with any illness that limits the patient's activity or mobility has more risk of developing depression (OR 2.68 CI 1.15 - 6.24). Elderly patients who were satisfied with their personal incomes (OR 0.29 CI 0.10 - 0.85), and who had children or son/daughter-in-law to take care of them when they are sick (OR 0.10 CI 0.01 - 0.83) have a lower chance of having depression. Screening the elderly for depression, would help in diagnosing the elderly depression better and offer them the treatment needed.

  12. Spoligotyping of Mycobacterium tuberculosis isolates from tuberculosis diagnosed patients at Dilla University Referral Hospital and other private clinics, Southern Ethiopia

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    Gebremedhin Gebrezgabiher

    2015-04-01

    Full Text Available Objective: To assess Mycobacterium tuberculosis (M. tuberculosis strains exsisting in Gedeo zone and the surrounding areas of the Southern Ethiopia using spoligotyping. Methods: A cross sectional study was carried out from February, 2012 to June, 2013 and 97 (76 sputum and 21 fine needle aspirate samples were taken from tuberculosis diagnosed patients at Dilla University Referral Hospital and other private clinics. Culturing, region of difference (RD9 deletion typing and spoligotyping techniques were employed to isolate M. tuberculosis strains. Results: Growth of mycobacteria was observed in 35.1% (34/97. Speciation of isolates showed that 91.2% (31/34 of the isolates were M. tuberculosis. Further characterization led to the identification of 23 different spoligotype patterns of M. tuberculosis of which 61% and 39% displayed unique and cluster patterns, respectively. The most dominant shared type was spoligotype international type 53. Of the 23 strains, 12 have not been registered in the international spoligotyping database (SpolDB4. Seventy one percent of the strains belonged to the Euro-American lineage. Conclusions: This study revealed the existence of both genetically diverse and clustered M. tuberculosis strains from tuberculosis patients in the area, suggesting reactivation of infection and recent transmission, respectively. Molecular epidemiology of M. tuberculosis should be done nationwide in order to set appropriate control measures.

  13. SOCIODEMOGRAPHIC FEATURES OF CHILD AND ADOLESCENTS ADMITTED TO KARADENIZ TECHNICAL UNIVERSITY MEDICAL FACULTY CHILD OUTPATIENT CLINIC WITH SUICIDE ATTEMPT

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    Evrim AKTEPE

    2006-12-01

    Full Text Available Assesment of sociodemographic and psychiatric characteristics of attempted suicide in children and adolescents. The aim of this study is to identify risk factors and sociodemographic, psychiatric characteristics of adolescents and children who attempted suicide. Suicide attempters (range 7-15 years, fifty-eight cases who referred to Karadeniz Technical University, School of Medicine, Department of Child and Adolescent Psychiatry outpatient clinic between January 2003 and January 2005 were analyzed retrospectively, in terms of sex, age, living residence, number of suicide attempts, educational achievement and level, psychiatric examinations, method of suicide, precipitating events, psychiatric evaluations of parents, socioeconomic status in our study. The majority of subjects were girls (89.7%. The commonest age group involved was 15-16 years (46.6%. Girls, aged 15-16 years, from middle-low socioeconomic status with low achievement at school, living in urban area were found to be risky group for suicide attempt. From the view of low tolerance to problems, insufficient coping abilites in youth; acquirement of problem solving capacity and aiding in familiar problems solutions may be efficient in prevention and treatment of suicide. [TAF Prev Med Bull 2006; 5(6.000: 444-454

  14. The Socio-Demographic and Clinical Characteristics of the Adult Epileptic Patients Applying to the Neurology Clinic of Erciyes University and the Relation of These Phenomena to Depression

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    Vesile Şenol

    2007-08-01

    Full Text Available OBJECTIVE: The epidemiological characteristics of epilepsy vary from society to society. Epilepsy, whose prevalence is between 0.5-1.0%, is usually seen in early and late ages, at the both of ends of life, and more often in males, and in people who have low income and education. Besides ıts neuropsychologic effects, epilepsy is a disease which has psychological, socilogical aspects such as social isolation, low self-esteem and depression. Depression is seen more often in people with epilepsy than people who don’t have this disease. The percentage of depression for the whole life-time for people with epilepsy is 10-30%. Age at onset of epilepsy, seizure type, frequency, time and the type of treatment (mono-poly therapy affect the incidence and degree of depression. OBJECTIVES: To define the socio-demographic and clinical characteristics of epilepsy cases, to determine the percentage of depressive disorders in epilepsy cases, to probe the characteristics of epileptic seizure and its relation to depression. METHODS: The study was conducted through a face-to-face survey of 102 adult epileptic patients who applied to the Erciyes University Epilepsy Outpatient Clinic between October 2004 and 2005. In order to gather the data, which was prepared by the researcher “A survey form for the epileptic individuals” and “The Turkish Version of Beck Depression Inventory”, whose accuracy and validity was checked by Hisli, was used. RESULTS: The average age for the cases is 34.3±12.6, the average age at seizure onset is 21.4±14.6 and in 66% of them the seizure started when they were under 25. Majority of the cases were male and lower than the minimum wage. Among the patients, 45.6% had generalized (tonic-clonic seizures, and 36% had been ≥1/month seizures and 32% seizure-free during the previous year. CONCLUSION: The average of depressive disorder was 29.4%. 15.7% of the cases were with major depression. Age at onset epilepsy, seizure type and

  15. A survey on viewpoints of nursing and midwifery students and their clinical instructors at Faculty of Nursing and Midwifery of Shahid Sadoughi University of Medical Sciences towards clinical education during 2009-2011

    Directory of Open Access Journals (Sweden)

    T Salimi

    2012-11-01

    Full Text Available Introduction: Clinical environments play a vital role in nursing and midwifery students' learning. The present study investigates the viewpoints of clinical instructors and nursing and midwifery students of Shahid Sadoughi University of Medical Sciences about clinical education status during 2009-2011. Methods: In this cross sectional research data were gathered using a researcher made questionnaire including five domains: educational plan, quality of clinical instructors function, role of clinical professionals in clinical education, educational facilities and space, clinical evaluation and professional satisfaction. The questionnaire was completed by clinical instructors and nursing and midwifery students. Convenient sampling was accomplished. Face validity, content validity and reliability of the questionnaire was assessed and confirmed by test – retest method. Results: Majority of clinical instructors, nursing and midwifery students reported day and evening work shifts more appropriate. Majority of clinical instructors reported the clinical education status pleasant, but 79.8% nursing students and 64.2% midwifery students reported it moderate. Comparing the mean of clinical education status from the viewpoints of clinical instructors didn't show a significant difference in the domain of "the role of the others impressive in clinical education", but there was a significant difference between the nursing and midwifery students in their view points about the domain. Conclusion: Clinical competency is an essential component in providing high quality nursing care, thus the educational planners should continue to evaluate the effectiveness of clinical education. Boosting the clinical learning environment domains such as “successful instructors”, “professional values”, “professional relationship with the members of caring team” and “conflict management” could make the clinical experience attractive and assure students

  16. Actitud del gobierno ante el 1º de mayo, desde 1890 hasta la Segunda República

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    Lucía Rivas Lara

    1988-01-01

    Full Text Available El 1° de Mayo, cuyo origen estuvo en la aspiración obrera a la jornada de ocho horas, se celebró por primera vez en Estados Unidos en 1886, después de muchos años de lucha de los trabajadores en los diversos países por el acortamiento de las jornadas, dado que hasta entonces habían sido de 12 a 16 horas según los lugares. Pero este 1° de mayo de 1886 tuvo un nacimiento espontáneo entre los trabajadores anarquistas norteamericanos, merced a la decisión de un congreso de la Federación Americana del Trabajo (AFL, sin perspectiva de continuidad ni trascendencia más allá de sus fronteras. No obstante, en el marco de su país tuvo un notable éxito consiguiendo con él muchos trabajadores la jornada de ocho horas, y sirviendo de precedente.

  17. Experiences of the Nuclear Medicine Service at the University Hospital Surgical Clinic Dr. Salvador Allende 2013-2015

    International Nuclear Information System (INIS)

    Suárez Iznaga, Rodolfo; Pozo Almaguer, Armando del; Gil Valdés, Doris; Fleitas Anaya, Ricardo

    2016-01-01

    The Nuclear Medicine Service of the University Hospital Surgical Clinic D r. Salvador Allende , located in the municipality of Cerro, began the provision of scintigraphic services in May 2013. A retrospective descriptive and analytical study was carried out from May 2013 to December 2015 from the archived scintigraphic reports. The objective of the study was to present the results of the Nuclear Medicine Service during this period. The data were reflected in percentages, using tables and graphs. To determine the existence of a statistically significant relationship between the variables were used: Chi square test with a level of significance α = 0.05 being positive if p <0.05. Until December 2015, 798 cases had been reported, which included Bone scans (88.34%), renal (10.65%) and thyroid scans for follow-up of cancer patients (1%); (76.82%) and the female sex was the most attended with 446 (55.89%) patients, there were no statistically significant differences between the scintigraphic studies and the sex of the patients. There were statistically significant differences between the scintigraphic studies and the age of the patients. The most frequent diagnoses were: bone scintigraphy, metastasis in 86.52% of patients, renal cyst scintigraphy (48.78%) and dynamic scintigraphy of the kidneys with obstructive functional involvement (63.64%) It was recommended to create the necessary technical and human resources conditions to be able to introduce other scintigraphy studies in the Nuclear Medicine Service such as: breast scintigraphy and lymph node scans, high demand in the medical center. In addition, to use scientifically the criteria of approval of patients in the consultation of classification of the service, with the aim of achieving a better selection of the applicants for scintigraphic studies, which would favor a more rational and efficient use of these studies.

  18. [Hysterectomies at the Conakry university hospitals: social, demographic, and clinical characteristics, types, indications, surgical approaches, and prognosis].

    Science.gov (United States)

    Baldé, I S; Sy, T; Diallo, B S; Diallo, Y; Mamy, M N; Diallo, M H; Bah, E M; Diallo, T S; Keita, N

    2014-01-01

    The objectives of this study were to calculate the frequency of hysterectomies at the Conakry university hospitals (Donka Hospital and Ignace Deen Hospital), describe the women's social, demographic, and clinical characteristics, and identify the key indications, the surgical techniques used, and the prognosis. This was a 2-year descriptive study, retrospective for the first year (May 2011-April 2012) and prospective for the second (May 2012-April 2013), of 333 consecutive hysterectomies performed in the obstetrics and gynecology departments of these two hospitals. Hysterectomy is one of the surgical procedures most commonly performed in these departments (following cesarean deliveries), with frequency of 4.4% interventions. The profile of the women undergoing this surgery was that of a woman aged younger than 49 years (61%), married (75.7%), multiparous (33%), of childbearing age (61%), and with no history of abdominal or pelvic surgery (79.6%). Nearly all hysterectomies were total (95%, compared with 5% subtotal; the approach was abdominal in 82.25% of procedures and vaginal in 17.75%. The most common indication for surgery was uterine fibroids (39.6%), followed by genital prolapse (22.2%), and obstetric emergencies (17.8%). The average duration of surgery was 96 minutes for abdominal and 55 minutes for vaginal hysterectomies. The principal intraoperative complication was hemorrhage (12.31%), and the main postoperative complication parietal suppuration (21.02%). The average length of hospital stay was 10.3 days for abdominal hysterectomies and 7.15 days for vaginal procedures. We recorded 14 deaths for a lethality rate of 4.2%; most of these deaths were associated with hemorrhagic shock during or after an obstetric hysterectomy (93%). Hysterectomy remains a common intervention in developing countries. Its indications are common during the pregnancy and postpartum period, with high morbidity and mortality rates. Improving obstetric coverage could reduce its

  19. Clinical and echocardiographic characteristics and outcomes in congestive heart failure at the Hospital of The State University of Haiti.

    Science.gov (United States)

    Malebranche, Rodolphe; Tabou Moyo, Christian; Morisset, Paul-Henry; Raphael, Nernst-Atwood; Wilentz, James Robert

    2016-08-01

    This study aimed to evaluate the clinical and epidemiologic profile of congestive heart failure at the principal free-care hospital in Haiti. Cardiovascular disease represents the most prevalent cause of admissions to the medical service of the University Hospital of the State of Haiti. No previous study has examined the demographics of congestive heart failure in urban Haiti. Two hundred forty-seven patients presented to the inpatient service between May 2011 and May 2013. Evaluation included history and physical, CBC, renal/metabolic profile, serum glucose, anti-HIV antibody, ECG, chest radiograph and echocardiogram. Treatment included angiotensin converting enzyme inhibitors, furosemide and spironolactone, carvedilol, digoxin and anticoagulation. Women (62.4%) outnumbered men; patients were relatively young (mean age 50.1) and from the lowest socio-economic levels of the population. Nearly all (98.8%) presented with NYHA III-IV status, with correspondingly high mortality (23.3%). Echocardiography showed 73% dilated cardiomyopathy; 83% showed moderate to severe LV systolic dysfunction (mean EF 36.5 +/- 15%) and 17% preserved LV systolic function. The three principal etiologies were dilated cardiomyopathy (29%) hypertensive cardiomyopathy (27%) and peripartum cardiomyopathy (20%). Ischemic cardiomyopathy was rare (3.4%). At 27 months follow-up, 76.7% of the patients were alive and well. Among those who died, mean survival time was 113 days. Readmission carried a poor prognosis. This congestive heart failure study from Haiti shows an unusually high proportion of young women, primarily due to peripartum cardiomyopathy. Ischemic cardiomyopathy is rare, as in Africa. Further study is warranted to address the particular problem of the high frequency of peripartum cardiomyopathy in this population. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Clinical Features and Treatment Modes of Mandibular Fracture at the Department of Oral and Maxillofacial Surgery, Shimane University Hospital, Japan.

    Directory of Open Access Journals (Sweden)

    Hiroto Tatsumi

    Full Text Available The number of elderly patients with maxillofacial trauma is rapidly increasing due to active lifestyles and longevity. Shimane prefecture has the fastest growing proportion of elderly individuals in Japan. The aim of this study was to reveal the distinctive features and treatment modes of mandibular fracture treatment mode in patients requiring hospitalization at the Department of Oral and Maxillofacial Surgery, Shimane University Hospital, Japan.Patient age, sex, period between injury and first consultation, years since injury, cause of injury, fracture site, treatment, and duration of hospitalization were evaluated. Univariate Poisson regression, relative risk with 95% confidence interval based on the Wald test, Fisher's exact test, and Kruskal-Wallis test were used to explore associations among clinical and demographic variables.In total, 305 patients were diagnosed with and hospitalized for mandibular fracture from 1980 to 2010. Younger age increased the risk for mandibular fracture. Incidence was higher in males than females, particularly in the young, but the male to female ratio decreased with age. The period until first hospital consultation decreased progressively over the study period. Fall was a much more frequent cause in patients aged ≥60 than in those aged <60 years. Mandibular fracture with condyle, symphysis, and angle involvement were most common and were associated with sex, age, and treatment mode. Length of hospitalization has decreased since 1980.In our department, patients aged ≥60 years accounted for a greater proportion of mandibular fracture cases than in many previous studies, reflecting the greater proportion of elderly residents in Shimane prefecture.

  1. Tuberculosis among Healthcare Workers at Chiang Mai University Hospital, Thailand: Clinical and Microbiological Characteristics and Treatment Outcomes.

    Science.gov (United States)

    Inchai, Juthamas; Liwsrisakun, Chalerm; Bumroongkit, Chaiwat; Euathrongchit, Juntima; Tajarernmuang, Pattraporn; Pothirat, Chaicharn

    2018-05-24

    Tuberculosis (TB) among healthcare workers (HCWs) highly affects morbidity and TB transmission in hospitals. A retrospective cohort study of TB among HCWs (HCW-TB) was conducted using a registered database from 2003 to 2016 at Chiang Mai University Hospital to determine clinical and microbiological characteristics and treatment outcomes of HCW-TB. A total of 76 patients comprising 54 nurses (71.1%), 12 physicians (15.8%), and 10 paramedics (13.2%) were diagnosed with TB disease. The men to women ratio was 25:51, with a mean age of 37.0±11.6 years, a median work duration of 12.0 years (5-20) and a body mass index of 19.4±2.5 kg/m 2 . Within the HCW-TB group, 28 (36.8%) worked in the Medical Department, 12 (15.8%) worked in the Outpatient Department/Emergency Room, and 9 (11.8%) worked in the Surgical Department. Pulmonary TB (PTB) was the most common manifestation of HCW-TB (92.1%). Sputum acid-fast stains were positive among 28 (40.0%) HCWs with PTB. Mycobacterium tuberculosis cultures were positive in 26 (34.2%) patients. Drug susceptibility testing showed sensitivity to all first-line drugs (75.0%), resistance to any one first-line drug (20.8%), and multidrug-resistant TB comprised 4.2%. The end-of-treatment success rate was 100%. Therefore, TB control guidelines should be strictly implemented to prevent TB transmission in healthcare settings.

  2. Introducing computer-assisted training sessions in the clinical skills lab at the Faculty of Medicine, Suez Canal University.

    Science.gov (United States)

    Hosny, Somaya; Mishriky, Adel M; Youssef, Mirella

    2008-01-01

    The Faculty of Medicine, Suez Canal University clinical skills lab was established in 1981 as the first skills lab in Egypt to cope with innovation in medical education adopted since school inauguration in 1978. Students are trained using their peers or models. Training is done weekly, guided by checklists tested for validity and reliability and updated regularly. Students receive immediate feedback on their performance. Recently, the number of students has increased, leading to challenges in providing adequate supervision and training experiences. A project to design and implement a computer-assisted training (CAT) system seemed to be a plausible solution. To assess the quality of a newly developed CAT product, faculty and students' satisfaction with it, and its impact on the learning process. The project involved preparation of multimedia video-films with a web interface for links of different scientific materials. The project was implemented on second year students. A quality check was done to assess the product's scientific content, and technical quality using questionnaires filled by 84 faculty members (139 filled forms) and 175 students (924 filled forms). For assessment of impact, results of examinations after project implementation were compared with results of 2nd year students of previous 3 years. More faculty (96.3%) were satisfied with the product and considered its quality good to excellent, compared to 93.9% of students, p < 0.001. Most faculty (76.2%) have agreed on its suitability for self-learning, while most students considered the product would be suitable after modification. The percentage of students' failures was lower after project implementation, compared to previous 3 years, p < 0.05. CAT materials developed for training of second year students in skills lab proved to be of good scientific content and quality, and suitable for self-learning. Their use was associated with lower failure rates among students. A randomized trial is recommended

  3. Making Canada a destination for medical tourists: why Canadian provinces should not try to become "Mayo Clinics of the North".

    Science.gov (United States)

    Turner, Leigh

    2012-05-01

    When Canadian researchers examine the subject of medical tourism, they typically focus on ethical, social, public health and health policy issues related to Canadians seeking health services in other countries. They emphasize study of Canada as a departure point for medical tourists rather than as a potential destination for international patients. Several influential voices have recently argued that provincial healthcare systems in Canada should market health services to international patients. Proponents of marketing Canada as a destination for medical tourists argue that attracting international patients will generate revenue for provincial healthcare systems. Responding to such proposals, I argue that there are at least seven reasons why provincial health systems in Canada should not dedicate institutional, financial and health human resources to promoting themselves as destinations for medical tourists.

  4. The Mayo Clinic experience with Morel-Lavallée lesions: establishment of a practice management guideline.

    Science.gov (United States)

    Nickerson, Terry P; Zielinski, Martin D; Jenkins, Donald H; Schiller, Henry J

    2014-02-01

    Although uncommon, Morel-Lavallée lesions (also called closed degloving injuries) are associated with considerable morbidity in trauma patients. There is lack of consensus regarding proper management of these lesions. Management options include nonoperative therapies, along with percutaneous and operative techniques. We sought to define the factors associated with failure of percutaneous aspiration to better identify patients requiring immediate operative management. We retrospectively searched our prospectively collected database for patient records containing the terms Morel-Lavallée, closed degloving injury, or posttraumatic seroma from February 2, 2004, through December 23, 2011. Treatment methods included compression wraps or observation (nonoperative management), percutaneous aspiration, or operative management with incision/drainage or formal debridement of skin and soft tissues that resulted in wound vacuum-assisted closure placement and/or split-thickness skin graft (operative management). The treatment groups were compared using univariate analysis and χ testing. We identified 79 patients with 87 Morel-Lavallée lesions in the setting of trauma. Most were caused by motor vehicle collisions (25%). No difference was observed between the treatment groups in sex, body mass index, anticoagulation treatment, diabetes mellitus, smoking history, or alcohol use. The percutaneous aspiration group had higher rates of recurrence (56% vs. 19% and 15% in nonoperative and operative groups, respectively). The percentage of patients who had aspiration of more than 50 mL of fluid was higher for lesions that recurred than for lesions that resolved (83% vs. 33%, p = 0.02). Aspiration of more than 50 mL of fluid from Morel-Lavallée lesions was much more common among lesions that recurred (83%) than among those that resolved (33%). We therefore recommend that aspiration of more than 50 mL of fluid from a Morel-Lavallée lesion prompts operative intervention. We have now adopted this as a practice management guideline. Therapeutic/care management study, level III.

  5. Quality initiatives: improving patient flow for a bone densitometry practice: results from a Mayo Clinic radiology quality initiative.

    Science.gov (United States)

    Aakre, Kenneth T; Valley, Timothy B; O'Connor, Michael K

    2010-03-01

    Lean Six Sigma process improvement methodologies have been used in manufacturing for some time. However, Lean Six Sigma process improvement methodologies also are applicable to radiology as a way to identify opportunities for improvement in patient care delivery settings. A multidisciplinary team of physicians and staff conducted a 100-day quality improvement project with the guidance of a quality advisor. By using the framework of DMAIC (define, measure, analyze, improve, and control), time studies were performed for all aspects of patient and technologist involvement. From these studies, value stream maps for the current state and for the future were developed, and tests of change were implemented. Comprehensive value stream maps showed that before implementation of process changes, an average time of 20.95 minutes was required for completion of a bone densitometry study. Two process changes (ie, tests of change) were undertaken. First, the location for completion of a patient assessment form was moved from inside the imaging room to the waiting area, enabling patients to complete the form while waiting for the technologist. Second, the patient was instructed to sit in a waiting area immediately outside the imaging rooms, rather than in the main reception area, which is far removed from the imaging area. Realignment of these process steps, with reduced technologist travel distances, resulted in a 3-minute average decrease in the patient cycle time. This represented a 15% reduction in the initial patient cycle time with no change in staff or costs. Radiology process improvement projects can yield positive results despite small incremental changes.

  6. A study on task-analysis of clinical pathologists as medical consultants in Nihon University Hospital--a Japanese perspective by comparison with current status in the USA.

    Science.gov (United States)

    Kumasaka, K; Yanai, M; Hosokawa, N; Iwasaki, Y; Hoshino, T; Arashima, Y; Hayashi, K; Murakami, J; Tsuchiya, T; Kawano, K

    2000-07-01

    To identify our role and the customers' satisfaction, the on-call consultation service records of the Department of Clinical Pathology, Nihon University School of Medicine, Itabashi Hospital (NUIH), were analyzed. Between 1995 and 1998, 1,789 consultation services were recorded, and approximately 40% were from physicians, and 50% were from medical technologists. During office hours, many physicians made contact with us at the office of clinical pathology, the clinical laboratory and other places in the hospital by various means. They asked us to interpret multidisciplinary laboratory data, and to provide the specific information that might affect clinical management. Medical technologists asked for clinical information of patients with extreme measured values and requested that we contact with physicians. In contrast, on weekends/holidays or after routine working hours, physicians sometimes requested non-automated laboratory tests such as peripheral blood smears/bone marrow smears or Gram stains. The major contents of our responses to medical technologists were concerned with blood banking and handling of instruments not to be operated in routine work. These results reconfirm that we are still required to have clinical competence for common laboratory procedures and to have the capability of interpretation of multidisciplinary laboratory data in the university hospital. Traditionally, most Japanese clinical pathologists have been focused their attention on bench work in research laboratories. However, the present study shows that the clinical pathologists need to bridge the real gap between laboratory technology and patient care. Our on-call service system can enhance the education of clinical pathologists, and improve not only laboratory quality assurance but also patient care. In addition, in response to a need for customer access to this service with a shortage of clinical pathologists, a more effective method would be to set up a proactive systemic approach in

  7. Determinants of completion of advance directives: a cross-sectional comparison of 649 outpatients from private practices versus 2158 outpatients from a university clinic.

    Science.gov (United States)

    Pfirstinger, Jochen; Bleyer, Bernhard; Blum, Christian; Rechenmacher, Michael; Wiese, Christoph H; Gruber, Hans

    2017-12-21

    To compare outpatients from private practices and outpatients from a university clinic regarding the determinants of completion of advance directives (AD) in order to generalise results of studies from one setting to the other. Five determinants of completion of AD were studied: familiarity with AD, source of information about AD, prior experiences with own life-threatening diseases or family members in need of care and motives in favour and against completion of AD. Observational cross-sectional study. Private practices and a university clinic in Germany in 2012. 649 outpatients from private practices and 2158 outpatients from 10 departments of a university clinic. Completion of AD, familiarity with AD, sources of information about AD (consultation), prior experiences (with own life-threatening disease and family members in need of care), motives in favour of or against completion of AD, sociodemographic data. Determinants of completion of AD did not differ between outpatients from private practices versus university clinic outpatients. Prior experience with severe disease led to a significantly higher rate of completion of AD (33%/36% with vs 24%/24% without prior experience). Participants with completion of AD had more often received legal than medical consultation before completion, but participants without completion of AD are rather aiming for medical consultation. The motives in favour of or against completion of AD indicated inconsistent patterns. Determinants of completion of AD are comparable in outpatients from private practices and outpatients from a university clinic. Generalisations from university clinic samples towards a broader context thus seem to be legitimate. Only one-third of patients with prior experience with own life-threatening diseases or family members in need of care had completed an AD as expression of their autonomous volition. The participants' motives for or against completion of AD indicate that ADs are considered a kind of

  8. Assessment of Clinical Education in the Alborz University of Medical Sciences from Surgical Technology and Anesthesiology Students’ Point of View

    Directory of Open Access Journals (Sweden)

    T. Bahrami Babaheidary

    2012-07-01

    Conclusion: Because of surgical technology and anesthesiology students needs to acquire clinical skills along with theoretical training, providing suitable clinical environment seems to be critical to achieve essential in-depth experience in professional aspects.

  9. Factors influencing the choice of antidepressants: A study of antidepressant prescribing practice at University psychiatric clinic in Belgrade

    Directory of Open Access Journals (Sweden)

    Marić Nađa P.

    2012-01-01

    Full Text Available Background/Aim. Antidepressants are a widely used class of drugs. The aim of this study was to investigate different aspects of antidepressant prescribing practice at University Psychiatric Clinic in Belgrade. Methods. This cross-sectional study was carried out by retrospective analysis of the patient's medical charts. The study included all patients with antidepressant prescribed at discharge during 2009 (n = 296. The evaluation was focused on patient- related factors (socio-demographic and illness related, psychiatrist-related factors (sex and duration of working experience and drug related factors (type of antidepressant, dose, polypharmacy and reimbursement by national health insurance. Results. Antidepressants were prescribed for unipolar depression (F32-34, ICD X either without comorbidity (46.2% or with comorbidity (24.7%, mostly as a monotherapy (91% had one antidepressant, to the patients who were 65% female, aged 50.1 ± 8.9, most of them with 12 years of education (52.6%, married (69.3% and employed (55.9%. The majority of patients had a history of two hospitalizations (Med 2; 25th-75th perc. 1-4 during nine years (Med 9; 25th-75th perc. 2-15 after the first episode of depression. Among them, 19% were found to be suicidal in a lifetime. The single most prescribed antidepressant was sertraline (20.4%, followed by fluoxetine (13.3% and maprotiline (11.7%. Utilization of antidepressants was positively correlated with the rate of reimbursement (p < 0.01. The most prescribed antidepressant group was selective serotonin reuptake inhibitors (SSRI (47.8%, followed by tricyclic antidepresants (TCA (25.3% and new antidepressants - venlafaxine, tianeptine, mirtazapine, bupropion, trazodone (15.1%. Most of the drugs were prescribed in doses which are at the lower end of the recommended dose-range. Regarding severity of the actual depressive episode, TCA were prescribed for severe depression with psychotic features, while SSRI were choice for

  10. Managing disclosure of research misconduct by a graduate student to a university mental health professional during a clinical counseling session.

    Science.gov (United States)

    Taylor, Holly A; Wilfond, Benjamin S

    2013-01-01

    This case looks at the question of how to consider obligations of confidentiality by a mental health professional who works for an institution and learns that a student has been using a drug intended for an animal research project. Dr. Paul Appelbaum, MD, a psychiatrist at Columbia University, examines the issue of the limits of confidentiality. Nicholas Steneck, PhD, a scholar in research misconduct at the University of Michigan, explores the obligations to report research misconduct. Walter Limehouse, MD, an ethicist at the Medical University of South Carolina, considers the systems issues raised by this case and offers some suggestions that might change the institutional environment.

  11. The effects of work on the health of nurses who work in clinical surgery departments at university hospitals.

    Science.gov (United States)

    Silva, Rosângela Marion da; Zeitoune, Regina Célia Gollner; Beck, Carmem Lúcia Colomé; Martino, Milva Maria Figueiredo de; Prestes, Francine Cassol

    2016-08-08

    to analyze the effects of work on the health of nurses who work in clinical surgery departments at university hospitals in relation to physical, social and psychological suffering and pain. a quantitative transversal study was carried out between 2012 and 2013 in four institutions in a state located in the south of Brazil. We studied 65 nurses who responded to questions on their habits. We also obtained sociodemographical information on them as well as conducting an evaluation on work relational damage using an evaluation scale. Associations were checked through the use of the Chi-Sqaure and Fisher's exact test. Correlations were checked using the Spearmann test. we found that physical ailments persisted and that there were connections between social and psychological pain/suffering and variable physical activities as well as connections with accidents in the work place and the option to work shifts. We noted correlations between social and psychological pain/suffering. nurses had their health compromised due to their work in clinical surgery departments. analisar os efeitos do trabalho na saúde de enfermeiros que atuam em clínicas cirúrgicas de hospitais universitários, relacionando-os aos danos físicos, sociais e psicológicos. estudo quantitativo, transversal, realizado entre 2012 e 2013 em quatro instituições de um Estado da região sul do Brasil. A amostra foi composta por 65 enfermeiros que responderam questões sobre os hábitos de vida e dados sociodemográficos e a Escala de Avaliação de Danos Relacionados ao Trabalho. Associações foram verificadas pelo teste Qui-Quadrado e Exato de Fisher e as correlações pelo teste de Spearmann. prevaleceu o adoecimento físico, encontrando associação entre os fatores Danos Sociais e Psicológicos e as variáveis prática de atividade física, acidente de trabalho e opção pelo turno de trabalho. Evidenciou-se correlação entre Danos Sociais e Psicológicos. o trabalho realizado por enfermeiros que atuam

  12. Uterine fibroids and urinary disorders: An analysis using the medical imaging of 72 cases in Kinshasa University Clinics from 1998 to 2003

    International Nuclear Information System (INIS)

    Ndaye, B.; Ntandu, U.; Maswapi, K.; Djamba, O.; Kitenge, N.

    2010-01-01

    Cross sectional study of 672 cases with clinical analysis and medical imaging whose average age is 44,5 years. This analysis looked at 672 cases of women's diagnosed with fibroids 1 january 1998 to 1 january 2003 in the department of obstetrics gynecology in the oncology and radiology of the university clinics in Kinshasa. All cases with diagnosis, using the clinical and medical imaging (ultrasound and hysterosalpingography and or intravenous urography) had fibroids were reviewed to identify the consequences of these on the urinary tract. The most frequent clinical signs were menorrhagia (22%), the menometrorrhagia (21,1%) and pelvic heaviness (20%). Radiological signs seen on intravenous urography were compressing the bladder dome (34,7%), bilateral ureteral diversion (15,2%) with hydronephrosis upstream (15,2%)

  13. Gastrointestinal helminths of Gentoo penguins (Pygoscelis papua) from Stranger Point, 25 de Mayo/King George Island, Antarctica.

    Science.gov (United States)

    Diaz, Julia Inés; Fusaro, Bruno; Longarzo, Lucrecia; Coria, Néstor Rubén; Vidal, Virginia; Jerez, Silvia; Ortiz, Juana; Barbosa, Andrés

    2013-05-01

    The aim of this work is to contribute to the knowledge of gastrointestinal parasites of the Gentoo penguin (Pygoscelis papua) from 25 de Mayo/King George Island (South Shetlands, Antarctica). Gastrointestinal tracts of 37 fresh dead individuals (21 chicks, 10 juveniles, and 6 adults) were collected from December 2006 to February 2012 and examined for macroparasites. Four adult parasite species were found: one Cestoda species (Parorchites zederi), two Nematoda species (Stegophorus macronectes and Tetrameres wetzeli), and one Acanthocephalan (Corynosoma shackletoni). Two species of immature acanthocephalans, Corynosoma hamanni and Corynosoma bullosum, were found in a single host. This is the first record of Tetrameres wetzeli in Gentoo penguins. The low parasite richness observed could be related to the stenophagic and pelagic diet of this host species which feeds almost exclusively on krill.

  14. Implementation of a model of quality control program in the radiodiagnostic service at the general hospital Dos de Mayo

    International Nuclear Information System (INIS)

    Acosta Reginfo, N.; Ramirez Quijada, R.

    1998-01-01

    In order to implement a model of quality control program, the General Hospital Dos de Mayo was selected, since it manages a specialized radiology service - defined according to the OMS criteria - This radiology service attends nearly 60 % of total patients of the Hospital. This program intends to be a model for application to another hospitals havings similar characteritics, since any formal quality control program has been implemented in neither private nor public hospitals in the country. The model, while allowing to make measurements of main parameters, also allows to verify that radiation doses to patients, radiation workers and public trend to a level as low as reasonably achievable, and also to yield images with enough diagnostic quality, and to induce work environment with shared responsibility and commitment

  15. Salinity monitoring using remote sensing in the 038 Rio Mayo Irrigation District. Sonora, Mexico, by remote sensing

    International Nuclear Information System (INIS)

    Pulido Madrigal, L.; Gonzalez Meraz, J.

    2009-01-01

    a soil salinity survey was carried out in the Rio Mayo irrigation district (ID) in 1996, using satellite imagery along with and EM-38 electromagnetic (EM) device. Data from Landsat TM imagery were calibrated with field data, according to the Plant Indicator methodology. This methodology yielded a partial salinity map of the ID, but including only those areas where indicator crops were cultivated. The remaining non-mapped areas were surveyed with an EM-38 electromagnetic device, generating a second partial salinity map. Both partial maps were integrated to get a complete soil salinity map of the ID. In 2001, another soil salinity survey was carried out using solely the EM device. The results of both methodologies were analyzed, resulting in less affected areas in 2001 compared too those obtained in 1996. (Author) 4 refs.

  16. Qualitative analysis on the field training program for clinical school counselling―Interview survey on psychology department of the universities having post graduate field training program―

    OpenAIRE

    岡本, 淳子; 佐藤, 秀行; 金, 亜美; 水﨑, 光保

    2016-01-01

     In this study, we have interviewed 20 universities with psychology departments that have the postgraduate field training programs of clinical school counselling for more than a year to find out the currentsituation. The results of the study revealed that the field training programs are implementedthrough various channels, largely categorized into the following types: 1)counselling support to thelocal schools through the board of education; 2)counselling support to the individual students thr...

  17. Lower and Middle Ordovician conodonts of Laurentian affinity from blocks of limestone in the Rosroe Formation, South Mayo Trough, western Ireland and their palaeogeographic implication

    DEFF Research Database (Denmark)

    Stouge, Svend; Harper, David A. T.; Sevastopulo, George D.

    2016-01-01

    The Middle Ordovician Rosroe Formation consists of some 1350m of coarse, mainly siliciclastic to volcaniclastic sedimentary rocks, deposited in a submarine fan environment, and is restricted to the southern limb of the South Mayo Trough, western Ireland. Discrete allochthonous blocks, reaching 5m...

  18. State of Clinical Education at Tehran University of Medical Sciences from the Viewpoint of Students of Nursing & Midwifery

    Directory of Open Access Journals (Sweden)

    Sh Baraz Pardenjani

    2008-01-01

    Full Text Available Introduction : Clinical education is considered as the heart of medicine and health care due to the importance of training expert manpower. To achieve this goal, education quality should be promoted, this requiring its continuous evaluation. In this regard, application of appropriate educational strategies by competent clinical trainers or instructors leads to an improvement in the clinical education outcomes. This study was carried out to assess the learning method of clinical skills and its barriers from the viewpoint of students of midwifery. Materials & Methods : This descriptive cross-sectional study was conducted on 140 employed BS midwives in Yazd Province who had a 6-month working experience using a questionnaire including demographic information and items on the common clinical skills grading, skills learning methods, and barriers to clinical learning. Having collected the questionnaires, the data were analyzed using SPSS. Results : The findings of the study revealed that the rate of clinical skills was at a good level for most of the subjects (56.5%, at an intermediate level for 30.7 %, and at a low level for 12.8% of the subjects. The correlation coefficients were statistically significant between subjects' level of clinical skills and age, department, and clinical experience. In studying the learning methods of clinical skills, 46.6% of learning was attributed to trainers, while 69.3% of the learning barriers were attributed to lack of sufficient cases during education, and 68.6% were attributed to insufficient practical training. Conclusion : Although the graduates had an acceptable level of clinical skills, the need for improving clinical education and administering continuous education programs for controlling and warranting care quality was markedly obvious. As the subjects reported, learning was attributed to trainers, while learning barriers were attributed to lack of sufficient cases during training, and insufficient practical

  19. Effectiveness of Short Message Service Text-Based Smoking Cessation Intervention Among University Students: A Randomized Clinical Trial.

    Science.gov (United States)

    Müssener, Ulrika; Bendtsen, Marcus; Karlsson, Nadine; White, Ian R; McCambridge, Jim; Bendtsen, Preben

    2016-03-01

    Smoking is globally the most important preventable cause of ill health and death. Mobile telephone interventions and, in particular, short message service (SMS) text messaging, have the potential to overcome access barriers to traditional health services, not least among young people. To determine the effectiveness of a text-based smoking cessation intervention among young people. A single-blind, 2-arm, randomized clinical trial (Nicotine Exit [NEXit]) was conducted from October 23, 2014, to April 17, 2015; data analysis was performed from April 23, 2014, to May 22, 2015. Participants included daily or weekly smokers willing to set a quit date within 1 month of enrollment. The study used email to invite all college and university students throughout Sweden to participate. The NEXit core program is initiated with a 1- to 4-week motivational phase during which participants can choose to set a stop date. The intervention group then received 157 text messages based on components of effective smoking cessation interventions for 12 weeks. The control group received 1 text every 2 weeks thanking them for participating in the study, with delayed access to the intervention. The primary outcomes were self-reported prolonged abstinence (not having smoked >5 cigarettes over the past 8 weeks) and 4-week point prevalence of complete smoking cessation shortly after the completion of the intervention (approximately 4 months after the quit date). A total of 1590 participants, mainly between 21 and 30 years of age, were randomized into the study; 827 (573 [69.3%] women) were allocated to the intervention group and 763 (522 [68.4%] women) were included in the control group. Primary outcome data were available for 783 (94.7%) of the intervention group and 719 (94.2%) of the control group. At baseline, participants were smoking a median (range) of 63 (1-238) and 70 (2-280) cigarettes per week, respectively. Eight-week prolonged abstinence was reported by 203 participants (25.9%) in the

  20. Evaluation of the effect of early clinical exposure on professional attitude of dental students of Shahid Sadoughi University of Medical Sciences in 2011-2012

    Directory of Open Access Journals (Sweden)

    H. Aghili

    2013-06-01

    Full Text Available Introduction : Learning dentistry could have many tension and anxieties like encountering to a strange clinical environment. Early clinical exposure (ECE is supposed to control these stresses. ECE program is an increasingly widespread component of educational curriculum. This study aims to determine the effect of early clinical exposure on the attitude of dental students’ towards dental education and profession. Methods: An analytic study was performed on all 72 dental students studying basic science at Faculty of Dentistry of Shahid Sadoughi University of Medical Sciences consisted of a short term course of introduction to clinical environment in academic year of 2011-2012. Every 12 students attended in an one day ECE course from 8 AM to 1 PM. Students ' attitude towards dental profession and education were assessed by a questionnaire included 25 items before and after the course .For data analysis descriptive paired-t-test was used. Results: All students completed the questionnaires. Students' attitude towards dental education and profession was evaluated. Mean score of students' attitude before and after exposure to clinical environment were 94.6 and 100.5 respectively .Significant differences were found in the students' attitude before and after the course (P=0.001 Conclusion: Based on the results of this study, we found a positive effect of early clinical exposure on attitudes of first and second year dental students. Demographic variations had an effect on the students' attitude .Therefore we suggest that early clinical exposure should be added to educational curriculum of dental students.

  1. A controlled trial of automated classification of negation from clinical notes

    Directory of Open Access Journals (Sweden)

    Carruth William

    2005-05-01

    Full Text Available Abstract Background Identification of negation in electronic health records is essential if we are to understand the computable meaning of the records: Our objective is to compare the accuracy of an automated mechanism for assignment of Negation to clinical concepts within a compositional expression with Human Assigned Negation. Also to perform a failure analysis to identify the causes of poorly identified negation (i.e. Missed Conceptual Representation, Inaccurate Conceptual Representation, Missed Negation, Inaccurate identification of Negation. Methods 41 Clinical Documents (Medical Evaluations; sometimes outside of Mayo these are referred to as History and Physical Examinations were parsed using the Mayo Vocabulary Server Parsing Engine. SNOMED-CT™ was used to provide concept coverage for the clinical concepts in the record. These records resulted in identification of Concepts and textual clues to Negation. These records were reviewed by an independent medical terminologist, and the results were tallied in a spreadsheet. Where questions on the review arose Internal Medicine Faculty were employed to make a final determination. Results SNOMED-CT was used to provide concept coverage of the 14,792 Concepts in 41 Health Records from John's Hopkins University. Of these, 1,823 Concepts were identified as negative by Human review. The sensitivity (Recall of the assignment of negation was 97.2% (p Conclusion Automated assignment of negation to concepts identified in health records based on review of the text is feasible and practical. Lexical assignment of negation is a good test of true Negativity as judged by the high sensitivity, specificity and positive likelihood ratio of the test. SNOMED-CT had overall coverage of 88.7% of the concepts being negated.

  2. University clinic and private practice treatment outcomes in Class I extraction and nonextraction patients: A comparative study with the American Board of Orthodontics Objective Grading System.

    Science.gov (United States)

    Mislik, Barbara; Konstantonis, Dimitrios; Katsadouris, Alexios; Eliades, Theodore

    2016-02-01

    The aim of this study was to compare treatment outcomes in university vs private practice settings with Class I patients using the American Board of Orthodontics Objective Grading System. A parent sample of 580 Class I patients treated with and without extractions of 4 first premolars was subjected to discriminant analysis to identify a borderline spectrum of 66 patients regarding the extraction modality. Of these patients, 34 were treated in private orthodontic practices, and 32 were treated in a university graduate orthodontic clinic. The treatment outcomes were evaluated using the 8 variables of the American Board of Orthodontics Objective Grading System. The total scores ranged from 10 to 47 (mean, 25.44; SD, 9.8) for the university group and from 14 to 45 (mean, 25.94; SD, 7.7) for the private practice group. The university group achieved better scores for the variables of buccolingual inclination (mean difference, 2.28; 95% confidence interval [CI], 0.59, 3.98; P = 0.01) and marginal ridges (mean difference, 1.32; 95% CI, 0.28, 2.36; P = 0.01), and the private practice group achieved a better score for the variable of root angulation (mean difference, -0.65; 95% CI, -1.26, -0.03; P = 0.04). However, no statistically intergroup differences were found between the total American Board of Orthodontics Objective Grading System scores (mean difference, -0.5; 95% CI, -3.82, 4.82; P = 0.82). Patients can receive similar quality of orthodontic treatment in a private practice and a university clinic. The orthodontists in the private practices were more successful in angulating the roots properly, whereas the orthodontic residents accomplished better torque control of the posterior segments and better marginal ridges. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

  3. Outcomes from the first mouth cancer awareness and clinical check-up day in the Dublin Dental University Hospital.

    LENUS (Irish Health Repository)

    MacCarthy, Denise

    2012-04-01

    To increase public awareness about mouth cancer, the Dublin Dental University Hospital (DDUH) hosted an awareness day and free mouth check-up in September 2010. The messages of information, self-examination and risk management, and the importance of early detection, were available to all attendees. The role of general dental and medical practitioners in examination of the mouth was stressed.

  4. Screening for psychosocial problems in children attending the pediatric clinic at king Khalid university hospital (KKUH in Riyadh (KSA

    Directory of Open Access Journals (Sweden)

    Ibrahim H Al-Ayed

    2008-01-01

    Conclusion: This study revealed the feasibility of screening for behavioral problems of children in an outpatient setting. It is necessary to implement screening procedures for psycho-behavioral problems, and train pediatricians to screen children presenting at clinics.

  5. Strategic planning for clinical services: the University of Texas M.D. Anderson Hospital and Tumor Institute.

    Science.gov (United States)

    Anderson, R W

    1986-09-01

    A formal, hospitalwide strategic-planning process provides structure for the pharmacy's plans for implementing clinical services. The state-supported clinical cancer and research center began a formal strategic-planning process in 1981. The institution's planning report, prepared every two years and covering three two-year periods, drives the institution's budget through the state's biennial budget process. The report focuses on each department's responsibilities, areas of service, and relationship to the mission of the institution. Through the long-range planning process, upper-level administrators learned that pharmacy was eager not only to provide high-volume drug distribution services but also to assume direct patient-care and research responsibilities. This prompted an organizational change for pharmacy from a hospital department to a clinical division. The division of pharmacy now consists of three professional departments (patient care, pharmacy research, and pharmacy academic programs) and an administrative support service area. Services offered by each of the three departments are discussed, along with specific initiatives planned for the years 1987-1993. Within the next few years, all managers will come from the ranks of clinical practitioners; nonpharmacists will oversee financial and human resource functions. The division encourages existing pharmacy staff members to enhance their clinical skills through staff development programs. Strategic planning serves the dual purposes of structuring plans for implementing clinical pharmacy services and communicating pharmacy's goals within the institution.

  6. Effects of Rosmarinus officinalis L. on memory performance, anxiety, depression, and sleep quality in university students: A randomized clinical trial.

    Science.gov (United States)

    Nematolahi, Pouya; Mehrabani, Mitra; Karami-Mohajeri, Somayyeh; Dabaghzadeh, Fatemeh

    2018-02-01

    To evaluate the effects of oral rosemary on memory performance, anxiety, depression, and sleep quality in university students. In this double-blinded randomized controlled trial, the 68 participating students randomly received 500 mg rosemary and placebo twice daily for one month. Prospective and retrospective memory performance, depression, anxiety and sleep quality of the students were measured using Prospective and Retrospective Memory Questionnaire, Hospital Anxiety and Depression Scale, and Pittsburgh Sleep Quality Inventory at baseline and after one month. The scores of all the scales and subscales except the sleep latency and sleep duration components of Pittsburgh Sleep Quality Inventory were significantly decreased in the rosemary group in comparison with the control group after one month. Rosemary as a traditional herb could be used to boost prospective and retrospective memory, reduce anxiety and depression, and improve sleep quality in university students. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Interdisciplinary Development of an Improved Emergency Department Procedural Work Surface Through Iterative Design and Use Testing in Simulated and Clinical Environments.

    Science.gov (United States)

    Zhang, Xiao C; Bermudez, Ana M; Reddy, Pranav M; Sarpatwari, Ravi R; Chheng, Darin B; Mezoian, Taylor J; Schwartz, Victoria R; Simmons, Quinneil J; Jay, Gregory D; Kobayashi, Leo

    2017-03-01

    A stable and readily accessible work surface for bedside medical procedures represents a valuable tool for acute care providers. In emergency department (ED) settings, the design and implementation of traditional Mayo stands and related surface devices often limit their availability, portability, and usability, which can lead to suboptimal clinical practice conditions that may affect the safe and effective performance of medical procedures and delivery of patient care. We designed and built a novel, open-source, portable, bedside procedural surface through an iterative development process with use testing in simulated and live clinical environments. The procedural surface development project was conducted between October 2014 and June 2016 at an academic referral hospital and its affiliated simulation facility. An interdisciplinary team of emergency physicians, mechanical engineers, medical students, and design students sought to construct a prototype bedside procedural surface out of off-the-shelf hardware during a collaborative university course on health care design. After determination of end-user needs and core design requirements, multiple prototypes were fabricated and iteratively modified, with early variants featuring undermattress stabilizing supports or ratcheting clamp mechanisms. Versions 1 through 4 underwent 2 hands-on usability-testing simulation sessions; version 5 was presented at a design critique held jointly by a panel of clinical and industrial design faculty for expert feedback. Responding to select feedback elements over several surface versions, investigators arrived at a near-final prototype design for fabrication and use testing in a live clinical setting. This experimental procedural surface (version 8) was constructed and then deployed for controlled usability testing against the standard Mayo stands in use at the study site ED. Clinical providers working in the ED who opted to participate in the study were provided with the prototype

  8. Internet-based guided self-help for university students with anxiety, depression and stress: a randomized controlled clinical trial.

    Science.gov (United States)

    Day, Victor; McGrath, Patrick J; Wojtowicz, Magdalena

    2013-07-01

    Anxiety, depression and stress, often co-occurring, are the psychological problems for which university students most often seek help. Moreover there are many distressed students who cannot, or choose not to, access professional help. The present study evaluated the efficacy of an internet-based guided self-help program for moderate anxiety, depression and stress. The program was based on standard cognitive behavior therapy principles and included 5 core modules, some of which involved options for focusing on anxiety and/or depression and/or stress. Trained student coaches provided encouragement and advice about using the program via e-mail or brief weekly phone calls. Sixty-six distressed university students were randomly assigned to either Immediate Access or a 6-week Delayed Access condition. Sixty-one percent of Immediate Access participants completed all 5 core modules, and 80% of all participants completed the second assessment. On the Depression, Anxiety and Stress Scales-21, Immediate Access participants reported significantly greater reductions in depression (ηp(2)=. 07), anxiety (ηp(2)=. 08) and stress (ηp(2)=. 12) in comparison to participants waiting to do the program, and these improvements were maintained at a six month follow-up. The results suggest that the provision of individually-adaptable, internet-based, self-help programs can reduce psychological distress in university students. Copyright © 2013 Elsevier Ltd. All rights reserved.

  9. Effectiveness of group cognitive–behavioral treatment for childhood anxiety disorders in community clinics: benchmarking against an efficacy trial at a university clinic

    DEFF Research Database (Denmark)

    Jónsson, Hjalti; Arendt, Kristian Bech; Jørgensen, Lisbeth

    in Denmark (Arendt & Thastum, 2013). Objective: To evaluate the outcomes of evidence based, manualized group cognitive-behavioural treatment (CBT) for children and adolescent with anxiety disorders, when delivered in an outpatient Child and Adolescent Psychiatry or in a community based School Counselling...... Service in Denmark. Method: Psychologists and psychiatrists from three Child and Adolescent Psychiatry clinics and four community bases School Counselling Services are trained and supervised in a manualized group CBT treatment program (Cool Kids) for Childhood anxiety. Ninety-six children with anxiety...... disorders aged between 7 - 14 are expected to be included, equally divided between Psychiatric clinics (n = 48) and School Counselling services (n =48). The treatment consists of 10 2-hour group sessions with 5-6 children and their parents. Results are measured by independent diagnostic interviews...

  10. A Matrix Mentoring Model That Effectively Supports Clinical and Translational Scientists and Increases Inclusion in Biomedical Research: Lessons From the University of Utah.

    Science.gov (United States)

    Byington, Carrie L; Keenan, Heather; Phillips, John D; Childs, Rebecca; Wachs, Erin; Berzins, Mary Anne; Clark, Kim; Torres, Maria K; Abramson, Jan; Lee, Vivian; Clark, Edward B

    2016-04-01

    Physician-scientists and scientists in all the health professions are vital members of the U.S. biomedical workforce, but their numbers at academic health centers are declining. Mentorship has been identified as a key component in retention of faculty members at academic health centers. Effective mentoring may promote the retention of clinician-scientists in the biomedical workforce. The authors describe a holistic institutional mentoring program to support junior faculty members engaged in clinical and translational science at the University of Utah. The clinical and translational scholars (CATS) program leverages the resources of the institution, including the Center for Clinical and Translational Science, to augment departmental resources to support junior faculty investigators and uses a multilevel mentoring matrix that includes self, senior, scientific, peer, and staff mentorship. Begun in the Department of Pediatrics, the program was expanded in 2013 to include all departments in the school of medicine and the health sciences. During the two-year program, scholars learn management essentials and have leadership training designed to develop principal investigators. Of the 86 program participants since fiscal year 2008, 92% have received extramural awards, 99% remain in academic medicine, and 95% remain at the University of Utah. The CATS program has also been associated with increased inclusion of women and underrepresented minorities in the institutional research enterprise. The CATS program manifests institutional collaboration and coordination of resources, which have benefited faculty members and the institution. The model can be applied to other academic health centers to support and sustain the biomedical workforce.

  11. Universal suprapubic approach for complete mesocolic excision and central vascular ligation using the da Vinci Xi® system: from cadaveric models to clinical cases.

    Science.gov (United States)

    Yeo, Shen Ann; Noh, Gyoung Tae; Han, Jeong Hee; Cheong, Chinock; Stein, Hubert; Kerdok, Amy; Min, Byung Soh

    2017-12-01

    There has been little enthusiasm for performing robotic colectomy for colon cancer in recent years due to multiple factors, one being that the previous robotic systems such as the da Vinci Si ® (dVSi) were poorly designed for multi-quadrant surgery. The new da Vinci Xi ® (dVXi) system enables colectomy with central mesocolic excision to be performed easily in a single docking procedure. We developed a universal port placement strategy to allow right and left hemicolectomies to be performed via a suprapubic approach and a Pfannensteil extraction site. This proof of concept paper describes the development and subsequent clinical application of this setup. After extensive training on the dVXi system concepts in collaboration with clinical development engineers, we developed a port placement strategy which was tested and adapted after performing experimental surgery in three cadaveric models. Subsequently our port placement was used for two clinical cases of suprapubic right and left hemicolectomy. With some modifications of port placements after the initial cadaveric colectomies, we have developed a potentially universal suprapubic port placement strategy for robotic colectomy with complete mesocolic excision and central vascular ligation using the dVXi robotic system. This port placement strategy was applied successfully in our first two clinical cases. Based on our cadaveric laboratory as well as our initial clinical application, the suprapubic port placement strategy for the dVXi system with its improved features over the dVSi can feasibly perform right and left hemicolectomy with complete mesocolic excision and central vascular ligation. Further studies will be required to establish efficacy as well as safety profile of these procedures.

  12. A designated centre for people with disabilities operated by Western Care Association - Mayo

    LENUS (Irish Health Repository)

    Harrison, Peter

    2017-06-01

    The experimental gingivitis study of Löe et al.1 demonstrated a cause and effect relationship between plaque accumulation and gingival inflammation, and helped to establish plaque\\/biofilm as the primary risk factor for gingivitis. When healthy individuals withdrew oral hygiene efforts, gingival inflammation ensued within 21 days in all subjects. Once effective plaque removal was recommenced, clinical gingival health was quickly re-established – indicating that plaque-associated inflammation is modifiable by plaque control. As current consensus confirms that gingivitis and periodontitis may be viewed as a continuum of disease,2 the rationale for achieving effective plaque control is clear.

  13. Bone mineral density status and frequency of osteoporosis and clinical fractures in 155 patients with psoriatic arthritis followed in a university hospital.

    Science.gov (United States)

    Busquets, Noemi; Vaquero, Carmen Gómez; Moreno, Jesús Rodríguez; Vilaseca, Daniel Roig; Narváez, Javier; Carmona, Loreto; Nolla, Joan M

    2014-01-01

    To assess the bone mineral density (BMD) and the frequency of osteoporosis and clinical fractures in a large group of Spanish patients with psoriatic arthritis (PsA). BMD was determined by DXA in all the patients who were willing to participate and had peripheral PsA regularly evaluated in a tertiary university hospital. All patients underwent a physical examination and general laboratory analysis. We gathered demographic and clinical variables related with BMD and risk of fractures. We also recorded the history of clinical low impact fractures. The population of reference to calculate T-score and Z-score came from a Spanish database. One hundred and fifty-five patients were included (64 postmenopausal women, 26 premenopausal women and 65 men). The clinical forms of PsA were: 46% oligoarticular and 54% polyarticular. Mean disease duration was 13.7±9.4 years and mean ESR was 21.8±13.9mm/h; 66% of patients had received glucocorticoid treatment. We found no differences in BMD status between the patients and the Spanish general population, neither in the whole series nor in each defined subgroup. Frequency of osteoporosis was 16%; it was higher in postmenopausal women (28%) than in men (9%) or premenopausal women (4%). Frequency of clinical fractures was 13%; it accounted specially in postmenopausal women. The magnitude of the problem of osteoporosis in PsA seems to be mild. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  14. The clinical significance of quality of life assessments in oncology: a summary for clinicians

    NARCIS (Netherlands)

    Sloan, Jeff A.; Frost, Marlene H.; Berzon, Rick; Dueck, Amylou; Guyatt, Gordon; Moinpour, Carol; Sprangers, Mirjam; Ferrans, Carol; Cella, David

    2006-01-01

    BACKGROUND: A series of six manuscripts with an introduction appeared in the Mayo Clinic Proceedings, based upon the collective effort of 30 individuals with an interest and expertise in assessing the clinical significance of quality of life (QOL) assessments. The series of manuscripts described the

  15. Clinical Commentary by Barbara Segal, a Consultant Child and Adolescent Psychotherapist Working in University College London Hospitals

    Science.gov (United States)

    Segal, Barbara

    2010-01-01

    This moving clinical account describes the psychotherapeutic work of a child psychotherapist undertaken in a hospital room with 13-year-old Maya, after the sudden onset of a terrifying and serious illness, Guillain-Barre syndrome, leaving her with paralysis and extreme weakness. The first session takes place almost three weeks after Maya's…

  16. [Tumors of the 4th ventricle and the craniospinal transitional zone. Review of patients of the Neurosurgical Clinic of the Department of Medicine of the Karl Marx University].

    Science.gov (United States)

    Niebeling, H G; Fried, H; Goldhahn, W E; Skrzypczak, J; Brachmann, J; Eichler, I

    1983-01-01

    From a total of 1,028 infratentorial tumours operated on at the Neurosurgical Hospital of the Section Medicine of the Karl-Marx University Leipzig in the last 30 years, 167 tumours in the region of the 4th ventrical have been selected. Their statistical processing was carried out with respect to specific localisation, average age, kind of tumour, sex, clinical findings, duration of case history, application of instrumental diagnostic procedures and radicality of operation, success and failure. Some fundamental conclussions are drawn. A subdivision in detail will be contained in the following articles based on this material.

  17. Transplantation of the heart: An overview of 40 years' clinical and research experience at Groote Schuur Hospital and the University of Cape Town: Part II. Laboratory research experience.

    Science.gov (United States)

    Hassoulas, J

    2012-03-29

    Extensive experimental research on various aspects of heart transplantation was undertaken during the first 2 decades. An overview of this work is presented, and some still unpublished work has been included. Experimental laboratory investigation was an integral activity of the cardiac transplantation programme at the University of Cape Town over these years, and has remained so ever since. These studies provided invaluable fundamental information upon which future clinical work was based. It is therefore necessary to briefly mention and discuss this information, most of which has been published in detail by the various investigators concerned.

  18. Present status and future directions of the Mayo/IBM PACS project

    Science.gov (United States)

    Morin, Richard L.; Forbes, Glenn S.; Gehring, Dale G.; Salutz, James R.; Pavlicek, William

    1991-07-01

    This joint project began in 1988 and was motivated by the need to develop an alternative to the archival process in place at that time (magnetic tape) for magnetic resonance imaging and neurological computed tomography. In addition, this project was felt to be an important step in gaining the necessary clinical experience for the future implementation of various aspects of electronic imaging. The initial phase of the project was conceived and developed to prove the concept, test the fundamental components, and produce performance measurements for future work. The key functions of this phase centered on attachment of imaging equipment (GE Signa) and archival processes using a non-dedicated (institutionally supplied) local area network (LAN). Attachment of imaging equipment to the LAN was performed using commercially available devices (Ethernet, PS/2, Token Ring). Image data were converted to ACR/NEMA format with retention of the vendor specific header information. Performance measurements were encouraging and led to the design of following projects. The second phase has recently been concluded. The major features of this phase have been to greatly expand the network, put the network into clinical use, establish an efficient and useful viewing station, include diagnostic reports in the archive data, provide wide area network (WAN) capability via ISDN, and establish two-way real-time video between remote sites. This phase has heightened both departmental and institutional thought regarding various issues raised by electronic imaging. Much discussion regarding both present as well as future archival processes has occurred. The use of institutional LAN resources has proven to be adequate for the archival function examined thus far. Experiments to date have shown that use of dedicated resources will be necessary for retrieval activities at even a basic level. This report presents an overview of the background present status and future directions of the project.

  19. Prevalence of TMJ Disorders among the Patients Attending the Dental Clinic of Ajman University of Science and Technology–Fujairah Campus, UAE

    Directory of Open Access Journals (Sweden)

    Kashef K. AlShaban

    2018-01-01

    Full Text Available The objective of this study was to determine the prevalence of temporomandibular joint (TMJ disorders (if any among the patients attending the dental clinic (for routine dental treatment of Ajman University of Science and Technology (AUST–Fujairah campus, UAE, and its possible causes. A sample of 100 adult patients attending the dental clinic of AUST for different types of dental treatment were collected; the routine examination of the TMJ and possible disorders such as clicking, crepitation, limitation or deviation during mouth opening, or tenderness reveals that 41% of the sample experience varying degrees of disorders in the TMJ. Radiographs were taken if needed (panoramic radiograph. The information was collected and recorded for each patient through questionnaires.

  20. Outcome prediction in home- and community-based brain injury rehabilitation using the Mayo-Portland Adaptability Inventory.

    Science.gov (United States)

    Malec, James F; Parrot, Devan; Altman, Irwin M; Swick, Shannon

    2015-01-01

    The objective of the study was to develop statistical formulas to predict levels of community participation on discharge from post-hospital brain injury rehabilitation using retrospective data analysis. Data were collected from seven geographically distinct programmes in a home- and community-based brain injury rehabilitation provider network. Participants were 642 individuals with post-traumatic brain injury. Interventions consisted of home- and community-based brain injury rehabilitation. The main outcome measure was the Mayo-Portland Adaptability Inventory (MPAI-4) Participation Index. Linear discriminant models using admission MPAI-4 Participation Index score and log chronicity correctly predicted excellent (no to minimal participation limitations), very good (very mild participation limitations), good (mild participation limitations), and limited (significant participation limitations) outcome levels at discharge. Predicting broad outcome categories for post-hospital rehabilitation programmes based on admission assessment data appears feasible and valid. Equations to provide patients and families with probability statements on admission about expected levels of outcome are provided. It is unknown to what degree these prediction equations can be reliably applied and valid in other settings.

  1. The Mayo Portland Adaptability Inventory-4 outcome measure is superior to UK FIM+FAM in a British military population.

    Science.gov (United States)

    McGilloway, Emer; Mitchell, James; Dharm-Datta, Shreshth; Roberts, Andrew; Tilley, Haydn; Etherington, John

    2016-01-01

    The aim of this study was to identify the most appropriate rehabilitation outcome measure for use in a young adult population with acquired brain injury. A 2-year prospective study of patients admitted to a UK military neuro-rehabilitation unit with acquired brain injury to compare the appropriateness of the Functional Independence Measure/Functional Assessment Measure (FIM+FAM) vs the Mayo-Portland Adaptability Inventory Version 4 (MPAI-4) in assessing outcomes. Patients were assessed at admission, discharge and at 4-month follow-up using FIM+FAM and MPAI-4. The FIM+FAM total motor score showed a marked ceiling affect, 42% of patients scored the maximum on admission rising to 80% at discharge. The MPAI-4 did not show significant ceiling effects. The other sub-scales of FIM+FAM and MPAI-4 were generally comparable, no more than 17% achieved ceiling at follow-up. This is the first comparative study of FIM+FAM and MPAI-4 in a young adult military population following acquired brain injury. All patients showed improvements in both outcome measures following intensive inpatient rehabilitation. However, the MPAI-4 did not show ceiling effects in motor scores. This measure was, therefore, found to be more appropriate in the cohort.

  2. Klebsiella pneumoniae nueva Delhi metalo-betalactamasa en el Hospital Nacional Dos de Mayo: Lima, Perú

    Directory of Open Access Journals (Sweden)

    Cristhian Resurrección-Delgado

    Full Text Available La emergencia de enterobacterias productoras de carbapenemasas de tipo Nueva Delhi Metalo beta-lactamasas (NDM, representan, hoy en día, un verdadero problema de salud pública mundial. La presencia de este mecanismo de resistencia limita o anula las opciones terapéuticas para combatir a estas bacterias. En Latinoamérica, las cifras son cada vez más elevadas, pues se reportan en Guatemala, Colombia, Chile, Argentina, entre otros. Perú no ha descrito, hasta la fecha, la presencia de este patrón de resistencia; sin embargo, desde hace varios años se presume de su existencia. Se describen nueve casos de Klebsiella pneumoniae NDM, como agentes infecciosos o colonizantes, en pacientes críticamente enfermos, en su mayoría con patología neuroquirúrgica, del Hospital Nacional Dos de Mayo, en Lima - Perú. Los pacientes de la serie descrita a continuación, representan los primeros reportes de Klebsiella pneumoniae NDM en el Perú.

  3. El primero de mayo en la ciudad de México en los tiempos de la revolución.

    Directory of Open Access Journals (Sweden)

    Anna Ribera Carb\\u00F3

    2006-01-01

    Full Text Available De entre las tradiciones inventadas por los trabajadores del mundo, la más exitosa es, sin duda, la del Primero de Mayo que sirvió para cohesionar a grupos obreros de distinta denominación ideológica y a crear entre ellos conciencia de clase como ninguna otra. En México la conmemoración empezó a realizarse de manera tardía. Fue en 1913 cuando se organizó en la ciudad de México la primera manifestación masiva a partir de la iniciativa de la Casa del Obrero Mundial fundada un año antes y vinculada al pensamiento anarcosindicalista. Fue justamente con esta manifestación que la clase obrera empezó a construir su propio espacio en la capital del país y convirtió a la Casa del Obrero Mundial en un elemento fundamental del entramado político de la Revolución Mexicana.

  4. Study of adverse events following immunisation with universal and newer vaccines in the Serampore IMA Child Clinic over a period of 7 years.

    Science.gov (United States)

    Das, Pradip Kumar

    2013-04-01

    Immunisation is an important part of childcare practice. It is one of the most beneficial and cost effective measures for the prevention of diseases. From the previous retrospective studies, it was evident that smallpox has been completely eradicated throughout now-a-days with the wholehearted and sincere efforts of healthcare providers by applying efficient and safe vaccine against smallpox, same is true also to polio which is now close to worldwide eradication and measles and rubella are no longer endemic in certain parts of the world. Not only has that with the introduction of safer and more efficient newer vaccines, the incidence of most other vaccine preventable disease of childhood also reduced considerably. The aim of the present study is to estimate the incidence and clinical presentation of adverse events following immunisation with universal and newer vaccines for a period of seven years using prospective active surveillance. Children under the age of 7 years were taken for universal and newer scheduled vaccinations given in the Serampore IMA Child Clinic under the supervision of the clinicians maintaining strictly the guidelines of Expanded Programme of Immunisation (Government of India). This study of adverse events following immunisation in the Serampore IMA Child Clinic confirms that the adverse events such as fever (0.37%), pain and swelling at the site of injection (0.32%0, urticarial rash (0.02%), anaphylactic shock (0.003%) are negligible. There were only two reports of anaphylaxis following preschool and infant schedule vaccines, including measles, mumps and rubella (MMR), Haemophilus influenzae type B vaccines and typhoid vaccines in approximately 52,000 infants received over a period of 7 years starting from 1st April, 2005 to 31st March, 2012 and there were no deaths or longterm effects reported during the post follow-up period in the Serampore IMA Child Clinic.

  5. Prevalence of obsessive-compulsive disorder in patients with opium addiction that refer to the addiction clinics affiliated to the Lorestan University of Medical Sciences in 2015

    Directory of Open Access Journals (Sweden)

    Samaneh Mohamadpour

    2016-12-01

    Full Text Available Background : The existence of OCD-like symptom in patients with  opium addiction , , the lack of a coherent,  and shows the necessity of this study. The aim of this research is to study of prevalence of obsessive-compulsive disorder in patients with opioid dependency that refer to the addiction clinics affiliated to the lorestan university of medical sciences. Materials and Methods: This research is a cross-sectional descriptive study. In this study, 200 patients with opioid dependency who attended to the addiction clinics affiliated to the Lorestan University of Medical Science were selected by convenience sampling method from December to February in 2013. Data collected by using instruments including Demographic Questionnaire and Zohar-fineberg screening questionnaire obsession. Descriptive and inferential statistical indicators by spss-20 software were used for data analysis. Results: In this study all participants were man. The mean and standard deviation of the respondents’ age and term drug abuse were in order 41/72±11/96 and 12/02±8/87. Patients were % 71 married, % 56 self-employed and in terms of education % 43 level of diploma. Also, 31 patients were with (% 15/05 obsessive-compulsive disorder and 169 patients were (% 84/5 without obsessive-compulsive disorder. Conclusion: In creating drug abuse disorder, other disorders and symptoms may contribute and have important roles. Therefore, diagnosis and attention to it is important. Accordingly, clinical specialists on the results of such research design appropriate clinical trials or modify of existing interventions.

  6. Surgical treatment of 137 cases with chronic subdural hematoma at the university clinical center of Kosovo during the period 2008-2012

    Directory of Open Access Journals (Sweden)

    Agon Y Mekaj

    2015-01-01

    Full Text Available Background: Chronic subdural hematoma (CSDH is frequent pathology in neurosurgical practice. The aim of this study is to present the first series of patients with CSDH, who got surgically treated in Clinic of Neurosurgery, University Clinical Center of Kosovo. Materials and Methods: This is a retrospective study that included 137 patients with CSDH who had been treated during the period 2008-2012. The data were collected and analyzed from the archives and protocols of the University Clinical Center of Kosovo. Patients were analyzed in many aspects such as age, gender, etiological factors, clinical features, localization, diagnoses, methods of surgical interventions, recurrences and mortality of patients. Results: From 137 patients with CSDH, 106 (77.3% were males and 31 (22.7% females. Average age of patients was 62.85 years. Analyzed according to the decades, the highest number of causes with CSDH was between 70 and 79 years (46%. The head trauma has been responsible for CSDH in 88 patients (64.3%, while the main symptom was headache (92 patients or 67.1%. One burr-hole trepanation with closed drainage system has been used in majority of cases (in 101 patients or 73.7%. The recurrence of CSDH was 6.5%, whereas mortality 2.9%. Conclusion: CSDH is more common in elderly patients. The male-female ratio is 3.4:1. Like other authors we also think that treatment with one burr-hole and drainage is a method of choice, because of its simplicity and safety.

  7. Surgical treatment of 137 cases with chronic subdural hematoma at the university clinical center of Kosovo during the period 2008–2012

    Science.gov (United States)

    Mekaj, Agon Y.; Morina, Arsim A.; Mekaj, Ymer H.; Manxhuka-Kerliu, Suzana; Miftari, Ermira I.; Duci, Shkelzen B.; Hamza, Astrit R.; Gashi, Musli M.; Xhelaj, Mentor R.; Kelmendi, Fatos M.; Morina, Qamile Sh.

    2015-01-01

    Background: Chronic subdural hematoma (CSDH) is frequent pathology in neurosurgical practice. The aim of this study is to present the first series of patients with CSDH, who got surgically treated in Clinic of Neurosurgery, University Clinical Center of Kosovo. Materials and Methods: This is a retrospective study that included 137 patients with CSDH who had been treated during the period 2008–2012. The data were collected and analyzed from the archives and protocols of the University Clinical Center of Kosovo. Patients were analyzed in many aspects such as age, gender, etiological factors, clinical features, localization, diagnoses, methods of surgical interventions, recurrences and mortality of patients. Results: From 137 patients with CSDH, 106 (77.3%) were males and 31 (22.7%) females. Average age of patients was 62.85 years. Analyzed according to the decades, the highest number of causes with CSDH was between 70 and 79 years (46%). The head trauma has been responsible for CSDH in 88 patients (64.3%), while the main symptom was headache (92 patients or 67.1%). One burr-hole trepanation with closed drainage system has been used in majority of cases (in 101 patients or 73.7%). The recurrence of CSDH was 6.5%, whereas mortality 2.9%. Conclusion: CSDH is more common in elderly patients. The male-female ratio is 3.4:1. Like other authors we also think that treatment with one burr-hole and drainage is a method of choice, because of its simplicity and safety. PMID:25883478

  8. Clinical characteristics of adult patients with inborn errors of metabolism in Spain: A review of 500 cases from university hospitals

    Directory of Open Access Journals (Sweden)

    J. Pérez-López

    2017-03-01

    Full Text Available Patients with inborn errors of metabolism (IEMs have become an emerging and challenging group in the adult healthcare system whose needs should be known in order to implement appropriate policies and to adapt adult clinical departments. We aimed to analyze the clinical characteristics of adult patients with IEMs who attend the most important Spanish hospitals caring for these conditions. A cohort study was conducted in 500 patients, categorized by metabolic subtype according to pathophysiological classification. The most prevalent group of IEMs was amino acid disorders, with 108 (21.6% patients diagnosed with phenylketonuria. Lysosomal storage disorders were the second group, in which 32 (6.4% and 25 (5% patients had Fabry disease and Gaucher disease respectively. The great clinical heterogeneity, the significant delay in diagnosis after symptom onset, the existence of some degree of physical dependence in a great number of patients, the need for a multidisciplinary and coordinated approach, and the lack of specific drug treatment are common features in this group of conditions.

  9. History of Cardiothoracic Surgery at Columbia University: A Century at the Vanguard of Clinical Care, Education, and Innovation.

    Science.gov (United States)

    Argenziano, Michael; Smith, Craig R; Spotnitz, Henry M; Steinglass, Kenneth M; Bacha, Emile

    2016-01-01

    The Columbia University Cardiothoracic Surgery Program dates back to the earliest days of the specialty itself, when the first pioneers ventured into the chest, and eventually the heart, to treat diseases previously believed to be beyond the reach of medicine. This spirit of innovation, creativity, and vision has grown over the ensuing century and has driven the development of advances that have defined the specialty and saved countless lives. From novel techniques for the repair of complex congenital cardiac defects and acquired cardiovascular diseases, to comprehensive management of lung and esophageal maladies, and to the marvel of minimally invasive and percutaneous interventions, the march of progress has never been stronger, more dramatic, or more consequential that it is at Columbia today. Fueled by people who -- as descendants of those early pioneers -- have been raised in the "Columbia culture," the commitment to innovation and education has never been greater. Copyright © 2016. Published by Elsevier Inc.

  10. Clinical Exposure to Transgender Medicine Improves Students' Preparedness Above Levels Seen with Didactic Teaching Alone: A Key Addition to the Boston University Model for Teaching Transgender Healthcare

    Science.gov (United States)

    Park, Jason A.; Safer, Joshua D.

    2018-01-01

    Abstract Purpose: Transgender individuals are medically underserved in the United States and face many documented disparities in care due to providers' lack of education, training, and comfort. We have previously demonstrated that specific transgender medicine content in a medical school curriculum increases students' willingness to treat transgender patients. However, we have also identified that those same students are less comfortable with transgender care relative to care for lesbian, gay, and bisexual patients. We aimed to demonstrate that clinical exposure to care for transgender patients would help close this gap. Methods: At Boston University School of Medicine, we piloted a transgender medicine elective where students rotate on services that provide clinical care for transgender individuals. Pre- and postsurveys were administered to students who participated in the elective. Results: After completing the elective, students who reported “high” comfort increased from 45% (9/20) to 80% (16/20) (p=0.04), and students who reported “high” knowledge regarding management of transgender patients increased from 0% (0/20) to 85% (17/20) (ptransgender-specific content into medical curricula improves student knowledge and comfort with transgender medical care, gaps remain. Clinical exposure to transgender medicine during clinical years can contribute to closing that gap and improving access to care for transgender individuals. PMID:29344576

  11. Clinical Exposure to Transgender Medicine Improves Students' Preparedness Above Levels Seen with Didactic Teaching Alone: A Key Addition to the Boston University Model for Teaching Transgender Healthcare.

    Science.gov (United States)

    Park, Jason A; Safer, Joshua D

    2018-01-01

    Purpose: Transgender individuals are medically underserved in the United States and face many documented disparities in care due to providers' lack of education, training, and comfort. We have previously demonstrated that specific transgender medicine content in a medical school curriculum increases students' willingness to treat transgender patients. However, we have also identified that those same students are less comfortable with transgender care relative to care for lesbian, gay, and bisexual patients. We aimed to demonstrate that clinical exposure to care for transgender patients would help close this gap. Methods: At Boston University School of Medicine, we piloted a transgender medicine elective where students rotate on services that provide clinical care for transgender individuals. Pre- and postsurveys were administered to students who participated in the elective. Results: After completing the elective, students who reported "high" comfort increased from 45% (9/20) to 80% (16/20) ( p =0.04), and students who reported "high" knowledge regarding management of transgender patients increased from 0% (0/20) to 85% (17/20) ( p <0.001 ) . Conclusion: Although integrating evidence-based, transgender-specific content into medical curricula improves student knowledge and comfort with transgender medical care, gaps remain. Clinical exposure to transgender medicine during clinical years can contribute to closing that gap and improving access to care for transgender individuals.

  12. Global benchmarking of medical student learning outcomes? Implementation and pilot results of the International Foundations of Medicine Clinical Sciences Exam at The University of Queensland, Australia.

    Science.gov (United States)

    Wilkinson, David; Schafer, Jennifer; Hewett, David; Eley, Diann; Swanson, Dave

    2014-01-01

    To report pilot results for international benchmarking of learning outcomes among 426 final year medical students at the University of Queensland (UQ), Australia. Students took the International Foundations of Medicine (IFOM) Clinical Sciences Exam (CSE) developed by the National Board of Medical Examiners, USA, as a required formative assessment. IFOM CSE comprises 160 multiple-choice questions in medicine, surgery, obstetrics, paediatrics and mental health, taken over 4.5 hours. Significant implementation issues; IFOM scores and benchmarking with International Comparison Group (ICG) scores and United States Medical Licensing Exam (USMLE) Step 2 Clinical Knowledge (CK) scores; and correlation with UQ medical degree cumulative grade point average (GPA). Implementation as an online exam, under university-mandated conditions was successful. Mean IFOM score was 531.3 (maximum 779-minimum 200). The UQ cohort performed better (31% scored below 500) than the ICG (55% below 500). However 49% of the UQ cohort did not meet the USMLE Step 2 CK minimum score. Correlation between IFOM scores and UQ cumulative GPA was reasonable at 0.552 (p benchmarking is feasible and provides a variety of useful benchmarking opportunities.

  13. Models of Interinstitutional Partnerships between Research Intensive Universities and Minority Serving Institutions (MSI) across the Clinical Translational Science Award (CTSA) Consortium

    Science.gov (United States)

    Fair, Alecia; Norris, Keith; Verbalis, Joseph G.; Poland, Russell; Bernard, Gordon; Stephens, David S.; Dubinett, Steven M.; Imperato‐McGinley, Julianne; Dottin, Robert P.; Pulley, Jill; West, Andrew; Brown, Arleen; Mellman, Thomas A.

    2013-01-01

    Abstract Health disparities are an immense challenge to American society. Clinical and Translational Science Awards (CTSAs) housed within the National Center for Advancing Translational Science (NCATS) are designed to accelerate the translation of experimental findings into clinically meaningful practices and bring new therapies to the doorsteps of all patients. Research Centers at Minority Institutions (RCMI) program at the National Institute on Minority Health and Health Disparities (NIMHD) are designed to build capacity for biomedical research and training at minority serving institutions. The CTSA created a mechanism fostering formal collaborations between research intensive universities and minority serving institutions (MSI) supported by the RCMI program. These consortium‐level collaborations activate unique translational research approaches to reduce health disparities with credence to each academic institutions history and unique characteristics. Five formal partnerships between research intensive universities and MSI have formed as a result of the CTSA and RCMI programs. These partnerships present a multifocal approach; shifting cultural change and consciousness toward addressing health disparities, and training the next generation of minority scientists. This collaborative model is based on the respective strengths and contributions of the partnering institutions, allowing bidirectional interchange and leveraging NIH and institutional investments providing measurable benchmarks toward the elimination of health disparities. PMID:24119157

  14. Los movimientos sociales en la transición democrática. El caso de las Madres de Plaza de Mayo: sentimiento y discurso

    Directory of Open Access Journals (Sweden)

    Martín D'ALESSANDRO

    2009-11-01

    Full Text Available RESUMEN: El presente artículo hace un repaso por el surgimiento y consolidación de Madres de Plaza de Mayo como movimiento social que inició sus actividades cuestionando la lucha antisubversiva emprendida por la dictadura militar argentina. Plantea además como este movimiento ha sufrido una radicalización de su discurso en la época de la transición a la democracia, cuando se desarrolla el enjuiciamiento de las Juntas Militares, y a partir de ese momento deciden enfrentarse al "sistema burgués". El discurso de Madres de Plaza de Mayo es inicialmente ético y moral para posteriormente adquirir matices de izquierda.ABSTRACT: This article analyzes the emergence and consolidation of the "Madres de Plaza de Mayo" as a social movement which initiated its action questioning the repressive policies led by the Argentine military dictatorship. It shows how the "Madres" undertook a radicalization of its discourse during the democratic transition, as the military "Juntas" were tried by Argentine courts. At this moment, the "Madres" dcided to struggle against the "bourgeois system." The discourse of the Madres was initially ethical and moral, and it became later left wing oriented.

  15. The influence of simulated clinical use on the flexibility of rotary ProTaper Universal, K3 and EndoSequence nickel-titanium instruments.

    Science.gov (United States)

    Viana, A C D; Pereira, E S J; Bahia, M G A; Buono, V T L

    2013-09-01

    To investigate the influence of cyclic flexural and torsional loading on the flexibility of ProTaper Universal, K3 and EndoSequence nickel-titanium instruments, in view of the hypothesis that these types of loading would decrease the flexibility of the selected NiTi rotary files. The instruments evaluated were S2 and F1 ProTaper Universal, sizes 20 and 25, .06 taper K3, and sizes 20 and 25, .06 taper EndoSequence. Flexibility was determined by 45° bending tests according to ISO 3630-1 specification. Values of the bending moment (MB ) obtained with new instruments were considered as the control group (CG). Bending tests were then conducted in instruments previously fatigued to one-fourth and three-fourths of their average fatigue life (fatigue groups, FG¼ and FG¾), as well as after cyclic torsional loading (torsional group, TG). Fatigue tests were carried out in a bench device that allowed the files to rotate freely inside an artificial canal with an angle of curvature of 45° and a radius of 5 mm. Cyclic torsional loading tests were performed that entailed rotating the instrument from zero angular deflection to 180° and then returning to zero applied torque in 20 cycles. Data were analysed using one-way analysis of variance at a significance level of 5%. Simulated clinical use by means of flexural fatigue tests did not affect the flexibility of the instruments, except for a significant increase in flexibility observed in a few instruments (P instruments and after cyclic torsional loading showed no significant differences between them (P > 0.05). The flexibility of rotary ProTaper Universal, K3 and EndoSequence NiTi instruments, measured in bending tests, was not adversely affected by simulated clinical use in curved root canals. © 2013 International Endodontic Journal. Published by John Wiley & Sons Ltd.

  16. Process and outcome measures of quality of care at the diabetes outpatient clinic, University College Hospital, Ibadan.

    Science.gov (United States)

    Adeleye, J O; Kuti, M A

    2017-02-01

    The study aims to assess the quality of care provided at a diabetes outpatient clinic of a tertiary hospital in Nigeria using quality indicators approved by the National Diabetes Quality Improvement Alliance (NDQIA). The medical records of patients who had visited the clinic at least two times within a 12 months period preceding the index visit were reviewed during a 5 month period. Process measure indicators, approved by the NDQIA (evaluating the functioning of the clinic) and outcome measures, published by the American Diabetes Association, (evaluating the health status of the attending patients) were retrieved from the medical records. The 332 records reviewed showed that the most consistently performed process measures were blood pressure and weight measurement (>90%). Foot examination was done infrequently (10.5%). Less than 50% had at least an annual low-density lipoprotein cholesterol (LDL-C) and hemoglobin A1c testing done. The mean (standard deviation) HbA1C (%), LDL-C (mg/dL) systolic blood pressure (SBP) (mmHg), and diastolic blood pressure (DBP) (mmHg) were 7.6 (2.0), 107.3 (31.5), 134.3 (20.8), 79.5 (11.0), respectively. HbA1C >8.0%, LDL-C >130 mg/dL, SBP >130 mmHg, and DBP >90 mmHg) were observed in 34.8%, 21.1%, 40.4%, and 23.8%, respectively. Although the organization of the outpatient services allowed for good performance with regards to "free" services such as blood pressure and weight measurement, it performed suboptimally for foot examinations. Performance indicators that required payment were consistently underperformed. Regular assessment of the quality of care may help in the identification of opportunities for improvement in the organization and delivery of care.

  17. Strengths and Weaknesses of Clinical Education from the Viewpoints of Nursing and Midwifery Students in Shahrekord University of Medical Sciences, Shahrekord, Iran

    Directory of Open Access Journals (Sweden)

    M Delaram

    2012-07-01

    Full Text Available

    Background and Objectives: The viewpoints of students as basic elements of education, can improve the process of education. Thus this study was designed to detect the Strengths and weaknesses of clinical education from the viewpoints of nursing and midwifery students.

     

    Methods: In this cross–sectional study, 150 senior nursing and midwifery students in Shahrekord University of Medical Sciences were asked about the strengths and weaknesses of clinical education using a questionnaire. The questionnaire consisted of three sections including demographic characteristics, and the strengths and weaknesses of clinical education which was prepared based on five areas of the aims and educational programs, contact to students, educational environment, supervision and evaluation. Data analysis was done using t-test and Pearson's correlation coefficients and the value of p<0.05 was considered as significant.

     

    Results: The most important strengths points of clinical education included: considering the prerequisite of clinical education (79.7%, clarifying the students tasks (72.5%, on-time presence of trainers (88.7% and trainees (84.2%, providing opportunities of patient care for students (68.5%, good relationship between educational supervisor and the students (56.5%, students' library use in hospital (62.5% and taking practical exams at the end of each clinical education (58.5%. failing to ask students' views in planning the training program (84.9%, lack of congruence between the educational aims and personnel expectations (74.6%, stressful conditions for students (76.8%, lack of student support by personnel (85.5%, failing to use teaching aids (91.2% and lack of supervising in clinical education (69%, were among the most important weaknesses of clinical education.

  18. Training the next generation of research mentors: the University of California, San Francisco, Clinical & Translational Science Institute Mentor Development Program.

    Science.gov (United States)

    Feldman, Mitchell D; Huang, Laurence; Guglielmo, B Joseph; Jordan, Richard; Kahn, James; Creasman, Jennifer M; Wiener-Kronish, Jeanine P; Lee, Kathryn A; Tehrani, Ariane; Yaffe, Kristine; Brown, Jeanette S

    2009-06-01

    Mentoring is a critical component of career development and success for clinical translational science research faculty. Yet few programs train faculty in mentoring skills. We describe outcomes from the first two faculty cohorts who completed a Mentor Development Program (MDP) at UCSF. Eligibility includes having dedicated research time, expertise in a scientific area and a desire to be a lead research mentor. A post-MDP survey measured the program's impact on enhancement of five key mentoring skills, change in the Mentors-in-Training (MIT) self-rated importance of being a mentor to their career satisfaction, and overall confidence in their mentoring skills. Since 2007, 29 MITs participated in and 26 completed the MDP. Only 15% of the MITs reported any previous mentor training. Overall, 96% of MITs felt that participation in the MDP helped them to become better mentors. A majority reported a significant increase in confidence in mentoring skills and most reported an increased understanding of important mentoring issues at UCSF. MITs reported increased confidence in overall and specific mentoring skills after completion of the MDP. The MDP can serve as a model for other institutions to develop the next generation of clinical-translational research mentors.

  19. A designated centre for people with disabilities operated by Western Care Association, Mayo

    LENUS (Irish Health Repository)

    Szucs, Szilard

    2012-06-27

    AbstractBackgroundPeripheral nerve blocks are effective in treating acute pain, thereby minimizing the requirement for opiate analgesics. Fractured neck of femur (FNF) is a common, painful injury. The provision of effective analgesia to this cohort is challenging but an important determinant of their functional outcome. We investigated the analgesic efficacy of continuous femoral nerve block (CFNB) in patients with FNF.MethodsFollowing institutional ethical approval and with informed consent, patients awaiting FNF surgery were randomly allocated to receive either standard opiate-based analgesia (Group 1) or a femoral perineural catheter (Group 2). Patients in Group 1 received parenteral morphine as required. Those in Group 2 received a CFNB comprising a bolus of local anaesthetic followed by a continuous infusion of 0.25% bupivacaine. For both Groups, rescue analgesia consisted of intramuscular morphine as required and all patients received paracetamol regularly. Pain was assessed using a visual analogue scale at rest and during passive movement (dynamic pain score) at 30 min following first analgesic intervention and six hourly thereafter for 72 hours. Patient satisfaction with the analgesic regimen received was recorded using verbal rating scores (0-10). The primary outcome measured was dynamic pain score from initial analgesic intervention to 72 hours later.ResultsOf 27 recruited, 24 patients successfully completed the study protocol and underwent per protocol analysis. The intervals from recruitment to the study until surgery were similar in both groups [31.4(17.7) vs 27.5(14.2) h, P = 0.57]. The groups were similar in terms of baseline clinical characteristics. For patients in Group 2, pain scores at rest were less than those reported by patients in Group 1 [9.5(9.4) vs 31(28), P = 0.031]. Dynamic pain scores reported by patients in Group 2 were less at each time point from 30 min up to 54 hours [e.g at 6 h 30.7(23.4) vs 67.0(32.0), P = 0

  20. Clinical Trials

    Medline Plus

    Full Text Available ... Departments of Defense and Veterans Affairs; private companies; universities; and nonprofit organizations. NIH Institutes and Centers (including ... our campus or trials NIH has sponsored at universities, medical centers, and hospitals. ClinicalTrials.gov View a ...

  1. [Clinical and economic analysis of an internal medicine-infectious disease department at a university general hospital (2005-2006)].

    Science.gov (United States)

    Gómez, Joaquín; García-Vázquez, Elisa; Antonio Puertas, José; Ródenas, Julio; Herrero, José Antonio; Albaladejo, Carmen; Baños, Víctor; Canteras, Manuel; Alcaraz, Manolo

    2009-02-01

    Comparative study in patients with infectious diseases admitted to a specialized Internal Medicine-Infectious Diseases Department (IMID) versus those admitted to other medical departments in a university general hospital, investigating quality and cost-effectiveness. Analysis of patients in 10 principle diagnosis-related groups (DRGs) of infectious diseases admitted to the IMID were compared to those admitted to other medical departments (2005-2006). The DRG were divided in 4 main groups: respiratory infections (DGR 88, 89, 90, 540), urinary infections (DRG 320, 321), sepsis (DRG 416, 584), and skin infections (DRG 277, 278). For each group, quality variables (mortality and readmission rate), efficacy variables (mean hospital stay and mean DRG-based cost per patient) and complexity variables (case mix, relative weight, and functional index) were analyzed. 542 patients included in the 10 main infectious disease DRGs were admitted to IMID and 2404 to other medical departments. After adjusting for DRG case mix (case mix 0.99 for IMID and 0.89 for others), mean hospital stay (5.11 days vs. 7.65 days), mortality (3.5% vs. 7.9%) and mean DRG-based economic cost per patient (1521euro/patient vs. 2952euro/patient) was significantly lower in the group of patients hospitalized in IMID than the group in other medical departments (peconomic cost per patient. Creation and development of IMID departments should be an essential objective to improve healthcare quality and respond to social demands.

  2. A Survey on the Attitude of Professors & Residents of Clinical Wards about Disclosing the Results of Diagnoses for Incurable Patients at Urmia University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    SH Miri Ghaffarzadeh

    2012-05-01

    Full Text Available

    Background and Objectives: One of the most important and complicated problems in medical ethics is to disclose the full truth about diagnosis of incurable diseases which leads to death, and each therapist may be encountered with it during the years of medical profession.

    The aim of this study was to survey on attitude of professors and residents of clinical wards to disclose the diagnosis for incurable patients leading to death.

     

    Methods: In this descriptive study, sampling was carried out by a survey. All faculty members and their residents of teaching hospitals of Urmia University of Medical Sciences, Urmia, Iran, were surveyed as sample in 2007. Of 145 subjects, 138 responded to the questionnaire. The collected data were analyzed using Pearson and Spearman correlation tests with a p≤0.05 being considered as significant.

     

    Results: In this study, the tendency to disclose the diagnosis among faculty members and residents was 64.63%. Also, there was no significant relation between age, sex, university degree, educational field, years of service of the faculty members and residents of clinical wards with the tendency for telling the truth to incurable patients.

     

    Conclusion: Final analyses revealed that the faculty members and clinical residents of different fields in terms of diagnosis disclosure do not have a definite idea. However, the majority of them agree to disclose the full truth about diagnoses.

     

  3. Necesidades y demandas laborales de los empleadores de psicólogos/as clínicos, los meses de mayo a octubre de 2015

    OpenAIRE

    Torres Linares, Mayly Pastora

    2016-01-01

    Psychology in Ecuador is undergoing a process of change and transformation, both socially and educationally, based on the analysis carried out by the Government and its decision to modify the academic structure at the country’s universities. These changes are based on an analysis of the pedagogical model which is used for the teaching of Psychology in this country. With regard to clinical psychology, the need to broaden the knowledge of psychologists and clinical psyc...

  4. Accreditation of medical laboratories in Croatia--experiences of the Institute of Clinical Chemistry, University Hospital "Merkur", Zagreb.

    Science.gov (United States)

    Flegar-Mestrić, Zlata; Nazor, Aida; Perkov, Sonja; Surina, Branka; Kardum-Paro, Mirjana Mariana; Siftar, Zoran; Sikirica, Mirjana; Sokolić, Ivica; Ozvald, Ivan; Vidas, Zeljko

    2010-03-01

    Since 2003 when the international norm for implementation of quality management in medical laboratories (EN ISO 15189, Medical laboratories--Particular requirements for quality and competence) was established and accepted, accreditation has become practical, generally accepted method of quality management and confirmation of technical competence of medical laboratories in the whole world. This norm has been translated into Croatian and accepted by the Croatian Institute for Norms as Croatian norm. Accreditation is carried out on voluntary basis by the Croatian Accreditation Agency that has up to now accredited two clinical medical biochemical laboratories in the Republic of Croatia. Advantages of accredited laboratory lie in its documented management system, constant improvement and training, reliability of test results, establishing users' trust in laboratory services, test results comparability and interlaboratory (international) test results acceptance by adopting the concept of metrological traceability in laboratory medicine.

  5. An alternative path to improving university Earth science teaching and developing the geoscience workforce: Postdoctoral research faculty involvement in clinical teacher preparation

    Science.gov (United States)

    Zirakparvar, N. A.; Sessa, J.; Ustunisik, G. K.; Nadeau, P. A.; Flores, K. E.; Ebel, D. S.

    2013-12-01

    It is estimated that by the year 2020 relative to 2009, there will be 28% more Earth Science jobs paying ≥ $75,000/year1 in the U.S.A. These jobs will require advanced degrees, but compared to all arts and science advanced degrees, the number of physical science M.S. and Ph.D. awarded per year decreased from 2.5% in 1980 to 1.5% in 20092. This decline is reflected on a smaller scale and at a younger age: in the New York City school system only 36% of all 8th graders have basic proficiency in science 3. These figures indicate that the lack achievement in science starts at a young age and then extends into higher education. Research has shown that students in grades 7 - 12 4,5 and in university level courses 6 both respond positively to high quality science teaching. However, much attention is focused on improving science teaching in grades 7- 12, whereas at many universities lower level science courses are taught by junior research and contingent faculty who typically lack formal training, and sometimes interest, in effective teaching. The danger here is that students might enter university intending to pursue geoscience degrees, but then encounter ineffective instructors, causing them to lose interest in geoscience and thus pursue other disciplines. The crux of the matter becomes how to improve the quality of university-level geoscience teaching, without losing sight of the major benchmark of success for research faculty - scholarly publications reporting innovative research results. In most cases, it would not be feasible to sidetrack the research goals of early career scientists by placing them into a formal teacher preparation program. But what happens when postdoctoral research scientists take an active role in clinical teacher preparation as part of their research appointments? The American Museum of Natural History's Masters of Arts in Teaching (AMNH-MAT) urban residency pilot program utilizes a unique approach to grade 7 - 12 Earth Science teacher

  6. Informed consent in oncology clinical trials: A Brown University Oncology Research Group prospective cross-sectional pilot study.

    Directory of Open Access Journals (Sweden)

    Andrew Schumacher

    Full Text Available Informed consent forms (ICFs for oncology clinical trials have grown increasingly longer and more complex. We evaluated objective understanding of critical components of informed consent among patients enrolling in contemporary trials of conventional or novel biologic/targeted therapies.We evaluated ICFs for cancer clinical trials for length and readability, and patients registered on those studies were asked to complete a validated 14-question survey assessing their understanding of key characteristics of the trial. Mean scores were compared in groups defined by trial and patient characteristics.Fifty patients, of whom half participated in trials of immunotherapy or biologic/targeted agents and half in trials of conventional therapy, completed the survey. On average, ICFs for industry-originated trials (N = 9 trials were significantly longer (P < .0001 and had lower Flesch ease-of-reading scores (P = .003 than investigator-initiated trials (N = 11. At least 80% of patients incorrectly responded to three key questions which addressed the experimental nature of their trial therapy, its purported efficacy and potential risks relative to alternative treatments. The mean objective understanding score was 76.9±8.8, but it was statistically significantly lower for patients who had not completed high school (P = .011. The scores did not differ significantly by type of cancer therapy (P = .12 or trial sponsor (P = .38.Many participants enrolled on cancer trials had poor understanding of essential elements of their trial. In order to ensure true informed consent, innovative approaches, such as expanded in-person counseling adapted to the patient's education level or cultural characteristics should be evaluated across socio-demographic groups.Clinicaltrials.gov NCT01772511.

  7. Clinical Impact of Education Provision on Determining Advance Care Planning Decisions among End Stage Renal Disease Patients Receiving Regular Hemodialysis in University Malaya Medical Centre.

    Science.gov (United States)

    Hing Wong, Albert; Chin, Loh Ee; Ping, Tan Li; Peng, Ng Kok; Kun, Lim Soo

    2016-01-01

    Advance care planning (ACP) is a process of shared decision-making about future health-care plans between patients, health care providers, and family members, should patients becomes incapable of participating in medical treatment decisions. ACP discussions enhance patient's autonomy, focus on patient's values and treatment preferences, and promote patient-centered care. ACP is integrated as part of clinical practice in Singapore and the United States. To assess the clinical impact of education provision on determining ACP decisions among end-stage renal disease patients on regular hemodialysis at University Malaya Medical Centre (UMMC). To study the knowledge and attitude of patients toward ACP and end-of-life issues. Fifty-six patients were recruited from UMMC. About 43 questions pretest survey adapted from Lyon's ACP survey and Moss's cardiopulmonary resuscitation (CPR) attitude survey was given to patients to answer. An educational brochure is then introduced to these patients, and a posttest survey carried out after that. The results were analyzed using SPSS version 22.0. Opinion on ACP, including CPR decisions, showed an upward trend on the importance percentage after the educational brochure exposure, but this was statistically not significant. Seventy-five percent of participants had never heard of ACP before, and only 3.6% had actually prepared a written advanced directive. The ACP educational brochure clinically impacts patients' preferences and decisions toward end-of-life care; however, this is statistically not significant. Majority of patients have poor knowledge on ACP. This study lays the foundation for execution of future larger scale clinical trials, and ultimately, the incorporation of ACP into clinical practice in Malaysia.

  8. A Study of the anthropometric and demographical profile of patients presenting with coronary artery disease at Mayo Hospital, Lahore

    International Nuclear Information System (INIS)

    Qureshi, N.S.; Hanif, A.; Akhtar, B.; Bhatti, T.A.; Lutfullah; Iqbal, M.; Khaled, Z.N.; Bakhshi, I.M.; Khan, B.Z.

    2010-01-01

    Coronary artery disease (CAD) is very common in the South Asian sub-continent, yet there is relatively little published research available from these countries. Although we have a very active Cardiology Department in Mayo Hospital, Lahore, there is a parallel need for documentation of the data generated and its analysis for research and publication. This study was carried out to gain an insight into the nature of the risk factors and presentation of CAD in patients coming to our setup. Objectives: The objective was to study the relation of CAD with anthropometric (BMI, waist circumference, waist . to . height ratio) and demographical (age and gender) factors. Methodology: This study was carried out in the Department of Cardiology, Mayo Hospital, Lahore, for a duration of 17 months. We collected the required information (such as name, gender, and family history, demographical data and anthropometric measurements) on a prescribed proforma, managed and then analyzed accordingly. Results: In this study there were 302 (80.5%) males and 73 (19.5%) females. The number of males was significantly higher (p-value 0.000), but the frequency of different diagnoses was statistically the same in both males and females, i.e. p-value = 0.062. According to the WHO recommended criteria for the BMI of South Asian populations, there were 9(2.4%) people who were under weight, among these 7 (77.8%) were males and 2 (22.2%) were females patients. Out of 302 males, 7(2.3%) were under weight, 36 (11.9%) were of normal weight, 115 (38.1%) were overweight and the rest of 144 (47.7%) were obese. Among 73 females, 2 (2.7%) were under weight, 8 (11%) had normal weight, 15 (20.5%) were overweight and 48 (65.8%) were obese. The proportion of obesity was more in females in this study, p-value (0.000). The mean waist circumference of all patients was 95.57 +- 17.14 cm with a range of 53 - 190 cm. The waist circumference was statistically higher in males than females, p-value = 0.000. In 7 under

  9. [Start-up grants for young scientists in German medical universities : Can the clinical scientist be saved?

    Science.gov (United States)

    Pabst, R; Linke, P B; Neudeck, N B A; Schmiel, M; Ernst, S B

    2016-12-01

    German medical faculties currently have severe financial problems. There is the conflict between financing teaching medical students, inpatient and outpatient costs and supporting basic and applied research. Young postdocs can apply for a grant to start research projects to establish techniques on publishing data as a basis for applying for grants from the German Research Foundation or foundations with a critical review system. Successful applicants from the years 1998-2011 were asked to answer a questionnaire. The annual number of applications ranged from 28 to 96 per year. Within the first period of our analysis ranging from 1998 to 2004, a mean number of 69.5 % ± 14.0 % of submitted grant applications were approved annually in comparison to an average approval of 30.9 % ± 11 % in the years 2006-2001. In total 353 projects were funded with a mean amount of money for a project of approximately 18,640 EUR. The mean amount of external grant money following the start-up period was 7.2 times the money initially spent. That is an excellent return of investment. There were no differences between applicants from the department of surgery or department of internal medicine. In the meantime, 56 % of men and 42 % of women have achieved the academic degree university lecturer (privatdozent). Furthermore, 71 % of the participants evaluated this start-up research as supportive for their postdoctoral qualification (habilitation). The program for initial investment for young postdocs by internal start-up grants is overall successful.

  10. The present state of the diabetic clinic in the first department of internal medicine of Niigata University Hospital

    International Nuclear Information System (INIS)

    Nakagawa, Osamu; Oyama, Yasuro; Suzuki, Katsunori

    1998-01-01

    The treatment of diabetic complications in Niigata University were reported. Of all patients, 23.6% were treated by diabetic therapy alone, 37.8% were administered with SU drug and, in addition, about 50% were treated by a glucosidase inhibitor (αGI) or troglitazone. Insulin was used in 26.2% of the patients. Patients with NIDDM in whom the onset of simple retinopathy could be specified, were divided into 2 groups; Group S, with simple retinopathy without progression and Group P, with progression to preproliferative or proliferative retinopathy. Between the 2 groups, there were significant differences in the period of suffering from simple retinopathy, HbA1c and TC b. The association of the retinopathy with the short period would mean that HbA1c and TC were poorly controlled in these patients. In attention to silent myocardial ischemia and significance of cerebral blood flow scintigraphy, there was no significant difference regarding the presence or absence of angina pain or incidence of abnormal findings of scintigraphy or coronary angiography. It was difficult to predict the presence of silent myocardial ischemia from the presence or absence of diabetic neuropathy. Cerebral blood flow scintigraphy was performed in 37 diabetic patients, 25 patients were allocated to a group having uneven distribution of RI which never detected normally and an ununiform drop of peripheral blood flow (Micro group) and 12 cases without these findings to another group (Non-micro group). In the Micro group, HbA1c was significantly higher and the incidence of diabetic nephropathy was also higher. αGI was used to improve postprandial hyperglycemia in patients with NIDDM. It was more effective when being used concomitantly with a SU agent although the effect tended to decrease relatively in the cases of long term use. Improvement was observed in 90% of the patients which showed BMI of 24.2 or above. (K.H.)

  11. The present state of the diabetic clinic in the first department of internal medicine of Niigata University Hospital

    Energy Technology Data Exchange (ETDEWEB)

    Nakagawa, Osamu; Oyama, Yasuro; Suzuki, Katsunori [Niigata Univ. (Japan). School of Medicine] [and others

    1998-10-01

    The treatment of diabetic complications in Niigata University were reported. Of all patients, 23.6% were treated by diabetic therapy alone, 37.8% were administered with SU drug and, in addition, about 50% were treated by a glucosidase inhibitor ({alpha}GI) or troglitazone. Insulin was used in 26.2% of the patients. Patients with NIDDM in whom the onset of simple retinopathy could be specified, were divided into 2 groups; Group S, with simple retinopathy without progression and Group P, with progression to preproliferative or proliferative retinopathy. Between the 2 groups, there were significant differences in the period of suffering from simple retinopathy, HbA1c and TC b. The association of the retinopathy with the short period would mean that HbA1c and TC were poorly controlled in these patients. In attention to silent myocardial ischemia and significance of cerebral blood flow scintigraphy, there was no significant difference regarding the presence or absence of angina pain or incidence of abnormal findings of scintigraphy or coronary angiography. It was difficult to predict the presence of silent myocardial ischemia from the presence or absence of diabetic neuropathy. Cerebral blood flow scintigraphy was performed in 37 diabetic patients, 25 patients were allocated to a group having uneven distribution of RI which never detected normally and an ununiform drop of peripheral blood flow (Micro group) and 12 cases without these findings to another group (Non-micro group). In the Micro group, HbA1c was significantly higher and the incidence of diabetic nephropathy was also higher. {alpha}GI was used to improve postprandial hyperglycemia in patients with NIDDM. It was more effective when being used concomitantly with a SU agent although the effect tended to decrease relatively in the cases of long term use. Improvement was observed in 90% of the patients which showed BMI of 24.2 or above. (K.H.)

  12. A model (CMBP) for collaboration between university college and nursing practice to promote research utilization in students' clinical placements: a pilot study.

    Science.gov (United States)

    Elsborg Foss, Jette; Kvigne, Kari; Wilde Larsson, Bodil; Athlin, Elsy

    2014-08-01

    A collaborative project was initiated in Norway between a university college and a hospital in order to improve RNs' and nursing students' research utilization in clinical placements. This paper describes the model (CMBP) that was developed, its first application, and evaluation. The evaluation aimed at describing nurses' and students' experiences of the CMBP related to collaboration, facilitation, learning, and impact on nursing care. Thirty-eight students from the second and third year of nursing education, and four nurses answered questionnaires with closed and open ended questions. In addition two of the nurses wrote diaries. Data were subjected to qualitative and quantitative analysis. Almost all participants reported that collaboration between nursing college and nursing practice had been beneficial. Most students and all nurses reported about valuable learning, increased understanding of research utilization, and improved quality of nursing care. Both students and RNs recommended the CMBP to be used in all clinical placements to support academic learning and increase research utilization in clinical practice. Despite study limitations the findings indicate that the CMBP has a potential to be a useful model for teaching RNs' and students EBP. However, further refinement of the model is needed, followed by a more comprehensive implementation and evaluation. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. [Geriatric Trauma Center DGU®: Evaluation of clinical and economic parameters : A pilot study in a german university hospital].

    Science.gov (United States)

    Knobe, M; Böttcher, B; Coburn, M; Friess, T; Bollheimer, L C; Heppner, H J; Werner, C J; Bach, J-P; Wollgarten, M; Poßelt, S; Bliemel, C; Bücking, B

    2018-04-19

    Previous studies on orthogeriatric models of care suggest that there is substantial variability in how geriatric care is integrated in the patient management and the necessary intensity of geriatric involvement is questionable. The aim of the current prospective cohort study was the clinical and economic evaluation of fragility fracture treatment pathways before and after the implementation of a geriatric trauma center in conformity with the guidelines of the German Trauma Society (DGU). A comparison of three different treatment models (6 months each) was performed: A: Standard treatment in Orthopaedic Trauma; B: Special care pathways with improvement of the quality management system and implementation of standard operating procedures; C: Interdisciplinary treatment with care pathways and collaboration with geriatricians (ward round model). In the 151 examined patients (m/w 47/104; 83.5 (70-100) years; A: n = 64, B: n = 44, C: n = 43) pathways with orthogeriatric comanagement (C) improved frequency of postoperative mobilization (p = 0.021), frequency of osteoporosis prophylaxis (p = 0.001) and the discharge procedure (p = 0.024). In comparison to standard treatment (A), orthogeriatric comanagement (C) was associated with lower rates of mortality (9% vs. 2%; p = 0.147) and cardio-respiratory complications (39% vs. 28%; p = 0.235) by trend. In this context, there were low rates of myocardial infarction (6% vs. 0%), dehydration (6% vs. 0%), cardiac dysrhythmia (8% vs. 0%), pulmonary decompensation (28% vs. 16%), electrolyt dysbalance (34% vs. 19%) and pulmonary edema (11% vs. 2%). Duration of stay in an intensive care unit was 29 h (A) and 18 h (C) respectively (p = 0.205), with consecutive reduction in costs. A sole establishment of a special care pathway for older hip fracture patients (B) showed a lower rate of myocardial infarction (A: 11%, B: 0%, C: 0%; p = 0.035). There was a clear tendency to a better overall

  14. Intravenous thrombolytic treatment experiences in patients with acute ischemic stroke at the University of Kocatepe, Neurology Clinics

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    Serdar Oruç

    2015-12-01

    Full Text Available INTRODUCTION: This study aimed to discuss the results of the intravenous thrombolytic treatment (IV-tPA to acute ischemic stroke patients, in the light of the literature. METHODS: We performed our study with forty acute ischemic stroke patients who were receiving the IV-tPA in the intensive care unit of our neurology clinic between 2011 and 2015.. The demographic, clinical and radiological data were collected retrospectively. The intracranial hemorrhage detected within 3 months after discharge and neurological status at the end of the 3rd month were evaluated by using modified Rankin scale (MRS and National Institutes of Health Stroke Scale (NIHSS scores. The symptom-to-needle time, Alberta stroke programe early computed tomography score (ASPECT and initial and follow-up scores of NIHSS were analyzed. RESULTS: Fifteen patients were female, twenty-five were male, and the mean age was 66.45±10.56. The initial mean NIHSS score was 13±4.33, whereas it was 4,10±3,37at 3rd month. The initial mean ASPECT score was 8.23±1.20. Symptomatic intracranial hemorrhage was detected in 1 patient and asymptomatic intracranial hemorrhage was detected in 6. The mean symptom-to-needle time was 139,0±48,1 minutes. The neurological disability of 13 patients ( %32.5 were fully recovered at the end of the 3rd month, while 7 patients were died. (% 17,5 The initial NIHSS and ASPECT scores were significantly different between group of patients with a MRS score between 0-2 and between 3-6 (p=0.03 and p=0.006; respectively, while the symptom-to-needle time was not different (p=0.79. DISCUSSION AND CONCLUSION: The results of the current study are in accordance with previous studies in the literature. These results have shown that the IV-tPA treatment is efficient and safe treatment modality in acute ischemic stroke, and reduces disability at the end of the 3rd month.

  15. ATTITUDES OF MEDICAL STUDENTS TOWARDS TAKING PART-TIME JOBS: A STUDY AMONGST FIRST YEAR CLINICAL STUDENTS OF THE COLLEGE OF MEDICINE, UNIVERSITY OF IBADAN.

    Science.gov (United States)

    Kanmodi, K K; Akinloye, A G; Aladelusi, T O

    2017-06-01

    Student part-time jobs are employments taken up by students while in school. Students in tertiary institutions do engage in part-time jobs because of the associated benefits. Some of these benefits include work experience, independence, financial support, and job satisfaction. Different studies have reported different attitudes towards taking part-time jobs among university students. To determine the attitudes of medical students in their first clinical year of study at the University of Ibadan medical school towards taking up parttime medical jobs within the university hospital. This study was a descriptive cross-sectional study conducted among medical students in their first clinical year of study. Eighty one first clinical - year medical students were recruited to participate in this study. All participants were interviewed using a self-administered questionnaire to obtain information on bio-data, scholarship benefit status, level of satisfaction with monthly income, choices of part-time jobs, and the factors that might informed choice of a part-time job. No questionnaire was discarded because all were correctly filled. Data collected was coded, entered, and analysed using the SPSS version 16 software. Analyses of all variables were done using descriptive statistics. The mean age of the 81 respondents was 20.8 (±1.6) years and 51.9% were males. A higher proportion of the male respondents were studying on scholarship (57.1%), compared to that of the females (31.6%). Respondents studying on scholarship had a higher level of financial satisfaction. Over 90% of the participants supported the idea of part-time medical job creation for medical students. The majority of the respondents (64.2%) prefer to take up the job position of research assistantships. The amount of wages to be earned was the most predominant factor considered among the male respondents in their decision for taking up a part-time medical job, while opportunity to learn new skills was the most

  16. The dynamics of clinical students speciality preference: A study of the College of Medicine, University of Lagos

    Directory of Open Access Journals (Sweden)

    O J Akinsola

    2013-01-01

    Full Text Available Background: Undergraduate medical education is only an initial step in training the highly differentiated doctor. The medical specialties chosen by doctors for their career play an important part in workforce planning of healthcare services and as a predictive index in the composition of medical graduates and potential physicians. However, there is little theoretical understanding of how different medical specialties are perceived or how choices are made. Objective: The aim of this study is to shed more light on how medical students view specialisation as well as to discover the factors that strongly influence their choice of medical specialty. Methodology: This study was a descriptive cross-sectional study carried out using anonymous self-administered questionnaire. Simple random sampling technique was used. Data management and analysis was done using SPSS software version 15.0. Results: The response rate was 93.7%. The respondents had a good overall knowledge about specialisation in Medicine as 175 (98.3% of the respondents knew about specialisation in Medicine as well as the different specialties in Medicine. Majority 126 (70.8% of the respondents would want to specialise and about two-thirds, 112 (62.9% indicated preferred specialties as Obstetrics & Gynecology 31 (17.5%, Pediatrics 30 (16.7%, Surgery 25 (14.3%, Internal medicine 17 (9.5% and Public Health 14 (7.9%. Conclusion: The study revealed the patterns of preference of medical students to medical specialty and factors that strongly influence their choice during clinical postings.

  17. Model for prioritization of Graduate Medical Education funding at a university setting - Engagement of GME committee with the Clinical Enterprise.

    Science.gov (United States)

    Are, Chandrakanth; Suh, Melissa; Carpenter, Lauren; Stoddard, Hugh; Hamm, Vicki; DeVries, Matthew; Goldner, Whitney; Jarzynka, Kimberly; Parker, Jennifer; Simonson, Jean; Talmon, Geoffrey; Vokoun, Chad; Gold, Jeffrey; Mercer, David; Wadman, Michael

    2017-07-19

    Funding for graduate medical education (GME) is becoming scarce and is likely to worsen. There is a higher degree of accountability and return on investment demanded from public funds dedicated to GME. Academic centers (AC) partnered with clinical enterprises (CE) are finding it increasingly difficult to retain sustainable funding streams for GME activities. To develop and implement a novel algorithmic funding model at one AC in symbiotic partnership with the CE for all 50 GME programs with nearly 500 residents. A new GME Finance and Workforce Committee was convened which was tasked with developing the novel algorithmic financial model to prioritize GME funding. Early outcomes measures that were monitored consisted of: satisfaction of all stakeholders and financial savings. The model was presented to all the stakeholders and was well received and approved. Early signs, demonstrated AC and CE satisfaction with the model, financial savings and increased efficiency. This GME funding model may serve as a template for other academic centers with tailored modifications to suit their local needs, demands and constraints. Copyright © 2017. Published by Elsevier Inc.

  18. Operation and adjuvante radiotherapy of oropharyngeal carcinomas. Clinical results at the University of Wuerzburg between the years 1998-2010

    International Nuclear Information System (INIS)

    Rosenheim, Eva

    2016-01-01

    Results of a retrospective study at the University of Wuerzburg: Patients and methods: In a retrospective study the factors of influence on the locoregional control, the overall survival and the disease free survival of 106 patients with histological approved oropharyngeal cancer were tested with uni- and multivariate analysis. The median age at the date of the primary diagnosis was 55 years. A median follow up surveillance of 36 months could be achieved (between 5 to 126 months). In 18 cases (17%) the primary tumor could be removed in sano (safety margin >3mm). In 34 cases (32%) were detected close resection margins (<3mm) and in 54 cases the resection margins were not free of tumor cells (R1 resection). Patients, who were treated with chemotherapy, because of the increased recurrency risk, were 24% of the patient database. The concept of medical treatment: The tumorbed of the primary tumor and the cervical lymphatic drain received a radiation dose of 56 Gy (2 Gy/ treatment, 5 fractions a week). Patients with R0 resections received doses from 56 to 60 Gy. Patients with close resections margins received a higher dose of 60 to 66 Gy at the tumorbed and patients with R1 resections were treated with a boost up to 66 to 70 Gy. Patients with UICC 4 status with an increased recurrency risk received an additional chemotherapy with cisplatin (40mg/m"2 a week) in 1 to 4 cycles as well a boost of the tumorbed up to 66 to 70 Gy. In the univariate analysis with the Kaplan-Maier Plat method following factors of influence were detected: tumor status (p-value 0,003), lymph node status (p-value 0,048), chemotherapy (p-value 0,047), second tumor (p-value 0,003) and the overall tumor volume (p-value 0,000). Results of the multivariate analysis In the Cox regression analysis the tumor status and the development of a second tumor were detected as factors of influence of the 5 year overall survival rate and the 5 year disease free survival survival rate. Regarding to the overall

  19. The use of Amniotic membrane in the treatment of Burns in Children: a clinical trial at the university Teaching Hospital, Lusaka

    International Nuclear Information System (INIS)

    Katebe, K.R.C

    1995-01-01

    This is a clinical trial which was carried out at the University Teaching Hospital, Lusaka from the 1st of July to the 31st December, 1994. It involved treatment of burns in forty children using gamma irradiated amniotic membrane produced at the hospital. The results showed that it is feasible to produce Gamma irradiated biological dressings from amniotic membrane at this hospital. The amniotic membrane was easy to apply on burns and the treatment was acceptable to the majority of parents with burnt children. The use of amniotic membrane was non inflammatory to the wounds in all forty patients (100%), reduced wound infection in thirty three patients (82.5%), increased the rate of wound healing in thirty nine patients (97.5%), and resulted in good quality wound healing in thirty one patients (77.5%). Therefore, the treatment offers a good alternative in the treatment of burns in children at the hospital

  20. The results of the treatment of patients with chronic myeloid leukemia at the Medical Clinic of the University of Tuebingen 1969-1978

    International Nuclear Information System (INIS)

    Pfeilsticker, U.

    1982-01-01

    The results of treatment of 111 patients with myeloid leukemia at the Medical Clinic of the University of Tuebingen from the years 1969 to 1971 were evaluated under a testing, which occurred at the same time, of the therapeutically differential importance of the spleen size before the beginning of therapy and of the influence of various factors on the treatment success of spleen irradiation. The median survival time of the 111 patients after diagnosis was 43 months. The primary busulfan therapy increased survival time in comparison to the therapy with spleen irradiation, but not statistically significantly. With more greatly enlarged spleens there was no recognizable advantage in either form of treatment. For a better evaluation of the therapy success stricter remission criteria appeared to be required. (orig.) [de

  1. Prevalence and phenotypic characterization of Enterococcus species isolated from clinical samples of pediatric patients in Jimma University Specialized Hospital, south west Ethiopia.

    Science.gov (United States)

    Toru, Milkiyas; Beyene, Getnet; Kassa, Tesfaye; Gizachew, Zeleke; Howe, Rawleigh; Yeshitila, Biruk

    2018-05-08

    This study was done to determine the prevalence and phenotypic characterization of Enterococcus species isolated from clinical samples of pediatric patients in Jimma University Specialized Hospital, Southwest Ethiopia. The overall prevalence of Enterococci species was 5.5% (22/403). Five (22.7%) of Enterococci species were vancomycin resistant. Haemolysin, gelatinase and biofilm production was seen among 45.5, 68.2 and 77.3% of isolates respectively. The overall rate of antibiotic resistance was 95.5% (21/22). High resistance was observed against norfloxacin (87.5%), and tetracycline (77.3%). Whereas, low resistance (36.5%) was observed against ciprofloxacin and eighteen (80.8%) of the isolates were multi-drug resistant.

  2. Ageing, exposure to pollution, and interactions between climate change and local seasons as oxidant conditions predicting incident hematologic malignancy at KINSHASA University clinics, Democratic Republic of CONGO (DRC).

    Science.gov (United States)

    Nkanga, Mireille Solange Nganga; Longo-Mbenza, Benjamin; Adeniyi, Oladele Vincent; Ngwidiwo, Jacques Bikaula; Katawandja, Antoine Lufimbo; Kazadi, Paul Roger Beia; Nzonzila, Alain Nganga

    2017-08-23

    The global burden of hematologic malignancy (HM) is rapidly rising with aging, exposure to polluted environments, and global and local climate variability all being well-established conditions of oxidative stress. However, there is currently no information on the extent and predictors of HM at Kinshasa University Clinics (KUC), DR Congo (DRC). This study evaluated the impact of bio-clinical factors, exposure to polluted environments, and interactions between global climate changes (EL Nino and La Nina) and local climate (dry and rainy seasons) on the incidence of HM. This hospital-based prospective cohort study was conducted at Kinshasa University Clinics in DR Congo. A total of 105 black African adult patients with anaemia between 2009 and 2016 were included. HM was confirmed by morphological typing according to the French-American-British (FAB) Classification System. Gender, age, exposure to traffic pollution and garages/stations, global climate variability (El Nino and La Nina), and local climate (dry and rainy seasons) were potential independent variables to predict incident HM using Cox regression analysis and Kaplan Meier curves. Out of the total 105 patients, 63 experienced incident HM, with an incidence rate of 60%. After adjusting for gender, HIV/AIDS, and other bio-clinical factors, the most significant independent predictors of HM were age ≥ 55 years (HR = 2.4; 95% CI 1.4-4.3; P = 0.003), exposure to pollution and garages or stations (HR = 4.9; 95% CI 2-12.1; P pollution, combined local dry season + La Nina and combined local dry season + El Nino were the most significant predictors of incident hematologic malignancy. These findings highlight the importance of aging, pollution, the dry season, El Nino and La Nina as related to global warming as determinants of hematologic malignancies among African patients from Kinshasa, DR Congo. Cancer registries in DRC and other African countries will provide more robust database for future researches on

  3. Potential and limits of mammography (Statistical and casuistic investigation of clinically positive, mammographically negative cases among the patients of Goettingen Radiological University Hospital)

    Energy Technology Data Exchange (ETDEWEB)

    Pforte, A.

    1978-01-01

    In the radiological clinic of the Goettingen University, 23,945 patients were mammographed from 1971 to 1977. For 612 patients with existing clinical findings, a negative radiological finding was established; as for the 202 patients who are dealt with in this paper, in 192 of these cases a histological or cytological clarification was carried out; 10 other cases were observed over a longer period. The average age of the patients examined was 39.7 years. The maximum frequency with regard to the age lies in the 5th life decade with 26.2%. Corresponding to the Goettingen model, the patients examined were assigned to 4 main groups in accordance to their parenchymal structure. In relation to the mamma structure, the clinical finding in 53.9% is hardening and in 46.1% nodes. As for the nodes, most have the size of cherry or plum (21.3%), this is followed by those with the size of beans (13,8%) and lenses (10.9%). A coherence between age and size of the clinical finding cannot be manifested definitely. In nearly half of the cases, the histological or cytological examination revealed a mastopathy (48.9%). In 10.4% a fibroadenoma was found and in 2.1% a carcinoma. In the remaining 32,8% the finding referred to lipomas, mastitis, atypical cells or negative cytological results. Related to the age, mastopathy is dominant in women between 20 and 60 years of age. In women below 20 years, fibroadenomas are dominant, in women in their 7th decade other benign diagnoses which in the 8th decade are of the same frequency as carcinomas. With increasing age, the number of fibroadenomas decreases.

  4. Assessment of Knowledge, Attitudes and Practice of Clinical Faculty Members of Alborz University of Medical Sciences Towards Evidence Based Medicine (EBM and Its Using

    Directory of Open Access Journals (Sweden)

    D. salehifar

    2017-06-01

    Full Text Available Background: Evidence based medicine (EBM is an approach to improve the quality of clinical decision making, treatment and care provided to patients. This study aimed to assess the knowledge, attitude and practice of faculty members of Alborz University of Medical Sciences about EBM. Methods: A cross sectional study was conducted in 2015 and 40 physicians participated. Data were collected by a valid and reliable structured questionnaire consisting 17 knowledge items, 8 attitude items and 12 items for practices about EBM. Using SPSS software version 19 data analyses was done. Results: From a total of 49 faculty members 40 responded the questionnaires in which 62.5% were female, the mean average age was 40.6 years and mean time of job experience was 8.1 years. About half of the respondents had participated in an EBM workshop, 10% of the participants have stated that do not know EBM and 37.5% had low knowledge, only 7.5% had adequate knowledge. Ninety percent of the respondents believed that EBM has an important role in promoting quality of care and 82% of them were interested to take part in EBM workshops. The information source for clinical practice in 70% of the participants was the text book, 55% Cochrane, and 45% clinical experience. Conclusion: Faculty members had a positive attitude toward EBM; although a vast majority of them claimed that they practice based on evidence in clinical settings, about half of them stated had not adequate knowledge about EBM. Therefore, it is necessary to keep their knowledge up to date. 

  5. Integration of basic science and clinical medicine: the innovative approach of the cadaver biopsy project at the Boston University School of Medicine.

    Science.gov (United States)

    Eisenstein, Anna; Vaisman, Lev; Johnston-Cox, Hillary; Gallan, Alexander; Shaffer, Kitt; Vaughan, Deborah; O'Hara, Carl; Joseph, Lija

    2014-01-01

    Curricular integration has emerged as a consistent theme in medical education reform. Vertical integration of topics such as pathology offers the potential to bring basic science content into the clinical arena, but faculty/student acceptance and curricular design pose challenges for such integration. The authors describe the Cadaver Biopsy Project (CBP) at Boston University School of Medicine as a sustainable model of vertical integration. Faculty and select senior medical students obtained biopsies of cadavers during the first-year gross anatomy course (fall 2009) and used these to develop clinical cases for courses in histology (spring 2010), pathology (fall 2010-spring 2011), and radiology (fall 2011 or spring 2012), thereby linking students' first experiences in basic sciences with other basic science courses and later clinical courses. Project goals included engaging medical stu dents in applying basic science princi ples in all aspects of patient care as they acquire skills. The educational intervention used a patient (cadaver)-centered approach and small-group, collaborative, case-based learning. Through this project, the authors involved clinical and basic science faculty-plus senior medical students-in a collaborative project to design and implement an integrated curriculum through which students revisited, at several different points, the microscopic structure and pathophysiology of common diseases. Developing appropriate, measurable out comes for medical education initiatives, including the CBP, is challenging. Accumu lation of qualitative feedback from surveys will guide continuous improvement of the CBP. Documenting longer-term impact of the curricular innovation on test scores and other competency-based outcomes is an ultimate goal.

  6. The effectiveness of CPR training during anesthesia internship rotation on improvement of interns, knowledge and clinical skills of Lorestan university of medical sciences

    Directory of Open Access Journals (Sweden)

    sepideh Vahabi

    2015-09-01

    Full Text Available Background : Since only the correct and effective Cardiopulmonary Resuscitation (CPR can increase the survival of patients with cardiopulmonary arrest, the aim of this study is to determine the effects of CPR training in the anesthetioligy ward to improve CPR knowledge and clinical skills of interns of Lorestan university of medical sciences. Materials and Methods : A 10-month Educational experimental study was done on 31 undergraduate medical students at Lorestan university of medical sciences in 2013. During a period of 15 days of anesthesiology internship course, all these students underwent CPR training including Basic Life Support ( BLS , Advanced Cardiac Life Support ( ACLS and practical skills. Data were collected via a questionnaire with 4 parts including demographic, pre and post knowledge and skills as standpoint of interns and ward,s professor. Results: After training the mean of score about knowledge of CPR and its practical skills significantly increased from 5.68 to 7.94 and 10.65 to 23.45 respectivly (PV=0.0001 . A significant relationship between preinternship exam score and knowledge of CPR before anesthesiology internship course was shown (PV=0.001, but there was no significant relationship with practical skills score pre and post CPR training in anesthesilogy ward.(PV=0.38 Conclusion: The CPR training course in anesthetiology ward leads to significant increase in CPR skills and Knowledge of medical interns. Adding this course to undergraduated medical students is essential

  7. [Epidemiological, clinical, cytologic and immunophenotypic aspects of acute leukemia in children: the experience at the hematology laboratory of IBN SINA University Hospital Center].

    Science.gov (United States)

    Doumbia, Mariam; Uwingabiye, Jean; Bissan, Aboubacar; Rachid, Razine; Benkirane, Souad; Masrar, Azlarab

    2016-01-01

    The aim of this study was to describe epidemiological, cytologic and immunophenotypic aspects of acute leukemias (AL) in children diagnosed at IBN SINA University Hospital Center and to determine the concordance between cytology and immunophenotyping results. This is a cross-sectional study conducted in the hematology laboratory of IBN SINA University Hospital Center between June 2012 and May 2014. Among the 104 cases with diagnosed AL, 52% were boys with a sex-ratio H/F= 1.32, the average age was 5.7 years. The distribution of different types of AL was: lymphoid AL (LAL) (74%), myeloid (AML) (20.2%), biphenotypic AL (BAL) (65.8%). Among the LALs, 78% were classified as B LAL and 22% as T LAL. Clinical signs were mainly presented with tumor syndrome (73.1%), fever (61%) and hemorrhagic syndrome (50%). The most common blood count abnormalities were: thrombopenia (89.4%), anemia (86.5%), hyperleukocytosis (79.8%). The rate of peripheral and bone marrow blasts was statistically higher for LAL than for AML and BAL (p <0.001). The rate of relapse and mortality was 21.2% and 16. 3% respectively. Concordance rate between the results of cytology and of immunophenotyping was 92.7% for LAL and 82.6% for AML. Diagnosis of AL is always based primarily on cytology. Immunophenotyping allowed us to make a better distinction between acute leukemias. The management of paediatric AL is a major health problem which requires specialized care centers.

  8. A cross-sectional study of anxiety and marital quality among women with breast cancer at a university clinic in western Saudi Arabia

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    Faten N. Al-Zaben

    2015-10-01

    Full Text Available Objectives: To examine relationship between the quality of marital relationship and anxiety among women with breast cancer (BC in the Kingdom of Saudi Arabia (KSA. Methods: This cross-sectional study recruited a consecutive series of 49 married women with BC seen in the Al-Amoudi Breast Cancer Center of Excellence at King Abdulaziz University, Jeddah, KSA in early 2013. Participants completed the Hospital Anxiety and Depression Scale, Spouse Perception Scale, and Quality of Marriage Index forms, and answered questions on demographic and cancer characteristics. Results: Anxiety symptoms indicating “possible” anxiety disorder were present in 10.4% and “probable” anxiety disorder in 14.6% (25% total. No significant relationship was found between the quality of marital relationship and anxiety symptoms (B=-0.04, standard error=0.05, t=-0.81, p=0.42. Anxiety was primarily driven by low education, poor socioeconomic status, and young age. Conclusion: Anxiety symptoms are prevalent among married women with BC seen in a university-based clinic in the KSA. Further research is needed to determine whether a diagnosis of BC adversely affects marital relationship, and whether this is the cause for anxiety in these women.

  9. Radiation therapy of cancer of the cervix, corpus uteri and vagina at the 1st University Clinic of Gynaecology in Vienna from 1950 to 1979

    International Nuclear Information System (INIS)

    Kucera, H.

    1980-01-01

    On the occasion of the 30th anniversary of the department of radiotherapy of th 1st University-Clinic of Gynaecology and Obstetrics in Vienna, the results obtained in the treatment of gynaecologic malignancy are presented. During this period, more than 10 000 malignant tumors of the female genital tract were treated, including 3605 cases of cancer of the cervix, 1412 endometrial carcinomas and 397 cases of cancer of the vagina. The principal method of irradiation was local application of radium. Dosage was established empirically after measurements on a model. In addition conventional percutaneous roentgen therapy was used until 1972, when telecobalt irradiation equipment was put into use. Five-year survival rates for cervical, endometrial and vaginal cancer are presented for the years from 1950 through 1972. These results are attributed primarily to intracavitary radium application. Of 2687 cases with cervical cancer 1222 (45.5%) were alive after five years, in stage III cervical cancer 535 out of 1321 (40.5%). The latest international tables published in the Annual Report give a five-year survival rate of 31.7% for stage-III cancer of the cervix. Of 994 cases of endometrial cancer 473 were alive after five years (49.8%), while the Annual Report gives a five-year survival rate of 39.0% for primary irradiation in endometrial cancer. For cancer of the vagina, our five-year survival rate was 42.8% (127 patients out of a total of 297), while the Annual Report gives 37.3%. This demonstrates, that the results obtained at the department of radiotherapy of the 1st University Clinic of Gynaecology and Obstetrics in Vienna are better than the international average. Apart from the different methods of treatment the importance of primary radiation therapy in gynaecologic oncology is pointed out, and the side effects and complications are discussed. (orig.) [de

  10. The clinical academic workforce of the future: a cross-sectional study of factors influencing career decision-making among clinical PhD students at two research-intensive UK universities.

    Science.gov (United States)

    Lopes, Joana; Ranieri, Veronica; Lambert, Trevor; Pugh, Chris; Barratt, Helen; Fulop, Naomi J; Rees, Geraint; Best, Denise

    2017-08-28

    To examine clinical doctoral students' demographic and training characteristics, career intentions, career preparedness and what influences them as they plan their future careers. Online cross-sectional census surveys at two research-intensive medical schools in England in 2015-2016. All medically qualified PhD students (N=523) enrolled at the University of Oxford and University College London were invited to participate. We report on data from 320 participants (54% male and 44% female), who were representative by gender of the invited population. Career intentions. Respondents were mainly in specialty training, including close to training completion (25%, n=80), and 18% (n=57) had completed training. Half (50%, n=159) intended to pursue a clinical academic career (CAC) and 62% (n=198) were at least moderately likely to seek a clinical lectureship (CL). However, 51% (n=163) had little or no knowledge about CL posts. Those wanting a CAC tended to have the most predoctoral medical research experience (χ 2 (2, N=305)=22.19, p=0.0005). Key reasons cited for not pursuing a CAC were the small number of senior academic appointments available, the difficulty of obtaining research grants and work-life balance. Findings suggest that urging predoctoral clinicians to gain varied research experience while ensuring availability of opportunities, and introducing more flexible recruitment criteria for CL appointments, would foster CACs. As CL posts are often only open to those still in training, the many postdoctoral clinicians who have completed training, or nearly done so, do not currently gain the opportunity the post offers to develop as independent researchers. Better opportunities should be accompanied by enhanced career support for clinical doctoral students (eg, to increase knowledge of CLs). Finally, ways to increase the number of senior clinical academic appointments should be explored since their lack seems to significantly influence career decisions. © Article author

  11. Clinical Trials

    Medline Plus

    Full Text Available ... sponsor clinical trials. Many other groups, companies, and organizations also sponsor clinical trials. Examples include Government Agencies, ... and Veterans Affairs; private companies; universities; and nonprofit organizations. NIH Institutes and Centers (including the NHLBI) usually ...

  12. Clinical Trials

    Medline Plus

    Full Text Available ... and Centers sponsor clinical trials. Many other groups, companies, and organizations also sponsor clinical trials. Examples include ... U.S. Departments of Defense and Veterans Affairs; private companies; universities; and nonprofit organizations. NIH Institutes and Centers ( ...

  13. Referencias: mayo de 1964

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    Boletín Cultural y Bibliográfico Banco de la República

    1964-05-01

    Full Text Available Don Isidoro Laverde Amaya desempeñó en el campo de la inteligencia todos los oficios imaginables, desde el relato histórico hasta la crítica literaria, pasando por la poesía, la biografía, el teatro, el cuento y el periodismo.

  14. Knowledge and Acceptability of Human Papillomavirus Vaccination among Women Attending the Gynaecological Outpatient Clinics of a University Teaching Hospital in Lagos, Nigeria.

    Science.gov (United States)

    Okunade, Kehinde S; Sunmonu, Oyebola; Osanyin, Gbemisola E; Oluwole, Ayodeji A

    2017-01-01

    This study was aimed at determining the knowledge and acceptability of HPV vaccine among women attending the gynaecology clinics of the Lagos University Teaching Hospital (LUTH). This was a descriptive cross-sectional study involving 148 consecutively selected women attending the gynaecology clinic of LUTH. Relevant information was obtained from these women using an interviewer-administered questionnaire. The data was analysed and then presented by simple descriptive statistics using tables and charts. Chi-square statistics were used to test the association between the sociodemographical variables and acceptance of HPV vaccination. All significance values were reported at P < 0.05. The mean age of the respondents was 35.7 ± 9.7 years. The study showed that 36.5% of the respondents had heard about HPV infection while only 18.9% had knowledge about the existence of HPV vaccines. Overall, 81.8% of the respondents accepted that the vaccines could be administered to their teenage girls with the level of education of the mothers being the major determinant of their acceptability ( P = 0.013). Awareness of HPV infections and existence of HPV vaccines is low. However, the acceptance of HPV vaccines is generally high. Efforts should be made to increase the awareness about cervical cancer, its aetiologies, and prevention via HPV vaccination.

  15. Teaching Translational Research to Medical Students: The New York University School of Medicine's Master's of Science in Clinical Investigation Dual‐Degree Program

    Science.gov (United States)

    Pillinger, Michael; Plottel, Claudia S.; Galeano, Claudia; Maddalo, Scott; Hochman, Judith S.; Cronstein, Bruce N.; Gold‐von Simson, Gabrielle

    2015-01-01

    Abstract To develop the next generation of translational investigators, New York University School of Medicine (NYUSOM) and the NYU‐NYC Health and Hospitals Corporation Clinical and Translational Science Institute (NYU‐HHC CTSI) developed the Master's of Science in Clinical Investigation dual‐degree (MD/MSCI) program. This 5‐year program dedicates 1 year to coursework and biomedical research, followed by a medical school/research overlap year, to prepare students for academic research careers. This paper details the MD/MSCI program's curriculum and approach to mentorship, describes the research/professional interests of students, and reports student productivity. In the first 4 years of the program (2010–2014) 20 students were matriculated; 7 (35%) were women, and 12 (60%) research projects were in surgical specialties. To date, 14 students have applied to residency, and half pursued surgical residency programs. Our students have produced 68 accepted abstracts, 15 abstracts in submission, 38 accepted papers, and 24 papers in submission. Despite the time‐limited nature of this program, additional training in research design and implementation has promoted a high level of productivity. We conclude that dual‐degree training in medicine and translational research is feasible for medical students and allows for meaningful participation in valuable projects. Follow‐up is warranted to evaluate the academic trajectory of these students. PMID:26365704

  16. Teaching Translational Research to Medical Students: The New York University School of Medicine's Master's of Science in Clinical Investigation Dual-Degree Program.

    Science.gov (United States)

    Gillman, Jennifer; Pillinger, Michael; Plottel, Claudia S; Galeano, Claudia; Maddalo, Scott; Hochman, Judith S; Cronstein, Bruce N; Gold-von Simson, Gabrielle

    2015-12-01

    To develop the next generation of translational investigators, New York University School of Medicine (NYUSOM) and the NYU-NYC Health and Hospitals Corporation Clinical and Translational Science Institute (NYU-HHC CTSI) developed the Master's of Science in Clinical Investigation dual-degree (MD/MSCI) program. This 5-year program dedicates 1 year to coursework and biomedical research, followed by a medical school/research overlap year, to prepare students for academic research careers. This paper details the MD/MSCI program's curriculum and approach to mentorship, describes the research/professional interests of students, and reports student productivity. In the first 4 years of the program (2010-2014) 20 students were matriculated; 7 (35%) were women, and 12 (60%) research projects were in surgical specialties. To date, 14 students have applied to residency, and half pursued surgical residency programs. Our students have produced 68 accepted abstracts, 15 abstracts in submission, 38 accepted papers, and 24 papers in submission. Despite the time-limited nature of this program, additional training in research design and implementation has promoted a high level of productivity. We conclude that dual-degree training in medicine and translational research is feasible for medical students and allows for meaningful participation in valuable projects. Follow-up is warranted to evaluate the academic trajectory of these students. © 2015 Wiley Periodicals, Inc.

  17. Radiological appearance from 250 patients of the Clinic and Policlinic for Radiology at the University of Munich with histologically detected bronchial carcinoma

    International Nuclear Information System (INIS)

    Bruckmayer, G.

    1982-01-01

    From 250 patients of the Clinic and Policlinic for Radiology at the University of Munich from 1975 to 1979 the radiomorphology of the central and peripheral bronchial carcinoma is demonstrated. The sex ratio of 6.3/1, the age distribution with its peak between 60 and 70 years of age and the localisations with a predominance in the right lung and a preferred infection of the upper lobes from our study agreed with the results from the literature. Characteristic early symptoms are missing with bronchial carcinoma, although clinical symptoms in the rule are the first evidence. For early recognition the first and easiest diagnostic procedure is the radiological examination of the thorax in two planes. Circular foci and peripheral tumor shadows, which occur with the spreading of the mediastinum or the hilus, in these patients about 50%, are in large amounts suspicious of a malignancy and indicate an advanced stage. Because the prognosis of the bronchial carcinoma depends on the histological structure of the tumor and on the point in time of diagnosis, an improvement of the life expectancy can only be reached by early detection. In the risk group of smokers over 40 years of age and of professionally exposed people, even minor changes should be considered as carcinoma until the opposite can be proven. (orig./TRV) [de

  18. The Italian version of the Mayo-Portland Adaptability Inventory-4. A new measure of brain injury outcome.

    Science.gov (United States)

    Cattelani, R; Corsini, D; Posteraro, L; Agosti, M; Saccavini, M

    2009-12-01

    The assessment of major obstacles to community integration which may result from an acquired brain injury (ABI) is needed for rational planning and effective management of ABI patients' social adjustment. Currently, such a generally acceptable measure is not available for the Italian population. This paper reports the translation process, the internal consistency, and the inter-rater reliability data for the Italian version of the Mayo-Portland Adaptability Inventory-4 (MPAI-4), a useful measure with highly developed and well documented psychometric properties. The MPAI-4 is specifically designed to assess socially relevant aspects of physical status and cognitive-behavioural competence following ABI. It is a 29-item inventory which is divided into three subdomains (Abilities, Adjustment, and Participation indices) covering a reasonably representative range Twenty ABI patients with at least one-year discharge from the rehabilitation facilities were submitted to the Italian MPAI-4. They were independently rated by two different rehabilitation professionals and a family member/significant other serving as informant (SO). Internal consistency was assessed by calculating the Cronbach's alpha values. Inter-rater agreement for individual items was statistically examined by determining the interclass correlation coefficient (ICC). In addition to the 8% of perfectly correspondent sentences, a clear prevalence (75.5%) of minor semantic variations and formal variations with no semantic value at the sentence-to-sentence matching was found. Full-scale Cronbach's alpha was 0.951 and 0.947 for the two professionals (rater #1 and rater #2, respectively), and was 0.957 for the family member serving as informant (rater #3). Full-Scale ICC (2.1) between professionals and SOs was 0.804 (CI=95%; lower-upper bound=0.688-0.901). The Italian MPAI-4 shares many psychometric features with the original English version, demonstrates both good internal consistency and good inter

  19. Evolución y letalidad por endocarditis infecciosa en pacientes atendidos en el Hospital Nacional Dos de Mayo

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    Evelyn Sánchez

    2006-06-01

    Full Text Available Objetivo: Evaluar la evolución y letalidad de los pacientes portadores de endocarditis infecciosa, así como la presencia de complicaciones y la influencia de estas sobre la mortalidad. Diseño: Estudio longitudinal no concurrente. Lugar: Servicio de cardiología del Hospital 2 de Mayo, hospital universitario. Pacientes: Pacientes con diagnóstico de endocarditis infecciosa. Intervenciones: Se revisó las historias clínicas de los pacientes con diagnóstico de endocarditis infecciosa atendidos entre junio de 1999 y junio de 2005. Se evaluó los criterios clínicos, de laboratorio y ecocardiográficos (criterios de Duke empleados en el diagnóstico. Para el análisis estadístico, se realizó el análisis descriptivo y comparativo con el empleo de las pruebas de Fisher y t de Student y la comparación de las curvas de Kaplan Meier, para evaluar la supervivencia a través de la prueba de rango logarítmico. Principales medidas de resultados: Evaluación de supervivencia: Complicaciones y mortalidad en pacientes en endocarditis infecciosa. Resultados: Se estudió 75 pacientes, la edad promedio fue 42,1±20,4 años, 66,7% del sexo masculino. El 93,3% tenía cardiopatía de base. La presentación clínica incluyó insuficiencia cardiaca congestiva (73,3%, encefalopatía (17,3% y fenómenos embólicos (50,6%. Se evaluó la evolución de los parámetros de laboratorio, evidenciándose deterioro de la función renal. El ecocardiograma evidenció presencia de vegetaciones en 97,3% y complicaciones, como rotura valvar (8%, abscesos valvares (4%. Durante la evolución, se sometió a cirugía a 14,7%. La letalidad general fue 14,7%, la cual estuvo influenciada por el número de complicaciones, en particular las complicaciones sépticas y renales, que impactaron de igual manera en la probabilidad de supervivencia de estos pacientes. Conclusiones: Se registró una letalidad general de 14,7%. La probabilidad de supervivencia se vio afectada

  20. Putting Research Findings into Clinical Practice; Feasibility of integrated evidence-based care pathways in otorhinolaryngology head and neck surgery at Sultan Qaboos University Hospital, Oman

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    Deepa Bhargava

    2012-05-01

    Full Text Available Objectives: A perception exists that clinicians in Oman are reluctant to adopt evidence-based practice (EBP. This pilot study was undertaken to study the feasibility of using EBP pathways at the point of care in otorhinolaryngology head and neck surgery. The ultimate aim was to facilitate EBP with the probability of developing a new system for implementing research findings/translational research at the clinical point of care. Methods: A cross-sectional prospective questionnaire pilot survey of clinicians at Sultan Qaboos University Hospital (SQUH, Oman, a tertiary care medical centre, was undertaken. Respondents included 135 physicians and surgeons with between 3 months and 25 years of clinical experience and included personnel ranging from interns to senior consultants, in areas ranging from primary care to specialist care. Results: Of those polled, 90% (95% confidence interval (CI 85–95% either strongly agreed or agreed that evidence-based practice protocols (EBPP could help in decision making. A total of 87.4% of participants (95% CI 81.8–93% either strongly agreed or agreed that EBPPs can improve clinical outcomes; 91.8% of participants (95% CI 87.2–96.4% would use and apply EBPP in day-to-day care if they were available at the point of care and embedded in the hospital information system. Conclusions: The perception that clinicians at SQUH are reluctant to adopt EBP is incorrect. The introduction of EBP pathways is very feasible at the primary care level. Institutional support for embedding EBP in hospital information systems is needed as well as further outcome research to assess the improvement in quality of care.

  1. Incidencia de anemia ferropénica y factores asociados en las gestantes del distrito de Rapayan, Ancash, Perú: Periodo mayo 2010 - marzo 2011

    OpenAIRE

    Vite Gutiérrez, Flor Yessenia

    2011-01-01

    Objetivo: Conocer la incidencia de anemia ferropénica y factores asociados en la gestación en el distrito de Rapayan, Ancash, Perú. Material y método: estudio prospectivo, analítico y longitudinal en 39 gestantes del distrito de Rapayán, provincia de Huari, departamento de Ancash, Perú durante el periodo comprendido entre mayo 2010 y marzo del 2011. Se procedió a tomar muestras de sangre del total de la muestra n= 39 gestantes, durante los tres trimestres con el fin de controlar los niveles d...

  2. Seroprevalence of human papillomavirus immunoglobulin G antibodies among women presenting at the reproductive health clinic of a university teaching hospital in Nigeria

    Directory of Open Access Journals (Sweden)

    Aminu M

    2014-05-01

    Full Text Available M Aminu,1 JZ Gwafan,1 HI Inabo,1 AO Oguntayo,2 EE Ella,1 AK Koledade21Department of Microbiology, Faculty of Science, Ahmadu Bello University, 2Department of Obstetrics and Gynaecology, Ahmadu Bello University Teaching Hospital, Zaria, NigeriaBackground: Human papillomavirus (HPV is the cause of 90%–95% of squamous cell cancers. Persistent infection with high-risk HPV can lead to development of precancerous lesions of the cervix in 5%–10% of infected women, and can progress to invasive cervical cancer 15–20 years later. This study was conducted to determine the seroprevalence of HPV immunoglobulin G (IgG antibodies among women of reproductive age attending a reproductive health clinic at Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.Methods: The study was descriptive, cross-sectional, and experimental, combining the use of a structured questionnaire and analysis of serum samples obtained from 350 consecutive consenting women. The serum samples were analyzed for IgG antibodies to HPV by enzyme-linked immunosorbent assay.Results: We found a seroprevalence of 42.9% (150/350 for IgG antibodies to HPV in these women. Women aged 45–49 years and those who had their sexual debut aged 20–23 years had the highest HPV seroprevalence, ie, 50% (57/114 and 51.1% (46/90, respectively. Presence of antibodies varied according to sociodemographic factors, but was significantly associated with educational status, tribe, and religion (P<0.05. Human papillomavirus infection was not significantly associated with the reproductive characteristics and sexual behavior of the women. Antibodies to HPV were detected in 50.0% (9/18 of women with a family history of cervical cancer and in 30.8% (4/13 of those with a history or signs of WHIM (warts, hypogammaglobulinemia, immunodeficiency, myelokathexis syndrome as a genetic disorder (P>0.05.Conclusion: Further studies are needed to determine the HPV serotypes and evaluate the risk of natural development

  3. Palatine Tonsils Asymmetry: 10 Years Experience of the Otorhinolaryngology Service of the Clinical Hospital of the Federal University of Paraná

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    Ballin, Annelyse Cristine

    2011-01-01

    Full Text Available Introduction: A few patients with asymmetric palatine tonsils have lymphoma; but most lymphomas in palatine tonsils evolve with tonsillar asymmetry. Objective: To report the profile of patients and histopathological changes in patients submitted to adenotonsillectomy/tonsillectomy with disproportional palatine tonsils. Method: Retrospective study based on data analysis from the Pathologic Anatomy Service Database and in the review of reports of patients submitted to adenotonsillectomy and tonsillectomy with palatine tonsils asymmetry during the period from October 1999 through October 2009 at the Clinical Hospital (HC of the Federal University of Paraná (UFPR. Results: 50 patients took part, aged between 3 to 53 years old, mean age of 14.05 years. The anatomopathological exam confirmed 48 patients (96% with lymphoid hyperplasia and 2 cases of lymphoma (4%. These included men aged from 40 to 53 yeas with complaint of unilateral increase of the tonsil, one of whom had other symptoms (asthenia and weight loss. Upon physical examination: tonsils disproportion without involvement of other organs or lymph nodes. Conclusion: Our study is according to the literature as regards the fact the lymphomas are more common in men, the patient is the first one to notice the increase in volume and the asymmetry is larger than 2 degrees between palatine tonsils in cases of lymphoma. Although it is rare, even in the presence of differences, there are chances for the asymmetry to evolve to a malignant profile. The need for anatomopathological evaluation of a part must be considered along with other clinical data that suggests a malignant profile.

  4. Diagnosis and Incidence of Spondylosis and Cervical Disc Disorders in the University Clinical Hospital in Olsztyn, in Years 2011–2015

    Science.gov (United States)

    Włodarczyk, Andrzej; Wojtkiewicz, Joanna

    2018-01-01

    Background Disorders connected with the musculoskeletal and central nervous system dysfunction are the most significant clinical problem worldwide. Our earlier research has shown that back and spinal disorders and lumbar disc disorders were most frequently diagnosed using MRI scanner at the University Clinical Hospital (UCH) in Olsztyn in years 2011–2015. We have also observed that another two diseases of spinal column, spondylosis and cervical disc disorders, were also very prevalent. The main objective of this work was to analyze the prevalence of spondylosis and cervical disc disorders in the study population diagnosed at UCH in years 2011–2015. Methods The digital database including patients' diagnostic and demographic information was generated based on MRI reports from years 2011–2015 and analyzed using SPSS software. Results Within the study group (n = 13298) the most frequently MRI-diagnosed diseases were musculoskeletal group (M00–M99; n = 7711; 57,98%) and cervical disc disorders (M50; n = 1659; 12,47%) and spondylosis (M47, n = 611; 4,59%). More women (67%) than men (33%) were enrolled in the study, and the largest fraction of the study population was in the range of 51–60 years, with about 1/3 of cases of both diseases diagnosed in early age range of 31–40 years. Conclusion Significant number of patients presenting with either of the spine disorders at the young age of 31–40 years points to the necessity of introducing methods preventing disorders of the vertebral column at younger age, preferably at school age. PMID:29770333

  5. Diagnosis and Incidence of Spondylosis and Cervical Disc Disorders in the University Clinical Hospital in Olsztyn, in Years 2011–2015

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    Małgorzata Kolenkiewicz

    2018-01-01

    Full Text Available Background. Disorders connected with the musculoskeletal and central nervous system dysfunction are the most significant clinical problem worldwide. Our earlier research has shown that back and spinal disorders and lumbar disc disorders were most frequently diagnosed using MRI scanner at the University Clinical Hospital (UCH in Olsztyn in years 2011–2015. We have also observed that another two diseases of spinal column, spondylosis and cervical disc disorders, were also very prevalent. The main objective of this work was to analyze the prevalence of spondylosis and cervical disc disorders in the study population diagnosed at UCH in years 2011–2015. Methods. The digital database including patients’ diagnostic and demographic information was generated based on MRI reports from years 2011–2015 and analyzed using SPSS software. Results. Within the study group (n=13298 the most frequently MRI-diagnosed diseases were musculoskeletal group (M00–M99; n=7711; 57,98% and cervical disc disorders (M50; n=1659; 12,47% and spondylosis (M47, n=611; 4,59%. More women (67% than men (33% were enrolled in the study, and the largest fraction of the study population was in the range of 51–60 years, with about 1/3 of cases of both diseases diagnosed in early age range of 31–40 years. Conclusion. Significant number of patients presenting with either of the spine disorders at the young age of 31–40 years points to the necessity of introducing methods preventing disorders of the vertebral column at younger age, preferably at school age.

  6. The profile of Cerebrovascular Accident patients assisted at the Physical Therapy Neurological Clinic of the University of Passo Fundo - doi:10.5020/18061230.2007.p22

    Directory of Open Access Journals (Sweden)

    Daiane Mazzola

    2012-01-01

    Full Text Available The Cerebrovascular accident (CVA results from the blood restriction to the brain, leading to the quick development of clinical signs of local or global cerebral function disturbances and its symptoms remain for a period longer than 24 hour or lead to the death. The aim of this study was to set a profile of the patients diagnosed with CVA, who had been assisted at the Physical Therapy Neurological Clinic of Passo Fundo University, from March-2005 to March-2006. This was a quantitative, descriptive and retrospective documental study with data collecting on 43 medical records, in which the following variables were studied: the patient’s gender, race, age group and origin, illness occurrence, type of CVA, functional diagnosis, risk factors, secondary complications, and the situation of the assistance. The outcomes showed that 31 (72.09% patients were males, 39 (90.7% were whites and the predominant age group was 50 to 59 years old. As for the type of CVA, 37 (86.1% of the cases were ischemic. As risk factors, the systemic arterial hypertension and the cardiac disease were the most frequent with 34 (79% and 06 (13.9% subjects, respectively. Most of the patients (n= 24; 55.8% didn’t present secondary associated complications and depression was the predominant factor found in the others (n= 9; 20.9%. From the results, it is concluded that the patients’ profile in the studied sample consists of male whites, in the age group of 50-59 years with ischemic cerebrovascular lesions.

  7. Cross-infection and infection control in dentistry: Knowledge, attitude and practice of patients attended dental clinics in King Abdulaziz University Hospital, Jeddah, Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Nahla K. Ibrahim

    2017-07-01

    Full Text Available The objective of the study was to determine the level of Knowledge, Attitude and Practice (KAP of patients attended dental clinics at King Abdulaziz University Hospital (KAUH regarding cross infections and infection control in dentistry. A cross-sectional study was conducted among 225 patients who attended the dental clinics of KAUH, Jeddah, Saudi Arabia, 2014. A standardized, confidential, anonymous, interviewing questionnaire was used. Knowledge about dental infections was assessed by 12 MCQs. The attitudes were assessed through answering seven statements on a three- point Likert scale. Patients’ self reported practices were also evaluated. Descriptive and inferential statistics were done.Results of the study revealed that 39.5%, 38.7% and 21.8% of the participants obtained poor, fair and satisfactory level of knowledge about infections and infection control in dentistry, respectively. Social media was the commonest source of information about dental infection. Participant's educational level was significantly associated with the level of knowledge about dental infection. Patients had positive attitudes towards infection control in dentistry. Regarding self-reported practice, only few participants would ask dentists about sterilization of dental instruments (9.3%, wearing face mask (13.3% and gloves (16.4% if they don’t do so. In conclusion, our participants had good attitudes towards infection control in dentistry. However, their knowledge and practice need improvements. Conduction of educational programs is needed through social media, mass media, schools and public places. These programs involve both patients and providers. Keywords: Patient safety, Cross infection, Dental infection, Infection control, Emerging diseases, KAP

  8. Initiation of universal tumor screening for Lynch syndrome in colorectal cancer patients as a model for the implementation of genetic information into clinical oncology practice.

    Science.gov (United States)

    Cohen, Stacey A; Laurino, Mercy; Bowen, Deborah J; Upton, Melissa P; Pritchard, Colin; Hisama, Fuki; Jarvik, Gail; Fichera, Alessandro; Sjoding, Britta; Bennett, Robin L; Naylor, Lorraine; Jacobson, Angela; Burke, Wylie; Grady, William M

    2016-02-01

    Lynch syndrome confers a hereditary predisposition to colorectal and other cancers. Universal tumor screening (UTS) for Lynch syndrome is recommended by several professional societies, but the implementation can be complex. This article describes the evaluation, process development, and initiation of Lynch syndrome UTS at a tertiary referral cancer center. A multidisciplinary team developed the new process design. Issues in 5 themes were noted: timing, funding, second-opinion patients, result processing, and the role of genetics providers. A committee approach was used to examine each issue for process-improvement development. The issues related to testing were addressed individually for the successful implementation of UTS at the institutional level. In the conventional-care period, 9 of 30 cases (30%) received Lynch syndrome screening, and 4 cases were referred to medical genetics. During the 6 months following the implementation of UTS, 32 of 44 patients (73%) received Lynch syndrome screening. The 13 unscreened patients all had identified reasons for nonscreening (eg, financial limitations). Ten patients were referred to medical genetics, which identified no new cases of Lynch syndrome, but a low-risk adenomatous polyposis coli (APC) variant was detected in 1 individual. The implementation of effective Lynch syndrome UTS can feasibly alter practice at the institutional level. This experience with the assessment and management of issues relevant to the successful implementation of a new clinical care paradigm based on emerging technology has implications for the uptake of advances across molecular oncology into clinical practice, and this is highly relevant in the current era of rapidly evolving genomic technology. © 2015 American Cancer Society.

  9. Calreticulin mutation analysis in non-mutated Janus kinase 2 essential thrombocythemia patients in Chiang Mai University: analysis of three methods and clinical correlations.

    Science.gov (United States)

    Rattarittamrong, Ekarat; Tantiworawit, Adisak; Kumpunya, Noppamas; Wongtagan, Ornkamon; Tongphung, Ratchanoo; Phusua, Arunee; Chai-Adisaksopha, Chatree; Hantrakool, Sasinee; Rattanathammethee, Thanawat; Norasetthada, Lalita; Charoenkwan, Pimlak; Lekawanvijit, Suree

    2018-03-09

    The primary objective was to determine the prevalence of calreticulin (CALR) mutation in patients with non-JAK2V617F mutated essential thrombocythemia (ET). The secondary objectives were to evaluate the accuracy of CALR mutation analysis by high-resolution melting (HRM) analysis and real-time polymerase chain reaction (PCR) compared with DNA sequencing and to compare clinical characteristics of CALR mutated and JAK2V617F mutated ET. This was a prospective cohort study involving ET patients registered at Chiang Mai University in the period September 2015-September 2017 who were aged more than 2 years, and did not harbor JAK2V617F mutation. The presence of CALR mutation was established by DNA sequencing, HRM, and real-time PCR for type 1 and type 2 mutation. Clinical data were compared with that from ET patients with mutated JAK2V617F. Twenty-eight patients were enrolled onto the study. CALR mutations were found in 10 patients (35.7%). Three patients had type 1 mutation, 5 patients had type 2 mutation, 1 patient had type 18 mutation, and 1 patients had novel mutations (c.1093 C-G, c.1098_1131 del, c.1135 G-A). HRM could differentiate between the types of mutation in complete agreement with DNA sequencing. Patients with a CALR mutation showed a significantly greater male predominance and had a higher platelet count when compared with 42 JAK2V617F patients. The prevalence of CALR mutation in JAK2V617F-negative ET in this study is 35.7%. HRM is an effective method of detecting CALR mutation and is a more advantageous method of screening for CALR mutation.

  10. [Cost-effectiveness of the clinical treatment of Grave's disease in a public University Hospital: a retrospective analysis and prospective projection for a therapeutic approach].

    Science.gov (United States)

    Lima, Nicolau; Knobel, Meyer; Camargo, Rosalinda Y; Tomimori, Eduardo; Medeiros-Neto, Geraldo

    2005-08-01

    The aim of the present study was to evaluate a new proposal for increasing compliance to the clinical management of patients with Graves' disease (GD) in a large and public University Hospital. The patients were carefully selected (no previous GD treatment, goiter volume less than 6 mL must be living in the metro area of São Paulo), received medication at no cost, were contacted frequently by the social worker and alerted for the date of consultation and only referred to a single endocrinologist during all phases of treatment. We recruited 229 patients with GD that were initially treated with methimazole (MMI--60 mg q.d) in a single daily dose followed by a combination of MMI (20 mg) plus L-T4 (100 microg) daily for 24 months. Only 83 patients (36.2%) completed the protocol and were subdivided in: Group 1 (n= 34) that were in remission for 3 years after discontinuation of the MMI and Group 2 (n= 49) that presented recurrence of GD between 2 and 36 months without MMI. Predictive factors associated with remission were: decrease of the glandular volume, serum TG< 40 ng/mL and normal TRAb values. We concluded that in spite of a careful protocol planned to increase compliance, more than 60% of patients with GD did not complete the therapeutic trial and were referred for radioiodine treatment. The solution for this low therapeutic success for GD should be the possible identification of factors that would indicate patients that are not inclined to follow a long period of clinical therapy.

  11. Clinical and academic use of electronic and print books: the Health Sciences Library System e-book study at the University of Pittsburgh.

    Science.gov (United States)

    Folb, Barbara L; Wessel, Charles B; Czechowski, Leslie J

    2011-07-01

    The purpose of the Health Sciences Library System (HSLS) electronic book (e-book) study was to assess use, and factors affecting use, of e-books by all patron groups of an academic health sciences library serving both university and health system-affiliated patrons. A web-based survey was distributed to a random sample (n=5,292) of holders of library remote access passwords. A total of 871 completed and 108 partially completed surveys were received, for an approximate response rate of 16.5%-18.5%, with all user groups represented. Descriptive and chi-square analysis was done using SPSS 17. Library e-books were used by 55.4% of respondents. Use by role varied: 21.3% of faculty reported having assigned all or part of an e-book for class readings, while 86% of interns, residents, and fellows reported using an e-book to support clinical care. Respondents preferred print for textbooks and manuals and electronic format for research protocols, pharmaceutical, and reference books, but indicated high flexibility about format choice. They rated printing and saving e-book content as more important than annotation, highlighting, and bookmarking features. Respondents' willingness to use alternate formats, if convenient, suggests that libraries can selectively reduce title duplication between print and e-books and still support library user information needs, especially if publishers provide features that users want. Marketing and user education may increase use of e-book collections.

  12. [Impact of driving cessation on daily transportation utility in elderly people with cognitive decline: a survey of patients in the memory clinic of an urban university hospital].

    Science.gov (United States)

    Kawano, Naoko; Makino, Taeko; Suzuki, Yusuke; Umegaki, Hiroyuki

    2009-09-01

    In the present study our goal was to explore the impact of driving cessation on daily transportation utility in older people with cognitive decline. A total of 101 older persons participated in our survey of responding of a questionnaire about driving and other methods for traveling, administered at the memory clinic of the geriatric outpatient unit of Nagoya University Hospital. Of this total, 48 (47.5%) still had driving licenses, 16 (15.8%) had licenses that had expired, and 37 (36.6%) had no driving experience. The majority of license holders (77.1%) were active drivers, and we found that license holders tend to utilize public transport loss than older people without driving experience. Furthermore, among those who had ceased driving, there was a contrast in daily transportation utility between those with dementia and those without dementia, with the former accessing public transport less frequently. When clinicians advise drivers with dementia to cease driving, these patients need special attention to assist them in providing alternative ways of transportation.

  13. The relationship between dental caries and body mass index and food habits in children referred to dentistry clinic of Tabriz university of medical sciences

    Directory of Open Access Journals (Sweden)

    javad Mohtadinia

    2011-03-01

    Full Text Available Regarding to the importance of food habits and the probable role of obesity in dental caries, this study was done to assess the relationship between teeth decay index in children and body mass index, and food habits in dentistry clinic of Tabriz university of medical sciences. Materials and Methods: In this cross-sectional analytic study 202 children aged 3-12 years old were selected randomly. For assessing dental caries, decayed, missed, and filled teeth index and for evaluating food habits, semi quantitative food frequency questionnaire were used. Data were analyzed using Correlation test and Regression analysis. Results: The overall mean of decayed, missed, and filled teeth index in the children of this study was 7.61±3.80. There were significant reverse correlations between this index and age (r = -0.176, and fruit consumption (r = -0.155 (P0.05. Considering the last regression model, age, mother job, and frequency of nuts consumption were significant predictors for decayed teeth number. Conclusion: The results of this study indicated that high fruit consumption was associated with less dental caries and among foods which were evaluated, consumption of nuts was significant predictor for decayed teeth number.

  14. [The impact of UV radiation B and C in vitro on different of bacteria strains isolated from patients hospitalized in the Warsaw Medical University Clinics].

    Science.gov (United States)

    Rongies, Witold; Wultańska, Dorota; Kot, Katarzyna; Bogusz, Aleksandra; Rongies, Magdalena; Świercz, Paweł; Swierszcz, Paweł; Lewandowska, Monika; Cholewińska, Grazyna; Meisel-Mikołajczyk, Felicja

    2011-01-01

    Infections in human body caused by various microbes are a significant problem in modern medicine. Special attention is put to infections of wounds, which are a significant threat to the life of patients. Attempts to treat these wounds base mainly on the application of various chemical preparations (locally) and systematic antibiotic treatment. UV radiation, because of its anti-bacterial activity, appear a complementary issue in therapy. AIM OF THE SURVEY: The aim of this study was an examination of the sensitivity of bacteria strains isolated from patients hospitalised in the Warsaw Medical University clinics, and prove that antibiotics and operation of UV B and C radiation with Endolamp 474 may become a complementary or alternative method of treatment. The study used 65 strains grown aerobically (15 strains of Escherichia coli, 20 strains of Pseudomonas aeruginosa, 15 strains of Staphylococcus aureus, 15 strains of Streptococcus and Enterococcus sp). The same strains were planted on different excipients and were subjected to UV radiation using Endolamp 474. Correctly prepared strains were radiated from a 25 cm distance in various durations (from 5 seconds to 105 seconds). As a result of UV irradiation of microorganisms studied B and C using 474 Endolampy received varied, but the great sensitivity to the effects of this radiation, in all tested bacterial strains. UV radiation on microorganisms requires further study, also in vivo.

  15. [Obstetric emergency and non-emergency transfers to the university teaching hospital Yalgado ouedraogo of Ouagadougou: A 3-year study of their epidemiologic, clinical, and prognostic aspects].

    Science.gov (United States)

    Ouattara, A; Ouedraogo, C M; Ouedraogo, A; Lankoande, J

    2015-01-01

    to describe the epidemiologic, clinical, and prognostic aspects of the emergency and non-emergency transfers of obstetric patients to Yalgado Ouédraogo University Hospital Center (UHC-YO) in Ouagadougou. this retrospective descriptive study looked at the outcomes of women transferred, on an emergency basis or not, to the obstetrics department of the UHC-YO. The study population comprised all women transferred to the department during 2010, 2011, and 2012. during the study period, there were 9,806 admissions for obstetric disorders: 43% were transfers. The patients' mean age was 26.11 years [(13-49]. Women transferred from health care facilities within the city of Ouagadougou accounted for 96% of the sample. The leading reason for these transfers - emergency or not - was preeclampsia and eclampsia (24.57%). We recorded a total of 161 maternal deaths, for a mortality rate of 3.9%. Approximately 26.55% of the newborns received immediate intensive care and were then transferred to the neonatology department. maternal and neonatal prognosis is always poor in cases transferred to UHC-YO, despite increased funding for emergency obstetric and neonatal care. Increased population awareness of the importance of prenatal consultation and adequate funding for health care facilities to provide equipment for emergency transfers and staff training in the management of obstetric and neonatal emergencies would probably improve these mortality and morbidity rates.

  16. Pediatric liver transplantation using left hepatic segments from living related donors: surgical experience in 100 recipients at Saint-Luc University Clinics.

    Science.gov (United States)

    Darwish, Ahmed A; Bourdeaux, Christophe; Kader, Hesham A; Janssen, Magda; Sokal, Etienne; Lerut, Jan; Ciccarelli, Olga; Veyckemans, Francis; Otte, Jean-Bernard; de Goyet, Jean de Ville; Reding, Raymond

    2006-05-01

    Living-related liver transplantation was developed in the context of deceased donor organ shortage, which is particularly acute for pediatric recipients. This retrospective study analyzes the surgical technique and complications in the first 100 pediatric liver transplantation using left segmental liver grafts from living donors, performed at Saint-Luc University Clinics between July 1993 and April 2002. Pre-operative evaluation in donors and recipients, analysis of the surgical technique, and postoperative complications were reviewed. After a median follow-up period of 2526 days, no donor mortality was encountered, with a minimal morbidity and no long-term sequelae. At one and five yr post-transplantation, the actuarial patient survival rates were 94% and 92%, the corresponding figures being 92% and 89% for graft survival. The incidences of portal vein and hepatic artery thromboses, and of biliary complications were 14%, 1%, and 27%, respectively. Living-related liver transplantation in children constitutes an efficient therapy for liver failure to face the increased demand for liver grafts. Donor morbidity was kept to acceptable incidence, and surgical technique in the recipient needs to be tailored to minimize postoperative complications.

  17. Use of international foundations of medicine clinical sciences examination to evaluate students' performance in the local examination at the University of Sharjah, United Arab Emirates.

    Science.gov (United States)

    Dash, Nihar Ranjan; Abdalla, Mohamed Elhassan; Hussein, Amal

    2017-01-01

    Several medical schools around the world are moving away from isolated, locally developed in-house assessments to the introduction of external examinations into their curriculum. Although the objective varies, it is typically done to evaluate, audit, and compare students' performance to international standards. Similarly, the International Foundations of Medicine-Clinical Sciences Examination (IFOM-CSE) was introduced in the College of Medicine at the University of Sharjah as an external assessment criterion in addition to the existing in-house assessments. The aim of this study was to compare the student performance in this newly introduced IFOM-CSE examination and the existing in-house final examination in the college. The scores of three consecutive final-year undergraduate medical student batches (2013-2015) who took both the IFOM-CSE and the existing in-house final examination were analyzed. Pearson correlation and one-way analysis of variance test were conducted using SPSS 22. The students' scores in the IFOM-CSE and in the final examination prepared locally were highly correlated with Pearson correlation coefficients of 0.787 for batch 2013, 0.827 for batch 2014, and 0.830 for batch 2015 (P correlated with their scores in the IFOM-CSE over all the three batches. Thus, introduction of external examination can be an important evaluation tool to a comprehensive internal assessment system providing evidence of external validity.

  18. Sociodemographic and Clinical Characteristics of Persons Presenting with Deliberate Self-harm to the Accident and Emergency Department of the University Hospital of the West Indies

    Directory of Open Access Journals (Sweden)

    M Henry

    2015-03-01

    Full Text Available Objective: The primary objective of this study was to determine the sociodemographic and clinical characteristics of all persons who presented to the Accident and Emergency Department of the University Hospital of the West Indies with a history of deliberate harm over a six-month period. Methods: The dockets of patients presenting with deliberate self-harm were collected and reviewed for the information. A questionnaire was designed to extract the information. Data were analysed using SPSS version 17 and RXC programme. Results: Of the total number of dockets reviewed (n = 61, 78% of patients were below age 40 years, with a mean age of 28 years. Sixty-four per cent were female, 82% were single, 83% lived with someone, 80% had a secondary school level of education and 72% were unemployed. Overdose of medications was the main method of harm. Seventy-five per cent of patients did not use illicit substances. There was a significant association found between reason for self-harm and psychiatric illness (p < 0.001. Conclusion: Given these preliminary results, it would be useful to conduct a wider, island-wide study to determine the extent of self-harming behaviour in Jamaica so that appropriate interventions can be implemented to reduce this problem.

  19. Prevalence and clinical impact of sensitization to latex and fruits in dentistry students at the University of Antioquia, and its relationship with allergy to fruits

    Directory of Open Access Journals (Sweden)

    Echenique Manrique, Alejandro

    2015-04-01

    Full Text Available Objective: To determine the prevalence and clinical impact of sensitization to latex and to five tropical fruits (banana, avocado, kiwi, pineapple and passion fruit in dentistry students. Methods: Analytical cross-sectional study of 128 dentistry students at University of Antioquia in Medellín, Colombia. Information was collected by means of a questionnaire and skin prick tests with latex and fruits were done. Results: All students reported having had contact with latex. Nine of them informed at least one episode of adverse reaction to contact with latex without proof of sensitization to it. Five reported at least one reaction with one of the fruits, but skin prick tests were negative. Four of the 14 students who reported gastrointestinal symptoms were sensitized to latex or to one of the tested fruits. Overall, latex sensitization rate was 3.1%. Conclusion: This percentage of sensitization to latex is lower than that in other studies; this may be due to the expression of immune mechanisms other than IgE mediation. We failed to demonstrate a higher sensitization rate to latex as students advanced in their career. The association between gastrointestinal symptoms and sensitization to both fruit and latex is to be emphasized.

  20. Development and Clinical Implementation of a Universal Bolus to Maintain Spot Size During Delivery of Base of Skull Pencil Beam Scanning Proton Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Both, Stefan, E-mail: Stefan.Both@uphs.upenn.edu [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Shen, Jiajian [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Department of Radiation Oncology, Mayo Clinic, Phoenix, Arizona (United States); Kirk, Maura; Lin, Liyong; Tang, Shikui; Alonso-Basanta, Michelle; Lustig, Robert; Lin, Haibo; Deville, Curtiland; Hill-Kayser, Christine; Tochner, Zelig; McDonough, James [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States)

    2014-09-01

    Purpose: To report on a universal bolus (UB) designed to replace the range shifter (RS); the UB allows the treatment of shallow tumors while keeping the pencil beam scanning (PBS) spot size small. Methods and Materials: Ten patients with brain cancers treated from 2010 to 2011 were planned using the PBS technique with bolus and the RS. In-air spot sizes of the pencil beam were measured and compared for 4 conditions (open field, with RS, and with UB at 2- and 8-cm air gap) in isocentric geometry. The UB was applied in our clinic to treat brain tumors, and the plans with UB were compared with the plans with RS. Results: A UB of 5.5 cm water equivalent thickness was found to meet the needs of the majority of patients. By using the UB, the PBS spot sizes are similar with the open beam (P>.1). The heterogeneity index was found to be approximately 10% lower for the UB plans than for the RS plans. The coverage for plans with UB is more conformal than for plans with RS; the largest increase in sparing is usually for peripheral organs at risk. Conclusions: The integrity of the physical properties of the PBS beam can be maintained using a UB that allows for highly conformal PBS treatment design, even in a simple geometry of the fixed beam line when noncoplanar beams are used.

  1. The accident of stereotaxic radiosurgery at the University hospital center of Toulouse. Expert report n.2. Dosimetric and clinical evaluation. Risk analysis

    International Nuclear Information System (INIS)

    2008-01-01

    The regional center of stereotaxic radiosurgery (C.R.R.S.) of the University hospital center (C.H.U.) of Toulouse is equipped since april 2006 with a Novalis accelerator (Brainlab) devoted to radiosurgery and intra skull stereotaxic radiotherapy.In april 2007, during an intercomparison of dosimetry files coming from various sites, the Brainlab society detects an anomaly. The analysis made by the society concludes to the use of an unsuited detector for the measurement of a dosimetry parameter during the accelerator initial calibration. Following this error, 145 patients (on 172 patients treated since the center opening) suffer of an overdose whom importance is variable. On the 26. june 2007 the Authority of nuclear safety (Asn) requires an expertise on the following points: checking of the experimental protocols of micro-beams calibration before and after correction of the dysfunction; analysis at the theoretical level of the neurological complications risk at long term for the exposed patients. The second point of this request is the subject of this report. It gives the synthesis of the whole of information, at the clinical and dosimetric level and outlines successively: the expertise methodology; the cohort of patients treated at the C.R.R.S.; the parameters of the risk analysis of neurological complications; the different risk analysis according the pathologies treated at the C.R.R.S.; the recommendations. (N.C.)

  2. Utilization of contraception among sexually active HIV positive women attending art clinic in University of Gondar Hospital: a hospital based cross-sectional study.

    Science.gov (United States)

    Worke, Mulugeta Dile; Bezabih, Lealem Meseret; Woldetasdik, Mulat Adefris

    2016-10-21

    Contraception helps to prevent unplanned pregnancies among human immune virus positive women. The contraceptive utilization status and associated factors were not well addressed in the study area. Therefore, this study aimed to assess utilization of contraceptives and associated factors among human immune virus positive reproductive age group women appearing at anti-retroviral therapy clinic at the University of Gondar Hospital, North West Ethiopia. An institution based cross-sectional study was conducted among 397 systematically selected HIV positive reproductive age women who visited ART unit of the University of Gondar teaching referral hospital from January 8-20, 2014. The data were collected using pre tested and structured questionnaires through face-to-face interviews. The data were entered into Epi-Info version 3.5, and cleaned and analyzed using SPSS version 20. Descriptive summary of the data and logistic regression were used to identify possible predictors using odds ratio with 95 % confidence interval and P-value of 0.05. The study revealed that the overall utilization of any type of contraception was 50 %. Of them, 4.1 % got contraception from anti-retroviral therapy unit. Fear of side effects was the most common (42 %) reason for not using contraception. Women who attended secondary education, married and who had 4-6 children were more likely to use contraception than their counterparts were; (AOR: 5.63; 95 % CI: 1.74-18.21), (AOR: 8.07; 95 % CI: 3.10-20.99) and (AOR: 3.61; 95 % CI: 1.16-11.26) respectively. However, Women between 35-49 years, had no intention to have another child and discordant couples were 83 %, 76 % and 65 % less likely to use contraception respectively than their counterparts. The results of this study revealed that the utilization of contraception was low. Women between 35-49 years, those who had no intention to have another child and whose partner was HIV sero-negative and fear of side effect of the contraception

  3. Informe Ana Libertad Baratti de la Cuadra : Informe de Radio Universidad Nacional de La Plata sobre la recuperación de la nieta número 115, por Abuelas de Plaza de Mayo

    OpenAIRE

    Pigeau, Nora; Barnes de Carlotto, Estela; Lovazzano, Eduardo; Velazco, Luis; Cuadra, Estela de la; Cardoso, Miriam

    2014-01-01

    Informe de Radio Universidad Nacional de La Plata sobre el hallazgo de la nieta número 115, recuperada por Abuelas de Plaza de Mayo: Ana Libertad Baratti de la Cuadra. El 22 de agosto de 2014 la ciudad de La Plata y el país entero celebró el encuentro de la nieta de la co-fundadora y primera presidenta de la Asociación Abuelas de Plaza de Mayo, Alicia “Licha” Zubasnabar de De la Cuadra: apareció Ana Libertad Baratti de la Cuadra. Héctor Carlos Baratti y de Elena de la Cuadra fueron se...

  4. [Breech presentation: mode of delivery and maternal and fetal outcomes at the Ignace Deen Clinic of Gynecology and Obstetrics, Conakry University Hospital].

    Science.gov (United States)

    Sy, T; Diallo, Y; Diallo, A; Soumah, A; Diallo, F B; Hyjazi, Y; Diallo, M S

    2011-01-01

    The authors in a prospective, analytical study of 8 months from January 1st to August 31st performed at the Ignace Deen Clinic of Gynecology and Obstetrics, Conakry University Hospital; assessed the impact of the mode of delivery in breech presentation on maternal and fetal outcome in the African context of Guinea. Breech presentation in mono fetal pregnancy of at least 28 weeks of amenorrhea was the inclusion criterion in this study. Among 1490 deliveries, 144 breech presentations were reviewed, representing a frequency of 9.66%. Half of breech deliveries (49.99%) were premature against only 11.85% in cephalic presentations. The breech was incomplete in 57.64% cases and complete in 42.35%. Caesarean section was performed in 40.97% of cases against 39.54% in cephalic presentation. The indications were often primiparity (30.50%), acute fetal distress (28.81%) and macrosomia (23.72%). Deliveries through the lower route frequently used the maneuver of Bracht (52.50%). 54.16% of the new-born babies had a fetal weight lower than 2500 g at born. Morbid Apgar score at the 1st minute after delivery through the lower route was found in 69.40% of the breech presentation born babies; however, this rate was 32.70% in cephalic presentation (p=0.000). The maternal morbidity concerned essentially perineal lesions (26.53%). The outcome is largely better in case of delivery through the upper route. The caesarean section is an alternative for the improvement of fetal outcome in countries with low resources.

  5. [Prevalence of reactions secundary to mosquito bites Aedes aegypti at en el Regional Center of Allergy and Clinical Immunology, University Hospital, de Monterrey, Nuevo Leon].

    Science.gov (United States)

    González Diaz, Sandra Nora; Cruz, Alfredo Arias; Sedó Mejía, Giovanni A; Rojas Lozano, Antonio A; Valenzuela, Enrique Avitia; Vidaurri Ojeda, Alma C

    2010-01-01

    although systemic reactions resulting from hymenoptera stings have been studied extensively, the prevalence of allergic reactions to mosquitoes is unknown. to investigate the prevalence of allergic reactions to Aedes aegypti bites in patients seeking treatment at the Allergy and Clinical Immunology Regional Center of Jose E Gonzalez University Hospital in Monterrey, Mexico. we carried out a cross-sectional, descriptive study that included patients receiving skin tests for aeroallergens; skin sensitivity to mosquito bites was also tested. A questionnaire was used to obtain information about previous allergic reactions to mosquito bites. a total of 482 patients between 2 and 60 years of age were included; 53% were female, 407 (84.4%) had a history of local reactions to mosquito bites. Twelve patients (2.4%) stated a history of large local reaction; three (0.6%) of them with a positive skin prick test, one (0.2%) of those had systemic reaction history to mosquito. Eighty five (17.6%) patients had a positive mosquito skin test and 307 (63.6%) had a positive skin test for at least one aeroallergen. Seventy-eight (91.7%) of the 85 patients with a positive mosquito skin test had a history of local skin reactions to mosquito bite (odds ratio: 2.303 [confidence interval (CI) 1.037-5.10]. There was no statistically significance association between allergic diseases and mosquito allergy. adverse reactions and allergic reactions to mosquito bites occur frequently. However mosquito allergy is low. Further studies are required to determine the prevalence of mosquito allergy in the general population.

  6. Seroprevalence of human papillomavirus immunoglobulin G antibodies among women presenting at the reproductive health clinic of a university teaching hospital in Nigeria.

    Science.gov (United States)

    Aminu, M; Gwafan, Jz; Inabo, Hi; Oguntayo, Ao; Ella, Ee; Koledade, Ak

    2014-01-01

    Human papillomavirus (HPV) is the cause of 90%-95% of squamous cell cancers. Persistent infection with high-risk HPV can lead to development of precancerous lesions of the cervix in 5%-10% of infected women, and can progress to invasive cervical cancer 15-20 years later. This study was conducted to determine the seroprevalence of HPV immunoglobulin G (IgG) antibodies among women of reproductive age attending a reproductive health clinic at Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. The study was descriptive, cross-sectional, and experimental, combining the use of a structured questionnaire and analysis of serum samples obtained from 350 consecutive consenting women. The serum samples were analyzed for IgG antibodies to HPV by enzyme-linked immunosorbent assay. We found a seroprevalence of 42.9% (150/350) for IgG antibodies to HPV in these women. Women aged 45-49 years and those who had their sexual debut aged 20-23 years had the highest HPV seroprevalence, ie, 50% (57/114) and 51.1% (46/90), respectively. Presence of antibodies varied according to sociodemographic factors, but was significantly associated with educational status, tribe, and religion (Pwomen. Antibodies to HPV were detected in 50.0% (9/18) of women with a family history of cervical cancer and in 30.8% (4/13) of those with a history or signs of WHIM (warts, hypogammaglobulinemia, immunodeficiency, myelokathexis) syndrome as a genetic disorder (P>0.05). Further studies are needed to determine the HPV serotypes and evaluate the risk of natural development of HPV-related malignancies among women in the study area.

  7. Influenza A/H1N1/2009 virus - experience of the clinical microbiology laboratory of the “L. Sacco” University Hospital in Milan

    Directory of Open Access Journals (Sweden)

    Lisa Lucia Chenal

    2011-06-01

    Full Text Available In the spring of 2009, a new variant of influenza A/H1N1 virus that had never been isolated before, was identified. From April 27 to December 31, 2009 the respiratory samples of 974 patients, obtained from suspected cases of pandemic influenza A virus infection, were analyzed at the Clinical Microbiology Laboratory of the “L. Sacco” University Hospital in Milan. The diagnosis of influenza A/H1N1 infection was performed initially through the use of different molecular biological methods: Seeplex® RV12 ACE Detection (Seegene, NUCLISENS® EASYQ® INFLUENZA A/B (bioMérieux, Influenza A/B Q-PCR Alert (Nanogen running in parallel with rRT-PCR (CDC to confirm the positivity to the new influenza virus, then was used a single specific test, Fast set H1N1v (Arrow Diagnostics. Retrospective study of data showed that 293 (30.1% patients were positive for the new strain of influenza A/H1N1 virus and 8 (0.8% for influenza A other than H1N1 virus.The distribution of influenza A/H1N1 cases showed two peaks, one on July (62.9% and the other one on October (36%, moreover we observed that 155 patients (53% out of 293 positive for influenza A/H1N1 virus aged under 20 years old. The first positivity peak was found in travelers and the second one, occurred 2-3 months prior to the classic seasonal epidemic influenza, was attributed to autochthonous cases , by which the virus ha