Quarterly report of Biological and Medical Research Division, April 1955

Energy Technology Data Exchange (ETDEWEB)

Brues, A.M.

1955-04-01

This report is a compilation of 48 investigator prepared summaries of recent progress in individual research programs of the Biology and Medical Division of the Argonne National Laboratory for the quarterly period ending April,1955. Individual reports are about 3-6 pages in length and often contain research data.

Advertising by academic medical centers.

Science.gov (United States)

Larson, Robin J; Schwartz, Lisa M; Woloshin, Steven; Welch, H Gilbert

2005-03-28

Many academic medical centers have increased their use of advertising to attract patients. While the content of direct-to-consumer pharmaceutical advertisements (ads) has been studied, to our knowledge, advertising by academic medical centers has not. We aimed to characterize advertising by the nation's top academic medical centers. We contacted all 17 medical centers named to the US News & World Report 2002 honor roll of "America's Best Hospitals" for a semistructured interview regarding their advertising practices. In addition, we obtained and systematically analyzed all non-research-related print ads placed by these institutions in their 5 most widely circulating local newspapers during 2002. Of the 17 institutions, 16 reported advertising to attract patients; 1 stated, "We're just word of mouth." While all 17 centers confirmed the presence of an institutional review board process for approving advertising to attract research subjects, none reported a comparable process for advertising to attract patients. We identified 127 unique non-research-related print ads for the 17 institutions during 2002 (mean, 7.5; range, 0-39). Three ads promoted community events with institution sponsorship, 2 announced genuine public services, and 122 were aimed at attracting patients. Of the latter group, 36 ads (29.5%) promoted the medical center as a whole, while 65 (53.3%) promoted specific clinical departments and 21 (17.2%) promoted single therapeutic interventions or diagnostic tests. The most commonly used marketing strategies included appealing to emotions (61.5%), highlighting institution prestige (60.7%), mentioning a symptom or disease (53.3%), and promoting introductory lectures or special offers likely to lead to further business (47.5%). Of the 21 ads for single interventions, most were for unproved (38.1%) or cosmetic (28.6%) procedures. While more than half of these ads presented benefits, none quantified their positive claims and just 1 mentioned potential harms

Life Sciences Division and Center for Human Genome Studies 1994

Energy Technology Data Exchange (ETDEWEB)

Cram, L.S.; Stafford, C. [comp.

1995-09-01

This report summarizes the research and development activities of the Los Alamos National Laboratory`s Life Sciences Division and the biological aspects of the Center for Human Genome Studies for the calendar year 1994. The technical portion of the report is divided into two parts, (1) selected research highlights and (2) research projects and accomplishments. The research highlights provide a more detailed description of a select set of projects. A technical description of all projects is presented in sufficient detail so that the informed reader will be able to assess the scope and significance of each project. Summaries useful to the casual reader desiring general information have been prepared by the group leaders and appear in each group overview. Investigators on the staff of the Life Sciences Division will be pleased to provide further information.

Medications (for IBS)

Medline Plus

Full Text Available ... J. Lembo, MD, Instructor of Medicine, Harvard Medical School; Division of Gastroenterology, Beth Israel Deaconess Medical Center, ... doctor. We advise seeing a physician whenever a health problem arises requiring an expert’s care. © Copyright 1998- ...

Medications (for IBS)

Medline Plus

Full Text Available ... J. Lembo, MD, Instructor of Medicine, Harvard Medical School; Division of Gastroenterology, Beth Israel Deaconess Medical Center, ... arises requiring an expert’s care. © Copyright 1998-2018 International Foundation for Functional Gastrointestinal Disorders, Inc. (IFFGD). All ...

Characterizing customers at medical center farmers' markets.

Science.gov (United States)

Kraschnewski, Jennifer L; George, Daniel R; Rovniak, Liza S; Monroe, Diana L; Fiordalis, Elizabeth; Bates, Erica

2014-08-01

Approximately 100 farmers' markets operate on medical center campuses. Although these venues can uniquely serve community health needs, little is known about customer characteristics and outreach efforts. Intercept survey of markets and market customers between August 2010 and October 2011 at three medical centers in different geographic regions of the US (Duke University Medical Center, Cleveland Clinic, and Penn State Hershey Medical Center) were conducted. Markets reported serving 180-2,000 customers per week and conducting preventive medicine education sessions and community health programs. Customers (n = 585) across markets were similar in sociodemographic characteristics--most were middle-aged, white, and female, who were employees of their respective medical center. Health behaviors of customers were similar to national data. The surveyed medical center farmers' markets currently serve mostly employees; however, markets have significant potential for community outreach efforts in preventive medicine. If farmers' markets can broaden their reach to more diverse populations, they may play an important role in contributing to community health.

75 FR 66795 - Enesco, LLC, Gund Division, Distribution Center, Edison, NJ; Notice of Affirmative Determination...

Science.gov (United States)

2010-10-29

... Division, Distribution Center, Edison, NJ; Notice of Affirmative Determination Regarding Application for..., Distribution Center, Edison, New Jersey (subject firm). The determination was issued on August 27, 2010. The...). The workers are engaged in activities related to the supply of packaging and distribution services...

Strom Thurmond Biomedical Research Center at the Medical Univesity for South Carolina Charleston, South Carolina

Energy Technology Data Exchange (ETDEWEB)

1994-02-01

The Department of Energy (DOE) has prepared an Environmental Assessment (EA) evaluating the proposed construction and operation of the Strom Thurmond Biomedical Research Center (Center) at the Medical University of South Carolina (MUSC), Charleston, SC. The DOE is evaluating a grant proposal to authorize the MUSC to construct, equip and operate the lower two floors of the proposed nine-story Center as an expansion of on-going clinical research and out-patient diagnostic activities of the Cardiology Division of the existing Gazes Cardiac Research Institute. Based on the analysis in the EA, the DOE has determined that the proposed action does not constitute a major federal action significantly affecting the quality of the human environment within the meaning of the NEPA. Therefore, the preparation of an Environmental Impact Statement is not required.

A Comparative Analysis of Patient Access Modes at Wilford Hall United States Air Force Medical Center and Selected Civilian Medical Centers

Science.gov (United States)

1983-12-01

In A COMPARATIVE ANALYSIS OF PATIENT ACCESS MODES AT WILFORD HALL UNITED STATES AIR FORCE MEDICAL CENTER N AND SELECTED CIVILIAN MEDICAL CENTERS0 N...current patient access modes at WHMC and several civilian medical centers of comparable size. This project has pursued the subject of patient access in...selected civilian medical centers which are comparable to WHMC in size, specialty mix, workload, and mission, providing responsive and efficient patient

Academic Medical Centers as digital health catalysts.

Science.gov (United States)

DePasse, Jacqueline W; Chen, Connie E; Sawyer, Aenor; Jethwani, Kamal; Sim, Ida

2014-09-01

Emerging digital technologies offer enormous potential to improve quality, reduce cost, and increase patient-centeredness in healthcare. Academic Medical Centers (AMCs) play a key role in advancing medical care through cutting-edge medical research, yet traditional models for invention, validation and commercialization at AMCs have been designed around biomedical initiatives, and are less well suited for new digital health technologies. Recently, two large bi-coastal Academic Medical Centers, the University of California, San Francisco (UCSF) through the Center for Digital Health Innovation (CDHI) and Partners Healthcare through the Center for Connected Health (CCH) have launched centers focused on digital health innovation. These centers show great promise but are also subject to significant financial, organizational, and visionary challenges. We explore these AMC initiatives, which share the following characteristics: a focus on academic research methodology; integration of digital technology in educational programming; evolving models to support "clinician innovators"; strategic academic-industry collaboration and emergence of novel revenue models. Copyright © 2014 Elsevier Inc. All rights reserved.

Characterizing customers at medical center farmers’ markets1

Science.gov (United States)

Kraschnewski, Jennifer L.; George, Daniel R.; Rovniak, Liza S.; Monroe, Diana L.; Fiordalis, Elizabeth; Bates, Erica

2014-01-01

Approximately 100 farmers’ markets operate on medical center campuses. Although these venues can uniquely serve community health needs, little is known about customer characteristics and outreach efforts. Intercept survey of markets and market customers between August 2010-October 2011 at three medical centers in different geographic regions of the US: Duke University Medical Center, Cleveland Clinic, and Penn State Hershey Medical Center were conducted. Markets reported serving 180–2000 customers per week and conducting preventive medicine education sessions and community health programs. Customers (n=585) across markets were similar in sociodemographic characteristics – most were middle-aged, white, and female, who were employees of their respective medical center. Health behaviors of customers were similar to national data. The surveyed medical center farmers’ markets currently serve mostly employees; however, markets have significant potential for community outreach efforts in preventive medicine. If farmers’ markets can broaden their reach to more diverse populations, they may play an important role in contributing to community health. PMID:24421001

Medical Waste Management in Community Health Centers.

Science.gov (United States)

Tabrizi, Jafar Sadegh; Rezapour, Ramin; Saadati, Mohammad; Seifi, Samira; Amini, Behnam; Varmazyar, Farahnaz

2018-02-01

Non-standard management of medical waste leads to irreparable side effects. This issue is of double importance in health care centers in a city which are the most extensive system for providing Primary Health Care (PHC) across Iran cities. This study investigated the medical waste management standards observation in Tabriz community health care centers, northwestern Iran. In this triangulated cross-sectional study (qualitative-quantitative), data collecting tool was a valid checklist of waste management process developed based on Iranian medical waste management standards. The data were collected in 2015 through process observation and interviews with the health center's staff. The average rate of waste management standards observance in Tabriz community health centers, Tabriz, Iran was 29.8%. This case was 22.8% in dimension of management and training, 27.3% in separating and collecting, 31.2% in transport and temporary storage, and 42.9% in sterilization and disposal. Lack of principal separation of wastes, inappropriate collecting and disposal cycle of waste and disregarding safety tips (fertilizer device performance monitoring, microbial cultures and so on) were among the observed defects in health care centers supported by quantitative data. Medical waste management was not in a desirable situation in Tabriz community health centers. The expansion of community health centers in different regions and non-observance of standards could predispose to incidence the risks resulted from medical wastes. So it is necessary to adopt appropriate policies to promote waste management situation.

Environmental and Medical Sciences Division progress report January - December, 1980

International Nuclear Information System (INIS)

Hainge, W.M.

1982-02-01

A progress report on the work performed during 1980 by the Environmental and Medical Sciences Division at UKAEA Harwell is given. The programmes considered were atmospheric pollution; landfill research; monitoring of radioactive fallout and other radionuclides and trace elements in the environment; radioactive and non-radioactive aerosol metabolic studies; inhalation toxicology of radioactive aerosols and other hazardous materials; chemical analytical services; and radiation physics in dosimetry research, applied radiation spectrometry and data systems. (U.K.)

Estate of Behringer v. Medical Center at Princeton.

Science.gov (United States)

1991-04-25

Dr. William Behringer, a staff member at the Medical Center at Princeton, was diagnosed with AIDS. Afterwards, Behringer received numerous phone calls from various people expressing awareness of his illness, and his surgical privileges at the Center were suspended. He sued the Medical Center, alleging a breach of confidentiality and discrimination. The Superior Court of New Jersey, Mercer County, held that the Medical Center had breached its duty of confidentiality when it failed to take reasonable precautions to prevent Behringer's AIDS diagnosis from becoming public knowledge. Nevertheless, although New Jersey's anti-discrimination statutes protected Dr. Behringer from having his surgical privileges revoked, the Medical Center demonstrated a reasonable risk to patients that justified suspending Dr. Behringer's privileges, or alternatively, requiring his patients' informed consent before operating. The court found that the risk included not only actual HIV transmission, but also the possibility of surgical accidents.

A new concept for medical imaging centered on cellular phone technology.

Directory of Open Access Journals (Sweden)

Yair Granot

2008-04-01

Full Text Available According to World Health Organization reports, some three quarters of the world population does not have access to medical imaging. In addition, in developing countries over 50% of medical equipment that is available is not being used because it is too sophisticated or in disrepair or because the health personnel are not trained to use it. The goal of this study is to introduce and demonstrate the feasibility of a new concept in medical imaging that is centered on cellular phone technology and which may provide a solution to medical imaging in underserved areas. The new system replaces the conventional stand-alone medical imaging device with a new medical imaging system made of two independent components connected through cellular phone technology. The independent units are: a a data acquisition device (DAD at a remote patient site that is simple, with limited controls and no image display capability and b an advanced image reconstruction and hardware control multiserver unit at a central site. The cellular phone technology transmits unprocessed raw data from the patient site DAD and receives and displays the processed image from the central site. (This is different from conventional telemedicine where the image reconstruction and control is at the patient site and telecommunication is used to transmit processed images from the patient site. The primary goal of this study is to demonstrate that the cellular phone technology can function in the proposed mode. The feasibility of the concept is demonstrated using a new frequency division multiplexing electrical impedance tomography system, which we have developed for dynamic medical imaging, as the medical imaging modality. The system is used to image through a cellular phone a simulation of breast cancer tumors in a medical imaging diagnostic mode and to image minimally invasive tissue ablation with irreversible electroporation in a medical imaging interventional mode.

Johnson Space Center Health and Medical Technical Authority

Science.gov (United States)

Fogarty, Jennifer A.

2010-01-01

1.HMTA responsibilities: a) Assure program/project compliance with Agency health and medical requirements at identified key decision points. b) Certify that programs/projects comply with Agency health and medical requirements prior to spaceflight missions. c) Assure technical excellence. 2. Designation of applicable NASA Centers for HMTA implementation and Chief Medical Officer (CMO) appointment. 3. Center CMO responsible for HMTA implementation for programs and projects at the center. JSC HMTA captured in "JSC HMTA Implementation Plan". 4. Establishes specifics of dissenting opinion process consistent with NASA procedural requirements.

Division of Biological and Medical Research research summary 1984-1985

Energy Technology Data Exchange (ETDEWEB)

Barr, S.H. (ed.)

1985-08-01

The Division of Biological and Medical Research at Argonne National Laboratory conducts multidisciplinary research aimed at defining the biological and medical hazards to man from energy technologies and new energy options. These technically oriented studies have a strong base in fundamental research in a variety of scientific disciplines, including molecular and cellular biology, biophysics, genetics, radiobiology, pharmacology, biochemistry, chemistry, environmental toxicology, and epidemiology. This research summary is organized into six parts. The first five parts reflect the Divisional structure and contain the scientific program chapters, which summarize the activities of the individual groups during the calendar year 1984 and the first half of 1985. To provide better continuity and perspective, previous work is sometimes briefly described. Although the summaries are short, efforts have been made to indicate the range of research activities for each group.

Division of Biological and Medical Research research summary 1984-1985

International Nuclear Information System (INIS)

Barr, S.H.

1985-08-01

The Division of Biological and Medical Research at Argonne National Laboratory conducts multidisciplinary research aimed at defining the biological and medical hazards to man from energy technologies and new energy options. These technically oriented studies have a strong base in fundamental research in a variety of scientific disciplines, including molecular and cellular biology, biophysics, genetics, radiobiology, pharmacology, biochemistry, chemistry, environmental toxicology, and epidemiology. This research summary is organized into six parts. The first five parts reflect the Divisional structure and contain the scientific program chapters, which summarize the activities of the individual groups during the calendar year 1984 and the first half of 1985. To provide better continuity and perspective, previous work is sometimes briefly described. Although the summaries are short, efforts have been made to indicate the range of research activities for each group

Lead from the center. How to manage divisions dynamically.

Science.gov (United States)

Raynor, M E; Bower, J L

2001-05-01

Conventional wisdom holds that a company's divisions should be given almost total autonomy--especially under conditions of uncertainty--because they are closer to emerging technologies, customers, and competitors than corporate headquarters could ever be. But research from Michael Raynor and Joseph Bower suggests that the corporate office should be more, not less, directive in turbulent markets. Rapid changes in an industry make it difficult to predict where and when synergies among divisions might emerge. With so many possibilities and such uncertainty, companies can't afford to sacrifice their ability to flexibly execute business strategy. Corporate headquarters must play an active role in defining the scope of division-level strategy, the authors say, so that divisions do not act in ways that undermine opportunities to collaborate in the future. But neither can companies afford to sacrifice the competitiveness of their divisions as stand-alone businesses. In creating corporate-level strategic flexibility, a corporate office must balance the need for divisional autonomy now with the potential need for cooperation in the future. Through an examination of four corporations--Sprint, WPP, Teradyne, and Viacom--the authors challenge traditional approaches to diversification in which a company's divisions are either related (they share resources and collaborate) or unrelated (they compete for resources and operate as stand-alone businesses). They argue that companies should adopt a dynamic approach to cooperation among divisions, enabling varying degrees of relatedness between divisions depending on strategic circumstances. The authors offer four tactics to help executives manage divisions dynamically.

Medical waste management in Jordan: A study at the King Hussein Medical Center

International Nuclear Information System (INIS)

Oweis, Rami; Al-Widyan, Mohamad; Al-Limoon, Ohood

2005-01-01

As in many other developing countries, the generation of regulated medical waste (RMW) in Jordan has increased significantly over the last few decades. Despite the serious impacts of RMW on humans and the environment, only minor attention has been directed to its proper handling and disposal. This study was conducted in the form of a case study at one of Jordan's leading medical centers, namely, the King Hussein Medical Center (KHMC). Its purpose was to report on the current status of medical waste management at KHMC and propose possible measures to improve it. In general, it was found that the center's administration was reasonably aware of the importance of medical waste management and practiced some of the measures to adequately handle waste generated at the center. However, it was also found that significant voids were present that need to be addressed in the future including efficient segregation, the use of coded and colored bags, better handling and transfer means, and better monitoring and tracking techniques, as well as the need for training and awareness programs for the personnel

An Artist in the University Medical Center. Review.

Science.gov (United States)

James, A. Everette, Jr.

1991-01-01

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

U.S. academic medical centers under the managed health care environment.

Science.gov (United States)

Guo, K

1999-06-01

This research investigates the impact of managed health care on academic medical centers in the United States. Academic medical centers hold a unique position in the U.S. health care system through their missions of conducting cutting-edge biomedical research, pursuing clinical and technological innovations, providing state-of-the-art medical care and producing highly qualified health professionals. However, policies to control costs through the use of managed care and limiting resources are detrimental to academic medical centers and impede the advancement of medical science. To survive the threats of managed care in the health care environment, academic medical centers must rely on their upper level managers to derive successful strategies. The methods used in this study include qualitative approaches in the form of key informants and case studies. In addition, a survey questionnaire was sent to 108 CEOs in all the academic medical centers in the U.S. The findings revealed that managers who perform the liaison, monitor, entrepreneur and resource allocator roles are crucial to ensure the survival of academic medical centers, so that academic medical centers can continue their missions to serve the general public and promote their well-being.

An academic medical center under prolonged rocket attack--organizational, medical, and financial considerations.

Science.gov (United States)

Bar-El, Yaron; Michaelson, Moshe; Hyames, Gila; Skorecki, Karl; Reisner, Shimon A; Beyar, Rafael

2009-09-01

The Rambam Medical Center, the major academic health center in northern Israel, serving a population of two million and providing specialized tertiary care, was exposed to an unprecedented experience during the Second Lebanon War in the summer of 2006. For more than one month, it was subjected to continuous rocket attacks, but it continued to provide emergency and routine medical services to the civilian population and also served the military personnel who were evacuated from the battlefront. To accomplish the goals of serving the population while itself being under fire, the Rambam Medical Center had to undertake major organizational decisions, which included maximizing safety within the hospital by shifting patients and departments, ensuring that the hospital was properly fortified, managing the health professional teams' work schedules, and providing needed services for the families of employees. The Rambam Medical Center's Level I trauma center expertise included multidisciplinary teams and extensive collaborations; modern imaging modalities usually reserved for peacetime medical practice were frequently used. The function of the hospital teams during the war was efficient and smooth, based on the long-term actions taken to prepare for disasters and wartime conditions. Routine hospital services continued, although at 60% of normal occupancy. Financial losses incurred were primarily due to the decrease in revenue-generating activity. The two most important components of managing the hospital under these conditions are (1) the ability to arrive at prompt and meaningful decisions with respect to the organizational and medical hospital operations and (2) the leadership and management of the professional staff and teams.

[NEURO-ONCOLOGY A NEW FIELD IN DAVIDOFF CANCER CENTER AT RABIN MEDICAL CENTER].

Science.gov (United States)

Yust-Katz, Shlomit; Limon, Dror; Abu-Shkara, Ramez; Siegal, Tali

2017-08-01

Neuro-oncology is a subspecialty attracting physicians from medical disciplines such as neurology, neurosurgery, pediatrics, oncology, and radiotherapy. It deals with diagnosis and management of primary brain tumors, as well as metastatic and non-metastatic neurological manifestations that frequently affect cancer patients including brain metastases, paraneoplastic syndromes and neurological complications of cancer treatment. A neuro-oncology unit was established in Davidoff Cancer Center at Rabin Medical Center. It provides a multidisciplinary team approach for management of brain tumors and services, such as expert outpatient clinics and inpatient consultations for the departments of oncology, hematology, bone marrow transplantation and other departments in the Rabin Medical Center. In addition, expert consultation is frequently provided to other hospitals that treat cancer patients with neurological manifestations. The medical disciplines that closely collaborate for the daily management of neuro-oncology patients include radiotherapy, hematology, oncology, neuro-surgery, neuro-radiology and neuro-pathology. The neuro-oncology center is also involved in clinical and laboratory research conducted in collaboration with researchers in Israel and abroad. The new service contributes substantially to the improved care of cancer patients and to the advance of research topics in the field of neuro-oncology.

Consumerism: forcing medical practices toward patient-centered care.

Science.gov (United States)

Ozmon, Jeff

2007-01-01

Consumerism has been apart of many industries over the years; now consumerism may change the way many medical practices deliver healthcare. With the advent of consumer-driven healthcare, employers are shifting the decision-making power to their employees. Benefits strategies like health savings accounts and high-deductible insurance plans now allow the patients to control how and where they spend their money on medical care. Practices that seek to attract the more affluent and informed consumers are beginning to institute patient-centered systems designs that invite patients to actively participate in their healthcare. This article will outline the changes in the healthcare delivery system facing medical practices, the importance of patient-centered care, and six strategies to implement to change toward more patient-centered care.

Delinquent Medical Service Accounts at Landstuhl Regional Medical Center Need Additional Management Oversight

Science.gov (United States)

2016-04-28

Treasury for collection when the debts are delinquent more than 120 days.9 Further, UBOs can transfer debt to the Defense Finance and Accounting ...Comptroller); • Defense Finance and Accounting Service; • MEDCOM; • RHCE; and • LRMC. During the site visits to LRMC and MEDCOM, we observed daily...Uniform Business Office Manual,” November 2006; and • MEDCOM Finance and Accounting Division Standard Operating Procedures Medical Services Account

Implementing the patient-centered medical home in complex adaptive systems: Becoming a relationship-centered patient-centered medical home.

Science.gov (United States)

Flieger, Signe Peterson

This study explores the implementation experience of nine primary care practices becoming patient-centered medical homes (PCMH) as part of the New Hampshire Citizens Health Initiative Multi-Stakeholder Medical Home Pilot. The purpose of this study is to apply complex adaptive systems theory and relationship-centered organizations theory to explore how nine diverse primary care practices in New Hampshire implemented the PCMH model and to offer insights for how primary care practices can move from a structural PCMH to a relationship-centered PCMH. Eighty-three interviews were conducted with administrative and clinical staff at the nine pilot practices, payers, and conveners of the pilot between November and December 2011. The interviews were transcribed, coded, and analyzed using both a priori and emergent themes. Although there is value in the structural components of the PCMH (e.g., disease registries), these structures are not enough. Becoming a relationship-centered PCMH requires attention to reflection, sensemaking, learning, and collaboration. This can be facilitated by settings aside time for communication and relationship building through structured meetings about PCMH components as well as the implementation process itself. Moreover, team-based care offers a robust opportunity to move beyond the structures to focus on relationships and collaboration. (a) Recognize that PCMH implementation is not a linear process. (b) Implementing the PCMH from a structural perspective is not enough. Although the National Committee for Quality Assurance or other guidelines can offer guidance on the structural components of PCMH implementation, this should serve only as a starting point. (c) During implementation, set aside structured time for reflection and sensemaking. (d) Use team-based care as a cornerstone of transformation. Reflect on team structures and also interactions of the team members. Taking the time to reflect will facilitate greater sensemaking and learning and

Lessons learned: mobile device encryption in the academic medical center.

Science.gov (United States)

Kusche, Kristopher P

2009-01-01

The academic medical center is faced with the unique challenge of meeting the multi-faceted needs of both a modern healthcare organization and an academic institution, The need for security to protect patient information must be balanced by the academic freedoms expected in the college setting. The Albany Medical Center, consisting of the Albany Medical College and the Albany Medical Center Hospital, was challenged with implementing a solution that would preserve the availability, integrity and confidentiality of business, patient and research data stored on mobile devices. To solve this problem, Albany Medical Center implemented a mobile encryption suite across the enterprise. Such an implementation comes with complexities, from performance across multiple generations of computers and operating systems, to diversity of application use mode and end user adoption, all of which requires thoughtful policy and standards creation, understanding of regulations, and a willingness and ability to work through such diverse needs.

Characteristics of medical teachers using student-centered teaching methods.

Science.gov (United States)

Kim, Kyong-Jee; Hwang, Jee-Young

2017-09-01

This study investigated characteristics of medical teachers who have adopted student-centered teaching methods into their teaching. A 24-item questionnaire consisted of respondent backgrounds, his or her use of student-centered teaching methods, and awareness of the school's educational objectives and curricular principles was administered of faculty members at a private medical school in Korea. Descriptive statistics and chi-square analysis were conducted to compare faculty use of student-centered approaches across different backgrounds and awareness of curricular principles. Overall response rate was 70% (N=140/200), approximately 25% (n=34) of whom were using student-centered teaching methods. Distributions in the faculty use of student-centered teaching methods were significantly higher among basic sciences faculty (versus clinical sciences faculty), with teaching experiences of over 10 years (versus less than 10 years), and who were aware of the school's educational objectives and curricular principles. Our study indicates differences in medical faculty's practice of student-centered teaching across disciplines, teaching experiences, and their understanding of the school's educational objectives curricular principles. These findings have implications for faculty development and institutional support to better promote faculty use of student-centered teaching approaches.

Measuring the efficiency of dental departments in medical centers: a nonparametric analysis approach.

Science.gov (United States)

Wang, Su-Chen; Tsai, Chi-Cheng; Huang, Shun-Te; Hong, Yu-Jue

2002-12-01

Data envelopment analysis (DEA), a cross-sectional study design based on secondary data analysis, was used to evaluate the relative operational efficiency of 16 dental departments in medical centers in Taiwan in 1999. The results indicated that 68.7% of all dental departments in medical centers had poor performance in terms of overall efficiency and scale efficiency. All relatively efficient dental departments were in private medical centers. Half of these dental departments were unable to fully utilize available medical resources. 75.0% of public medical centers did not take full advantage of medical resources at their disposal. In the returns to scale, 56.3% of dental departments in medical centers exhibited increasing returns to scale, due to the insufficient scale influencing overall hospital operational efficiency. Public medical centers accounted for 77.8% of the institutions affected. The scale of dental departments in private medical centers was more appropriate than those in public medical centers. In the sensitivity analysis, the numbers of residents, interns, and published papers were used to assess teaching and research. Greater emphasis on teaching and research in medical centers has a large effect on the relative inefficiency of hospital operation. Dental departments in private medical centers had a higher mean overall efficiency score than those in public medical centers, and the overall efficiency of dental departments in non-university hospitals was greater than those in university hospitals. There was no information to evaluate the long-term efficiency of each dental department in all hospitals. A different combination of input and output variables, using common multipliers for efficiency value measurements in DEA, may help establish different pioneering dental departments in hospitals.

Opportunity for Collaboration Between Radiation Injury Treatment Network Centers and Medical Toxicology Specialists.

Science.gov (United States)

Davlantes, Elizabeth; Shartar, Samuel; Venero, Jennifer; Steck, Alaina; Langston, Amelia; Kazzi, Ziad N

2017-08-01

The Radiation Injury Treatment Network (RITN) comprises >50 centers across the United States that are poised to care for victims of a radiation emergency. The network is organized around bone marrow transplant centers because these facilities excel in both radiation medicine and the care of patients with severe bone marrow depression. A radiation emergency may cause not only irradiation from an external source but also internal contamination with radioactive material. Because medical toxicologists are trained in radiation injury management and have expertise in the management of internal contamination, RITN centers may benefit from partnerships with medical toxicology resources, which may be located at academic medical centers, hospital inpatient clinical services, outpatient clinics, or poison control centers. We determined the locations of existing RITN centers and assessed their proximity to various medical toxicology resources, including medical toxicology fellowship programs, inpatient toxicology services, outpatient toxicology clinics, and poison control centers. Data were derived from publicly available Internet sources in March 2015. The majority of RITN centers do not have a medical toxicology fellowship, an inpatient toxicology service, or an outpatient toxicology clinic within the same institution. Fifty-seven percent of RITN centers have at least one of these resources located in the same city, however, and 73% of centers have at least one of these resources or a poison control center within the same city. Ninety-five percent of RITN centers have at least one medical toxicology resource within the state. Most RITN centers are located in the same city as at least one medical toxicology resource. Establishing relationships between RITN centers and medical toxicologists needs to be explored further.

Needs Assessment for Research Use of High-Throughput Sequencing at a Large Academic Medical Center.

Directory of Open Access Journals (Sweden)

Albert Geskin

Full Text Available Next Generation Sequencing (NGS methods are driving profound changes in biomedical research, with a growing impact on patient care. Many academic medical centers are evaluating potential models to prepare for the rapid increase in NGS information needs. This study sought to investigate (1 how and where sequencing data is generated and analyzed, (2 research objectives and goals for NGS, (3 workforce capacity and unmet needs, (4 storage capacity and unmet needs, (5 available and anticipated funding resources, and (6 future challenges. As a precursor to informed decision making at our institution, we undertook a systematic needs assessment of investigators using survey methods. We recruited 331 investigators from over 60 departments and divisions at the University of Pittsburgh Schools of Health Sciences and had 140 respondents, or a 42% response rate. Results suggest that both sequencing and analysis bottlenecks currently exist. Significant educational needs were identified, including both investigator-focused needs, such as selection of NGS methods suitable for specific research objectives, and program-focused needs, such as support for training an analytic workforce. The absence of centralized infrastructure was identified as an important institutional gap. Key principles for organizations managing this change were formulated based on the survey responses. This needs assessment provides an in-depth case study which may be useful to other academic medical centers as they identify and plan for future needs.

Academic medical center libraries on the Web.

Science.gov (United States)

Tannery, N H; Wessel, C B

1998-10-01

Academic medical center libraries are moving towards publishing electronically, utilizing networked technologies, and creating digital libraries. The catalyst for this movement has been the Web. An analysis of academic medical center library Web pages was undertaken to assess the information created and communicated in early 1997. A summary of present uses and suggestions for future applications is provided. A method for evaluating and describing the content of library Web sites was designed. The evaluation included categorizing basic information such as description and access to library services, access to commercial databases, and use of interactive forms. The main goal of the evaluation was to assess original resources produced by these libraries.

Moral dilemmas faced by hospitals in time of war: the Rambam Medical Center during the second Lebanon war.

Science.gov (United States)

Bar-El, Yaron; Reisner, Shimon; Beyar, Rafael

2014-02-01

Rambam Medical Center, the only tertiary care center and largest hospital in northern Israel, was subjected to continuous rocket attacks in 2006. This extreme situation posed serious and unprecedented ethical dilemmas to the hospital management. An ambiguous situation arose that required routine patient care in a tertiary modern hospital together with implementation of emergency measures while under direct fire. The physicians responsible for hospital management at that time share some of the moral dilemmas faced, the policy they chose to follow, and offer a retrospective critical reflection in this paper. The hospital's first priority was defined as delivery of emergency surgical and medical services to the wounded from the battlefields and home front, while concomitantly providing the civilian population with all elective medical and surgical services. The need for acute medical service was even more apparent as the situation of conflict led to closure of many ambulatory clinics, while urgent or planned medical care such as open heart surgery and chemotherapy continued. The hospital management took actions to minimize risks to patients, staff, and visitors during the ongoing attacks. Wards were relocated to unused underground spaces and corridors. However due to the shortage of shielded spaces, not all wards and patients could be relocated to safer areas. Modern warfare will most likely continue to involve civilian populations and institutes, blurring the division between peaceful high-tech medicine and the rough battlefront. Hospitals in high war-risk areas must be prepared to function and deliver treatment while under fire or facing similar threats.

St. Luke's Medical Center: technologizing health care

International Nuclear Information System (INIS)

Tumanguil, S.S.

1994-01-01

The computerization of the St. Luke's Medical Center improved the hospital administration and management, particularly in nuclear medicine department. The use of computer-aided X-ray simulator machine and computerized linear accelerator machine in diagnosing and treating cancer are the most recent medical technological breakthroughs that benefited thousands of Filipino cancer patients. 4 photos

Environment and Medical Sciences Division Progress Report

International Nuclear Information System (INIS)

Hainge, W.M.

1980-06-01

The 1979 annual progress report of the UKAEA Environmental and Medical Sciences Division covers both radiological and non-nuclear research programmes in the environmental and toxicological fields. The specific topics were 1) 'atmospheric pollution' which included the analysis of atmospheric trace gases by gas chromatography/mass spectrometry, the life cycle of atmospheric sulphur compounds, photochemical pollution, studies on stratospheric reactions, stratospheric ozone and the effects of pollutants, upper air sampling and monitoring gaseous atmospheric pollutants with passive samplers; 2) miscellaneous 'environmental safety projects'; 3) 'radiation physics' projects concerning a) radioactive fallout, b) studies of stable trace elements in the atmospheric environment and studies of radioactivity in the environment, c) various aspects of dosimetry research including radiation biophysics, d) personnel dosimetry, e) applied radiation spectrometry and f) data systems; 5) 'aerosol and metabolic studies' including whole body counting studies; 6) 'inhalation toxicology and radionuclide analysis' studies including actinide inhalation, cytotoxicity and fibrogenicity of non-radioactive dusts, asbestos and glass fibre research, a Qauntimet 720 image analysis service and radionuclide analysis in biological materials; and 7) 'analytical services' used in relation to 'environmental safety and chemical analysis' projects. (U.K.)

Patient Workload Profile: National Naval Medical Center (NNMC), Bethesda, MD.

Science.gov (United States)

1980-06-01

AD-A09a 729 WESTEC SERVICES NC SAN DIEGOCA0S / PATIENT WORKLOAD PROFILE: NATIONAL NAVAL MEDICAL CENTER NNMC),- ETC(U) JUN 80 W T RASMUSSEN, H W...provides site workload data for the National Naval Medical Center (NNMC) within the following functional support areas: Patient Appointment...on managing medical and patient data, thereby offering the health care provider and administrator more powerful capabilities in dealing with and

Defining the medical imaging requirements for a rural health center

CERN Document Server

2017-01-01

This book establishes the criteria for the type of medical imaging services that should be made available to rural health centers, providing professional rural hospital managers with information that makes their work more effective and efficient. It also offers valuable insights into government, non-governmental and religious organizations involved in the planning, establishment and operation of medical facilities in rural areas. Rural health centers are established to prevent patients from being forced to travel to distant urban medical facilities. To manage patients properly, rural health centers should be part of regional and more complete systems of medical health care installations in the country on the basis of a referral and counter-referral program, and thus, they should have the infrastructure needed to transport patients to urban hospitals when they need more complex health care. The coordination of all the activities is only possible if rural health centers are led by strong and dedicated managers....

Division of Biological and Medical Research annual report 1978

Energy Technology Data Exchange (ETDEWEB)

Rosenthal, M.W. (ed.)

1978-01-01

The research during 1978 in the Division of Biological and Medical Research, Argonne National Laboratory, is summarized. Studies related to nuclear energy include responses of beagles to continuous low-level /sup 60/Co gamma radiation, and development of leukemic indicators; comparison of lifetime effects in mice of low-level neutron and /sup 60/Co gamma radiation; genetic effects of high LET radiations; and metabolic and therapeutic studies of heavy metals. Studies of nonnuclear energy sources deal with characterization and toxicological evaluation of effluents of fluidized bed combustion and coal gasification; electrical storage systems; electric fields associated with energy transmission; and development of population projection models and assessment of human risk. Basic research studies include fundamental structural and biophysical investigations; circadian rhythms; mutagenesis in bacteria and mammalian cells; cell killing, damage, and repair in mammalian cells; carcinogenesis and cocarcinogenesis; the use of liposomes as biological carriers; and studies of environmental influences on life-span, physiological performance, and circadian cycles. In the area of medical development, proteins in urine and tissues of normal and diseased humans are analyzed, and advanced analytical procedures for use of stable isotopes in clinical research and diagnosis are developed and applied. The final sections of the report cover support facilities, educational activities, the seminar program, staff talks, and staff publications.

Division of Biological and Medical Research annual report 1978

International Nuclear Information System (INIS)

Rosenthal, M.W.

1978-01-01

The research during 1978 in the Division of Biological and Medical Research, Argonne National Laboratory, is summarized. Studies related to nuclear energy include responses of beagles to continuous low-level 60 Co gamma radiation, and development of leukemic indicators; comparison of lifetime effects in mice of low-level neutron and 60 Co gamma radiation; genetic effects of high LET radiations; and metabolic and therapeutic studies of heavy metals. Studies of nonnuclear energy sources deal with characterization and toxicological evaluation of effluents of fluidized bed combustion and coal gasification; electrical storage systems; electric fields associated with energy transmission; and development of population projection models and assessment of human risk. Basic research studies include fundamental structural and biophysical investigations; circadian rhythms; mutagenesis in bacteria and mammalian cells; cell killing, damage, and repair in mammalian cells; carcinogenesis and cocarcinogenesis; the use of liposomes as biological carriers; and studies of environmental influences on life-span, physiological performance, and circadian cycles. In the area of medical development, proteins in urine and tissues of normal and diseased humans are analyzed, and advanced analytical procedures for use of stable isotopes in clinical research and diagnosis are developed and applied. The final sections of the report cover support facilities, educational activities, the seminar program, staff talks, and staff publications

Management of a comprehensive radiation safety program in a major American University and affiliated academic medical center

International Nuclear Information System (INIS)

Yoshizumi, T.T.; Reiman, R.E.; Vylet, V.; Clapp, J.R.; Thomann, W.R.; Lyles, K.W.

2000-01-01

Duke University, which operates under eight radiation licenses issued by the State of North Carolina, consists of a leading medical center including extensive inpatient and outpatient facilities, a medical school, biomedical research labs, and an academic campus including two major accelerator facilities. The Nuclear Medicine and Radiation Oncology departments handle over 40,000 diagnostic and therapeutic procedures annually, including approximately 160 radioiodine therapeutic cases. In biomedical research labs, about 300 professors are authorized to use radioactive materials. Over 2,000 radiation workers are identified on campus. Over the past two years, we have transformed the existing radiation safety program into a more responsive and more accountable one. Simultaneously, the institutional 'culture' changed, and the Radiation Safety Division came to be viewed as a helpful ally by investigators. The purpose of this paper is to present our experiences that have made this transformation possible. Our initiatives included; (a) defining short-term and long-term goals; (b) establishing a definitive chain of authority; (c) obtaining an external review by a consultant Health Physicist; (d) improving existing radiation safety programs; (e) reorganizing the Radiation Safety Division, with creation of multidisciplinary professional staff positions; (f) implementing campus-wide radiation safety training, (g) increasing technician positions; (h) establishing monthly medical center radiation safety executive meeting. As a result progress made at the Divisional level includes; (a) culture change by recruiting professionals with academic credentials and recent college graduates; (b) implementing weekly staff meetings and monthly quality assurance meetings; (c) achieving academic prominence by publishing and presenting papers in national meetings; (d) senior staff achieving faculty appointments with academic departments; (e) senior staff participating in graduate student

Fox Chase Cancer Center's Genitourinary Division: a national resource for research, innovation and patient care.

Science.gov (United States)

Uzzo, Robert G; Horwitz, Eric M; Plimack, Elizabeth R

2016-04-01

Founded in 1904, Fox Chase Cancer Center remains committed to its mission. It is one of 41 centers in the country designated as a Comprehensive Cancer Center by the National Cancer Institute, is a founding member of the National Comprehensive Cancer Network, holds the magnet designation for nursing excellence, is one of the first to establish a family cancer risk assessment program, and has achieved national distinction because of the scientific discoveries made there that have advanced clinical care. Two of its researchers have won Nobel prizes. The Genitourinary Division is nationally recognized and viewed as one of the top driving forces behind the growth of Fox Chase due to its commitment to initiating and participating in clinical trials, its prolific contributions to peer-reviewed publications and presentations at scientific meetings, its innovations in therapies and treatment strategies, and its commitment to bringing cutting-edge therapies to patients.

Assessing the Academic Medical Center as a Supportive Learning Community

Science.gov (United States)

Gannon, Sam C.

2011-01-01

Academic medical centers are well-known for their emphasis on teaching, research and public service; however, like most large, bureaucratic organizations, they oftentimes suffer from an inability to learn as an organization. The role of the research administrator in the academic medical center has grown over time as the profession itself has…

["AGAINST ALL ODDS" - PROMOTING RESEARCH, CLINICAL DEVELOPMENT AND MEDICAL SERVICES OF THE CONFLICT IN THE GALILEE MEDICAL CENTER].

Science.gov (United States)

Bornstein, Jacob

2017-05-01

The Galilee Medical Center (GMC) is unique in several aspects. Firstly, in the clinical aspect: In recent years, led by the Director of Medical Center, Dr. Masad Barhoum, a considerable momentum of development has taken place to reduce health discrepancies between the center and the periphery. Despite the under- financing of the health system in the Galilee, the GMC opened new clinical departments, introduced advanced medical technology and key staff members were added. This approach is depicted in publications presented in the current issue. Secondly, the aspect of medicine standoff: The GMC is the nearest hospital to the border with neighboring countries. It is also a tertiary center for trauma, due to the establishment of the Department of Neurosurgery, Department of Oral and Maxillofacial Surgery and the Departments of Orthopedic Surgery, general invasive radiology and invasive radiology of the brain. In recent years, the medical center treated hundreds of victims of the civil war in Syria, a third of them - women and children. The injured patients presented unique medical problems that are described in the papers in this issue. Thirdly, the research aspect: The medical center is the main teaching facility of medical students of the Faculty of Medicine in the Galilee of Bar-Ilan University. The Faculty of Medicine, led by the Dean, Prof. Ran Tur-Kaspa, promotes research and teaching in the medical center. Even before the establishment of the Faculty of Medicine, former hospital director, Prof. Shaul Shasha, not only extolled the importance of research, but established a research laboratory years ago. The laboratory continues to pursue translational research by the physicians of the medical center, led by Dr. Shifra Sela and Prof. Batya Kristal, and supported by the current medical center director, Dr. Masad Barhoum. Several studies conducted in this research laboratory are published herewith. With these unique aspects and despite the discrimination in funding

A research on the enhancement of research management efficiency for the division of research, Korea cancer center hospital

International Nuclear Information System (INIS)

Lee, S. W.; Ma, K. H.; Kim, J. R.; Lee, D. C.; Lee, J. H.

1999-06-01

The research activities of Korea Cancer Center Hospital have increased for the past a few years just in proportion to the increase of research budget, but the assisting manpower of the office of research management has never been increased and the indications are that the internal and external circumstances will not allow the recruitment for a fairly long time. It has, therefore, become inevitable to enhance the work efficiency of the office by analyzing the administrative research assistance system, finding out problems and inefficiency factors, and suggesting possible answers to them. The office of research management and international cooperation has conducted this research to suggest possible ways to facilitate the administrative support for the research activities of Korea Cancer Center Hospital By analyzing the change of research budget, organization of the division of research and administrative support, manpower, and the administrative research supporting system of other institutes, we suggested possible ways to enhance the work efficiency for administrative research support and developed a relative database program. The research report will serve as a data for the organization of research support division when the Radiation Medicine Research Center is established. The database program has already been used for research budget management

[Projects to accelerate the practical use of innovative medical devices to collaborate with TWIns, Center for Advanced Biomedical Sciences, Waseda University and School of Engineering, The University of Tokyo].

Science.gov (United States)

Niimi, Shingo; Umezu, Mitsuo; Iseki, Hiroshi; Harada, Hiroshi Kasanuki Noboru; Mitsuishi, Mamoru; Kitamori, Takehiko; Tei, Yuichi; Nakaoka, Ryusuke; Haishima, Yuji

2014-01-01

Division of Medical Devices has been conducting the projects to accelerate the practical use of innovative medical devices to collaborate with TWIns, Center for Advanced Biomedical Sciences, Waseda University and School of Engineering, The University of Tokyo. The TWIns has been studying to aim at establishment of preclinical evaluation methods by "Engineering Based Medicine", and established Regulatory Science Institute for Medical Devices. School of Engineering, The University of Tokyo has been studying to aim at establishment of assessment methodology for innovative minimally invasive therapeutic devices, materials, and nanobio diagnostic devices. This report reviews the exchanges of personnel, the implement systems and the research progress of these projects.

Patient-centered medical home model: do school-based health centers fit the model?

Science.gov (United States)

Larson, Satu A; Chapman, Susan A

2013-01-01

School-based health centers (SBHCs) are an important component of health care reform. The SBHC model of care offers accessible, continuous, comprehensive, family-centered, coordinated, and compassionate care to infants, children, and adolescents. These same elements comprise the patient-centered medical home (PCMH) model of care being promoted by the Affordable Care Act with the hope of lowering health care costs by rewarding clinicians for primary care services. PCMH survey tools have been developed to help payers determine whether a clinician/site serves as a PCMH. Our concern is that current survey tools will be unable to capture how a SBHC may provide a medical home and therefore be denied needed funding. This article describes how SBHCs might meet the requirements of one PCMH tool. SBHC stakeholders need to advocate for the creation or modification of existing survey tools that allow the unique characteristics of SBHCs to qualify as PCMHs.

[Patient-centered care. Improvement of communication between university medical centers and general practitioners for patients in neuro-oncology].

Science.gov (United States)

Renovanz, M; Keric, N; Richter, C; Gutenberg, A; Giese, A

2015-12-01

Communication between university medical centers and general practitioners (GP) is becoming increasingly more important in supportive patient care. A survey among GPs was performed with the primary objective to assess their opinion on current workflow and communication between GPs and the university medical center. The GPs were asked to score (grades 1-6) their opinion on the current interdisciplinary workflow in the care of patients with brain tumors, thereby rating communication between a university medical center in general and the neuro-oncology outpatient center in particular. Questionnaires were sent to1000 GPs and the response rate was 15 %. The mean scored evaluation of the university medical center in general was 2.62 and of the neuro-oncological outpatient clinic 2.28 (range 1-6). The most often mentioned issues to be improved were easier/early telephone information (44 %) and a constantly available contact person (49 %). Interestingly, > 60 % of the GPs indicated they would support web-based tumor boards for interdisciplinary and palliative neuro-oncological care. As interdisciplinary care for neuro-oncology patients is an essential part of therapy, improvement of communication between GPs and university medical centers is indispensable. Integrating currently available electronic platforms under data protection aspects into neuro-oncological palliative care could be an interesting tool in order to establish healthcare networks and could find acceptance with GPs.

Improving diabetes medication adherence: successful, scalable interventions

Directory of Open Access Journals (Sweden)

Zullig LL

2015-01-01

Full Text Available Leah L Zullig,1,2 Walid F Gellad,3,4 Jivan Moaddeb,2,5 Matthew J Crowley,1,2 William Shrank,6 Bradi B Granger,7 Christopher B Granger,8 Troy Trygstad,9 Larry Z Liu,10 Hayden B Bosworth1,2,7,11 1Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC, USA; 2Department of Medicine, Duke University, Durham, NC, USA; 3Center for Health Equity Research and Promotion, Pittsburgh Veterans Affairs Medical Center, Pittsburgh, PA, USA; 4Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, PA, USA; 5Institute for Genome Sciences and Policy, Duke University, Durham, NC, USA; 6CVS Caremark Corporation; 7School of Nursing, Duke University, Durham, NC, USA; 8Department of Medicine, Division of Cardiology, Duke University School of Medicine, Durham, NC, USA; 9North Carolina Community Care Networks, Raleigh, NC, USA; 10Pfizer, Inc., and Weill Medical College of Cornell University, New York, NY, USA; 11Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA Abstract: Effective medications are a cornerstone of prevention and disease treatment, yet only about half of patients take their medications as prescribed, resulting in a common and costly public health challenge for the US healthcare system. Since poor medication adherence is a complex problem with many contributing causes, there is no one universal solution. This paper describes interventions that were not only effective in improving medication adherence among patients with diabetes, but were also potentially scalable (ie, easy to implement to a large population. We identify key characteristics that make these interventions effective and scalable. This information is intended to inform healthcare systems seeking proven, low resource, cost-effective solutions to improve medication adherence. Keywords: medication adherence, diabetes mellitus, chronic disease, dissemination research

Division of Biological and Medical Research annual report, 1980

International Nuclear Information System (INIS)

Rosenthal, M.W.

1981-08-01

The research during 1980 in the Division of Biological and Medical Research, Argonne National Laboratory, is summarized. Research related to nuclear energy includes the delineation, in the beagle, of the responses to continuous low level 60 Co gamma radiation and the development of cellular indicators of preclinical phases of leukemia; comparison of lifetime effects in mice of low level neutron and 60 Co gamma radiation; studies of the genetic effects of high LET radiations; and studies of the gastrointestinal absorption of the actinide elements. Research related to nonuclear energy sources deals with characterization and toxicological evaluation of process streams and effluents of coal gasification; with electrical storage systems; and electric fields associated with energy transmission. Proteins in human urine and selected tissues are examined by two-dimensional electrophoresis to detect disease and pollutant related changes. Assessment of human risk associated with nuclearing collective dose commitment will result in more attention being paid to potential releases of radionuclides at relatively short times after disposal

Supply chain optimization at an academic medical center.

Science.gov (United States)

Labuhn, Jonathan; Almeter, Philip; McLaughlin, Christopher; Fields, Philip; Turner, Benjamin

2017-08-01

A successful supply chain optimization project that leveraged technology, engineering principles, and a technician workflow redesign in the setting of a growing health system is described. With continued rises in medication costs, medication inventory management is increasingly important. Proper management of central pharmacy inventory and floor-stock inventory in automated dispensing cabinets (ADCs) can be challenging. In an effort to improve control of inventory costs in the central pharmacy of a large academic medical center, the pharmacy department implemented a supply chain optimization project in collaboration with the medical center's inhouse team of experts on process improvement and industrial engineering. The project had 2 main components: (1) upgrading and reconfiguring carousel technology within an expanded central pharmacy footprint to generate accurate floor-stock inventory replenishment reports, which resulted in efficiencies within the medication-use system, and (2) implementing a technician workflow redesign and algorithm to right-size the ADC inventory, which decreased inventory stockouts (i.e., incidents of depletion of medication stock) and improved ADC user satisfaction. Through a multifaceted approach to inventory management, the number of stockouts per month was decreased and ADC inventory was optimized, resulting in a one-time inventory cost savings of $220,500. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

The Manned Spacecraft Center and medical technology

Science.gov (United States)

Johnston, R. S.; Pool, S. L.

1974-01-01

A number of medically oriented research and hardware development programs in support of manned space flights have been sponsored by NASA. Blood pressure measuring systems for use in spacecraft are considered. In some cases, complete new bioinstrumentation systems were necessary to accomplish a specific physiological study. Plans for medical research during the Skylab program are discussed along with general questions regarding space-borne health service systems and details concerning the Health Services Support Control Center.

Scientific activities 1980 Nuclear Research Center ''Democritos''

International Nuclear Information System (INIS)

1982-01-01

The scientific activities and achievements of the Nuclear Research Center Democritos for the year 1980 are presented in the form of a list of 76 projects giving title, objectives, responsible of each project, developed activities and the pertaining lists of publications. The 16 chapters of this work cover the activities of the main Divisions of the Democritos NRC: Electronics, Biology, Physics, Chemistry, Health Physics, Reactor, Scientific Directorate, Radioisotopes, Environmental Radioactivity, Soil Science, Computer Center, Uranium Exploration, Medical Service, Technological Applications, Radioimmunoassay and Training. (N.C.)

Reactor Engineering Division annual report

International Nuclear Information System (INIS)

1975-11-01

Research activities in fiscal 1974 in Reactor Engineering Division of eight laboratories and computing center are described. Works in the division are closely related with the development of a multi-purpose High-temperature Gas Cooled Reactor, the development of a Liquid Metal Fast Breeder Reactor in Power Reactor and Nuclear Fuel Development Corporation, and engineering of thermonuclear fusion reactors. They cover nuclear data and group constants, theoretical method and code development, integral experiment and analysis, shielding, heat transfer and fluid dynamics, reactor and nuclear instrumentation, dynamics analysis and control method development, fusion reactor technology and aspects of the computing center. (auth.)

Connecticut Children's Medical Center multi-year branding campaign.

Science.gov (United States)

Botvin, J

2000-01-01

As the only children's hospital in the state, Connecticut Children's Medical Center was challenged by the inherent complacency of parents. It met the challenge through a multi-level marketing effort which included television and radio, community outreach and strong media relations. By emphasizing the unique nature of children, the campaign affirms the need for a specialized children's health center.

Monthly Total Precipitation Observation for Climate Prediction Center (CPC)Forecast Divisions

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This ASCII dataset contains monthly total precipitation for 102 Forecast Divisions within the conterminous U.S. It is derived from the monthly NCDC climate division...

Monthly Mean Temperature Observation for Climate Prediction Center (CPC) Forecast Divisions

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This ASCII dataset contains monthly mean temperatures for 102 Forecast Divisions within the conterminous U.S. and is derived from the monthly NCDC climate division...

Chemistry-Nuclear Chemistry Division. Progress report, October 1980-September 1981

International Nuclear Information System (INIS)

Ryan, R.R.

1982-05-01

This report describes major progress in the research and development programs pursued by the Chemistry-Nuclear Chemistry Division of the Los Alamos National Laboratory during FY 1981. Topics covered include advanced analytical methods, atmospheric chemistry and transport, biochemistry, biomedical research, medical radioisotopes research, element migration and fixation, nuclear waste isolation research, inorganic and structural chemistry, isotope separation, analysis and applications, the newly established Nuclear Magnetic Resonance Center, atomic and molecular collisions, molecular spectroscopy, nuclear cosmochemistry, nuclear structure and reactions, pion charge exchange, radiochemical separations, theoretical chemistry, and unclassified weapons research

Chemistry-Nuclear Chemistry Division. Progress report, October 1980-September 1981

Energy Technology Data Exchange (ETDEWEB)

Ryan, R.R. (comp.)

1982-05-01

This report describes major progress in the research and development programs pursued by the Chemistry-Nuclear Chemistry Division of the Los Alamos National Laboratory during FY 1981. Topics covered include advanced analytical methods, atmospheric chemistry and transport, biochemistry, biomedical research, medical radioisotopes research, element migration and fixation, nuclear waste isolation research, inorganic and structural chemistry, isotope separation, analysis and applications, the newly established Nuclear Magnetic Resonance Center, atomic and molecular collisions, molecular spectroscopy, nuclear cosmochemistry, nuclear structure and reactions, pion charge exchange, radiochemical separations, theoretical chemistry, and unclassified weapons research.

Patient-Centered Tools for Medication Information Search.

Science.gov (United States)

Wilcox, Lauren; Feiner, Steven; Elhadad, Noémie; Vawdrey, David; Tran, Tran H

2014-05-20

Recent research focused on online health information seeking highlights a heavy reliance on general-purpose search engines. However, current general-purpose search interfaces do not necessarily provide adequate support for non-experts in identifying suitable sources of health information. Popular search engines have recently introduced search tools in their user interfaces for a range of topics. In this work, we explore how such tools can support non-expert, patient-centered health information search. Scoping the current work to medication-related search, we report on findings from a formative study focused on the design of patient-centered, medication-information search tools. Our study included qualitative interviews with patients, family members, and domain experts, as well as observations of their use of Remedy, a technology probe embodying a set of search tools. Post-operative cardiothoracic surgery patients and their visiting family members used the tools to find information about their hospital medications and were interviewed before and after their use. Domain experts conducted similar search tasks and provided qualitative feedback on their preferences and recommendations for designing these tools. Findings from our study suggest the importance of four valuation principles underlying our tools: credibility, readability, consumer perspective, and topical relevance.

Annual report of Technical Development Division of the Tono Geoscience Center, PNC in 1996 fiscal year

International Nuclear Information System (INIS)

1997-04-01

This is a report collected working results of research and development conducted at Technical Development Division of the Tono Geoscience Center, PNC (Power Reactor and Nuclear Fuel Development Corporation) in 1996 fiscal year. In this fiscal year, Ore Bed Analysis and Evaluation Group entered into this division by changing name of Resource Analysis and Evaluation Group, which was shared to conduct some actions such as survey of resource information, analysis of potential, evaluation of ore bed, and so forth. The other conducted works were same as those in last fiscal year. Beside them, as taking the Monju reactor accident on December 8, 1995 an opportunity, safety management of facility was reconsidered as the most important item, preparation of the mining facilities such as renewal of lifting winder in vertical road for survey, new construction of general management building, preparation around the precipitation pond, and so on were executed, as a response to normal work for the yearly elapsed change in the Tono Mine. (G.K.)

Financial impact of tertiary care in an academic medical center.

Science.gov (United States)

Huber, T S; Carlton, L M; O'Hern, D G; Hardt, N S; Keith Ozaki, C; Flynn, T C; Seeger, J M

2000-06-01

To analyze the financial impact of three complex vascular surgical procedures to both an academic hospital and a department of surgery and to examine the potential impact of decreased reimbursements. The cost of providing tertiary care has been implicated as one potential cause of the financial difficulties affecting academic medical centers. Patients undergoing revascularization for chronic mesenteric ischemia, elective thoracoabdominal aortic aneurysm repair, and treatment of infected aortic grafts at the University of Florida were compared with those undergoing elective infrarenal aortic reconstruction and carotid endarterectomy. Hospital costs and profit summaries were obtained from the Clinical Resource Management Office. Departmental costs and profit summary were estimated based on the procedural relative value units (RVUs), the average clinical cost per RVU ($33.12), surgeon charges, and the collection rate for the vascular surgery division (30.2%) obtained from the Faculty Group Practice. Surgeon work effort was analyzed using the procedural work RVUs and the estimated total care time. The analyses were performed for all payors and the subset of Medicare patients, and the potential impact of a 15% reduction in hospital and physician reimbursement was analyzed. Net hospital income was positive for all but one of the tertiary care procedures, but net losses were sustained by the hospital for the mesenteric ischemia and infected aortic graft groups among the Medicare patients. In contrast, the estimated reimbursement to the department of surgery for all payors was insufficient to offset the clinical cost of providing the RVUs for all procedures, and the estimated losses were greater for the Medicare patients alone. The surgeon work effort was dramatically higher for the tertiary care procedures, whereas the reimbursement per work effort was lower. A 15% reduction in reimbursement would result in an estimated net loss to the hospital for each of the tertiary

A crucial step in cell division identified | Center for Cancer Research

Science.gov (United States)

When cell division doesn’t go according to plan, the resulting daughter cells can become unstable or even cancerous. A team of CCR investigators has now discovered a crucial step required for normal cell division to occur. Read more...

Incorporating the principles of the patient- centered medical home into a student-run free clinic

Directory of Open Access Journals (Sweden)

Riddle MC

2014-09-01

Full Text Available Megan C Riddle,1,* Jiahui Lin,3,* Jonathan B Steinman,2 Joshua D Salvi,2 Margaret M Reynolds,3 Anne S Kastor,3,† Christina Harris,4 Carla Boutin-Foster3 1Department of Psychiatry and Behavioral Sciences, University of Washington, 2Weill Cornell/Rockefeller/Sloan-Kettering Tri-Institutional MD–PhD Program, 3Department of Internal Medicine, Weill Cornell Medical College, New York, NY, 4Department of Medicine, Division of General Internal Medicine, VA Greater Los Angeles Healthcare System, David Geffen School of Medicine at UCLA, LA, USA *These authors contributed equally to this work †Anne S Kastor passed away on July 5, 2013. Abstract: As the health care delivery landscape changes, medical schools must develop creative strategies for preparing future physicians to provide quality care in this new environment. Despite the growing prominence of the patient-centered medical home (PCMH as an effective model for health care delivery, few medical schools have integrated formal education on the PCMH into their curricula. Incorporating the PCMH model into medical school curricula is important to ensure that students have a comprehensive understanding of the different models of health care delivery and can operate effectively as physicians. The authors provide a detailed description of the process by which the Weill Cornell Community Clinic (WCCC, a student-run free clinic, has integrated PCMH principles into a service-learning initiative. The authors assessed patient demographics, diagnoses, and satisfaction along with student satisfaction. During the year after a PCMH model was adopted, 112 students and 19 licensed physicians volunteered their time. A review of the 174 patients seen from July 2011 to June 2012 found that the most common medical reasons for visits included management of hypertension, hyperlipidemia, diabetes, gastrointestinal conditions, arthritis, anxiety, and depression. During the year after the adoption of the PCMH model, 87

Military Construction: Renovation Plans at the Portsmouth Naval Medical Center

National Research Council Canada - National Science Library

1997-01-01

The Portsmouth Naval Medical Center is a teaching hospital that provides comprehensive health care services to active duty forces and, when space is available, provides medical services to other DOD beneficiaries (i.e...

Materials Sciences Division 1990 annual report

Energy Technology Data Exchange (ETDEWEB)

1990-12-31

This report is the Materials Sciences Division`s annual report. It contains abstracts describing materials research at the National Center for Electron Microscopy, and for research groups in metallurgy, solid-state physics, materials chemistry, electrochemical energy storage, electronic materials, surface science and catalysis, ceramic science, high tc superconductivity, polymers, composites, and high performance metals.

15 CFR 950.8 - Satellite Data Services Division (SDSD).

Science.gov (United States)

2010-01-01

... 15 Commerce and Foreign Trade 3 2010-01-01 2010-01-01 false Satellite Data Services Division (SDSD... THE ENVIRONMENTAL DATA SERVICE ENVIRONMENTAL DATA AND INFORMATION § 950.8 Satellite Data Services Division (SDSD). The Satellite Data Services Division of the EDIS National Climatic Center provides...

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

Directory of Open Access Journals (Sweden)

Kintzel, Melanie

2009-12-01

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

Marketing the academic medical center group practice.

Science.gov (United States)

Eudes, J A; Divis, K L

1992-01-01

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

Using Technology, Clinical Workflow Redesign, and Team Solutions to Achieve the Patient Centered Medical Home

Science.gov (United States)

2011-01-01

Redesign, and Team Solutions to Achieve the Patient Centered Medical Home LTC Nicole Kerkenbush, MHA, MN Army Medical Department, Office of the...TITLE AND SUBTITLE Using Technology, Clinical Workflow Redesign, and Team Solutions to Achieve the Patient Centered Medical Home 5a. CONTRACT...Describe how these tools are being used to implement the Patient Centered Medical Home care model 2 2011 MHS Conference MEDCOM AHLTA Provider Satisfaction

An Analysis of Medication Errors at the Military Medical Center: Implications for a Systems Approach for Error Reduction

National Research Council Canada - National Science Library

Scheirman, Katherine

2001-01-01

An analysis was accomplished of all inpatient medication errors at a military academic medical center during the year 2000, based on the causes of medication errors as described by current research in the field...

[The Ethics and Deontology division of the French National Council of Medical Doctors, eight years of activity, 1993-2001].

Science.gov (United States)

Hoerni, Bernard

2011-01-01

The activity of the division of Ethics and deontology of the French National council of medical doctors is analysed by its former president (1993-2001). Among a lot of topics, a new version of the professionnal Code of deontology and patients' information were the main subjects of reflection and action.

Investigating Medication Errors in Educational Health Centers of Kermanshah

Directory of Open Access Journals (Sweden)

Mohsen Mohammadi

2015-08-01

Full Text Available Background and objectives : Medication errors can be a threat to the safety of patients. Preventing medication errors requires reporting and investigating such errors. The present study was conducted with the purpose of investigating medication errors in educational health centers of Kermanshah. Material and Methods: The present research is an applied, descriptive-analytical study and is done as a survey. Error Report of Ministry of Health and Medical Education was used for data collection. The population of the study included all the personnel (nurses, doctors, paramedics of educational health centers of Kermanshah. Among them, those who reported the committed errors were selected as the sample of the study. The data analysis was done using descriptive statistics and Chi 2 Test using SPSS version 18. Results: The findings of the study showed that most errors were related to not using medication properly, the least number of errors were related to improper dose, and the majority of errors occurred in the morning. The most frequent reason for errors was staff negligence and the least frequent was the lack of knowledge. Conclusion: The health care system should create an environment for detecting and reporting errors by the personnel, recognizing related factors causing errors, training the personnel and create a good working environment and standard workload.

Reactor Engineering Division annual report

International Nuclear Information System (INIS)

1975-02-01

This report summarizes main research achievements in the 48th fiscal year which were made by Reactor Engineering Division consisted of eight laboratories and Computing Center. The major research and development projects, with which the research programmes in the Division are associated, are development of High Temperature Gas Cooled Reactor for multi-purpose use, development of Liquid Metal Fast Breeder Reactor conducted by Power Reactor and Nuclear Fuel Development Corporation, and Engineering Research Programme for Thermonuclear Fusion Reactor. Many achievements are reported in various research items such as nuclear data and group constants, theoretical method and code development, integral experiment and analysis, shielding, heat transfer and fluid dynamics, reactor and nuclear instrumentation, dynamics analysis and control method development, fusion reactor technology and activities of Computing Center. (auth.)

The Astrophysics Science Division Annual Report 2008

Science.gov (United States)

Oegerle, William; Reddy, Francis; Tyler, Pat

2009-01-01

The Astrophysics Science Division (ASD) at Goddard Space Flight Center (GSFC) is one of the largest and most diverse astrophysical organizations in the world, with activities spanning a broad range of topics in theory, observation, and mission and technology development. Scientific research is carried out over the entire electromagnetic spectrum from gamma rays to radio wavelengths as well as particle physics and gravitational radiation. Members of ASD also provide the scientific operations for three orbiting astrophysics missions WMAP, RXTE, and Swift, as well as the Science Support Center for the Fermi Gamma-ray Space Telescope. A number of key technologies for future missions are also under development in the Division, including X-ray mirrors, and new detectors operating at gamma-ray, X-ray, ultraviolet, infrared, and radio wavelengths. This report includes the Division's activities during 2008.

Operation of medical accelerator PATRO at Hyogo Ion Beam Medical Center

International Nuclear Information System (INIS)

Itano, A.; Akagi, T.; Higashi, A.; Fukushima, S.; Fujita, A.; Honda, Y.; Isa, H.; Nishikigouri, K.

2004-01-01

PATRO (Particle Accelerator for Therapy, Radiology and Oncology) is a medical accelerator facility for hadrontherapy of cancer at Hyogo Ion Beam Medical Center (HIBMC). Beam particles are proton (230 MeV) and carbon (320 MeV/u). After the beam commissioning and the tuning of irradiation system in 2000, we performed the clinical trials with proton and carbon beams from May 2001 until July 2002. We operated the accelerator for about 11,000 hours since the beginning of the beam tuning until the end of the clinical trials and for about 5,000 hours during the clinical trials. No serious troubles happened during the clinical trials. The stability and the reproducibility of the beams were well proved. (author)

A management plan for hospitals and medical centers facing radiation incidents.

Science.gov (United States)

Davari, Fereshteh; Zahed, Arash

2015-09-01

Nowadays, application of nuclear technology in different industries has largely expanded worldwide. Proportionately, the risk of nuclear incidents and the resulting injuries have, therefore, increased in recent years. Preparedness is an important part of the crisis management cycle; therefore efficient preplanning seems crucial to any crisis management plan. Equipped with facilities and experienced personnel, hospitals naturally engage with the response to disasters. The main purpose of our study was to present a practical management pattern for hospitals and medical centers in case they encounter a nuclear emergency. In this descriptive qualitative study, data were collected through experimental observations, sources like Safety manuals released by the International Atomic Energy Agency and interviews with experts to gather their ideas along with Delphi method for polling, and brainstorming. In addition, the 45 experts were interviewed on three targeted using brainstorming and Delphi method. We finally proposed a management plan along with a set of practicality standards for hospitals and medical centers to optimally respond to nuclear medical emergencies when a radiation incident happens nearby. With respect to the great importance of preparedness against nuclear incidents adoption and regular practice of nuclear crisis management codes for hospitals and medical centers seems quite necessary.

Early experiences with big data at an academic medical center.

Science.gov (United States)

Halamka, John D

2014-07-01

Beth Israel Deaconess Medical Center (BIDMC), an academic health care institution affiliated with Harvard University, has been an early adopter of electronic applications since the 1970s. Various departments of the medical center and the physician practice groups affiliated with it have implemented electronic health records, filmless imaging, and networked medical devices to such an extent that data storage at BIDMC now amounts to three petabytes and continues to grow at a rate of 25 percent a year. Initially, the greatest technical challenge was the cost and complexity of data storage. However, today the major focus is on transforming raw data into information, knowledge, and wisdom. This article discusses the data growth, increasing importance of analytics, and changing user requirements that have shaped the management of big data at BIDMC. Project HOPE—The People-to-People Health Foundation, Inc.

Trends in the Use of Medical Imaging to Diagnose Appendicitis at an Academic Medical Center.

Science.gov (United States)

Repplinger, Michael D; Weber, Andrew C; Pickhardt, Perry J; Rajamanickam, Victoria P; Svenson, James E; Ehlenbach, William J; Westergaard, Ryan P; Reeder, Scott B; Jacobs, Elizabeth A

2016-09-01

To quantify the trends in imaging use for the diagnosis of appendicitis. A retrospective study covering a 22-year period was conducted at an academic medical center. Patients were identified by International Classification of Diseases-9 diagnosis code for appendicitis. Medical record data extraction of these patients included imaging test used (ultrasound, CT, or MRI), gender, age, and body mass index (BMI). The proportion of patients undergoing each scan was calculated by year. Regression analysis was performed to determine whether age, gender, or BMI affected imaging choice. The study included a total of 2,108 patients, including 967 (43.5%) females and 599 (27%) children (imaging used for the diagnosis of appendicitis decreased over time (P medical center, CT use increased more than 20-fold. However, no statistically significant trend was found for increased use of ultrasound or MRI. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Patient-centered medical homes for patients with disabilities.

Science.gov (United States)

Hernandez, Brigida; Damiani, Marco; Wang, T Arthur; Driscoll, Carolyn; Dellabella, Peter; LePera, Nicole; Mentari, Michael

2015-01-01

The patient-centered medical home is an innovative approach to improve health care outcomes. To address the unique needs of patients with intellectual and developmental disabilities (IDDs), a large health care provider reevaluated the National Committee for Quality Assurance's 6 medical home standards: (a) enhance access and continuity, (b) identify and manage patient populations, (c) plan and manage care, (d) provide self-care and community support, (e) track and coordinate care, and (f) measure and improve performance. This article describes issues to consider when serving patients with IDDs.

97 Medical Apparatuses tested at the Academic Medical Center (AMC) Amsterdam for interference by WLAN/WiFi signals

NARCIS (Netherlands)

Hensbroek, R.

2009-01-01

This research describes the influence of WLAN 1 signals on medical apparatuses in the Academic Medical Center (AMC) Amsterdam. The results in this report were obtained by testing medical equipment with WLAN signals. A comparable research was reported earlier. See TNO report KvL/P&Z 2007.117 dated

The Emergency Radiological Monitoring and Analysis Division of the United States Federal Radiological Monitoring and Assessment Center

International Nuclear Information System (INIS)

Thome, D.J.

2000-01-01

The U.S. Federal Radiological Emergency Response Plan (FRERP) provides the framework for integrating the various Federal agencies responding to a major radiological emergency. The FRERP authorises the creation of the Federal Radiological Monitoring and Assessment Center (FRMAC), which is established to co-ordinate all Federal agencies involved in the monitoring and assessment of the off-site radiological conditions in support of the impacted States and the Lead Federal Agency (LFA). Within the FRMAC, the Monitoring and Analysis Division is responsible for co-ordinating all FRMAC assets involved in conducting a comprehensive program of environmental monitoring, sampling, radioanalysis, and quality assurance. This program includes: 1. Aerial Radiological Monitoring - Fixed-Wing and Helicopter; 2. Field Monitoring and Sampling; 3. Radioanalysis - Mobile and Fixed Laboratories; 4. Radiation Detection Instrumentation - Calibration and Maintenance; 5. Environmental Dosimetry; 6. Integrated program of Quality Assurance. To assure consistency, completeness, and the quality of the data produced, a methodology and procedures manual is being developed. This paper discusses the structure, assets, and operations of the FRMAC Monitoring and Analysis Division and the content and preparation of the manual. (author)

PASTE: patient-centered SMS text tagging in a medication management system.

Science.gov (United States)

Stenner, Shane P; Johnson, Kevin B; Denny, Joshua C

2012-01-01

To evaluate the performance of a system that extracts medication information and administration-related actions from patient short message service (SMS) messages. Mobile technologies provide a platform for electronic patient-centered medication management. MyMediHealth (MMH) is a medication management system that includes a medication scheduler, a medication administration record, and a reminder engine that sends text messages to cell phones. The object of this work was to extend MMH to allow two-way interaction using mobile phone-based SMS technology. Unprompted text-message communication with patients using natural language could engage patients in their healthcare, but presents unique natural language processing challenges. The authors developed a new functional component of MMH, the Patient-centered Automated SMS Tagging Engine (PASTE). The PASTE web service uses natural language processing methods, custom lexicons, and existing knowledge sources to extract and tag medication information from patient text messages. A pilot evaluation of PASTE was completed using 130 medication messages anonymously submitted by 16 volunteers via a website. System output was compared with manually tagged messages. Verified medication names, medication terms, and action terms reached high F-measures of 91.3%, 94.7%, and 90.4%, respectively. The overall medication name F-measure was 79.8%, and the medication action term F-measure was 90%. Other studies have demonstrated systems that successfully extract medication information from clinical documents using semantic tagging, regular expression-based approaches, or a combination of both approaches. This evaluation demonstrates the feasibility of extracting medication information from patient-generated medication messages.

The Patient-Centered Medical Home Neighbor: A Critical Concept for a Redesigned Healthcare Delivery System

Science.gov (United States)

2011-01-25

Sharing Knowledge: Achieving Breakthrough Performance 2010 Military Health System Conference The Patient -Centered Medical Home Neighbor: A Critical...DATE 25 JAN 2011 2. REPORT TYPE 3. DATES COVERED 00-00-2011 to 00-00-2011 4. TITLE AND SUBTITLE The Patient -Centered Medical Home Neighbor: A...Conference What is the Patient -Centered Medical Home?  …a vision of health care as it should be  …a framework for organizing systems of care at both the

Access to patient-centered medical home among Ohio's Children with Special Health Care Needs.

Science.gov (United States)

Conrey, Elizabeth J; Seidu, Dazar; Ryan, Norma J; Chapman, Dj Sam

2013-06-01

Medical homes deliver primary care that is accessible, continuous, comprehensive, family centered, coordinated, compassionate and culturally effective. Children with special health care needs (CSHCN) require a wide range of support to maintain health, making medical home access particularly important. We sought to understand independent risk factors for lacking access. We analyzed Ohio, USA data from the National Survey of Children with Special Health Care Needs (2005-2006). Among CSHCN, 55.6% had medical home access. The proportion achieving each medical home component was highest for having a personal doctor/nurse and lowest for receiving coordinated care, family-centered care and referrals. Specific subsets of CSHCN were significantly and independently more likely to lack medical home access: Hispanic (AOR=3.08), moderate/high severity of difficulty (AOR=2.84), and any public insurance (AOR=1.60). Efforts to advance medical home access must give special attention to these CSHCN populations and improvements must be made to referral access, family-centered care, and care coordination.

A management plan for hospitals and medical centers facing radiation incidents

Directory of Open Access Journals (Sweden)

Fereshteh Davari

2015-01-01

Full Text Available Background: Nowadays, application of nuclear technology in different industries has largely expanded worldwide. Proportionately, the risk of nuclear incidents and the resulting injuries have, therefore, increased in recent years. Preparedness is an important part of the crisis management cycle; therefore efficient preplanning seems crucial to any crisis management plan. Equipped with facilities and experienced personnel, hospitals naturally engage with the response to disasters. The main purpose of our study was to present a practical management pattern for hospitals and medical centers in case they encounter a nuclear emergency. Materials and Methods: In this descriptive qualitative study, data were collected through experimental observations, sources like Safety manuals released by the International Atomic Energy Agency and interviews with experts to gather their ideas along with Delphi method for polling, and brainstorming. In addition, the 45 experts were interviewed on three targeted using brainstorming and Delphi method. Results: We finally proposed a management plan along with a set of practicality standards for hospitals and medical centers to optimally respond to nuclear medical emergencies when a radiation incident happens nearby. Conclusion: With respect to the great importance of preparedness against nuclear incidents adoption and regular practice of nuclear crisis management codes for hospitals and medical centers seems quite necessary.

Safety and Health Division achievements during 40 years

International Nuclear Information System (INIS)

Noriah Mod Ali

2012-01-01

During her speech, presenter outlined several issues regarding on establishment of Safety and Health Division since 40 years. This division contain of 3 sub unit; Physical Safety Group, Medical Physic Group and Non-ionizing Radiation group (NIR). The objectives of this division to implement R and D activities and services regarding safety and radiological health also non-radiological to ensure public safety, environment and asset suit with obligations established by authorities, IAEA standards and regulations.(author)

A renewed Medication Adherence Alliance call to action: harnessing momentum to address medication nonadherence in the United States

Directory of Open Access Journals (Sweden)

Zullig LL

2016-07-01

Full Text Available Leah L Zullig,1,2 Bradi B Granger,3 Hayden B Bosworth,1–4 On behalf of the Medication Adherence Alliance 1Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, 2Division of General Internal Medicine, Department of Medicine, Duke University, 3Duke Heart Center Nursing Research Program, School of Nursing, Duke University, 4Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA The problem: Nonadherence to prescription medications is a common and costly problem with multiple contributing factors, spanning the dimensions of individual behavior change, psychology, medicine, and health policy, among others. Addressing the problem of medication nonadherence requires strategic input from key experts in a number of fields.Meeting of experts: The Medication Adherence Alliance is a group of key experts, predominately from the US, in the field of medication nonadherence. Members include representatives from consumer advocacy groups, community health providers, nonprofit groups, the academic community, decision-making government officials, and industry. In 2015, the Medication Adherence Alliance convened to review the current landscape of medication adherence. The group then established three working groups that will develop recommendations for shifting toward solutions-oriented science.Commentary of expert opinion: From the perspective of the Medication Adherence Alliance, the objective of this commentary is to describe changes in the US landscape of medication adherence, framing the evolving field in the context of a recent think tank meeting of experts in the field of medication adherence. Keywords: medication adherence, health planning recommendations, chronic disease

The patient-centered medical home neighbor: A primary care physician's view.

Science.gov (United States)

Sinsky, Christine A

2011-01-04

The American College of Physicians' position paper on the patient-centered medical home neighbor (PCMH-N) extends the work of the patient-centered medical home (PCMH) as a means of improving the delivery of health care. Recognizing that the PCMH does not exist in isolation, the PCMH-N concept outlines expectations for comanagement, communication, and care coordination and broadens responsibility for safe, effective, and efficient care beyond primary care to include physicians of all specialties. As such, it is a fitting follow-up to the PCMH and moves further down the road toward improved care for complex patients. Yet, there is more work to be done. Truly transforming the U.S. health care system around personalized medical homes embedded in highly functional medical neighborhoods will require better staffing models; more robust electronic information tools; aligned incentives for quality and efficiency within payment and regulatory policies; and a culture of greater engagement of patients, their families, and communities.

Saclay Center of Nuclear Studies, Direction of Materials and Nuclear Fuels, Department of Physico-Chemistry, Division of Physical Chemistry. 1968 Annual report

International Nuclear Information System (INIS)

Schmidt, M.; Clerc, M.; Le Calve, J.; Bourene, M.; Lesigne, B.; Gillois, M.; Devillers, C.; Arvis, M.; Gilles, L.; Moreau, M.; Sutton, J.; Faraggi, M.; Desalos, J.; Tran Dinh Son; Barat, F.; Hickel, B.; Chachaty, C.; Forchioni, A.; Shiotani, M.; Larher, Y.; Maurice, P.; Le Bail, H.; Nenner, T.

1969-03-01

This document is the 1968 annual report of research activities at the Physico-Chemistry Department (Physical Chemistry Division), part of the Directorate of Materials and Nuclear Fuels of the CEA Saclay center of nuclear studies. The report is divided into two main parts: radiolysis and photolysis studies (gaseous phase, condensed phase), and general physico-chemical studies (sorption, molecular jets)

Division of Biological and Medical Research annual technical report 1982

International Nuclear Information System (INIS)

Rosenthal, M.W.

1983-05-01

This report summarizes research during 1982 in the Division of Biological and Medical Research, Argonne National Laboratory. Studies in Carcinogenesis address mechanisms of chemical and radiation carcinogenesis including the processes of tumor initiation and promotion. The studies employ rat liver and mouse skin models as well as human rodent cell culture systems. The use of liposomes for metal mobilization is also explored. Low Level Radiation studies include delineation of the hematopoietic and other responses of dogs to continuous low level gamma irradiation, comparison of lifetime effects in mice of low level neutron and gamma irradiation, and study of the genetic effects of high LET radiation. Molecular Biology research develops two-dimensional electrophoresis systems for diagnosis and detection of cancer and other diseases. Fundamental structural and biophysical investigations of immunoglobulins and other key proteins are included, as are studies of cell growth, and of molecular and cellular effects of solar uv light. Research in Toxicology uses cellular, physiological, whole animal, and chronobiological end points and chemical separations to elucidate mechanisms and evaluate hazards of coal conversion by-products, actinides, and toxic metals. The final sections cover support facilities, educational activities, seminars, staff talks, staff, and funding agencies

Division of Biological and Medical Research annual technical report, 1981

International Nuclear Information System (INIS)

Rosenthal, M.W.

1982-06-01

This report summarizes research during 1981 in the Division of Biological and Medical Research, Argonne National Laboratory. Studies in Low Level Radiation include comparison of lifetime effects in mice of low level neutron and gamma irradiation, delineation of the responses of dogs to continuous low level gamma irradiation, elucidation of mechanisms of radiation damage and repair in mammalian cells, and study of the genetic effects of high LET radiations. Carcinogenesis research addresses mechanisms of tumor initiation and promotion in rat liver, chemical carcinogenesis in cultured mammalian cells, and molecular and genetic mechanisms of chemical and ultraviolet mutagenesis in bacteria. Research in Toxicology uses a variety of cellular, whole animal, and chronobiological end points, chemical separations, and statistical models to evaluate the hazards and mechanisms of actions of metals, coal gasification by products, and other energy-related pollutants. Human Protein Index studies develop two-dimensional electrophoresis systems for diagnosis and detection of cancer and other disease. Biophysics research includes fundamental structural and biophysical investigations of immunoglobulins and key biological molecules using NMR, crystallographic, and x-ray and neutron small-angle scattering techniques. The final sections cover support facilities, educational activities, seminars, staff talks, staff, and funding agencies

Division of Biological and Medical Research annual technical report 1982

Energy Technology Data Exchange (ETDEWEB)

Rosenthal, M.W. (ed.)

1983-05-01

This report summarizes research during 1982 in the Division of Biological and Medical Research, Argonne National Laboratory. Studies in Carcinogenesis address mechanisms of chemical and radiation carcinogenesis including the processes of tumor initiation and promotion. The studies employ rat liver and mouse skin models as well as human rodent cell culture systems. The use of liposomes for metal mobilization is also explored. Low Level Radiation studies include delineation of the hematopoietic and other responses of dogs to continuous low level gamma irradiation, comparison of lifetime effects in mice of low level neutron and gamma irradiation, and study of the genetic effects of high LET radiation. Molecular Biology research develops two-dimensional electrophoresis systems for diagnosis and detection of cancer and other diseases. Fundamental structural and biophysical investigations of immunoglobulins and other key proteins are included, as are studies of cell growth, and of molecular and cellular effects of solar uv light. Research in Toxicology uses cellular, physiological, whole animal, and chronobiological end points and chemical separations to elucidate mechanisms and evaluate hazards of coal conversion by-products, actinides, and toxic metals. The final sections cover support facilities, educational activities, seminars, staff talks, staff, and funding agencies.

Division of Biological and Medical Research annual technical report, 1981

Energy Technology Data Exchange (ETDEWEB)

Rosenthal, M.W. (ed.)

1982-06-01

This report summarizes research during 1981 in the Division of Biological and Medical Research, Argonne National Laboratory. Studies in Low Level Radiation include comparison of lifetime effects in mice of low level neutron and gamma irradiation, delineation of the responses of dogs to continuous low level gamma irradiation, elucidation of mechanisms of radiation damage and repair in mammalian cells, and study of the genetic effects of high LET radiations. Carcinogenesis research addresses mechanisms of tumor initiation and promotion in rat liver, chemical carcinogenesis in cultured mammalian cells, and molecular and genetic mechanisms of chemical and ultraviolet mutagenesis in bacteria. Research in Toxicology uses a variety of cellular, whole animal, and chronobiological end points, chemical separations, and statistical models to evaluate the hazards and mechanisms of actions of metals, coal gasification by products, and other energy-related pollutants. Human Protein Index studies develop two-dimensional electrophoresis systems for diagnosis and detection of cancer and other disease. Biophysics research includes fundamental structural and biophysical investigations of immunoglobulins and key biological molecules using NMR, crystallographic, and x-ray and neutron small-angle scattering techniques. The final sections cover support facilities, educational activities, seminars, staff talks, staff, and funding agencies.

76 FR 71045 - Center for Biologics Evaluation and Research Report of Scientific and Medical Literature and...

Science.gov (United States)

2011-11-16

...] Center for Biologics Evaluation and Research Report of Scientific and Medical Literature and Information... period for the notice on its report of scientific and medical literature and information concerning the... ``Center for Biologics Evaluation and Research Report of Scientific and Medical Literature and Information...

Walter Reed Army Medical Center's Internet-based electronic health portal.

Science.gov (United States)

Abbott, Kevin C; Boocks, Carl E; Sun, Zhengyi; Boal, Thomas R; Poropatich, Ronald K

2003-12-01

Use of the World Wide Web (WWW) and electronic media to facilitate medical care has been the subject of many reports in the popular press. However, few reports have documented the results of implementing electronic health portals for essential medical tasks, such as prescription refills and appointments. At Walter Reed Army Medical Center, "Search & Learn" medical information, Internet-based prescription refills and patient appointments were established in January 2001. A multiphase retrospective analysis was conducted to determine the use of the "Search & Learn" medical information and the relative number of prescription refills and appointments conducted via the WWW compared with conventional methods. From January 2001 to May 2002, there were 34,741 refills and 819 appointments made over the Internet compared with 2,275,112 refills and approximately 500,000 appointments made conventionally. WWW activity accounted for 1.52% of refills and 0.16% of appointments. There was a steady increase in this percentage over the time of the analysis. In April of 2002, the monthly average of online refills had risen to 4.57% and online appointments were at 0.27%. Online refills were projected to account for 10% of all prescriptions in 2 years. The "Search & Learn" medical information portion of our web site received 147,429 unique visits during this same time frame, which was an average of 326 visitors per day. WWW-based methods of conducting essential medical tasks accounted for a small but rapidly increasing percentage of total activity at Walter Reed Army Medical Center. Subsequent phases of analysis will assess demographic and geographic factors and aid in the design of future systems to increase use of the Internet-based systems.

Comparison of chosen physical fitness characteristics of Turkish professional basketball players by division and playing position.

Science.gov (United States)

Köklü, Yusuf; Alemdaroğlu, Utku; Koçak, Fatma Ünver; Erol, A Emre; Fındıkoğlu, Gülin

2011-12-01

The purpose of the present study was to compare chosen physical fitness characteristics of Turkish professional basketball players in different divisions (first and second division) and playing positions. Forty-five professional male basketball players (14 guards, 15 forwards, 16 centers) participated in this study voluntarily. For each player, anthropometric measurements were performed, as well as a multi-stage 20 m shuttle run, isokinetic leg strength, squat jump (SJ), countermovement jump (CMJ), 10-30 meter single-sprint and T-drill agility tests. The differences in terms of division were evaluated by independent t-test and the differences by playing position were evaluated by one-way ANOVA with Post Hoc Tukey test. First division players' CMJ measurements were significantly higher than those of second division players' (p≤0.05), whereas second division players' 10 m sprint times were significantly better than those of first division players' (p≤0.05). In addition, forwards and centers were significantly taller than guards. Centers were significantly heavier and their T-drill test performances were inferior to those of forwards and guards (p≤0.05). Moreover, guards had a significantly higher maximal oxygen uptake (VO2 max) than centers. Guards and forwards showed significantly better performance in the 10 and 30 m sprint tests than centers (p≤0.05). Forwards and centers had significantly better left leg flexor strength at 180°.s(-1)(p≤0.05). In conclusion, the findings of the present study indicated that physical performance of professional basketball players differed among guards, forwards and centers, whereas there were not significant differences between first and second division players. According to the present study, court positions have different demands and physical attributes which are specific to each playing position in professional basketball players. Therefore, these results suggest that coaches should tailor fitness programs according to

78 FR 74163 - Harrison Medical Center, a Subsidiary of Franciscan Health System Bremerton, Washington; Notice...

Science.gov (United States)

2013-12-10

... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-83,070] Harrison Medical Center, a Subsidiary of Franciscan Health System Bremerton, Washington; Notice of Negative Determination... workers of Harrison Medical Center, a subsidiary of Franciscan Health System, Bremerton, Washington...

78 FR 10610 - TRICARE; Demonstration Project for Participation in Maryland Multi-Payer Patient Centered Medical...

Science.gov (United States)

2013-02-14

... National Committee on Quality Assurance Patient Centered Medical Home (PPC-PCMH) recognition criteria... quality improvements. TMA Defense Health Cost Assessment and Evaluation (DHCAPE) staff will calculate... Maryland Multi-Payer Patient Centered Medical Home Program (MMPCMHP) Demonstration AGENCY: Department of...

Quality control in the low activity radioanalytical laboratory of the Environmental Division, DIEAM.CN of NUCLEBRAS Research Center - CDTN

International Nuclear Information System (INIS)

Carvalho, M.A.G. de

1988-01-01

The Environmental Engineering Division - DIEAM.CN of NUCLEBRAS research center - CTDN, is in charge of the routine work related to the analysis of environment samples collected at several NUCLEBRAS facilities. This paper presents the procedures used for quality control of the analyses performed at the Laboratory. The samples are initially verified and recorded as soon as they arrive at the Division. From then on, each aliquot and each analysis will be controlled using a follow-up sheet. Once a year, the operational conditions of the Lab couting systems are verified thoroughly. At that time, the systems are calibrated using certified radioactivity standards. Performance of the detectors is checked using control graphs, which can indicate the need for specific procedures to be followed such as maintenance, decontamination or recalibration. In order to reduce the risk of mistakes and to increase the capacity for global data evaluation, a microcomputer is used for processing the counting data and for editing a final report. (author) [pt

Roles of Medical Record and Statistic Staff on Research at the Tawanchai Center.

Science.gov (United States)

Pattaranit, Rumpan; Chantachum, Vasana; Lekboonyasin, Orathai; Pradubwong, Suteera

2015-08-01

The medical record and statistic staffs play a crucial role behind the achievements of treatment and research of physicians, nurses and other health care professionals. The medical record and statistic staff are in charge of keeping patient medical records; creating databases; presenting information; sorting patient's information; providing patient medical records and related information for various medical teams and researchers; Besides, the medical record and statistic staff have collaboration with the Center of Cleft Lip-Palate, Khon Kaen University in association with the Tawanchai Project. The Tawanchai Center is an organization, involving multidisciplinary team which aims to continuing provide care for patients with cleft lip and palate and craniofacial deformities who need a long term of treatment since newborns until the age of 19 years. With support and encouragement from the Tawanchai team, the medical record and statistic staff have involved in research under the Tawanchai Centre since then and produced a number of publications locally and internationally.

Development of a longitudinal integrated clerkship at an academic medical center.

Science.gov (United States)

Poncelet, Ann; Bokser, Seth; Calton, Brook; Hauer, Karen E; Kirsch, Heidi; Jones, Tracey; Lai, Cindy J; Mazotti, Lindsay; Shore, William; Teherani, Arianne; Tong, Lowell; Wamsley, Maria; Robertson, Patricia

2011-04-04

In 2005, medical educators at the University of California, San Francisco (UCSF), began developing the Parnassus Integrated Student Clinical Experiences (PISCES) program, a year-long longitudinal integrated clerkship at its academic medical center. The principles guiding this new clerkship were continuity with faculty preceptors, patients, and peers; a developmentally progressive curriculum with an emphasis on interdisciplinary teaching; and exposure to undiagnosed illness in acute and chronic care settings. Innovative elements included quarterly student evaluation sessions with all preceptors together, peer-to-peer evaluation, and oversight advising with an assigned faculty member. PISCES launched with eight medical students for the 2007/2008 academic year and expanded to 15 students for 2008/2009. Compared to UCSF's traditional core clerkships, evaluations from PISCES indicated significantly higher student satisfaction with faculty teaching, formal didactics, direct observation of clinical skills, and feedback. Student performance on discipline-specific examinations and United States Medical Licensing Examination step 2 CK was equivalent to and on standardized patient examinations was slightly superior to that of traditional peers. Participants' career interests ranged from primary care to surgical subspecialties. These results demonstrate that a longitudinal integrated clerkship can be implemented successfully at a tertiary care academic medical center.

Business Case Analysis of the Walter Reed Army Medical Center Medical/Surgical Prime Vendor Generation III Service Level Electron Program

National Research Council Canada - National Science Library

Markot, Peter B

2007-01-01

...) staffing and medical/surgical services offered under the Prime Vendor (PV) Generation III contract would provide the best supply chain management solution for Walter Reed Army Medical Center (WRAMC...

Patient-Centered Medical Home in chronic obstructive pulmonary disease

Directory of Open Access Journals (Sweden)

Ortiz G

2011-10-01

Full Text Available Gabriel Ortiz1, Len Fromer21Pediatric Pulmonary Services, El Paso, TX; 2Department of Family Medicine, David Geffen School of Medicine, UCLA, Los Angeles, CA, USAAbstract: Chronic obstructive pulmonary disease (COPD is a progressive and debilitating but preventable and treatable disease characterized by cough, phlegm, dyspnea, and fixed or incompletely reversible airway obstruction. Most patients with COPD rely on primary care practices for COPD management. Unfortunately, only about 55% of US outpatients with COPD receive all guideline-recommended care. Proactive and consistent primary care for COPD, as for many other chronic diseases, can reduce hospitalizations. Optimal chronic disease management requires focusing on maintenance rather than merely acute rescue. The Patient-Centered Medical Home (PCMH, which implements the chronic care model, is a promising framework for primary care transformation. This review presents core PCMH concepts and proposes multidisciplinary team-based PCMH care strategies for COPD.Keywords: Patient-Centered Medical Home, chronic care model, chronic obstructive pulmonary disease, patient education, physician assistants, nurse practitioners

Naval Undersea Warfare Center Division Newport utilities metering, Phase 1

Energy Technology Data Exchange (ETDEWEB)

Carroll, D.M.

1992-11-01

Pacific Northwest Laboratory developed this report for the US Navy`s Naval Undersea Warfare Center Division Newport, Rhode Island (NUWC). The purpose of the report was to review options for metering electricity and steam used in the NUWC compound, and to make recommendations to NUWC for implementation under a follow-on project. An additional NUWC concern is a proposed rate change by the servicing utility, Newport Electric, which would make a significant shift from consumption to demand billing, and what effect that rate change would have on the NUWC utility budget. Automated, remote reading meters are available which would allow NUWC to monitor its actual utility consumption and demand for both the entire NUWC compound and by end-use in individual buildings. Technology is available to perform the meter reads and manipulate the data using a personal computer with minimal staff requirement. This is not meant to mislead the reader into assuming that there is no requirement for routine preventive maintenance. All equipment requires routine maintenance to maintain its accuracy. While PNL reviewed the data collected during the site visit, however, it became obvious that significant opportunities exist for reducing the utility costs other than accounting for actual consumption and demand. Unit costs for both steam and electricity are unnecessarily high, and options are presented in this report for reducing them. Additionally, NUWC has an opportunity to undertake a comprehensive energy resource management program to significantly reduce its energy demand, consumption, and costs.

Naval Undersea Warfare Center Division Newport utilities metering, Phase 1

Energy Technology Data Exchange (ETDEWEB)

Carroll, D.M.

1992-11-01

Pacific Northwest Laboratory developed this report for the US Navy's Naval Undersea Warfare Center Division Newport, Rhode Island (NUWC). The purpose of the report was to review options for metering electricity and steam used in the NUWC compound, and to make recommendations to NUWC for implementation under a follow-on project. An additional NUWC concern is a proposed rate change by the servicing utility, Newport Electric, which would make a significant shift from consumption to demand billing, and what effect that rate change would have on the NUWC utility budget. Automated, remote reading meters are available which would allow NUWC to monitor its actual utility consumption and demand for both the entire NUWC compound and by end-use in individual buildings. Technology is available to perform the meter reads and manipulate the data using a personal computer with minimal staff requirement. This is not meant to mislead the reader into assuming that there is no requirement for routine preventive maintenance. All equipment requires routine maintenance to maintain its accuracy. While PNL reviewed the data collected during the site visit, however, it became obvious that significant opportunities exist for reducing the utility costs other than accounting for actual consumption and demand. Unit costs for both steam and electricity are unnecessarily high, and options are presented in this report for reducing them. Additionally, NUWC has an opportunity to undertake a comprehensive energy resource management program to significantly reduce its energy demand, consumption, and costs.

Bendix Kansas City Division technological spinoff through 1978

International Nuclear Information System (INIS)

Barnes, H.T.

1979-02-01

The results of work of Bendix Kansas City Division are made available in the form of technical reports that are processed through the DOE Technical Information Center in Oak Ridge. The present report lists the documents released by the Division, along with author and subject indexes. Drawing sets released are also listed. Locations of report collections in the U.S., other countries, and international agencies are provided

DOE Center of Excellence in Medical Laser Applications. Final report, December 1, 1994--November 30, 1997

Energy Technology Data Exchange (ETDEWEB)

Jacques, S.L.

1998-01-01

An engineering network of collaborating medical laser laboratories are developing laser and optical technologies for medical diagnosis and therapy and are translating the engineering into medical centers in Portland OR, Houston TX, and Galveston TX. The Center includes the University of Texas M.D. Anderson Cancer Center, the University of Texas-Austin, Texas A and M University, Rice University, the University Texas Medical Branch-Galveston, Oregon Medical Laser Center (Providence St. Vincent Medical Center, Oregon Health Sciences University, and Oregon Graduate Institute, Portland, OR), and the University of Oregon. Diagnostics include reflectance, fluorescence, Raman IR, laser photoacoustics, optical coherence tomography, and several new video techniques for spectroscopy and imaging. Therapies include photocoagulation therapy, laser welding, pulsed laser ablation, and light-activated chemotherapy of cancer (photodynamic therapy, or PDT). Medical applications reaching the clinic include optical monitoring of hyperbilirubinemia in newborns, fluorescence detection of cervical dysplasia, laser thrombolysis of blood clots in heart attack and brain stroke, photothermal coagulant of benign prostate hyperplasia, and PDT for both veterinary and human cancer. New technologies include laser optoacoustic imaging of breast tumors and hemorrhage in head trauma and brain stroke, quality control monitoring of dosimetry during PDT for esophageal and lung cancer, polarization video reflectometry of skin cancer, laser welding of artificial tissue replacements, and feedback control of laser welding.

Relating calls to US poison centers for potential exposures to medications to Centers for Disease Control and Prevention reporting of influenza-like illness.

Science.gov (United States)

Beauchamp, Gillian A; McKeown, Nathanael J; Rodriguez, Sergio; Spyker, Daniel A

2016-03-01

The Centers for Disease Control (CDC) monitors influenza like illness (ILI) and the National Poison Data System (NPDS) warehouses call data uploaded by US poison centers regarding reported exposures to medication. We examined the relationship between calls to poison centers regarding reported exposures to medications commonly used to treat ILI and weekly reports of ILI. The CDC reports ILI, by age group, for each of 10 Health and Human Services (HHS) regions. We examined NPDS summary data from calls reported to poison centers regarding reported exposures to acetaminophen, cough/cold medications, and promethazine, for the same weeks, age groups, and HHS regions for influenza seasons 2000-2013. ILI and NPDS exposures were examined using graphical plots, descriptive statistics, stepwise regression analysis, and Geographic Information Systems (GIS). About 5,101,841 influenza-like illness cases were reported to the CDC, and 2,122,940 calls regarding reported exposures to medications commonly used to treat ILI, were reported by poison centers to the NPDS over the 13 flu seasons. Analysis of stepwise models of the linear untransformed data involving 24 NPDS data groups and for 60 ILI measures, over the 13 influenza seasons, demonstrated that reported exposures to medications used to treat ILI correlated with reported cases of ILI with a median R(2 )=( )0.489 (min R(2 )=( )0.248, max R(2 )=( )0.717), with mean ± SD of R(2 )=( )0.494 ± 0.121. Median number of parameters used (degrees of freedom - 1) was 7. NPDS data regarding poison center calls for selected ILI medication exposures were highly correlated with CDC ILI data. Since NPDS data are available in real time, it provides complimentary ILI monitoring. This approach may provide public health value in predicting other illnesses which are not currently as thoroughly monitored.

Hospital CIO Explains Blockchain Potential: An Interview with Beth Israel Deaconess Medical Center's John Halamka.

Science.gov (United States)

Mertz, Leslie

2018-01-01

Work is already underway to bring blockchain technology to the healthcare industry, and hospital administrators are trying to figure out what it can do for them, their clinicians, and their patients. That includes administrators at Beth Israel Deaconess Medical Center, a leading academic medical center located in Boston.

A Study to Determine Patient Waiting Time at the Outpatient Pharmacy at Wilford Hall USAF Medical Center

Science.gov (United States)

1988-06-01

at Wilford Hall USAF Medical Center significantly reduced the patient wait time at the main outpatient pharmacy. Satellite pharmacies have been ).’l...PRESENTING TO WINDOW 1, 19 MAR 88. 47 C:. A’.’E-:A: -ESCRIRTIONS PER PATIENT ...........48 H. WILFORD HALL MEDICAL CENTER OUTPATIENT QUESTIONNAIRE...that wait times at tne outpatient pharmacy were excessive. It was this concern that motivated the Medical Center Administrator to request that patient

ADP Analysis project for the Human Resources Management Division

Science.gov (United States)

Tureman, Robert L., Jr.

1993-01-01

The ADP (Automated Data Processing) Analysis Project was conducted for the Human Resources Management Division (HRMD) of NASA's Langley Research Center. The three major areas of work in the project were computer support, automated inventory analysis, and an ADP study for the Division. The goal of the computer support work was to determine automation needs of Division personnel and help them solve computing problems. The goal of automated inventory analysis was to find a way to analyze installed software and usage on a Macintosh. Finally, the ADP functional systems study for the Division was designed to assess future HRMD needs concerning ADP organization and activities.

Development of a longitudinal integrated clerkship at an academic medical center

Directory of Open Access Journals (Sweden)

Ann Poncelet

2011-04-01

Full Text Available In 2005, medical educators at the University of California, San Francisco (UCSF, began developing the Parnassus Integrated Student Clinical Experiences (PISCES program, a year-long longitudinal integrated clerkship at its academic medical center. The principles guiding this new clerkship were continuity with faculty preceptors, patients, and peers; a developmentally progressive curriculum with an emphasis on interdisciplinary teaching; and exposure to undiagnosed illness in acute and chronic care settings. Innovative elements included quarterly student evaluation sessions with all preceptors together, peer-to-peer evaluation, and oversight advising with an assigned faculty member. PISCES launched with eight medical students for the 2007/2008 academic year and expanded to 15 students for 2008/2009. Compared to UCSF's traditional core clerkships, evaluations from PISCES indicated significantly higher student satisfaction with faculty teaching, formal didactics, direct observation of clinical skills, and feedback. Student performance on discipline-specific examinations and United States Medical Licensing Examination step 2 CK was equivalent to and on standardized patient examinations was slightly superior to that of traditional peers. Participants’ career interests ranged from primary care to surgical subspecialties. These results demonstrate that a longitudinal integrated clerkship can be implemented successfully at a tertiary care academic medical center.

Integration of pharmacists into a patient-centered medical home.

Science.gov (United States)

Scott, Mollie Ashe; Hitch, Bill; Ray, Lisa; Colvin, Gaye

2011-01-01

To define the joint principles of the patient-centered medical home (PCMH) and describe the integration of pharmacists into a PCMH. Family medicine residency training program in North Carolina from 2001 to 2011. Mountain Area Health Education Family Health Center is a family medicine residency training program that is part of the North Carolina Area Health Education Center system. The goal of the organization is to train and retain health care students and residents. The practice is recognized as a level III PCMH by the National Committee for Quality Assurance (NCQA) and seeks to provide quality, safe, patient-centered care according to the joint principles of PCMH. Pharmacists, nurses, nutritionists, care managers, Spanish translators, and behavioral medicine specialists work collaboratively with physicians to provide seamless, comprehensive care. The Department of Pharmacotherapy is embedded in the family medicine clinic. Three pharmacists and two pharmacy residents are involved in providing direct patient care services, ensuring access to community resources, assisting patients with transitions of care, providing interprofessional education, and participating in continuous quality improvement initiatives. The pharmacists serve as clinical pharmacist practitioners and provide medication therapy management services in a pharmacotherapy clinic, anticoagulation clinics, and an osteoporosis clinic and via an inpatient family medicine service. Multiple learners such as student pharmacists, pharmacy residents, and family medicine residents rotate through the various pharmacy clinics to learn about pharmacotherapeutic principles and the role of the pharmacist in PCMH. PCMH is a comprehensive, patient-centered, team-based approach to population management in the primary care setting. Pharmacists play a vital role in PCMH and make fundamental contributions to patient care across health care settings. Such innovations in the ambulatory care setting create a unique niche

Exploring Summer Medical Care Within the National Collegiate Athletic Association Division I Setting: A Perspective From the Athletic Trainer.

Science.gov (United States)

Mazerolle, Stephanie M; Eason, Christianne M; Goodman, Ashley

2016-02-01

Over the last few decades, the National Collegiate Athletics Association (NCAA) has made changes related to the increase in sanctioned team activities during summer athletics. These changes may affect how athletic training services are provided. To investigate the methods by which athletic training departments of NCAA institutions manage expectations regarding athletic training services during the summer. Mixed-methods qualitative and quantitative study. The NCAA Division I. Twenty-two athletic trainers (13 men, 9 women) participated. All were employed full time within the NCAA Division I setting. Participants were 35 ± 8 years of age (range, 26-52 years), with 12 ± 7 years (range, 3-29 years) of athletic training experience. All participants completed a series of questions online that consisted of closed- (demographic and Likert-scale 5-point) and open-ended items that addressed the research questions. Descriptive statistics, frequency distributions, and phenomenologic analyses were completed with the data. Peer review and multiple-analyst triangulation established credibility. Summer athletic training services included 3 primary mechanisms: individual medical care, shared medical care, or a combination of the 2. Participants reported working 40 ± 10 hours during the summer. Likert-item analysis showed that participants were moderately satisfied with their summer medical care structure (3.3 ± 1.0) and with the flexibility of summer schedules (3.0 ± 1.2). Yet the qualitative analysis revealed that perceptions of summer medical care were more positive for shared-care participants than for individual- or combination-care participants. The perceived effect on the athletic trainer included increased workload and expectations and a negative influence on work-life balance, particularly in terms of decreased schedule flexibility and opportunities for rejuvenation. For many, the summer season mimicked the hours, workload, and expectations of the nontraditional season

Early Lessons on Bundled Payment at an Academic Medical Center.

Science.gov (United States)

Jubelt, Lindsay E; Goldfeld, Keith S; Blecker, Saul B; Chung, Wei-Yi; Bendo, John A; Bosco, Joseph A; Errico, Thomas J; Frempong-Boadu, Anthony K; Iorio, Richard; Slover, James D; Horwitz, Leora I

2017-09-01

Orthopaedic care is shifting to alternative payment models. We examined whether New York University Langone Medical Center achieved savings under the Centers for Medicare and Medicaid Services Bundled Payments for Care Improvement initiative. This study was a difference-in-differences study of Medicare fee-for-service patients hospitalized from April 2011 to June 2012 and October 2013 to December 2014 for lower extremity joint arthroplasty, cardiac valve procedures, or spine surgery (intervention groups), or for congestive heart failure, major bowel procedures, medical peripheral vascular disorders, medical noninfectious orthopaedic care, or stroke (control group). We examined total episode costs and costs by service category. We included 2,940 intervention episodes and 1,474 control episodes. Relative to the trend in the control group, lower extremity joint arthroplasty episodes achieved the greatest savings: adjusted average episode cost during the intervention period decreased by $3,017 (95% confidence interval [CI], -$6,066 to $31). For cardiac procedures, the adjusted average episode cost decreased by $2,999 (95% CI, -$8,103 to $2,105), and for spinal fusion, it increased by $8,291 (95% CI, $2,879 to $13,703). Savings were driven predominantly by shifting postdischarge care from inpatient rehabilitation facilities to home. Spinal fusion index admission costs increased because of changes in surgical technique. Under bundled payment, New York University Langone Medical Center decreased total episode costs in patients undergoing lower extremity joint arthroplasty. For patients undergoing cardiac valve procedures, evidence of savings was not as strong, and for patients undergoing spinal fusion, total episode costs increased. For all three conditions, the proportion of patients referred to inpatient rehabilitation facilities upon discharge decreased. These changes were not associated with an increase in index hospital length of stay or readmission rate

Dealing With Deans and Academic Medical Center Leadership: Advice From Leaders.

Science.gov (United States)

Sanfilippo, Fred; Powell, Deborah; Folberg, Robert; Tykocinski, Mark

2018-01-01

The 2017 Association of Pathology Chairs Annual Meeting included a session for department chairs and other department leaders on "how to deal with deans and academic medical center leadership." The session was focused on discussing ways to foster positive relationships with university, medical school, and health system leaders, and productively address issues and opportunities with them. Presentations and a panel discussion were provided by 4 former pathology chairs who subsequently have served as medical deans and in other leadership positions including university provost, medical center CEO, and health system board chair. There was a strong consensus among the participants on how best to deal with superiors about problems, conflicts, and requests for additional resources and authority. The importance of teamwork and accountability in developing a constructive and collaborative relationship with leaders and peers was discussed in detail. Effectiveness in communication, negotiation, and departmental advocacy were highlighted as important skills. As limited resources and increased regulations have become growing problems for universities and health systems, internal stress and competition have increased. In this rapidly changing environment, advice on how chairs can interact most productively with institutional leaders is becoming increasingly important.

Physician Payment Methods and the Patient-Centered Medical Home: Comment on "A Troubled Asset Relief Program for the Patient-Centered Medical Home".

Science.gov (United States)

Quinn, Kevin

This commentary analyzes the patient-centered medical home (PCMH) model within a framework of the 8 basic payment methods in health care. PCMHs are firmly within the fee-for-service tradition. Changes to the process and structure of the Resource Based Relative Value Scale, which underlies almost all physician fee schedules, could make PCMHs more financially viable. Of the alternative payment methods being considered, shared savings models are unlikely to transform medical practice whereas capitation models place unrealistic expectations on providers to accept epidemiological risk. Episode payment may strike a feasible balance for PCMHs, with newly available episode definitions presenting opportunities not previously available.

Home medication support for childhood cancer: family-centered design and testing.

Science.gov (United States)

Walsh, Kathleen E; Biggins, Colleen; Blasko, Deb; Christiansen, Steven M; Fischer, Shira H; Keuker, Christopher; Klugman, Robert; Mazor, Kathleen M

2014-11-01

Errors in the use of medications at home by children with cancer are common, and interventions to support correct use are needed. We sought to (1) engage stakeholders in the design and development of an intervention to prevent errors in home medication use, and (2) evaluate the acceptability and usefulness of the intervention. We convened a multidisciplinary team of parents, clinicians, technology experts, and researchers to develop an intervention using a two-step user-centered design process. First, parents and oncologists provided input on the design. Second, a parent panel and two oncology nurses refined draft materials. In a feasibility study, we used questionnaires to assess usefulness and acceptability. Medication error rates were assessed via monthly telephone interviews with parents. We successfully partnered with parents, clinicians, and IT experts to develop Home Medication Support (HoMeS), a family-centered Web-based intervention. HoMeS includes a medication calendar with decision support, a communication tool, adverse effect information, a metric conversion chart, and other information. The 15 families in the feasibility study gave HoMeS high ratings for acceptability and usefulness. Half recorded information on the calendar to indicate to other caregivers that doses were given; 34% brought it to the clinic to communicate with their clinician about home medication use. There was no change in the rate of medication errors in this feasibility study. We created and tested a stakeholder-designed, Web-based intervention to support home chemotherapy use, which parents rated highly. This tool may prevent serious medication errors in a larger study. Copyright © 2014 by American Society of Clinical Oncology.

Engineering Physics and Mathematics Division progress report for period ending March 31, 1991

International Nuclear Information System (INIS)

1991-10-01

The primary purpose of this report is to provide an archival record of the activities of the Engineering Physics and Mathematics Division during the period September 1, 1989 through March 31, 1991. Earlier reports in this series are identified on the previous pages, along with the progress reports describing ORNL's research on the mathematical sciences prior to 1984 when those activities moved into the division. As in previous reports, our research is described through abstracts of journal articles, technical reports, and presentations. Summary lists of publications and presentations, staff additions and departures, scientific and professional activities of division staff, and technical conferences organized and sponsored by the division are included as appendices. The report is organized following the division of our research among four sections and information centers. These research areas are: Mathematical Sciences; Nuclear Data Measurement and Evaluations; Intelligent Systems; Nuclear Analysis and Shielding; and Engineering Physics Information Center

Tracking Active Learning in the Medical School Curriculum: A Learning-Centered Approach.

Science.gov (United States)

McCoy, Lise; Pettit, Robin K; Kellar, Charlyn; Morgan, Christine

2018-01-01

Medical education is moving toward active learning during large group lecture sessions. This study investigated the saturation and breadth of active learning techniques implemented in first year medical school large group sessions. Data collection involved retrospective curriculum review and semistructured interviews with 20 faculty. The authors piloted a taxonomy of active learning techniques and mapped learning techniques to attributes of learning-centered instruction. Faculty implemented 25 different active learning techniques over the course of 9 first year courses. Of 646 hours of large group instruction, 476 (74%) involved at least 1 active learning component. The frequency and variety of active learning components integrated throughout the year 1 curriculum reflect faculty familiarity with active learning methods and their support of an active learning culture. This project has sparked reflection on teaching practices and facilitated an evolution from teacher-centered to learning-centered instruction.

Diet and Cancer Prevention: Chewing on the Human Complexities | Division of Cancer Prevention

Science.gov (United States)

Speaker Johanna W. Lampe, PhD, RD Research Professor University of Washington Full Member and Associate Division Director Cancer Prevention Program Public Health Sciences Division Fred Hutchinson Cancer Research Center Seattle, WA |

United States academic medical centers: priorities and challenges amid market transformation.

Science.gov (United States)

Thompson, Irene M; Anason, Barbara

2012-01-01

United States academic medical centers (AMCs) have upheld their long-standing reputation for excellence by teaching and training the next generation of physicians, supporting medical research, providing world-class medical care, and offering breakthrough treatments for highly complex medical cases. In recent years, the pace and direction of change reshaping the American health care industry has created a set of new and profound challenges that AMC leaders must address in order to sustain their institutions. University HealthSystem Consortium (UHC) is an alliance of 116 leading nonprofit academic medical centers and 276 of their affiliated hospitals, all of which are focused on delivering world-class patient care. Formed in 1984, UHC fosters collaboration with and among its members through its renowned programs and services in the areas of comparative data and analytics, performance improvement, supply chain management, strategic research, and public policy. Each year, UHC surveys the executives of its member institutions to understand the issues they view as most critical to sustaining the viability and success of their organizations. The results of UHC's most recent 2011 member survey, coupled with a 2012 Strategic Health Perspectives Harris Interactive presentation, based in parton surveys of major health care industry stakeholders reveal the most important and relevant issues and opportunities that hospital leaders face today, as the United States health care delivery system undergoes a period of unprecedented transformation.

Division of Radiological Protection progress report 1982-1988

International Nuclear Information System (INIS)

Gupta, B.L.; Bhat, R.M.; Narayan, G.R.

1989-01-01

This report describes the work of the Division of Radiological Protection during 2-88, for implementation of radiation safety in all institutions in the country using radiation sources for medical, industrial and research applications. It gives information about personnel monitoring using photographic film and TLD badges, neutron monitoring badges, dosimetric techniques developed, calibration facilities and maintenance of national standards for radiation and radioactivity, design and fabrication of special radiation protection instruments, development of coloured indicators for indentification of radiation sterilized medical products, advisory and licencing services, regulation and transport of radioactive materials, periodic protection survey, education and training related to radiation safety programmes. About 500 publications by the staff of this Division are listed. (author). 46 figs

Results of an Institutional LGBT Climate Survey at an Academic Medical Center.

Science.gov (United States)

Chester, Sean D; Ehrenfeld, Jesse M; Eckstrand, Kristen L

2014-12-01

The purpose of this study was to characterize the climate and culture experienced by lesbian, gay, bisexual, and transgender (LGBT) employees and students at one large academic medical center. An anonymous, online institutional climate survey was used to assess the attitudes and experiences of LGBT employees and students. There were 42 LGBT and 14 non-LGBT survey participants. Results revealed that a surprisingly large percentage of LGBT individuals experienced pressure to remain "closeted" and were harassed despite medical center policies of non-discrimination. Continuing training, inclusive policies and practices, and the development of mechanisms to address LGBT-specific harassment are necessary for improving institutional climate.

[Standardization of the terminology of the academic medical centers and biomedical research centers, in the English language, for journal article sending].

Science.gov (United States)

Hochman, Bernardo; Locali, Rafael Fagionato; Oliveira Filho, Renato Santos de; Oliveira, Ricardo Leão de; Goldenberg, Saul; Ferreira, Lydia Masako

2006-01-01

To suggest a standardization, in the English language, the formatting of the citation of the research centers. From three more recent publications of the first 20 journals available in Brazilian Portal of Scientific Information - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), with bigger factor of impact during the year of 2004, according of information in ISI Web of Knowledge Journal Citation Reports database in biennium 2004-2005, had extracted the formats of citations of the research centers. An analogy to the institutional hierarchie step of the Federal University of Sao Paulo (UNIFESP) was carried out, and the formats most frequent, in the English language, had been adopted as standard to be suggested to cite the research centers for sending articles. In relation to the citation "Departamento", was standardized "Department of ..." (being "..." the name in English of the Department), to the citation "Programa de Pós-Graduação" "... Program", "Disciplina" "Division of ...", "Orgãos, Grupos e Associações" "... Group ", "Setor" "Section of...", "Centro" "Center for ...", "Unidade" "... Unit ", "Instituto" "Institute of ...", "Laboratório" "Laboratory of ..." and "Grupo" "Group of ...".

Marion duPont Scott Equine Medical Center uses innovative lameness treatment

OpenAIRE

Lee, Kate

2009-01-01

Virginia Tech's Marion duPont Scott Equine Medical Center is now offering an equine lameness therapy that prevents further degeneration of the affected joint and offers a longer-lasting benefit than traditional steroid treatment.

Tracking Active Learning in the Medical School Curriculum: A Learning-Centered Approach

Science.gov (United States)

McCoy, Lise; Pettit, Robin K; Kellar, Charlyn; Morgan, Christine

2018-01-01

Background: Medical education is moving toward active learning during large group lecture sessions. This study investigated the saturation and breadth of active learning techniques implemented in first year medical school large group sessions. Methods: Data collection involved retrospective curriculum review and semistructured interviews with 20 faculty. The authors piloted a taxonomy of active learning techniques and mapped learning techniques to attributes of learning-centered instruction. Results: Faculty implemented 25 different active learning techniques over the course of 9 first year courses. Of 646 hours of large group instruction, 476 (74%) involved at least 1 active learning component. Conclusions: The frequency and variety of active learning components integrated throughout the year 1 curriculum reflect faculty familiarity with active learning methods and their support of an active learning culture. This project has sparked reflection on teaching practices and facilitated an evolution from teacher-centered to learning-centered instruction. PMID:29707649

Engineering Physics and Mathematics Division progress report for period ending March 31, 1991

Energy Technology Data Exchange (ETDEWEB)

1991-10-01

The primary purpose of this report is to provide an archival record of the activities of the Engineering Physics and Mathematics Division during the period September 1, 1989 through March 31, 1991. Earlier reports in this series are identified on the previous pages, along with the progress reports describing ORNL's research on the mathematical sciences prior to 1984 when those activities moved into the division. As in previous reports, our research is described through abstracts of journal articles, technical reports, and presentations. Summary lists of publications and presentations, staff additions and departures, scientific and professional activities of division staff, and technical conferences organized and sponsored by the division are included as appendices. The report is organized following the division of our research among four sections and information centers. These research areas are: Mathematical Sciences; Nuclear Data Measurement and Evaluations; Intelligent Systems; Nuclear Analysis and Shielding; and Engineering Physics Information Center.

PTSD: National Center for PTSD

Medline Plus

Full Text Available ... by Center Staff Clinician’s Trauma Update PTSD Research Quarterly Publications Search Using the PILOTS Database What is ... Advisory Boards History and Achievements Divisions and Staff Leadership Divisions Executive Behavioral Science Clinical Neurosciences Dissemination & Training ...

A User-Centered Cooperative Information System for Medical Imaging Diagnosis.

Science.gov (United States)

Gomez, Enrique J.; Quiles, Jose A.; Sanz, Marcos F.; del Pozo, Francisco

1998-01-01

Presents a cooperative information system for remote medical imaging diagnosis. General computer-supported cooperative work (CSCW) problems addressed are definition of a procedure for the design of user-centered cooperative systems (conceptual level); and improvement of user feedback and optimization of the communication bandwidth in highly…

The financial management of research centers and institutes at U.S. medical schools: findings from six institutions.

Science.gov (United States)

Mallon, William T

2006-06-01

To explore three questions surrounding the financial management of research centers and institutes at U.S. medical schools: How do medical schools allocate institutional funds to centers and institutes? How and by whom are those decisions made? What are the implications of these decision-making models on the future of the academic biomedical research enterprise? Using a qualitative research design, the author and associates interviewed over 150 faculty members and administrators at six medical schools and their parent universities in 2004. Interview data were transcribed, coded, and analyzed using a grounded theory approach. This methodology generated rich descriptions and explanations of the six medical schools, which can produce extrapolations to, but not necessarily generalizable findings to, other institutions and settings. An examination of four dimensions of financial decision-making-funding timing, process, structure, and culture-produces two essential models of how medical schools approach the financial management of research centers. In the first, a "charity" model, center directors make hat-in-hand appeals directly to the dean, the result of which may depend on individual negotiation skills and personal relationships. In the second, a "planned-giving" model, the process for obtaining and renewing funds is institutionalized, agreed upon, and monitored. The ways in which deans, administrators, department chairs, and center directors attend to, decide upon, and carry out financial decisions can influence how people throughout the medical school think about interdisciplinary and collaborative activities marshalled though centers and institutes.

Experience report: a training center for health response

International Nuclear Information System (INIS)

Maurmo, Alexandre M.; Leite, Teresa C.S.B.

2009-01-01

The Professor Nelson Valverde Training Center was created within FEAM (The ELETRONUCLEAR Medical Assistance Foundation) with the objective of capacitating Radio Nuclear Accident Responders for the Health Area in the Almirante Alvaro Alberto Nuclear Central (Angra dos Reis - RJ - Brazil). The first step was structuring the contents for this training using IAEA's Manuals as base (EPR Medical - 2005, EPR First Responders - 2006 and TMT - Handbook - 2009) and data from REAC/TS. The second step was to capacitate instructors. The third step was the integration with the Company's Radiological Protection Division, giving radiological assessment. Finally, the development of training applications, ending with Drills, Tests and Assessment, gathering data and suggestions, objectifying the constant improvement. Training Programs with pre and post evaluations have been started. Since 2004 training internal courses were ministered for 125 professionals with annual re-training and were ministered to 130 professionals from several external institutions. During the same period training courses were ministered to 140 trainees from the Radiological Protection Division of The Nuclear Power Plant of Angra dos Reis, as First Lay Responders, objectifying the improvement of the quality of the emergency response. (author)

Satellite medical centers project

Science.gov (United States)

Aggarwal, Arvind

2002-08-01

World class health care for common man at low affordable cost: anywhere, anytime The project envisages to set up a national network of satellite Medical centers. Each SMC would be manned by doctors, nurses and technicians, six doctors, six nurses, six technicians would be required to provide 24 hour cover, each SMC would operate 24 hours x 7 days. It would be equipped with the Digital telemedicine devices for capturing clinical patient information and investigations in the form of voice, images and data and create an audiovisual text file - a virtual Digital patient. Through the broad band connectivity the virtual patient can be sent to the central hub, manned by specialists, specialists from several specialists sitting together can view the virtual patient and provide a specialized opinion, they can see the virtual patient, see the examination on line through video conference or even PCs, talk to the patient and the doctor at the SMC and controlle capturing of information during examination and investigations of the patient at the SMC - thus creating a virtual Digital consultant at the SMC. Central hub shall be connected to the doctors and consultants in remote locations or tertiary care hospitals any where in the world, thus creating a virtual hub the hierarchical system shall provide upgradation of knowledge to thedoctors in central hub and smc and thus continued medical education and benefit the patient thru the world class treatment in the smc located at his door step. SMC shall be set up by franchisee who shall get safe business opportunity with high returns, patients shall get Low cost user friendly worldclass health care anywhere anytime, Doctors can get better meaningful selfemplyment with better earnings, flexibility of working time and place. SMC shall provide a wide variety of services from primary care to world class Global consultation for difficult patients.

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

Science.gov (United States)

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

2017-01-01

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

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

Directory of Open Access Journals (Sweden)

Kraus SK

2017-06-01

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

An Architecture for Continuous Data Quality Monitoring in Medical Centers.

Science.gov (United States)

Endler, Gregor; Schwab, Peter K; Wahl, Andreas M; Tenschert, Johannes; Lenz, Richard

2015-01-01

In the medical domain, data quality is very important. Since requirements and data change frequently, continuous and sustainable monitoring and improvement of data quality is necessary. Working together with managers of medical centers, we developed an architecture for a data quality monitoring system. The architecture enables domain experts to adapt the system during runtime to match their specifications using a built-in rule system. It also allows arbitrarily complex analyses to be integrated into the monitoring cycle. We evaluate our architecture by matching its components to the well-known data quality methodology TDQM.

Overview of NASA Glenn Research Center's Communications and Intelligent Systems Division

Science.gov (United States)

Miranda, Felix A.

2016-01-01

The Communications and Intelligent Systems Division provides expertise, plans, conducts and directs research and engineering development in the competency fields of advanced communications and intelligent systems technologies for application in current and future aeronautics and space systems.

The economic impact and multiplier effect of a family practice clinic on an academic medical center.

Science.gov (United States)

Schneeweiss, R; Ellsbury, K; Hart, L G; Geyman, J P

1989-07-21

Academic medical centers are facing the need to expand their primary care referral base in an increasingly competitive medical environment. This study describes the medical care provided during a 1-year period to 6304 patients registered with a family practice clinic located in an academic medical center. The relative distribution of primary care, secondary referrals, inpatient admissions, and their associated costs are presented. The multiplier effect of the primary care clinic on the academic medical center was substantial. For every $1 billed for ambulatory primary care, there was $6.40 billed elsewhere in the system. Each full-time equivalent family physician generated a calculated sum of $784,752 in direct, billed charges for the hospital and $241,276 in professional fees for the other specialty consultants. The cost of supporting a primary care clinic is likely to be more than offset by the revenues generated from the use of hospital and referral services by patients who received care in the primary care setting.

Promoting cancer screening within the patient centered medical home.

Science.gov (United States)

Sarfaty, Mona; Wender, Richard; Smith, Robert

2011-01-01

While consensus has grown that primary care is the essential access point in a high-performing health care system, the current model of primary care underperforms in both chronic disease management and prevention. The Patient Centered Medical Home model (PCMH) is at the center of efforts to reinvent primary care practice, and is regarded as the most promising approach to addressing the burden of chronic disease, improving health outcomes, and reducing health spending. However, the potential for the medical home to improve the delivery of cancer screening (and preventive services in general) has received limited attention in both conceptualization and practice. Medical home demonstrations to date have included few evidence-based preventive services in their outcome measures, and few have evaluated the effect of different payment models. Decreasing use of hospitals and emergency rooms and an emphasis on improving chronic care represent improvements in effective delivery of healthcare, but leave opportunities for reducing the burden of cancer untouched. Data confirm that what does or does not happen in the primary care setting has a substantial impact on cancer outcomes. Insofar as cancer is the leading cause of death before age 80, the PCMH model must prioritize adherence to cancer screening according to recommended guidelines, and systems, financial incentives, and reimbursements must be aligned to achieve that goal. This article explores capacities that are needed in the medical home model to facilitate the integration of cancer screening and other preventive services. These capacities include improved patient access and communication, health risk assessments, periodic preventive health exams, use of registries that store cancer risk information and screening history, ability to track and follow up on tests and referrals, feedback on performance, and payment models that reward cancer screening. Copyright © 2011 American Cancer Society, Inc.

Towards a person-centered medical education: challenges and imperatives (I

Directory of Open Access Journals (Sweden)

Andrew Miles

2015-01-01

Full Text Available It is increasingly claimed that modern medicine has entered into crisis —a crisis of knowledge (uncertainty over what counts as “evidence” for decision-making and what does not, care (a deficit in sympathy, empathy, compassion, dignity, autonomy, patient safety (neglect, iatrogenic injury, malpractice, excess deaths, economic costs (which threaten to bankrupt health systems worldwide and clinical and institutional governance (a failure of basic and advanced management, inspirational and transformational leadership. We believe such a contention to be essentially correct. In the current article, we ask how the delineated components of the crisis can be individually understood in order to allow them to be collectively addressed. We ask how a transition can be effected away from impersonal, decontextualized and fragmented services in the direction of newer models of service provision that are personalized, contextualized and integrated. How, we ask, can we improve healthcare outcomes while simultaneously containing or lowering their costs? In initial answer to such questions —which are of considerable political as well as clinical significance— we assert that a new approach has become necessary, particularly in the context of the current epidemic of multi-morbid and socially complex long term illness. This new approach, we argue, is represented by the development and application of the concepts and methods of person-centered healthcare (PCH, a philosophy and technique in the care of the sick that enables clinicians and health systems to re-introduce humanistic ideals into clinical practice alongside continuing scientific advance, thereby restoring to medicine the humanism it has lost in over a century of empiricism. But the delivery of a person-centered healthcare within health systems requires a person-centered education and training. In this article we consider, then, why person-centered teaching innovations in the undergraduate medical

Exploring Summer Medical Care Within the National Collegiate Athletic Association Division I Setting: A Perspective From the Athletic Trainer

Science.gov (United States)

Mazerolle, Stephanie M.; Eason, Christianne M.; Goodman, Ashley

2016-01-01

Context:  Over the last few decades, the National Collegiate Athletics Association (NCAA) has made changes related to the increase in sanctioned team activities during summer athletics. These changes may affect how athletic training services are provided. Objective:  To investigate the methods by which athletic training departments of NCAA institutions manage expectations regarding athletic training services during the summer. Design:  Mixed-methods qualitative and quantitative study. Setting:  The NCAA Division I. Patients or Other Participants:  Twenty-two athletic trainers (13 men, 9 women) participated. All were employed full time within the NCAA Division I setting. Participants were 35 ± 8 years of age (range, 26−52 years), with 12 ± 7 years (range, 3−29 years) of athletic training experience. Data Collection and Analysis:  All participants completed a series of questions online that consisted of closed- (demographic and Likert-scale 5-point) and open-ended items that addressed the research questions. Descriptive statistics, frequency distributions, and phenomenologic analyses were completed with the data. Peer review and multiple-analyst triangulation established credibility. Results:  Summer athletic training services included 3 primary mechanisms: individual medical care, shared medical care, or a combination of the 2. Participants reported working 40 ± 10 hours during the summer. Likert-item analysis showed that participants were moderately satisfied with their summer medical care structure (3.3 ± 1.0) and with the flexibility of summer schedules (3.0 ± 1.2). Yet the qualitative analysis revealed that perceptions of summer medical care were more positive for shared-care participants than for individual- or combination-care participants. The perceived effect on the athletic trainer included increased workload and expectations and a negative influence on work-life balance, particularly in terms of decreased schedule flexibility and

Selection and construction of nuclear and radiation emergency medical center in a region

International Nuclear Information System (INIS)

Wang Guojun; He Xu; Liao Li; Gao Dong

2014-01-01

Three level of first-class comprehensive hospital is an important force of nuclear and radiation accident rescue, has a very rich experience in response to nuclear and radiation accidents and deal with large quantities of the sick and wounded. With the foundation and the ability of the construction and operation of medical emergency rescue center. This paper according to the median model location theory of emergency center, combined with the specific situation of the nuclear and radiation accident in Hunan Province, reference location, rescue experience, emergency allocation of resources, teaching and research capacity, establish regional medical emergency center of nuclear and radiation accidents based on three level of first-class comprehensive hospital, break the traditional concept that the center must be provincial capital,form a multi-level, three-dimensional, network of emergency hospital rescue system. The main duties of the center are accident emergency response, on-site treatment and technical guidance of accident, psychological grooming. The author propose building measures according to the duties of the center: increase national and provincial financial investment, carry out training, drills and first aid knowledge missionaries regularly, innovative materials management, speed up the construction of information platform, establish and improve the hospital rescue system, improve organization institution and system of plans, reengineering rescue process. (authors)

Cost-Benefit Analysis of Radiation Therapy Services at Tripler Army Medical Center

National Research Council Canada - National Science Library

Diehl, Diane S

2004-01-01

The purpose of this analysis was to examine the costs and benefits associated with continuance of "in-house" radiation therapy services to eligible beneficiaries at Tripler Army Medical Center (TAMC...

Key Elements of Clinical Physician Leadership at an Academic Medical Center

Science.gov (United States)

Dine, C. Jessica; Kahn, Jeremy M; Abella, Benjamin S; Asch, David A; Shea, Judy A

2011-01-01

Background A considerable body of literature in the management sciences has defined leadership and how leadership skills can be attained. There is considerably less literature about leadership within medical settings. Physicians-in-training are frequently placed in leadership positions ranging from running a clinical team or overseeing a resuscitation effort. However, physicians-in-training rarely receive such training. The objective of this study was to discover characteristics associated with effective physician leadership at an academic medical center for future development of such training. Methods We conducted focus groups with medical professionals (attending physicians, residents, and nurses) at an academic medical center. The focus group discussion script was designed to elicit participants' perceptions of qualities necessary for physician leadership. The lead question asked participants to imagine a scenario in which they either acted as or observed a physician leader. Two independent reviewers reviewed transcripts to identify key domains of physician leadership. Results Although the context was not specified, the focus group participants discussed leadership in the context of a clinical team. They identified 4 important themes: management of the team, establishing a vision, communication, and personal attributes. Conclusions Physician leadership exists in clinical settings. This study highlights the elements essential to that leadership. Understanding the physician attributes and behaviors that result in effective leadership and teamwork can lay the groundwork for more formal leadership education for physicians-in-training. PMID:22379520

Division of Biological and Medical Research annual report, 1979

International Nuclear Information System (INIS)

Rosenthal, M.W.

1979-01-01

Separate abstracts were prepared for 14 of the 20 sections included in this progress report. The other 6 sections include: introductory statements by the division director; descriptions of the animal, computer, electron microscope, and radiation support facilities; a listing of the educational activities, divisional seminars, and oral presentations by staff members; and divisional staff publications. An author index to the report is included

Materials Sciences Division 1990 annual report

International Nuclear Information System (INIS)

1990-01-01

This report is the Materials Sciences Division's annual report. It contains abstracts describing materials research at the National Center for Electron Microscopy, and for research groups in metallurgy, solid-state physics, materials chemistry, electrochemical energy storage, electronic materials, surface science and catalysis, ceramic science, high tc superconductivity, polymers, composites, and high performance metals

Gender Disparities in Faculty Rank: Factors that Affect Advancement of Women Scientists at Academic Medical Centers

Directory of Open Access Journals (Sweden)

Cristina M. López

2018-04-01

Full Text Available While a significant portion of women within academic science are employed within medical schools, women faculty in these academic medical centers are disproportionately represented in lower faculty ranks. The medical school setting is a critical case for both understanding and advancing women in basic sciences. This study highlights the findings from focus groups conducted with women faculty across Assistant, Associate, and Full Professor ranks (n = 35 in which they discussed barriers and facilitators for advancement of women basic scientists at an academic medical center. Qualitative analysis demonstrated several emergent themes that affect women’s advancement, including gendered expectation norms (e.g., good citizenship, volunteerism, work-life balance, mentorship/sponsorship, adoption of a team science approach, tenure process milestones, soft money research infrastructure, institution specific policies (or lack thereof, and operating within an MD-biased culture. These findings are compared with the extant literature of women scientists in STEM institutions. Factors that emerged from these focus groups highlight the need for evidence-based interventions in the often overlooked STEM arena of academic medical centers.

Five suggestions for future medical education in Korea.

Science.gov (United States)

Yang, Eunbae B; Meng, Kwang Ho

2014-09-01

This study is to investigate the historical characteristics of medical education and healthcare environment in Korea and to suggest the desirable direction for future medical education. We draw a consensus through the literature analysis and several debates from the eight experts of medical education. There are several historical characteristics of medical education: medical education as vocational education and training, as a higher education, rapid growth of new medical schools, change to the medical education system, curriculum development, reinforcement of medical humanities, improvement of teaching and evaluation methods, validation of the national health personnel licensing examination, accreditation system for quality assurance, and establishment of specialized medical education division. The changes of health care environment in medical education are development of medical technologies, changes in the structures of the population and diseases, growth of information and communication technology, consumer-centered society, and increased intervention by the third party stakeholder. We propose five suggestions to be made to improve future medical education. They are plan for outcome and competency-based medical education, connection between the undergraduate and graduate medical education, reinforcement of continuous quality improvement of medical education, reorganization of the medical education system and construction of leadership of "academic medicine."

Adherence to systemic therapies for immune-mediated inflammatory diseases in Lebanon: a physicians’ survey from three medical specialties

Directory of Open Access Journals (Sweden)

Ammoury A

2017-05-01

Full Text Available Alfred Ammoury,1 Jad Okais,2 Mireille Hobeika,3 Raymond B Sayegh,4 Rani H Shayto,5 Ala I Sharara5 1Division of Dermatology, St George Hospital University Medical Center, 2Division of Rheumatology, St Joseph University, 3AbbVie Levant, 4Division of Gastroenterology, St Joseph University, 5Department of Internal Medicine, Division of Gastroenterology, American University of Beirut Medical Center, Beirut, Lebanon Background: Immune-mediated inflammatory diseases (IMIDs are chronic conditions that may cause tissue damage and disability, reduced quality of life and increased mortality. Various treatments have been developed for IMIDs, including immune modulators and targeted biologic agents. However, adherence remains suboptimal. Methods: An adherence survey was used to evaluate physicians’ beliefs about adherence to medication in IMID and to evaluate if and how they manage adherence. The survey was distributed to 100 randomly selected physicians from three different specialties. Results were analyzed by four academic experts commissioned to develop an action plan to address practical and perceptual barriers to adherence, integrating it into treatment goals to maximize outcomes in IMID, thereby elevating local standards of care. Results: Eighty-two physicians participated in this study and completed the questionnaire. Most defined adherence as compliance with prescribed treatment. Although the majority of surveyed physicians (74% did not systematically measure adherence in their practice, 54% identified adherence as a treatment goal of equal or greater importance to therapeutic endpoints. Lack of time and specialized nursing support was reported as an important barrier to measuring adherence. The expert panel identified four key areas for action: 360° education (patient–nurse–physician, patient–physician communication, patient perception and concerns, and market access/cost. An action plan was developed centered on education and awareness

38 CFR 17.351 - Grants for the replacement and upgrading of equipment at Veterans Memorial Medical Center.

Science.gov (United States)

2010-07-01

... replacement and upgrading of equipment at Veterans Memorial Medical Center. 17.351 Section 17.351 Pensions... Philippines § 17.351 Grants for the replacement and upgrading of equipment at Veterans Memorial Medical Center. Grants to assist the Republic of the Philippines in the replacement and upgrading of equipment and in...

Materials Sciences Division 1990 annual report

Energy Technology Data Exchange (ETDEWEB)

1990-01-01

This report is the Materials Sciences Division's annual report. It contains abstracts describing materials research at the National Center for Electron Microscopy, and for research groups in metallurgy, solid-state physics, materials chemistry, electrochemical energy storage, electronic materials, surface science and catalysis, ceramic science, high tc superconductivity, polymers, composites, and high performance metals.

Clinical skill center: a review of present situation and importance in medical education curriculum

Directory of Open Access Journals (Sweden)

Haleh Talaei

2002-07-01

Full Text Available Clinical skill centers were designed in 1960, offers innovative, more effective clinical health care and treatment curriculum. Clinical skill center (CSC can provide a special facility for clinical and communication skills practice in a setting outside hospital wards in order to train students with enough confidence of confronting real patients. Learning clinical skills in these centers are not patient-dependent and by practicing on manikins and simulated models errors in real patients can be prevented. Moreover, possible feedback of this method can be used for evaluation and can improve quality and quantity of the education. This review intends to determine the purpose, undertaking, and structure of CSC. The study emphasizes the importance of integrating the clinical skill centers into the teaching curriculum of medical universities. Apparently, organizing clinical skill centers can play an important role for improving the quality and quantity of the educational system and consequently post-graduate performance. The authors recommend this program can be a solution for having both the knowledge and skill of diagnosis and treatment seasonal and rare diseases. Key words clinical skill center, medical education, curriculum

Radiation Protection Services Division: progress report for 1992-1993

International Nuclear Information System (INIS)

Massand, O.P.; Murthy, B.K.S.

1994-01-01

This report describes the work of the Radiation Protection Services Division during 1993, for implementation of radiation safety in all institutions in India using radiation sources in medical, industrial and research applications. It gives information about personnel monitoring using photographic film and TLD badges, neutron monitoring badges, advisory and licensing services, regulation, transport of radioactive materials and periodic protection survey. About 33 publications by the staff of the Division are also listed. (author). 4 tabs

Quantitative Analysis of Contributing Factors Affecting Patient Satisfaction in Family Medicine Service Clinics at Brooke Army Medical Center

Science.gov (United States)

2008-06-06

Predictors of patient satisfaction for Brooke Army Medical Center Family Medicine Service primary care clinics was performed. Data was obtained from...Factors Affecting Patient Satisfaction in Family Medicine Service Clinics at Brooke Army Medical Center Presented to MAJ Eric Schmacker, Ph.D. In...study. All patients ’ medical information was protected at all times and under no circumstances will be discussed or released to any outside agency

[HIGH VELOCITY PENETRATING HEAD AND NECK INJURIES OF SYRIAN CIVIL WAR CASUALTIES TREATED IN THE GALILEE MEDICAL CENTER].

Science.gov (United States)

Ronen, Ohad; Assadi, Nidal; Sela, Eyal

2017-05-01

For two years the State of Israel has been treating casualties from the Syrian civil war. The Galilee Medical Center in Nahariya is the main hospital for this humanitarian mission. Objectives: To evaluate the demographic and clinical characteristics of the casualties that were treated in our department. Information from medical records of all Syrian casualties evacuated to the Galilee Medical Center were evaluated. Between March 2013 and December 2014, 450 casualties were evacuated to the Galilee Medical Center. Of those, 45 were treated in the Department of Otolaryngology - Head and Neck Surgery. Of the 45 cases, 43 were male (95.5%) and the mean age was 30.4 years (range 1-79 years). There was a significant difference in terms of gender (p Syria, and 12 died. Of all Syrian injured treated in the ENT department, the vast majority were young men. The main cause of injury was gunshot wounds. It is likely that the lack of protective gear that exist in western armies is a factor in the complex injuries treated at the Galilee Medical Center.

A 5-year scientometric analysis of research centers affiliated to Tehran University of Medical Sciences

Science.gov (United States)

Yazdani, Kamran; Rahimi-Movaghar, Afarin; Nedjat, Saharnaz; Ghalichi, Leila; Khalili, Malahat

2015-01-01

Background: Since Tehran University of Medical Sciences (TUMS) has the oldest and highest number of research centers among all Iranian medical universities, this study was conducted to evaluate scientific output of research centers affiliated to Tehran University of Medical Sciences (TUMS) using scientometric indices and the affecting factors. Moreover, a number of scientometric indicators were introduced. Methods: This cross-sectional study was performed to evaluate a 5-year scientific performance of research centers of TUMS. Data were collected through questionnaires, annual evaluation reports of the Ministry of Health, and also from Scopus database. We used appropriate measures of central tendency and variation for descriptive analyses. Moreover, uni-and multi-variable linear regression were used to evaluate the effect of independent factors on the scientific output of the centers. Results: The medians of the numbers of papers and books during a 5-year period were 150.5 and 2.5 respectively. The median of the "articles per researcher" was 19.1. Based on multiple linear regression, younger age centers (p=0.001), having a separate budget line (p=0.016), and number of research personnel (p<0.001) had a direct significant correlation with the number of articles while real properties had a reverse significant correlation with it (p=0.004). Conclusion: The results can help policy makers and research managers to allocate sufficient resources to improve current situation of the centers. Newly adopted and effective scientometric indices are is suggested to be used to evaluate scientific outputs and functions of these centers. PMID:26157724

The Institute for Safe Medication Practices and Poison Control Centers: Collaborating to Prevent Medication Errors and Unintentional Poisonings.

Science.gov (United States)

Vaida, Allen J

2015-06-01

This article provides an overview on the Institute for Safe Medication Practices (ISMP), the only independent nonprofit organization in the USA devoted to the prevention of medication errors. ISMP developed the national Medication Errors Reporting Program (MERP) and investigates and analyzes errors in order to formulate recommendations to prevent further occurrences. ISMP works closely with the US Food and Drug Administration (FDA), drug manufacturers, professional organizations, and others to promote changes in package design, practice standards, and healthcare practitioner and consumer education. By collaborating with ISMP to share and disseminate information, Poison Control centers, emergency departments, and toxicologists can help decrease unintentional and accidental poisonings.

Patient-centered medical homes in Louisiana had minimal impact on Medicaid population's use of acute care and costs.

Science.gov (United States)

Cole, Evan S; Campbell, Claudia; Diana, Mark L; Webber, Larry; Culbertson, Richard

2015-01-01

The patient-centered medical home model of primary care has received considerable attention for its potential to improve outcomes and reduce health care costs. Yet little information exists about the model's ability to achieve these goals for Medicaid patients. We sought to evaluate the effect of patient-centered medical home certification of Louisiana primary care clinics on the quality and cost of care over time for a Medicaid population. We used a quasi-experimental pre-post design with a matched control group to assess the effect of medical home certification on outcomes. We found no impact on acute care use and modest support for reduced costs and primary care use among medical homes serving higher proportions of chronically ill patients. These findings provide preliminary results related to the ability of the patient-centered medical home model to improve outcomes for Medicaid beneficiaries. The findings support a case-mix-adjusted payment policy for medical homes going forward. Project HOPE—The People-to-People Health Foundation, Inc.

76 FR 59407 - Center for Biologics Evaluation and Research Report of Scientific and Medical Literature and...

Science.gov (United States)

2011-09-26

...] Center for Biologics Evaluation and Research Report of Scientific and Medical Literature and Information... Administration (FDA) is announcing the availability of its report of scientific and medical literature and... Research Report of Scientific and Medical Literature and Information on Non-Standardized Allergenic...

Activities of an ethics consultation service in a Tertiary Military Medical Center.

Science.gov (United States)

Waisel, D B; Vanscoy, S E; Tice, L H; Bulger, K L; Schmelz, J O; Perucca, P J

2000-07-01

The Joint Commission on Accreditation of Healthcare Organizations requires hospitals to have a mechanism to address issues of medical ethics. Most hospitals, especially those in the military, have an ethics committee composed solely of members who serve as an additional duty. To enhance the ethics consultation service, the 59th Medical Wing created a position under the chief of the medical staff for a full-time, fellowship-trained, medical ethicist. After establishment of this position, the number of consultations increased, a systematic program for caregiver education was developed and delivered, and an organizational presence was achieved by instituting positions on the institutional review board, the executive committee of the medical staff, and the credentials committee. Issues in medical care are becoming increasingly complicated, due in large part to financial stresses and technological advancements. Ethics consultation can help prevent and resolve many of these problems. This report discusses the activities of the first year of a full-time ethicist in a tertiary military medical center.

Implementation of epic beaker anatomic pathology at an academic medical center

Directory of Open Access Journals (Sweden)

John Larry Blau

2017-01-01

Full Text Available Background: Beaker is a relatively new laboratory information system (LIS offered by Epic Systems Corporation as part of its suite of health-care software and bundled with its electronic medical record, EpicCare. It is divided into two modules, Beaker anatomic pathology (Beaker AP and Beaker Clinical Pathology. In this report, we describe our experience implementing Beaker AP version 2014 at an academic medical center with a go-live date of October 2015. Methods: This report covers preimplementation preparations and challenges beginning in September 2014, issues discovered soon after go-live in October 2015, and some post go-live optimizations using data from meetings, debriefings, and the project closure document. Results: We share specific issues that we encountered during implementation, including difficulties with the proposed frozen section workflow, developing a shared specimen source dictionary, and implementation of the standard Beaker workflow in large institution with trainees. We share specific strategies that we used to overcome these issues for a successful Beaker AP implementation. Several areas of the laboratory-required adaptation of the default Beaker build parameters to meet the needs of the workflow in a busy academic medical center. In a few areas, our laboratory was unable to use the Beaker functionality to support our workflow, and we have continued to use paper or have altered our workflow. In spite of several difficulties that required creative solutions before go-live, the implementation has been successful based on satisfaction surveys completed by pathologists and others who use the software. However, optimization of Beaker workflows has continued to be an ongoing process after go-live to the present time. Conclusions: The Beaker AP LIS can be successfully implemented at an academic medical center but requires significant forethought, creative adaptation, and continued shared management of the ongoing product by

Burnout among nurses working in medical and educational centers in Shahrekord, Iran

Science.gov (United States)

Moghaddasi, Jaefar; Mehralian, Hossein; Aslani, Yousef; Masoodi, Reza; Amiri, Masoud

2013-01-01

Background: Nursing burnout is the main characteristic of job stress that is a delayed reaction to chronic stressful situations in the workplace which could affect nurses who do not have sufficient emotional energy to cope and communicate with different types of patients. There is also sometimes this belief that they do not have the required capabilities for their jobs. The aim of this study was the evaluation of burnout among nurses working in medical and educational centers in Shahrekord. Materials and Methods: This descriptive study was performed on 340 nurses working in medical and educational centers in Shahrekord in 2009. Samples were selected using proportionate random sampling. Demographic information and the Maslach Burnout Inventory (MBI) were filled in for all nurses. Results: Burnout was considerable among nurses. The results showed that 34.6, 28.8, and 95.7% of the nurses had emotional exhaustion (EE), high depersonalization (DP), and high reduced personal accomplishment (PA), respectively. The mean scores (± standard deviation) for EE, DP, and PA were 22.77 (12.44), 6.99 (6.23), and 32.20 (9.26), respectively. Conclusions: Our results showed that burnout was noticeable among nurses working in medical and educational centers in Shahrekord. Disproportionate relationship between the number of nurses, workload, and income was the most important factor affecting nursing burnout. Due to the importance of nursing in the health-care system, policy makers should adopt suitable strategies for increasing the satisfaction of nurses. PMID:24403925

Physics, Computer Science and Mathematics Division annual report, January 1--December 31, 1976

International Nuclear Information System (INIS)

Lepore, J.V.

1977-01-01

This annual report of the Physics, Computer Science and Mathematics Division describes the scientific research and other work carried out within the Division during the calendar year 1976. The Division is concerned with work in experimental and theoretical physics, with computer science and applied mathematics, and with the operation of a computer center. The major physics research activity is in high-energy physics; a vigorous program is maintained in this pioneering field. The high-energy physics research program in the Division now focuses on experiments with e + e - colliding beams using advanced techniques and developments initiated and perfected at the Laboratory. The Division continues its work in medium energy physics, with experimental work carried out at the Bevatron and at the Los Alamos Pi-Meson Facility. Work in computer science and applied mathematics includes construction of data bases, computer graphics, computational physics and data analysis, mathematical modeling, and mathematical analysis of differential and integral equations resulting from physical problems. The computer center serves the Laboratory by constantly upgrading its facility and by providing day-to-day service. This report is descriptive in nature; references to detailed publications are given

Physics, Computer Science and Mathematics Division annual report, January 1--December 31, 1976

Energy Technology Data Exchange (ETDEWEB)

Lepore, J.V. (ed.)

1977-01-01

This annual report of the Physics, Computer Science and Mathematics Division describes the scientific research and other work carried out within the Division during the calendar year 1976. The Division is concerned with work in experimental and theoretical physics, with computer science and applied mathematics, and with the operation of a computer center. The major physics research activity is in high-energy physics; a vigorous program is maintained in this pioneering field. The high-energy physics research program in the Division now focuses on experiments with e/sup +/e/sup -/ colliding beams using advanced techniques and developments initiated and perfected at the Laboratory. The Division continues its work in medium energy physics, with experimental work carried out at the Bevatron and at the Los Alamos Pi-Meson Facility. Work in computer science and applied mathematics includes construction of data bases, computer graphics, computational physics and data analysis, mathematical modeling, and mathematical analysis of differential and integral equations resulting from physical problems. The computer center serves the Laboratory by constantly upgrading its facility and by providing day-to-day service. This report is descriptive in nature; references to detailed publications are given. (RWR)

User-centered design of a mobile medication management.

Science.gov (United States)

Sedlmayr, Brita; Schöffler, Jennifer; Prokosch, Hans-Ulrich; Sedlmayr, Martin

2018-03-05

The use of a nationwide medication plan has been promoted as an effective strategy to improve patient safety in Germany. However, the medication plan only exists as a paper-based version, which is related to several problems, that could be circumvented by an electronic alternative. The main objective of this study was to report on the development of a mobile interface concept to support the management of medication information. The human-centered design (UCD) process was chosen. First the context of use was analyzed, and personas and an interaction concept were designed. Next, a paper prototype was developed and evaluated by experts. Based on those results, a medium-fidelity prototype was created and assessed by seven end-users who performed a thinking-aloud test in combination with a questionnaire based on the System Usability Scale (SUS). Initially for one persona/user type, an interface design concept was developed, which received an average SUS-Score of 92.1 in the user test. Usability problems have been solved so that the design concept could be fixed for a future implementation. Contribution: The approach of the UCD process and the methods involved can be applied by other researchers as a framework for the development of similar applications.

Quality improvement in healthcare delivery utilizing the patient-centered medical home model.

Science.gov (United States)

Akinci, Fevzi; Patel, Poonam M

2014-01-01

Despite the fact that the United States dedicates so much of its resources to healthcare, the current healthcare delivery system still faces significant quality challenges. The lack of effective communication and coordination of care services across the continuum of care poses disadvantages for those requiring long-term management of their chronic conditions. This is why the new transformation in healthcare known as the patient-centered medical home (PCMH) can help restore confidence in our population that the healthcare services they receive is of the utmost quality and will effectively enhance their quality of life. Healthcare using the PCMH model is delivered with the patient at the center of the transformation and by reinvigorating primary care. The PCMH model strives to deliver effective quality care while attempting to reduce costs. In order to relieve some of our healthcare system distresses, organizations can modify their delivery of care to be patient centered. Enhanced coordination of services, better provider access, self-management, and a team-based approach to care represent some of the key principles of the PCMH model. Patients that can most benefit are those that require long-term management of their conditions such as chronic disease and behavioral health patient populations. The PCMH is a feasible option for delivery reform as pilot studies have documented successful outcomes. Controversy about the lack of a medical neighborhood has created concern about the overall sustainability of the medical home. The medical home can stand independently and continuously provide enhanced care services as a movement toward higher quality care while organizations and government policy assess what types of incentives to put into place for the full collaboration and coordination of care in the healthcare system.

Cross-cultural medical education: can patient-centered cultural competency training be effective in non-Western countries?

Science.gov (United States)

Ho, Ming-Jung; Yao, Grace; Lee, Keng-Lin; Beach, Mary Catherine; Green, Alexander R

2008-01-01

No evidence addresses the effectiveness of patient-centered cultural competence training in non-Western settings. To examine whether a patient-centered cultural competency curriculum improves medical students' skills in eliciting the patients' perspective and exploring illness-related social factors. Fifty-seven medical students in Taiwan were randomly assigned to either the control (n = 27) or one of two intervention groups: basic (n = 15) and extensive (n = 15). Both intervention groups received two 2-hour patient-centered cultural competency workshops. In addition, the extensive intervention group received a 2-hour practice session. The control group received no training. At the end of the clerkship, all students were evaluated with an objective structured clinical examination (OSCE). Students in the extensive intervention group scored significantly higher than the basic intervention and control groups in eliciting the patient's perspective (F = 18.38, p social factors (F = 6.66, p = 0.003, eta(2) = 0.20). Patient-centered cultural competency training can produce improvement in medical students' cross-cultural communication skills in non-Western settings, especially when adequate practice is provided.

Spectrum of tablet computer use by medical students and residents at an academic medical center

Directory of Open Access Journals (Sweden)

Robert Robinson

2015-07-01

Full Text Available Introduction. The value of tablet computer use in medical education is an area of considerable interest, with preliminary investigations showing that the majority of medical trainees feel that tablet computers added value to the curriculum. This study investigated potential differences in tablet computer use between medical students and resident physicians.Materials & Methods. Data collection for this survey was accomplished with an anonymous online questionnaire shared with the medical students and residents at Southern Illinois University School of Medicine (SIU-SOM in July and August of 2012.Results. There were 76 medical student responses (26% response rate and 66 resident/fellow responses to this survey (21% response rate. Residents/fellows were more likely to use tablet computers several times daily than medical students (32% vs. 20%, p = 0.035. The most common reported uses were for accessing medical reference applications (46%, e-Books (45%, and board study (32%. Residents were more likely than students to use a tablet computer to access an electronic medical record (41% vs. 21%, p = 0.010, review radiology images (27% vs. 12%, p = 0.019, and enter patient care orders (26% vs. 3%, p < 0.001.Discussion. This study shows a high prevalence and frequency of tablet computer use among physicians in training at this academic medical center. Most residents and students use tablet computers to access medical references, e-Books, and to study for board exams. Residents were more likely to use tablet computers to complete clinical tasks.Conclusions. Tablet computer use among medical students and resident physicians was common in this survey. All learners used tablet computers for point of care references and board study. Resident physicians were more likely to use tablet computers to access the EMR, enter patient care orders, and review radiology studies. This difference is likely due to the differing educational and professional demands placed on

Community pharmacist collaboration with a patient-centered medical home: Establishment of a patient-centered medical neighborhood and payment model.

Science.gov (United States)

Luder, Heidi R; Shannon, Pam; Kirby, James; Frede, Stacey M

To determine the feasibility of a partnership between a community pharmacy and a patient-centered medical home (PCMH) by measuring the impact on office- and patient-level clinical outcomes. Kroger Pharmacy and a PCMH practice in Cincinnati, OH. The Kroger Co. is a large grocery store chain that operates 102 pharmacies in the Cincinnati-Dayton marketing area. The PCMH practice is an accredited PCMH office serving more than 9000 patients in the Cincinnati area. In a medical neighborhood, a PCMH coordinates care with other local specialty practices or partners. A partnership between the community pharmacy chain and the PCMH was established to create a medical neighborhood. The pharmacist spent 2 half-days per week at the PCMH. The pharmacist provided initial medication therapy management appointments in the PCMH and offered follow-up services in the office, the pharmacy, or both, depending on patient preference. The pharmacy received a capitated payment per patient per month for a predetermined number of 1000 high-risk patients. Office-level changes in clinical outcomes such as A1C, blood pressure, and lipid measures were collected and compared with those of a similar control office. In addition, patient-level outcomes such as change in A1C, blood pressure, lipids, and weight were measured. One hundred five patients were seen by the pharmacist during the study period, with 1.5% of the total managed at the office. There was a statistically significant increase in influenza vaccinations received. On a patient level, A1C and systolic blood pressure significantly improved. This project represents an exciting opportunity for community pharmacists to expand their scope of services through direct partnership with PCMHs and maintain a sustainable reimbursement structure. Copyright © 2018. Published by Elsevier Inc.

Calibration Laboratory for Medical Physics towards ISO/ IEC 17025 accreditation: Experience and challenges

International Nuclear Information System (INIS)

Asmaliza Hashim; Abdul Aziz Ramli; Muhammad Jamal Isa; Sharul Azlan Azizan

2011-01-01

Medical Physics Calibration Laboratory is laboratory where placed under Medical Physics Group, Radiation Healthy and Safety Division. This laboratory offers calibration services to their customers that covered doses calibration, tube voltan (kVp), exposure doses, sensitometer and densitometer. After 12 years of operation, it is the right time for this laboratory to upgrade their quality services based on ISO/ IEC 17025. Accreditation scope covered calibration for diagnostic doses only. Starting from 2009, serious effort was done to prepare the quality documents that covered quality manual, quality procedure and work orders. Meanwhile, several series of audit were done by Quality Management Center (QMC), now Innovation Management Center (IMC) with collaboration with Standard Department. This paper works revealed challenges and experience during the process toward ISO/ IEC 17025 accreditation. (author)

R and E: Communications and Intelligent Systems Division (LC)

Science.gov (United States)

Emerson, Dawn C.; Miranda, Felix A.

2015-01-01

This presentation is intended for the Ohio Federal Research Network's Centers of Excellence. The presentation provides an overview of the Communications and Intelligent Systems Division including current research and engineering work as well as future technology needs.

Development of a Hospital-based Massage Therapy Course at an Academic Medical Center.

Science.gov (United States)

Dion, Liza J; Cutshall, Susanne M; Rodgers, Nancy J; Hauschulz, Jennifer L; Dreyer, Nikol E; Thomley, Barbara S; Bauer, Brent

2015-03-01

Massage therapy is offered increasingly in US medical facilities. Although the United States has many massage schools, their education differs, along with licensure and standards. As massage therapy in hospitals expands and proves its value, massage therapists need increased training and skills in working with patients who have various complex medical concerns, to provide safe and effective treatment. These services for hospitalized patients can impact patient experience substantially and provide additional treatment options for pain and anxiety, among other symptoms. The present article summarizes the initial development and description of a hospital-based massage therapy course at a Midwest medical center. A hospital-based massage therapy course was developed on the basis of clinical experience and knowledge from massage therapists working in the complex medical environment. This massage therapy course had three components in its educational experience: online learning, classroom study, and a 25-hr shadowing experience. The in-classroom study portion included an entire day in the simulation center. The hospital-based massage therapy course addressed the educational needs of therapists transitioning to work with interdisciplinary medical teams and with patients who have complicated medical conditions. Feedback from students in the course indicated key learning opportunities and additional content that are needed to address the knowledge and skills necessary when providing massage therapy in a complex medical environment. The complexity of care in medical settings is increasing while the length of hospital stay is decreasing. For this reason, massage provided in the hospital requires more specialized training to work in these environments. This course provides an example initial step in how to address some of the educational needs of therapists who are transitioning to working in the complex medical environment.

The patient-centered medical home: an ethical analysis of principles and practice.

Science.gov (United States)

Braddock, Clarence H; Snyder, Lois; Neubauer, Richard L; Fischer, Gary S

2013-01-01

The patient-centered medical home (PCMH), with its focus on patient-centered care, holds promise as a way to reinvigorate the primary care of patients and as a necessary component of health care reform. While its tenets have been the subject of review, the ethical dimensions of the PCMH have not been fully explored. Consideration of the ethical foundations for the core principles of the PCMH can and should be part of the debate concerning its merits. The PCMH can align with the principles of medical ethics and potentially strengthen the patient-physician relationship and aspects of health care that patients value. Patient choice and these ethical considerations are central and at least as important as the economic and practical arguments in support of the PCMH, if not more so. Further, the ethical principles that support key concepts of the PCMH have implications for the design and implementation of the PCMH. This paper explores the PCMH in light of core principles of ethics and professionalism, with an emphasis both on how the concept of the PCMH may reinforce core ethical principles of medical practice and on further implications of these principles.

Evaluation of the ASCO Value Framework for Anticancer Drugs at an Academic Medical Center.

Science.gov (United States)

Wilson, Leslie; Lin, Tracy; Wang, Ling; Patel, Tanuja; Tran, Denise; Kim, Sarah; Dacey, Katie; Yuen, Courtney; Kroon, Lisa; Brodowy, Bret; Rodondi, Kevin

2017-02-01

Anticancer drug prices have increased by an average of 12% each year from 1996 to 2014. A major concern is that the increasing cost and responsibility of evaluating treatment options are being shifted to patients. This research compared 2 value-based pricing models that were being considered for use at the University of California, San Francisco (UCSF) Medical Center to address the growing burden of high-cost cancer drugs while improving patient-centered care. The Medication Outcomes Center (MOC) in the Department of Clinical Pharmacy, University of California, San Francisco (UCSF), School of Pharmacy focuses on assessing the value of medication-related health care interventions and disseminating findings to the UCSF Medical Center. The High Cost Oncology Drug Initiative at the MOC aims to assess and adopt tools for the critical assessment and amelioration of high-cost cancer drugs. The American Society of Clinical Oncology (ASCO) Value Framework (2016 update) and a cost-effectiveness analysis (CEA) framework were identified as potential tools for adoption. To assess 1 prominent value framework, the study investigators (a) asked 8 clinicians to complete the ASCO Value Framework for 11 anticancer medications selected by the MOC; (b) reviewed CEAs assessing the drugs; (c) generated descriptive statistics; and (d) analyzed inter-rater reliability, convergence validity, and ranking consistency. On the scale of -20 to 180, the mean ASCO net health benefit (NHB) total score across 11 drugs ranged from 7.6 (SD = 7.8) to 53 (SD = 9.8). The Kappa coefficient (κ) for NHB scores across raters was 0.11, which is categorized as "slightly reliable." The combined κ score was 0.22, which is interpreted as low to fair inter-rater reliability. Convergent validity indicates that the correlation between NHB scores and CEA-based incremental cost-effectiveness ratios (ICERs) was low (-0.215). Ranking of ICERs, ASCO scores, and wholesale acquisition costs indicated different results

Development of a Risk-Based Decision-Support-Model for Protecting an Urban Medical Center from a Nuclear Explosion

International Nuclear Information System (INIS)

Ben-Dor, G.; Shohet, I.M.; Ornai, D.; Brosh, B.

2014-01-01

Nuclear explosion is the worst man-made physical threat on the human society. The nuclear explosion includes several consequences, some of them are immediate and others are long term. The major influences are: long duration blast, extreme thermal release, nuclear radiations, and electro-magnetic pulse (EMP). Their damage range is very wide. When nuclear explosion occurs above or in an urban area it is possible that one or more medical centers will be affected. Medical centers include several layers of structures defined by their resistance capacity to the nuclear explosion influences, beginning with the structure's frame and ending with different systems and with vulnerable medical critical infrastructures such as communications, medical gas supply, etc. A comprehensive literature survey revealed that in spite of the necessity and the importance of medical centers in the daily life and especially in emergency and post nuclear explosion, there is a lack of research on this topic

Marion duPont Scott Equine Medical Center offers new treatment for lameness

OpenAIRE

Musick, Marjorie

2006-01-01

The Virginia-Maryland Regional College of Veterinary Medicine's Marion duPont Scott Equine Medical Center has begun offering a new therapy for treating lameness associated with osteoarthritis and cartilage damage in horses, a problem that affects all segments of the equine industry.

Creating and sustainable development of specialized centers as a way to improve quality of medical care

Directory of Open Access Journals (Sweden)

V. I. Guzeva

2016-01-01

Full Text Available Quality of care is evaluated on the completeness of the survey, the correct diagnosis, treatment efficacy, and its duration. Improving the quality and efficiency of medical care for children with paroxysmal disorders of consciousness is one of topical problems of neurology.Aim. The aim of the work is to justify the relationship between improving the quality of health care and sustainable development in the modern conditions of specialized medical centers on the example of the work on the identification and treatment of children with paroxysmal disorders of consciousness of the Center for diagnosis and treatment of epilepsy, and sleep disorders in children and adolescents at the department neurology, neurosurgery and medical genetics SPbGPMU.Materials and methods. For more accurate diagnosis and treatment at the Center conducted a comprehensive examination, including video-EEG оf 527 children aged 1 month to 18 years. A clinical trial study included medical cases, assessment of neurological and somatic status, the study of seizure types and forms of the disease. Instrumental methods of examination were determined by EEG and MRI studies of the brain.Main results. Comprehensive survey of sick children with monitoring video-EEG revealed that 317 children (60,1% had epileptic paroxysms and 210 children (39,8% – non-epileptic paroxysms. Correction treatment was performed in 284 (89,5% children with epileptic paroxysms and altered the treatment in 190 (90,4% children with epileptic paroxysms.Conclusion. The presented clinical data show the high effectiveness of the Centre in the diagnosis and treatment of children with paroxysmal disorders of consciousness. The accumulated experience in the Center confirms the relevance of the creation of the structure of scientific and educational institutions specialized centers in which patients will be given to high-quality medical care.

Factors that influence the choice to work in rural township health centers among 4,669 clinical medical students from five medical universities in Guangxi, China.

Science.gov (United States)

Qing, Yunbo; Hu, Guijie; Chen, Qingyun; Peng, Hailun; Li, Kailan; Wei, Jinling; Yi, Yanhua

2015-01-01

To produce competent undergraduate-level medical doctors for rural township health centers (THCs), the Chinese government mandated that medical colleges in Central and Western China recruit rural-oriented, tuition-waived medical students (RTMSs) starting in 2010. This study aimed to identify and assess factors that influence the choice to work in rural township health centers among both RTMSs and other students from five medical universities in Guangxi, China. An internet-based self-administered questionnaire survey was conducted with medical students in Guangxi province. Multinomial logistic regression was used to identify factors related to the attitudes toward work in a rural township health center. Among 4,669 medical students, 1,523 (33%) had a positive attitude and 2,574 (55%) had a neutral attitude toward working in THCs. Demographic characteristics, personal job concerns, and knowledge of THCs were associated with the choice of a career in THCs. The factors related to a positive attitude included the following: three-year program, a rural-oriented medical program, being male, an expectation of working in a county or township, a focus on medical career development, some perceived difficulty of getting a job, having family support, sufficient knowledge of THCs, optimism toward THC development, seeking lower working pressure, and a lower expected monthly salary. Male students in a three-year program or a rural-oriented tuition-waived medical education program were more likely to work in THCs. Selecting medical students through interviews to identify their family support and intentions to work in THCs would increase recruitment and retention. Establishing favorable policies and financial incentives to improve living conditions and the social status of rural physicians is necessary.

Factors that influence the choice to work in rural township health centers among 4,669 clinical medical students from five medical universities in Guangxi, China

Directory of Open Access Journals (Sweden)

Yunbo Qing

2015-07-01

Full Text Available Purpose: To produce competent undergraduate-level medical doctors for rural township health centers (THCs, the Chinese government mandated that medical colleges in Central and Western China recruit rural-oriented, tuition-waived medical students (RTMSs starting in 2010. This study aimed to identify and assess factors that influence the choice to work in rural township health centers among both RTMSs and other students from five medical universities in Guangxi, China. Methods: An internet-based self-administered questionnaire survey was conducted with medical students in Guangxi province. Multinomial logistic regression was used to identify factors related to the attitudes toward work in a rural township health center. Results: Among 4,669 medical students, 1,523 (33% had a positive attitude and 2,574 (55% had a neutral attitude toward working in THCs. Demographic characteristics, personal job concerns, and knowledge of THCs were associated with the choice of a career in THCs. The factors related to a positive attitude included the following: three-year program, a rural-oriented medical program, being male, an expectation of working in a county or township, a focus on medical career development, some perceived difficulty of getting a job, having family support, sufficient knowledge of THCs, optimism toward THC development, seeking lower working pressure, and a lower expected monthly salary. Conclusion: Male students in a three-year program or a rural-oriented tuition-waived medical education program were more likely to work in THCs. Selecting medical students through interviews to identify their family support and intentions to work in THCs would increase recruitment and retention. Establishing favorable policies and financial incentives to improve living conditions and the social status of rural physicians is necessary.

Prospects for rebuilding primary care using the patient-centered medical home.

Science.gov (United States)

Landon, Bruce E; Gill, James M; Antonelli, Richard C; Rich, Eugene C

2010-05-01

Existing research suggests that models of enhanced primary care lead to health care systems with better performance. What the research does not show is whether such an approach is feasible or likely to be effective within the U.S. health care system. Many commentators have adopted the model of the patient-centered medical home as policy shorthand to address the reinvention of primary care in the United States. We analyze potential barriers to implementing the medical home model for policy makers and practitioners. Among others, these include developing new payment models, as well as the need for up-front funding to assemble the personnel and infrastructure required by an enhanced non-visit-based primary care practice and methods to facilitate transformation of existing practices to functioning medical homes.

Collaborating to improve the global competitiveness of US academic medical centers.

Science.gov (United States)

Allen, Molly; Garman, Andrew; Johnson, Tricia; Hohmann, Samuel; Meurer, Steve

2012-01-01

President Obama announced the National Export Initiative in his 2010 State of the Union address and set the ambitious goal of doubling US exports by the end of 2014 to support millions of domestic jobs. Understanding the competitive position of US health care in the global market for international patients, University Health System Consortium (UHC), an alliance of 116 academic medical centers and 272 of their affiliated hospitals, representing 90 percent of the nation's non-profit academic medical centers partnered with Rush University, a private University in Chicago, IL and the International Trade Administration of the US Department of Commerce International Trade Administration (ITA) to participate in the Market Development Cooperator Program. The goal of this private-public partnership is to increase the global competitiveness of the US health care industry, which represents over 16 percent of the GDP, amongst foreign health care providers. This article provides an overview of the US health care market and outlines the aims of the US Cooperative for International Patient Programs, the end result of the partnership between UHC, ITA and Rush University.

Biennial report for 1982 and 1983 of Electronics Division

International Nuclear Information System (INIS)

1985-01-01

The research and development activities of the Electronics Division of the Bhabha Atomic Research Centre, Bombay during the years 1982 and 1983 is presented in the form of individual summaries arranged under the headings: reactor instrumentations, nuclear instruments, medical instrumentation, local area network, general instruments. Other activities of the Division such as servicing of electronic equipments, provision of wiring and PCB facilities to computer network and micro based systems, training etc are also decribed in brief. A list of staff-members is given at the end. (author)

Syndrome surveillance of fentanyl-laced heroin outbreaks: Utilization of EMS, Medical Examiner and Poison Center databases.

Science.gov (United States)

Moore, P Quincy; Weber, Joseph; Cina, Steven; Aks, Steven

2017-11-01

Describe surveillance data from three existing surveillance systems during an unexpected fentanyl outbreak in a large metropolitan area. We performed a retrospective analysis of three data sets: Chicago Fire Department EMS, Cook County Medical Examiner, and Illinois Poison Center. Each included data from January 1, 2015 through December 31, 2015. EMS data included all EMS responses in Chicago, Illinois, for suspected opioid overdose in which naloxone was administered and EMS personnel documented other criteria indicative of opioid overdose. Medical Examiner data included all deaths in Cook County, Illinois, related to heroin, fentanyl or both. Illinois Poison Center data included all calls in Chicago, Illinois, related to fentanyl, heroin, and other prescription opioids. Descriptive statistics using Microsoft Excel® were used to analyze the data and create figures. We identified a spike in opioid-related EMS responses during an 11-day period from September 30-October 10, 2015. Medical Examiner data showed an increase in both fentanyl and mixed fentanyl/heroin related deaths during the months of September and October, 2015 (375% and 550% above the median, respectively.) Illinois Poison Center data showed no significant increase in heroin, fentanyl, or other opioid-related calls during September and October 2015. Our data suggests that EMS data is an effective real-time surveillance mechanism for changes in the rate of opioid overdoses. Medical Examiner's data was found to be valuable for confirmation of EMS surveillance data and identification of specific intoxicants. Poison Center data did not correlate with EMS or Medical Examiner data. Copyright © 2017 Elsevier Inc. All rights reserved.

Goddard's Astrophysics Science Division Annual Report 2013

Science.gov (United States)

Weaver, Kimberly A. (Editor); Reddy, Francis J. (Editor); Tyler, Patricia A. (Editor)

2014-01-01

The Astrophysics Science Division (ASD) at Goddard Space Flight Center (GSFC) is one of the largest and most diverse astrophysical organizations in the world, with activities spanning a broad range of topics in theory, observation, and mission and technology development. Scientific research is carried out over the entire electromagnetic spectrum from gamma rays to radio wavelengths as well as particle physics and gravitational radiation. Members of ASD also provide the scientific operations for two orbiting astrophysics missions Fermi Gamma-ray Space Telescope and Swift as well as the Science Support Center for Fermi. A number of key technologies for future missions are also under development in the Division, including X-ray mirrors, space-based interferometry, high contrast imaging techniques to search for exoplanets, and new detectors operating at gamma-ray, X-ray, ultraviolet, infrared, and radio wavelengths. The overriding goals of ASD are to carry out cutting-edge scientific research, provide Project Scientist support for spaceflight missions, implement the goals of the NASA Strategic Plan, serve and support the astronomical community, and enable future missions by conceiving new concepts and inventing new technologies.

Program review of the USDA Center for Medical, Agricultural and Veterinary Entomology

Science.gov (United States)

The USDA-ARS Center for Medical, Agricultural and Veterinary Entomology (CMAVE) has a history that starts in 1932 in Orlando to develop methods to control mosquitoes, including malaria vectors under conditions simulating those of the south Pacific jungles, and other insects affecting man and animals...

MP-Division health and safety reference handbook

International Nuclear Information System (INIS)

Putnam, T.M.

1987-09-01

This report presents the objectives, organization, policies, and essential rules and procedures that have been adopted by MP Division and that form the basis of the Health and Safety Program of the Clinton P. Anderson Meson Physics Facility (LAMPF). The facility includes the beam-delivery systems for the Los Alamos Neutron Scattering Center and the Weapons Neutron Research Facility (LANSCE/WNR). The program is designed not only to assure the health and safety of all personnel, including users, in their work at LAMPF, and of MP-Division staff in their work on the LANSCE/WNR beam lines, but also to protect the facility (buildings and equipment) and the environment. 33 refs., 18 figs., 2 tabs

Division of Radiological Protection : progress report, 1989-1991

International Nuclear Information System (INIS)

Gupta, B.L.; Nagarajan, P.S.; Bhatt, B.C.; Seethapathy, A.; Pradhan, A.S.; Vishwakarma, R.R.

1992-01-01

This report describes the work of the Division of Radiological Protection during 1989-91, for implementation of radiation safety in all institutions in the country using radiation sources for medical, industrial and research applications. It gives information about personnel monitoring using photographic film and TLD badges, neutron monitoring badges, dosimetric techniques developed, calibration techniques for high-dose irradiators, design and fabrication of special radiation protection instruments, advisory and licensing services, regulation and transport of radioactive materials, periodic protection survey, education and training related to radiation safety programmes. About 164 publications by the staff of this Division are listed. (author). 1 index., 1 tab

Challenges and Opportunities to Improve Cervical Cancer Screening Rates in US Health Centers through Patient-Centered Medical Home Transformation

Directory of Open Access Journals (Sweden)

Olga Moshkovich

2015-01-01

Full Text Available Over the last 50 years, the incidence of cervical cancer has dramatically decreased. However, health disparities in cervical cancer screening (CCS persist for women from racial and ethnic minorities and those residing in rural and poor communities. For more than 45 years, federally funded health centers (HCs have been providing comprehensive, culturally competent, and quality primary health care services to medically underserved communities and vulnerable populations. To enhance the quality of care and to ensure more women served at HCs are screened for cervical cancer, over eight HCs received funding to support patient-centered medical home (PCMH transformation with goals to increase CCS rates. The study conducted a qualitative analysis using Atlas.ti software to describe the barriers and challenges to CCS and PCMH transformation, to identify potential solutions and opportunities, and to examine patterns in barriers and solutions proposed by HCs. Interrater reliability was assessed using Cohen’s Kappa. The findings indicated that HCs more frequently described patient-level barriers to CCS, including demographic, cultural, and health belief/behavior factors. System-level barriers were the next commonly cited, particularly failure to use the full capability of electronic medical records (EMRs and problems coordinating with external labs or providers. Provider-level barriers were least frequently cited.

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.

Information technology leadership in academic medical centers: a tale of four cultures.

Science.gov (United States)

Friedman, C P

1999-07-01

Persons and groups within academic medical centers bring consistent and predictable viewpoints to planning and decision making. The varied professional and academic cultures of these individuals appear to account primarily for the diversity of their viewpoints. Understanding these professional cultures can help leaders achieve some predictability in the complex environments for which they are responsible. Leaders in information technology in particular, in order to be successful, must become part-time anthropologists, immersing themselves in the varied workplaces of their constituents to understand the work they do and the cultures that have grown up around this work. Only in this way will they be able to manage the challenges that arise continuously as the technology and the needs it can address change over time. In this article, the author briefly describes the concept of culture, portrays four specific professional cultures that typically coexist in academic medical centers, and argues that understanding these cultures is absolutely critical to effective management and use of information resources.

Transportation Technical Environmental Information Center index

International Nuclear Information System (INIS)

Davidson, C.A.; Foley, J.T.

1979-01-01

In an effort to determine the environmental intensities to which energy materials in transit may be exposed, a ''Data Center'' of technical environmental information has been established by Sandia Laboratories, Division 5522, for the DOE Division of Environmental Control Technology. An index is presented which can be used to request data of interest

The Maryland Division of Correction hospice program.

Science.gov (United States)

Boyle, Barbara A

2002-10-01

The Maryland Division of Correction houses 24,000 inmates in 27 geographically disparate facilities. The inmate population increasingly includes a frail, elderly component, as well as many inmates with chronic or progressive diseases. The Division houses about 900 human immunodeficiency virus (HIV)-positive detainees, almost one quarter with an acquired immune deficiency syndrome (AIDS) diagnosis. A Ryan White Special Project of National Significance (SPNS) grant and the interest of a community hospice helped transform prison hospice from idea to reality. One site is operational and a second site is due to open in the future. Both facilities serve only male inmates, who comprise more than 95% of Maryland's incarcerated. "Medical parole" is still the preferred course for terminally ill inmates; a number have been sent to various local community inpatient hospices or released to the care of their families. There will always be some who cannot be medically paroled, for whom hospice is appropriate. Maryland's prison hospice program requires a prognosis of 6 months or less to live, a do-not-resuscitate (DNR) order and patient consent. At times, the latter two of these have been problematic. Maintaining the best balance between security requirements and hospice services to dying inmates takes continual communication, coordination and cooperation. Significant complications in some areas remain: visitation to dying inmates by family and fellow prisoners; meeting special dietary requirements; what role, if any, will be played by inmate volunteers. Hospice in Maryland's Division of Correction is a work in progress.

Drug Safety - Multiple Languages

Science.gov (United States)

... to Over the Counter Medications - Amarɨñña / አማርኛ (Amharic) MP3 Global Health Center Division of Infectious Diseases University ... to Over the Counter Medications - myanma bhasa (Burmese) MP3 Global Health Center Division of Infectious Diseases University ...

Outsourcing your medical practice call center: how to choose a vendor to ensure regulatory compliance.

Science.gov (United States)

Johnson, Bill

2014-01-01

Medical practices receive hundreds if not thousands of calls every week from patients, payers, pharmacies, and others. Outsourcing call centers can be a smart move to improve efficiency, lower costs, improve customer care, ensure proper payer management, and ensure regulatory compliance. This article discusses how to know when it's time to move to an outsourced call center, the benefits of making the move, how to choose the right call center, and how to make the transition. It also provides tips on how to manage the call center to ensure the objectives are being met.

Applications of instrumental neutron activation analysis in the Analytical Division of the Research Center Juelich (KFA)

International Nuclear Information System (INIS)

Erdtmann, G.

1991-12-01

The Radioanalytical Chemistry Section, as a part of the Central Division of Chemical Analysis of the Research Center KFA Juelich, has the task to provide and to apply nuclear methods in the analytical service for the institutes and projects of the KFA and to customers outside. A great part of this service is trace element determinations by neutron activation analysis using the research reactor FRJ-2. The procedure for the instrumental technique is described and mainly practical aspects are reported in detail. It is based on the k 0 -method developed by Simonits and DeCorte. The results are calculated from the peak areas of the γ-lines and the corresponding k 0 -factors. A new variant of this procedure is required, if the program used for the deconvolution of the γ-spectra provides absolute decay rates of the radionuclides instead of the γ-emission rates. This variant is also described. Some examples of analyses carried out in the analytical service are presented and discussed mainly with respect to accuracy of the results and detection limits. (orig.) [de

An approach to human-centered design of nuclear medical equipment: the system of caption of the thyroid

International Nuclear Information System (INIS)

Santos, Isaac J.A. Luquetti; Silva, Carlos Borges da; Santana, Marcos; Carvalho, Paulo Victor R.; Oliveira, Mauro Vitor de; Mol, Antonio Carlos Mol; Grecco, Claudio Henrique; Augusto, Silas Cordeiro

2005-01-01

Technology plays an important role in modern medical centers, making health care increasingly complex, relying on complex technical equipment. This technical complexity is particularly noticeable in the nuclear medicine and can increase the risks for human error. Human error has many causes such as performance shaping factors, organizational factors and user interface design. Poorly design human system interfaces of nuclear medical equipment can increase the risks for human error. If all nuclear medical equipment had been designed with good user interfaces, incidents and accidents could be reduced as well as he time required to learn how to use the equipment. Although some manufacturers of nuclear medical equipment have already integrate human factors principles in their products, there is still a need to steer the development of nuclear medical technology toward more human-centered approach. The aim of this paper is to propose a methodology that contributes to the design, development and evaluation of nuclear medical equipment and human system interface, towards a human-centered approach. This methodology includes the ergonomic approach, based on the operator activity analysis, together with human factors standards and guidelines, questionnaires and user based testing. We describe a case study in which this methodology is being applied in evaluation of the thyroid uptake system, getting essential information and data, that ill be used in development of a new system. (author)

Creating a longitudinal integrated clerkship with mutual benefits for an academic medical center and a community health system.

Science.gov (United States)

Poncelet, Ann Noelle; Mazotti, Lindsay A; Blumberg, Bruce; Wamsley, Maria A; Grennan, Tim; Shore, William B

2014-01-01

The longitudinal integrated clerkship is a model of clinical education driven by tenets of social cognitive theory, situated learning, and workplace learning theories, and built on a foundation of continuity between students, patients, clinicians, and a system of care. Principles and goals of this type of clerkship are aligned with primary care principles, including patient-centered care and systems-based practice. Academic medical centers can partner with community health systems around a longitudinal integrated clerkship to provide mutual benefits for both organizations, creating a sustainable model of clinical training that addresses medical education and community health needs. A successful one-year longitudinal integrated clerkship was created in partnership between an academic medical center and an integrated community health system. Compared with traditional clerkship students, students in this clerkship had better scores on Clinical Performance Examinations, internal medicine examinations, and high perceptions of direct observation of clinical skills.Advantages for the academic medical center include mitigating the resources required to run a longitudinal integrated clerkship while providing primary care training and addressing core competencies such as systems-based practice, practice-based learning, and interprofessional care. Advantages for the community health system include faculty development, academic appointments, professional satisfaction, and recruitment.Success factors include continued support and investment from both organizations' leadership, high-quality faculty development, incentives for community-based physician educators, and emphasis on the mutually beneficial relationship for both organizations. Development of a longitudinal integrated clerkship in a community health system can serve as a model for developing and expanding these clerkship options for academic medical centers.

Implementing the patient-centered medical home in residency education.

Science.gov (United States)

Doolittle, Benjamin R; Tobin, Daniel; Genao, Inginia; Ellman, Matthew; Ruser, Christopher; Brienza, Rebecca

2015-01-01

In recent years, physician groups, government agencies and third party payers in the United States of America have promoted a Patient-centered Medical Home (PCMH) model that fosters a team-based approach to primary care. Advocates highlight the model's collaborative approach where physicians, mid-level providers, nurses and other health care personnel coordinate their efforts with an aim for high-quality, efficient care. Early studies show improvement in quality measures, reduction in emergency room visits and cost savings. However, implementing the PCMH presents particular challenges to physician training programs, including institutional commitment, infrastructure expenditures and faculty training. Teaching programs must consider how the objectives of the PCMH model align with recent innovations in resident evaluation now required by the Accreditation Council of Graduate Medical Education (ACGME) in the US. This article addresses these challenges, assesses the preliminary success of a pilot project, and proposes a viable, realistic model for implementation at other institutions.

Diversity leadership: the Rush University Medical Center experience.

Science.gov (United States)

Clapp, J R

2010-01-01

Meeting the challenges of diversity is crucial, and within healthcare organizations a particularly strong case exists for a diversity strategy. Rush University Medical Center in 2006 was at an important juncture. Since its founding, the organization had made notable progress toward advancing diversity and inclusiveness. On the other hand, many diversity-related problems continued. Rush convened a committee to review the work of the institution in this area. The committee's report called for changes, and a Diversity Leadership Group (DLG) model was established. This article documents the progress made since 2006 through implementation of the DLG model. The changes prescribed for Rush are presented as recommendations and challenges that other healthcare organizations may find applicable to their own institutions.

SU-E-P-01: An Informative Review On the Role of Diagnostic Medical Physicist in the Academic and Private Medical Centers

International Nuclear Information System (INIS)

Weir, V; Zhang, J

2014-01-01

Purpose: The role of physicist in the academic and private hospital environment continues to evolve and expand. This becomes more obvious with the newly revised requirements of the Joint Commission (JC) on imaging modalities and the continued updated requirements of ACR accreditation for medical physics (i.e., starting in June 2014, a physicists test will be needed before US accreditation). We provide an informative review on the role of diagnostic medical physicist and hope that our experience will expedite junior physicists in understanding their role in medical centers, and be ready to more opportunities. Methods: Based on our experience, diagnostic medical physicists in both academic and private medical centers perform several clinical functions. These include providing clinical service and physics support, ensuring that all ionizing radiation devices are tested and operated in compliance with the State and Federal laws, regulations and guidelines. We also discuss the training and education required to ensure that the radiation exposure to patients and staff is as low as reasonably achievable. We review the overlapping roles of medical and health physicist in some institutions. Results: A detailed scheme on the new requirements (effective 7/1/2014) of the JC is provided. In 2015, new standards for fluoroscopy, cone beam CT and the qualifications of staff will be phased in. A summary of new ACR requirements for different modalities is presented. Medical physicist have other duties such as sitting on CT and fluoroscopy committees for protocols design, training of non-radiologists to meet the new fluoroscopy rules, as well as helping with special therapies such as Yittrium 90 cases. Conclusion: Medical physicists in both academic and private hospitals are positioned to be more involved and prominent. Diagnostic physicists need to be more proactive to involve themselves in the day to day activities of the radiology department

SU-E-P-01: An Informative Review On the Role of Diagnostic Medical Physicist in the Academic and Private Medical Centers

Energy Technology Data Exchange (ETDEWEB)

Weir, V [Baylor Health Care System, Dallas, TX (United States); Zhang, J [University of Kentucky, Lexington, KY (United States)

2014-06-01

Purpose: The role of physicist in the academic and private hospital environment continues to evolve and expand. This becomes more obvious with the newly revised requirements of the Joint Commission (JC) on imaging modalities and the continued updated requirements of ACR accreditation for medical physics (i.e., starting in June 2014, a physicists test will be needed before US accreditation). We provide an informative review on the role of diagnostic medical physicist and hope that our experience will expedite junior physicists in understanding their role in medical centers, and be ready to more opportunities. Methods: Based on our experience, diagnostic medical physicists in both academic and private medical centers perform several clinical functions. These include providing clinical service and physics support, ensuring that all ionizing radiation devices are tested and operated in compliance with the State and Federal laws, regulations and guidelines. We also discuss the training and education required to ensure that the radiation exposure to patients and staff is as low as reasonably achievable. We review the overlapping roles of medical and health physicist in some institutions. Results: A detailed scheme on the new requirements (effective 7/1/2014) of the JC is provided. In 2015, new standards for fluoroscopy, cone beam CT and the qualifications of staff will be phased in. A summary of new ACR requirements for different modalities is presented. Medical physicist have other duties such as sitting on CT and fluoroscopy committees for protocols design, training of non-radiologists to meet the new fluoroscopy rules, as well as helping with special therapies such as Yittrium 90 cases. Conclusion: Medical physicists in both academic and private hospitals are positioned to be more involved and prominent. Diagnostic physicists need to be more proactive to involve themselves in the day to day activities of the radiology department.

Implementation of Patient-Centered Medical Homes in Adult Primary Care Practices.

Science.gov (United States)

Alexander, Jeffrey A; Markovitz, Amanda R; Paustian, Michael L; Wise, Christopher G; El Reda, Darline K; Green, Lee A; Fetters, Michael D

2015-08-01

There has been relatively little empirical evidence about the effects of patient-centered medical home (PCMH) implementation on patient-related outcomes and costs. Using a longitudinal design and a large study group of 2,218 Michigan adult primary care practices, our study examined the following research questions: Is the level of, and change in, implementation of PCMH associated with medical surgical cost, preventive services utilization, and quality of care in the following year? Results indicated that both level and amount of change in practice implementation of PCMH are independently and positively associated with measures of quality of care and use of preventive services, after controlling for a variety of practice, patient cohort, and practice environmental characteristics. Results also indicate that lower overall medical and surgical costs are associated with higher levels of PCMH implementation, although change in PCMH implementation did not achieve statistical significance. © The Author(s) 2015.

76 FR 10070 - Division of Coal Mine Workers' Compensation; Proposed Extension of Existing Collection; Comment...

Science.gov (United States)

2011-02-23

... DEPARTMENT OF LABOR Office of Workers' Compensation Programs Division of Coal Mine Workers... Rereading (CM-933b), Medical History and Examination for Coal Mine Workers' Pneumoconiosis (CM-988), Report... interpretation of x-rays. When a miner applies for benefits, the Division of Coal Mine Workers' Compensation...

The Royal Naval Medical Services: delivering medical operational capability. the 'black art' of Medical Operational Planning.

Science.gov (United States)

Faye, M

2013-01-01

This article looks to dispel the mysteries of the 'black art' of Medical Operational Planning whilst giving an overview of activity within the Medical Operational Capability area of Medical Division (Med Div) within Navy Command Headquarters (NCHQ) during a period when the Royal Naval Medical Services (RNMS) have been preparing and reconfiguring medical capability for the future contingent battle spaces. The rolling exercise program has been used to illustrate the ongoing preparations taken by the Medical Operational Capability (Med Op Cap) and the Medical Force Elements to deliver medical capability in the littoral and maritime environments.

Integration of pharmacists into patient-centered medical homes in federally qualified health centers in Texas.

Science.gov (United States)

Wong, Shui Ling; Barner, Jamie C; Sucic, Kristina; Nguyen, Michelle; Rascati, Karen L

To describe the integration and implementation of pharmacy services in patient-centered medical homes (PCMHs) as adopted by federally qualified health centers (FQHCs) and compare them with usual care (UC). Four FQHCs (3 PCMHs, 1 UC) in Austin, TX, that provide care to the underserved populations. Pharmacists have worked under a collaborative practice agreement with internal medicine physicians since 2005. All 4 FQHCs have pharmacists as an integral part of the health care team. Pharmacists have prescriptive authority to initiate and adjust diabetes medications. The PCMH FQHCs instituted co-visits, where patients see both the physician and the pharmacist on the same day. PCMH pharmacists are routinely proactive in collaborating with physicians regarding medication management, compared with UC in which pharmacists see patients only when referred by a physician. Four face-to-face, one-on-one semistructured interviews were conducted with pharmacists working in 3 PCMH FQHCs and 1 UC FQHC to compare the implementation of PCMH with emphasis on 1) structure and workflow, 2) pharmacists' roles, and 3) benefits and challenges. On co-visit days, the pharmacist may see the patient before or after physician consultation. Pharmacists in 2 of the PCMH facilities proactively screen to identify diabetes patients who may benefit from pharmacist services, although the UC clinic pharmacists see only referred patients. Strengths of the co-visit model include more collaboration with physicians and more patient convenience. Payment that recognizes the value of PCMH is one PCMH principle that is not fully implemented. PCMH pharmacists in FQHCs were integrated into the workflow to address specific patient needs. Specifically, full-time in-house pharmacists, flexible referral criteria, proactive screening, well defined collaborative practice agreement, and open scheduling were successful strategies for the underserved populations in this study. However, reimbursement plans and provider

Energy Survey of Eisenhower Army Medical Center, Fort Gordon, Augusta, Georgia. Volume 2. Appendices

National Research Council Canada - National Science Library

1996-01-01

...) including low cost/no cost ECO's and perform complete evaluations of each. Energy equipment replacement projects already underway, approved, or planned by the Medical Center staff will be factored into the evaluations...

Communications and Collaboration Keep San Francisco VA Medical Center Project on Track

International Nuclear Information System (INIS)

Federal Energy Management Program

2001-01-01

This case study about energy saving performance contacts (ESPCs) presents an overview of how the Veterans Affairs Medical Center in San Francisco established an ESPC contract and the benefits derived from it. The Federal Energy Management Program instituted these special contracts to help federal agencies finance energy-saving projects at their facilities

Accelerator and Fusion Research Division 1989 summary of activities

International Nuclear Information System (INIS)

1990-06-01

This report discusses the research being conducted at Lawrence Berkeley Laboratory's Accelerator and Fusion Research Division. The main topics covered are: heavy-ion fusion accelerator research; magnetic fusion energy; advanced light source; center for x-ray optics; exploratory studies; high-energy physics technology; and bevalac operations

Comparison and alignment of an academic medical center's strategic goals with ASHP initiatives.

Science.gov (United States)

Engels, Melanie J; Chaffee, Bruce W; Clark, John S

2015-12-01

An academic medical center's strategic goals were compared and aligned with the 2015 ASHP Health-System Pharmacy Initiative and the Pharmacy Practice Model Initiative (PPMI). The department's pharmacy practice model steering committee identified potential solutions to narrow prioritized gaps using a modified nominal group technique and a multivoting dot technique. Five priority solutions were identified and assigned to work groups to develop business plans, which included admission medication history and reconciliation for high-risk patients and those with complex medication regimens, pharmacist provision of discharge counseling to high-risk patients and those with complex medication regimens, improved measurement and reporting of the impact of PPMI programs on patient outcomes, implementation of a departmentwide formalized peer review and evaluation process, and the greeting of every patient at some time during his or her visit by a pharmacy team member. Stakeholders evaluated the business plans based on feasibility, financial return on investment, and anticipated safety enhancements. The solution that received the highest priority ranking and was subsequently implemented was "improved measurement and reporting of the impact of PPMI programs on patient outcomes." A defined process was followed for identifying gaps among current practices at an academic medical center and the 2015 ASHP Health-System Pharmacy Initiative and the PPMI. A key priority to better document the impact of pharmacists on patient care was identified for our department by using a nominal group technique brainstorming process and a multivoting dot technique and creating standardized business plans for five potential priority projects. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

The Astrophysics Science Division Annual Report 2009

Science.gov (United States)

Oegerle, William (Editor); Reddy, Francis (Editor); Tyler, Pat (Editor)

2010-01-01

The Astrophysics Science Division (ASD) at Goddard Space Flight Center (GSFC) is one of the largest and most diverse astrophysical organizations in the world, with activities spanning a broad range of topics in theory, observation, and mission and technology development. Scientific research is carried out over the entire electromagnetic spectrum - from gamma rays to radio wavelengths - as well as particle physics and gravitational radiation. Members of ASD also provide the scientific operations for three orbiting astrophysics missions - WMAP, RXTE, and Swift, as well as the Science Support Center for the Fermi Gamma-ray Space Telescope. A number of key technologies for future missions are also under development in the Division, including X-ray mirrors, space-based interferometry, high contrast imaging techniques to search for exoplanets, and new detectors operating at gamma-ray, X-ray, ultraviolet, infrared, and radio wavelengths. The overriding goals of ASD are to carry out cutting-edge scientific research, provide Project Scientist support for spaceflight missions, implement the goals of the NASA Strategic Plan, serve and support the astronomical community, and enable future missions by conceiving new concepts and inventing new technologies.

Goddard's Astrophysics Science Division Annual Report 2011

Science.gov (United States)

Centrella, Joan; Reddy, Francis; Tyler, Pat

2012-01-01

The Astrophysics Science Division(ASD) at Goddard Space Flight Center(GSFC)is one of the largest and most diverse astrophysical organizations in the world, with activities spanning a broad range of topics in theory, observation, and mission and technology development. Scientific research is carried out over the entire electromagnetic spectrum from gamma rays to radiowavelengths as well as particle physics and gravitational radiation. Members of ASD also provide the scientific operations for three orbiting astrophysics missions WMAP, RXTE, and Swift, as well as the Science Support Center for the Fermi Gamma-ray Space Telescope. A number of key technologies for future missions are also under development in the Division, including X-ray mirrors, space-based interferometry, high contract imaging techniques to serch for exoplanets, and new detectors operating at gamma-ray, X-ray, ultraviolet, infrared, and radio wavelengths. The overriding goals of ASD are to carry out cutting-edge scientific research, and provide Project Scientist support for spaceflight missions, implement the goals of the NASA Strategic Plan, serve and suppport the astronomical community, and enable future missions by conceiving new conepts and inventing new technologies.

Development of a pharmacy student research program at a large academic medical center.

Science.gov (United States)

McLaughlin, Milena M; Skoglund, Erik; Bergman, Scott; Scheetz, Marc H

2015-11-01

A program to promote research by pharmacy students created through the collaboration of an academic medical center and a college of pharmacy is described. In 2009, Midwestern University Chicago College of Pharmacy and Northwestern Memorial Hospital (NMH) expanded their existing partnership by establishing a program to increase opportunities for pharmacy students to conduct clinical-translational research. All professional year 1, 2, or 3 students at the college, as well as professional year 4 students on rotation at NMH, can participate in the program. Central to the program's infrastructure is the mentorship of student leads by faculty- and hospital-based pharmacists. The mentors oversee the student research projects and guide development of poster presentations; student leads mentor junior students and assist with orientation and training activities. Publication of research findings in the peer-reviewed literature is a key program goal. In the first four years after program implementation, participation in a summer research program grew nearly 10-fold (mainly among incoming professional year 2 or 3 students, and student poster presentations at national pharmacy meetings increased nearly 20-fold; the number of published research articles involving student authors increased from zero in 2009 to three in 2012 and two in 2013. A collaborative program between an academic medical center and a college of pharmacy has enabled pharmacy students to conduct research at the medical center and has been associated with increases in the numbers of poster presentations and publications involving students. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Safety and cost-effectiveness analysis of laparoscopic splenectomy by secondary pedicle division using monopolar electrocautery.

Science.gov (United States)

Zhou, Jianyin; Liu, Pingguo; Yin, Zhenyu; Zhao, Yilin; Wang, Xiaomin

2013-09-01

The expense of laparoscopic splenectomy (LS) has limited its use in developing countries, while medical costs are increasing worldwide. In this study, we performed LS by secondary pedicle division using monopolar electrocautery to achieve cost savings. Over seven years, we performed 45 consecutive LSs by secondary pedicle division using monopolar electrocautery (n=17) or ultrasonic shears (n=28) at a single center. These were reviewed to assess outcome and cost. Mean operating time was 179.7min, 7 conversions to open operation (15.6%) were necessary. There were four postoperative complications (8.9%) and no deaths. Twenty-three of 28 (82.1%) patients with idiopathic thrombocytopenic purpura developed a long-term positive response; and mean operative cost was RMB6,577 (US$1,034), which was much lower than that of Endo-GIATM in published reports. Between the monopolar electrocautery and ultrasonic shears groups, there were no significant differences in demographic characteristics or intraoperative and postoperative details, but operative cost was significantly lower in the former (RMB4,416, US$696 vs. RMB7,889, US$1,243; pelectrocautery is safe, efficacious and economical.

Phased implementation of AT and T PACS at Duke University Medical Center

International Nuclear Information System (INIS)

Stockbridge, C.; Ravin, C.E.

1986-01-01

''Help me communicate more quickly and more effectively with referring clinicians''. This request was the driving behind the installation of the AT and T CommView System at Duke. The CommView System is a type of Digital Image Management System and Picture Archival Communication System whose chief purpose is to deliver interpolated diagnostic images to referring clinicians and attending physicians. The system acquires electronic images from modalities in a diagnostic imaging facility, stores these images in computer managed patient files and distributes these on demand over fiber optic cable to Display Consoles. The CommView System was designed at AT and T Bell Labs; it uses fiber optic ribbon cable between buildings fused to multistrand lightguide building cables to distribute images, typically around a medical center or campus at data transfer rates of 40 Mbps. This paper gives the rationale used in designing a start-up network and placing the initial equipment for a field of the AT and T CommView System in the Radiology Department of Duke University Medical Center

Medical basis for radiation accident preparedness

International Nuclear Information System (INIS)

Huebner, K.F.; Fry, S.A.

1980-01-01

The International Conference on The Medical Basis for Radiation Accident Preparedness was organized by the staff of the Radiation Emergency Assistance Center/Training Site (REAC/TS) of the Medical and Health Sciences Division of Oak Ridge Associated Universities (ORAU). The philosophical importance of relating, through investigation and education, the intellectual resources of higher education to the important social problems associated with energy, health, and the environment was the foundation of the meeting. The symposium, held under the auspices of the US Department of Energy, was the ninth since 1960 of a series of international conferences addressing the various aspects of radiation accidents. The approach of this most recent conference differed somewhat from that of those preceding it, in that it sought an international review of the gamut of the medical aspects of radiation injury, not only for the experts in the field, but also for other physicians and scientists who, in view of current events, have had the need to know thrust upon them. Individual entries were made for the separate papers

Strategies for the Integration of Medical and Health Representation within Law Enforcement Intelligence Fusion Centers

National Research Council Canada - National Science Library

Morrissey, James F

2007-01-01

Terrorism-related intelligence gathering, analysis and information dissemination would be improved and enhanced by including a medical and health element in law enforcement intelligence fusion centers...

Accelerator and Fusion Research Division 1989 summary of activities

Energy Technology Data Exchange (ETDEWEB)

1990-06-01

This report discusses the research being conducted at Lawrence Berkeley Laboratory's Accelerator and Fusion Research Division. The main topics covered are: heavy-ion fusion accelerator research; magnetic fusion energy; advanced light source; center for x-ray optics; exploratory studies; high-energy physics technology; and bevalac operations.

Parental Perceptions of Family Centered Care in Medical Homes of Children with Neurodevelopmental Disabilities.

Science.gov (United States)

Zajicek-Farber, Michaela L; Lotrecchiano, Gaetano R; Long, Toby M; Farber, Jon Matthew

2015-08-01

Life course theory sets the framework for strong inclusion of family centered care (FCC) in quality medical homes of children with neurodevelopmental disabilities (CNDD). The purpose of this study was to explore the perceptions of families with their experiences of FCC in medical homes for CNDD. Using a structured questionnaire, the Family-Centered Care Self-Assessment Tool developed by Family Voices, this study surveyed 122 parents of CNDD in a large urban area during 2010-2012. Data collected information on FCC in the provision of primary health care services for CNDD and focused on family-provider partnerships, care setting practices and policies, and community services. Frequency analysis classified participants' responses as strengths in the "most of the time" range, and weaknesses in the "never" range. Only 31 % of parents were satisfied with the primary health care their CNDD received. Based on an accepted definition of medical home services, 16 % of parents reported their CNDD had most aspects of a medical home, 64 % had some, and 20 % had none. Strengths in FCC were primarily evident in the family-provider partnership and care settings when focused on meeting the medical care needs of the child. Weaknesses in FCC were noted in meeting the needs of families, coordination, follow-up, and support with community resources. Improvements in key pediatric health care strategies for CNDD are recommended. CNDD and their families have multifaceted needs that require strong partnerships among parents, providers, and communities. Quality medical homes must include FCC and valued partnerships with diverse families and community-based providers.

On the scene: American University of Beirut Medical Center, Beirut, Lebanon.

Science.gov (United States)

Mouro, Gladys; Tashjian, Hera; Daaboul, Tania; Kozman, Katia; Alwan, Farah; Shamoun, Anthony

2011-01-01

American University of Beirut Medical Center is the first Magnet hospital in the Middle East. In this article, authors reflect back on the journey to excellence, specifically in establishing shared governance in a challenging cultural and organizational milieu. Perspectives from nurses at different levels are included to highlight their experiences throughout the journey. Evolution of the organization's shared governance model is described and initiatives of the councils are illustrated.

Examining Health Information Technology Implementations: Case of the Patient-Centered Medical Home

Science.gov (United States)

Behkami, Nima A.

2012-01-01

It has been shown that the use of Health Information Technology (HIT) is associated with reduced cost and increased quality of care. This dissertation examined the use of registries in Patient Centered Medical Home (PCMH) practices. A survey questionnaire was sent to a nationwide group of clinics certified for being a PCMH. They were asked to…

Transformation of an academic medical center: lessons learned from restructuring and downsizing.

Science.gov (United States)

Woodard, B; Fottler, M D; Kilpatrick, A O

1999-01-01

This article reviews management literature on health care transformation and describes the processes, including restructuring, job redesign, and downsizing, involved in one academic medical center's experience. The article concludes with lessons learned at each of the stages of the transformation process: planning, implementation, and process continuation. Managerial implications for similar transformation efforts in other health care organizations are suggested.

Analysis of the drug formulary and the purchasing process at a Moroccan university medical center.

Science.gov (United States)

Lachhab, Z; Serragui, S; Hassar, M; Cherrah, Y; Errougani, A; Ahid, S

2018-05-31

To give an overview of the pharmaceutical policy in the largest medical center in Morocco, a developing country in socio-economic transition. This is an analytical descriptive study of the drug formulary and the purchasing process carried out at the Ibn Sina University Medical Center. Our formulary included 830 drugs belonging to 14 classes according to the Anatomical, Therapeutic and Chemical (ATC) Classification System. There was a respective predominance of class N (21.8%), class B (13.5%), and class J (12.6%). Injectable route was dominant (46%). Drugs had a significant actual benefit in 70% (according to the French Data), reimbursable in 42.8%, essential in 29.2% according to World Health Organization (WHO) list, and in 36.9% according to the Moroccan list. The calls for tenders included 542 drugs representing 65% of the formulary, and the attribution rate was 71%. The main reason for non-attribution was the lack of offers. Generics accounted for 45% by volume and 26.5% by value. With this first study, we were able to identify key indicators on drugs used in the largest medical center in Morocco. The current challenge is to introduce pharmacoeconomics in decision making concerning the updates of the drug formulary.

Analysis of the Service Quality of Medical Centers Using Servqual Model (Case:Shaheed Rahnemoon Hospital

Directory of Open Access Journals (Sweden)

H Zare Ahmadabadi

2007-07-01

Full Text Available Introduction: Many organizations, especially service oriented ones, relative to their goals and mission, have a special view towards quality phenomena and its management. Methods: This paper analyzes medical service quality in one case; The internal section of Shaheed Rahnemoon Hospital Based on the basis of gap analysis model and Servqual technique. A questionnaire was designed and applied to measure expectations and perceptions of patients and personnel of the hospital. Results: On application of non-parametric statistical tests, we propose certain recommendations. These tests drive on five conceptual dimensions of service quality including intangibility, responsiveness, reliability, assurance and empathy. Results show that patients in this section were satisfied from the service provider’s responsiveness, but there are significant differences between expectations and perceptions in other dimensions. Conclusion: The service quality analysis models are useful for managers of medical centers to distinguish gaps between the two sides of service representation; patients and medical centers personnel. Ultimately, they can reinforce strengths and control weaknesses.

Use of CAHPS® patient experience survey data as part of a patient-centered medical home quality improvement initiative

Directory of Open Access Journals (Sweden)

Quigley DD

2015-07-01

Full Text Available Denise D Quigley,1 Peter J Mendel,1 Zachary S Predmore,2 Alex Y Chen,3 Ron D Hays41RAND Corporation, Santa Monica, CA, 2RAND Corporation, Boston, MA, 3AltaMed Health Services Corporation, 4Division of General Internal Medicine and Health Services Research, UCLA, Los Angeles, CA, USAObjective: To describe how practice leaders used Consumer Assessment of Healthcare Providers and Systems (CAHPS® Clinician and Group (CG-CAHPS data in transitioning toward a patient-centered medical home (PCMH.Study design: Interviews conducted at 14 primary care practices within a large urban Federally Qualified Health Center in California.Participants: Thirty-eight interviews were conducted with lead physicians (n=13, site clinic administrators (n=13, nurse supervisors (n=10, and executive leadership (n=2.Results: Seven themes were identified on how practice leaders used CG-CAHPS data for PCMH transformation. CAHPS® was used: 1 for quality improvement (QI and focusing changes for PCMH transformation; 2 to maintain focus on patient experience; 3 alongside other data; 4 for monitoring site-level trends and changes; 5 to identify, analyze, and monitor areas for improvement; 6 for provider-level performance monitoring and individual coaching within a transparent environment of accountability; and 7 for PCMH transformation, but changes to instrument length, reading level, and the wording of specific items were suggested.Conclusion: Practice leaders used CG-CAHPS data to implement QI, develop a shared vision, and coach providers and staff on performance. They described how CAHPS® helped to improve the patient experience in the PCMH model, including access to routine and urgent care, wait times, provider spending enough time and listening carefully, and courteousness of staff. Regular reporting, reviewing, and discussing of patient-experience data alongside other clinical quality and productivity measures at multilevels of the organization was critical in maximizing the

Patient-centered communication in digital medical encounters.

Science.gov (United States)

Alpert, Jordan M; Dyer, Karen E; Lafata, Jennifer Elston

2017-10-01

Patients are increasingly using the secure messaging function available through online patient portals to communicate with their health care providers, yet little is known about the characteristics of conversations that occur. The goal of this study is to describe the types of messages initiated by patients communicating via patient portals and to assess whether providers employ patient-centered strategies in their electronic responses. A total of 193 messages from 58 message threads between patients and providers were collected during a one-week period in a large health care system. Content analysis of patient messages was conducted and deductive analysis of provider responses was employed for two types of patient-centered communication, provider use of supportive talk and partnership building. Patients sent nearly double the number of messages compared to providers (65% versus 35%). Patient messages expressed concern, sought medical solutions and requested assistance with administrative tasks. Over half (53.4%) of provider replies did not contain language reflective of either partnership building or supportive talk. Partnership building language and supportive talk occurred at lower rates than documented in the literature on in-person encounters. This may represent a lost opportunity to strengthen the patient-provider relationship. As secure messaging is increasingly utilized as a form of patient-provider communication, it is important to understand how aspects of this communication channel, including the patient-centeredness of the language used by providers, impact patient-provider relationships and patient outcomes. Copyright © 2017 Elsevier B.V. All rights reserved.

Patient-Centered Medical Home Undergraduate Internship, Benefits to a Practice Manager: Case Study.

Science.gov (United States)

Sasnett, Bonita; Harris, Susie T; White, Shelly

Health services management interns become practice facilitators for primary care clinics interested in pursuing patient-centered recognition for their practice. This experience establishes a collaborative relationship between the university and clinic practices where students apply their academic training to a system of documentation to improve the quality of patient care delivery. The case study presents the process undertaken, benefits, challenges, lessons learned, and recommendations for intern, practice mangers, and educators. The practice manager benefits as interns become Patient-Centered Medical Home facilitators and assist practice managers in the recognition process.

Physics Division progress report for period ending September 30, 1990

International Nuclear Information System (INIS)

Livingston, A.B.

1991-03-01

The activities of this Division continue to be concentrated in the areas of experimental nuclear physics, experimental atomic physics, and theoretical nuclear and atomic physics. The Holifield Heavy Ion Research Facility and its operation as a national user facility continued as the single largest activity within the Division. The experimental nuclear physics program continues to emphasize heavy ion studies, with much of the activity centered at the Holifield Facility. The work with heavy ions at ultrarelativistic energies continues at the CERN SPS. Studies at the Brookhaven AGS, particularly in preparation of future experiments at RHIC, have seen an increased emphasis. A major consortium has been formed to propose the design and construction of a dimuon detector as the basis for one the principal experiments for RHIC. Also included are results from the increasing effort in particle physics, including participation in the L* proposal for the SSC. The UNISOR program, since its inception, has been associated intimately with the Division and, most particularly, with the Holifield Facility. A major area of experimental research for the Division is atomic physics. This activity comprises two groups: one on accelerator-based atomic physics, centered primarily at the EN-tandem and the Holifield Facility, but extending this year to an experiment at ultrarelativistic energies at the CERN SPS; and one on atomic physics in support of fusion energy, based primarily at the ECR ion source facility. Included in this section is also a description of a new effort in multicharged ion-surface interactions, and details of a planned upgrade of the ECR source

Physics Division progress report for period ending September 30, 1990

Energy Technology Data Exchange (ETDEWEB)

Livingston, A.B. (ed.)

1991-03-01

The activities of this Division continue to be concentrated in the areas of experimental nuclear physics, experimental atomic physics, and theoretical nuclear and atomic physics. The Holifield Heavy Ion Research Facility and its operation as a national user facility continued as the single largest activity within the Division. The experimental nuclear physics program continues to emphasize heavy ion studies, with much of the activity centered at the Holifield Facility. The work with heavy ions at ultrarelativistic energies continues at the CERN SPS. Studies at the Brookhaven AGS, particularly in preparation of future experiments at RHIC, have seen an increased emphasis. A major consortium has been formed to propose the design and construction of a dimuon detector as the basis for one the principal experiments for RHIC. Also included are results from the increasing effort in particle physics, including participation in the L* proposal for the SSC. The UNISOR program, since its inception, has been associated intimately with the Division and, most particularly, with the Holifield Facility. A major area of experimental research for the Division is atomic physics. This activity comprises two groups: one on accelerator-based atomic physics, centered primarily at the EN-tandem and the Holifield Facility, but extending this year to an experiment at ultrarelativistic energies at the CERN SPS; and one on atomic physics in support of fusion energy, based primarily at the ECR ion source facility. Included in this section is also a description of a new effort in multicharged ion-surface interactions, and details of a planned upgrade of the ECR source.

Lessons Learned from Implementing the Patient-Centered Medical Home

Directory of Open Access Journals (Sweden)

Ellen P. Green

2012-01-01

Full Text Available The Patient-Centered Medical Home (PCMH is a primary care model that provides coordinated and comprehensive care to patients to improve health outcomes. This paper addresses practical issues that arise when transitioning a traditional primary care practice into a PCMH recognized by the National Committee for Quality Assurance (NCQA. Individual organizations' experiences with this transition were gathered at a PCMH workshop in Alexandria, Virginia in June 2010. An analysis of their experiences has been used along with a literature review to reveal common challenges that must be addressed in ways that are responsive to the practice and patients’ needs. These are: NCQA guidance, promoting provider buy-in, leveraging electronic medical records, changing office culture, and realigning workspace in the practice to accommodate services needed to carry out the intent of PCMH. The NCQA provides a set of standards for implementing the PCMH model, but these standards lack many specifics that will be relied on in location situations. While many researchers and providers have made critiques, we see this vagueness as allowing for greater flexibility in how a practice implements PCMH.

Medical-Legal Partnerships At Veterans Affairs Medical Centers Improved Housing And Psychosocial Outcomes For Vets.

Science.gov (United States)

Tsai, Jack; Middleton, Margaret; Villegas, Jennifer; Johnson, Cindy; Retkin, Randye; Seidman, Alison; Sherman, Scott; Rosenheck, Robert A

2017-12-01

Medical-legal partnerships-collaborations between legal professionals and health care providers that help patients address civil legal problems that can affect health and well-being-have been implemented at several Veterans Affairs (VA) medical centers to serve homeless and low-income veterans with mental illness. We describe the outcomes of veterans who accessed legal services at four partnership sites in Connecticut and New York in the period 2014-16. The partnerships served 950 veterans, who collectively had 1,384 legal issues; on average, the issues took 5.4 hours' worth of legal services to resolve. The most common problems were related to VA benefits, housing, family issues, and consumer issues. Among a subsample of 148 veterans who were followed for one year, we observed significant improvements in housing, income, and mental health. Veterans who received more partnership services showed greater improvements in housing and mental health than those who received fewer services, and those who achieved their predefined legal goals showed greater improvements in housing status and community integration than those who did not. Medical-legal partnerships represent an opportunity to expand cross-sector, community-based partnerships in the VA health care system to address social determinants of mental health.

An analytics approach to designing patient centered medical homes.

Science.gov (United States)

Ajorlou, Saeede; Shams, Issac; Yang, Kai

2015-03-01

Recently the patient centered medical home (PCMH) model has become a popular team based approach focused on delivering more streamlined care to patients. In current practices of medical homes, a clinical based prediction frame is recommended because it can help match the portfolio capacity of PCMH teams with the actual load generated by a set of patients. Without such balances in clinical supply and demand, issues such as excessive under and over utilization of physicians, long waiting time for receiving the appropriate treatment, and non-continuity of care will eliminate many advantages of the medical home strategy. In this paper, by using the hierarchical generalized linear model with multivariate responses, we develop a clinical workload prediction model for care portfolio demands in a Bayesian framework. The model allows for heterogeneous variances and unstructured covariance matrices for nested random effects that arise through complex hierarchical care systems. We show that using a multivariate approach substantially enhances the precision of workload predictions at both primary and non primary care levels. We also demonstrate that care demands depend not only on patient demographics but also on other utilization factors, such as length of stay. Our analyses of a recent data from Veteran Health Administration further indicate that risk adjustment for patient health conditions can considerably improve the prediction power of the model.

Research Strategies for Academic Medical Centers: A Framework for Advancements toward Translational Excellence

Science.gov (United States)

Haley, Rand; Champagne, Thomas J., Jr.

2017-01-01

This review article presents a simplified framework for thinking about research strategy priorities for academic medical centers (AMCs). The framework can serve as a precursor to future advancements in translational medicine and as a set of planning guideposts toward ultimate translational excellence. While market pressures, reform uncertainties,…

Joint marketing cites excellence: Fairview-University Medical Center advertises cooperatively with University of Minnesota Physicians.

Science.gov (United States)

Botvin, Judith D

2004-01-01

Fairview-University Medical Center and University of Minnesota Physicians, both in Minneapolis, are enjoying the benefits of a co-branded advertising campaign. It includes print ads, brochures, and other marketing devices.

United States Department of Health and Human Services Biodosimetry and radiological/nuclear medical countermeasure programs

International Nuclear Information System (INIS)

Homer, Mary J.; Raulli, Robert; Esker, John; Moyer, Brian; Wathen, Lynne; DiCarlo-Cohen, Andrea L.; Maidment, Bert W.; Rios, Carmen; Macchiarini, Francesca; Hrdina, Chad; Prasanna, Pataje G.

2016-01-01

The United States Department of Health and Human Services (HHS) is fully committed to the development of medical countermeasures to address national security threats from chemical, biological, radiological, and nuclear agents. Through the Public Health Emergency Medical Countermeasures Enterprise, HHS has launched and managed a multi-agency, comprehensive effort to develop and operationalize medical countermeasures. Within HHS, development of medical countermeasures includes the National Institutes of Health (NIH), (led by the National Institute of Allergy and Infectious Diseases), the Office of the Assistant Secretary of Preparedness and Response/Biomedical Advanced Research and Development Authority (BARDA); with the Division of Medical Countermeasure Strategy and Requirements, the Centers for Disease Control and Prevention, and the Food and Drug Administration as primary partners in this endeavor. This paper describes various programs and coordinating efforts of BARDA and NIH for the development of medical countermeasures for radiological and nuclear threats. (authors)

Automated patient and medication payment method for clinical trials

Directory of Open Access Journals (Sweden)

Yawn BP

2013-01-01

Full Text Available Barbara P Yawn,1 Suzanne Madison,1 Susan Bertram,1 Wilson D Pace,2 Anne Fuhlbrigge,3 Elliot Israel,3 Dawn Littlefield,1 Margary Kurland,1 Michael E Wechsler41Olmsted Medical Center, Department of Research, Rochester, MN, 2UCDHSC, Department of Family Medicine, University of Colorado Health Science Centre, Aurora, CO, 3Brigham and Women's Hospital, Pulmonary and Critical Care Division, Boston, MA, 4National Jewish Medical Center, Division of Pulmonology, Denver, CO, USABackground: Published reports and studies related to patient compensation for clinical trials focus primarily on the ethical issues related to appropriate amounts to reimburse for patient's time and risk burden. Little has been published regarding the method of payment for patient participation. As clinical trials move into widely dispersed community practices and more complex designs, the method of payment also becomes more complex. Here we review the decision process and payment method selected for a primary care-based randomized clinical trial of asthma management in Black Americans.Methods: The method selected is a credit card system designed specifically for clinical trials that allows both fixed and variable real-time payments. We operationalized the study design by providing each patient with two cards, one for reimbursement for study visits and one for payment of medication costs directly to the pharmacies.Results: Of the 1015 patients enrolled, only two refused use of the ClinCard, requesting cash payments for visits and only rarely a weekend or fill-in pharmacist refused to use the card system for payment directly to the pharmacy. Overall, the system has been well accepted by patients and local study teams. The ClinCard administrative system facilitates the fiscal accounting and medication adherence record-keeping by the central teams. Monthly fees are modest, and all 12 study institutional review boards approved use of the system without concern for patient

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

Science.gov (United States)

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

2010-01-01

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

Division of Biological and Medical Research annual report, 1979. [Lead abstract

Energy Technology Data Exchange (ETDEWEB)

Rosenthal, M.W. (ed.)

1979-01-01

Separate abstracts were prepared for 14 of the 20 sections included in this progress report. The other 6 sections include: introductory statements by the division director; descriptions of the animal, computer, electron microscope, and radiation support facilities; a listing of the educational activities, divisional seminars, and oral presentations by staff members; and divisional staff publications. An author index to the report is included. (ERB)

Master's Level Graduate Training in Medical Physics at the University of Colorado Health Sciences Center.

Science.gov (United States)

Ibbott, Geoffrey S.; Hendee, William R.

1980-01-01

Describes the master's degree program in medical physics developed at the University of Colorado Health Sciences Center. Required courses for the program, and requirements for admission are included in the appendices. (HM)

Stakeholder Perspectives on Changes in Hypertension Care Under the Patient-Centered Medical Home.

Science.gov (United States)

O'Donnell, Alison J; Bogner, Hillary R; Cronholm, Peter F; Kellom, Katherine; Miller-Day, Michelle; McClintock, Heather F de Vries; Kaye, Elise M; Gabbay, Robert

2016-02-25

Hypertension is a major modifiable risk factor for cardiovascular and kidney disease, yet the proportion of adults whose hypertension is controlled is low. The patient-centered medical home (PCMH) is a model for care delivery that emphasizes patient-centered and team-based care and focuses on quality and safety. Our goal was to investigate changes in hypertension care under PCMH implementation in a large multipayer PCMH demonstration project that may have led to improvements in hypertension control. The PCMH transformation initiative conducted 118 semistructured interviews at 17 primary care practices in southeastern Pennsylvania between January 2011 and January 2012. Clinicians (n = 47), medical assistants (n = 26), office administrators (n = 12), care managers (n = 11), front office staff (n = 7), patient educators (n = 4), nurses (n = 4), social workers (n = 4), and other administrators (n = 3) participated in interviews. Study personnel used thematic analysis to identify themes related to hypertension care. Clinicians described difficulties in expanding services under PCMH to meet the needs of the growing number of patients with hypertension as well as how perceptions of hypertension control differed from actual performance. Staff and office administrators discussed achieving patient-centered hypertension care through patient education and self-management support with personalized care plans. They indicated that patient report cards were helpful tools. Participants across all groups discussed a team- and systems-based approach to hypertension care. Practices undergoing PCMH transformation may consider stakeholder perspectives about patient-centered, team-based, and systems-based approaches as they work to optimize hypertension care.

Benefits of the effective dose equivalent concept at a medical center

International Nuclear Information System (INIS)

Vetter, R.J.; Classic, K.L.

1991-01-01

A primary objective of the recommendations of the International Committee on Radiological Protection Publication 26 is to insure that no source of radiation exposure is unjustified in relation to its benefits. This objective is consistent with goals of the Radiation Safety Committee and Institutional Review Board at medical centers where research may involve radiation exposure of human subjects. The effective dose equivalent concept facilitates evaluation of risk by those who have little or no knowledge of quantities or biological effects of radiation. This paper presents effective dose equivalent data used by radiation workers and those who evaluate human research protocols as these data relate to personal dosimeter reading, entrance skin exposure, and target organ dose. The benefits of using effective dose equivalent to evaluate risk of medical radiation environments and research protocols are also described

Health Care Provider Burnout in a United States Military Medical Center During a Period of War.

Science.gov (United States)

Sargent, Paul; Millegan, Jeffrey; Delaney, Eileen; Roesch, Scott; Sanders, Martha; Mak, Heather; Mallahan, Leonard; Raducha, Stephanie; Webb-Murphy, Jennifer

2016-02-01

Provider burnout can impact efficiency, empathy, and medical errors. Our study examines burnout in a military medical center during a period of war. A survey including the Maslach Burnout Inventory (MBI), deployment history, and work variables was distributed to health care providers. MBI subscale means were calculated and associations between variables were analyzed. Approximately 60% of 523 respondents were active duty and 34% had deployed. MBI subscale means were 19.99 emotional exhaustion, 4.84 depersonalization, and 40.56 personal accomplishment. Frustration over administrative support was associated with high emotional exhaustion and depersonalization; frustration over life/work balance was associated with high emotional exhaustion. Levels of burnout in our sample were similar to civilian medical centers. Sources of frustration were related to administrative support and life/work balance. Deployment had no effect on burnout levels. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Patient-centered medical home initiatives expanded in 2009-13: providers, patients, and payment incentives increased.

Science.gov (United States)

Edwards, Samuel T; Bitton, Asaf; Hong, Johan; Landon, Bruce E

2014-10-01

Patient-centered medical home initiatives are central to many efforts to reform the US health care delivery system. To better understand the extent and nature of these initiatives, in 2013 we performed a nationwide cross-sectional survey of initiatives that included payment reform incentives in their models, and we compared the results to those of a similar survey we conducted in 2009. We found that the number of initiatives featuring payment reform incentives had increased from 26 in 2009 to 114 in 2013. The number of patients covered by these initiatives had increased from nearly five million to almost twenty-one million. We also found that the proportion of time-limited initiatives--those with a planned end date--was 20 percent in 2013, a decrease from 77 percent in 2009. Finally, we found that the dominant payment model for patient-centered medical homes remained fee-for-service payments augmented by per member per month payments and pay-for-performance bonuses. However, those payments and bonuses were higher in 2013 than they were in 2009, and the use of shared-savings models was greater. The patient-centered medical home model is likely to continue both to become more common and to play an important role in delivery system reform. Project HOPE—The People-to-People Health Foundation, Inc.

The Chemical Technology Division at Argonne National Laboratory: Applying chemical innovation to environmental problems

International Nuclear Information System (INIS)

1995-01-01

The Chemical Technology Division is one of the largest technical divisions at Argonne National Laboratory, a leading center for research and development related to energy and environmental issues. Since its inception in 1948, the Division has pioneered in developing separations processes for the nuclear industry. The current scope of activities includes R ampersand D on methods for disposing of radioactive and hazardous wastes and on energy conversion processes with improved efficiencies, lower costs, and reduced environmental impact. Many of the technologies developed by CMT can be applied to solve manufacturing as well as environmental problems of industry

Academic season does not influence cardiac surgical outcomes at US Academic Medical Centers.

Science.gov (United States)

Lapar, Damien J; Bhamidipati, Castigliano M; Mery, Carlos M; Stukenborg, George J; Lau, Christine L; Kron, Irving L; Ailawadi, Gorav

2011-06-01

Previous studies have demonstrated the influence of academic season on outcomes in select surgical populations. However, the influence of academic season has not been evaluated nationwide in cardiac surgery. We hypothesized that cardiac surgical outcomes were not significantly influenced by time of year at both cardiothoracic teaching hospitals and non-cardiothoracic teaching hospitals nationwide. From 2003 to 2007, a weighted 1,614,394 cardiac operations were evaluated using the Nationwide Inpatient Sample database. Patients undergoing cardiac operations at cardiothoracic teaching and non-cardiothoracic teaching hospitals were identified using the Association of American Medical College's Graduate Medical Education Tracking System. Hierarchic multivariable logistic regression analyses were used to estimate the effect of academic quarter on risk-adjusted outcomes. Mean patient age was 65.9 ± 10.9 years. Women accounted for 32.8% of patients. Isolated coronary artery bypass grafting was the most common operation performed (64.7%), followed by isolated valve replacement (19.3%). The overall incidence of operative mortality and composite postoperative complication rate were 2.9% and 27.9%, respectively. After accounting for potentially confounding risk factors, timing of operation by academic quarter did not independently increase risk-adjusted mortality (p = 0.12) or morbidity (p = 0.24) at academic medical centers. Risk-adjusted mortality and morbidity for cardiac operations were not associated with time of year in the US at teaching and nonteaching hospitals. Patients should be reassured of the safety of performance of cardiac operations at academic medical centers throughout a given academic year. Copyright © 2011 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Radiochemistry Division annual progress report : 1990

International Nuclear Information System (INIS)

Iyer, R.H.

1992-01-01

This progress report provides an account of the research and development activities of the Radiochemistry Division during the year 1990 in the areas of nuclear chemistry, actinide chemistry and spectroscopy. The main area of work in nuclear chemistry is centered around the fission process induced by reactor neutrons, and light and heavy ions on actinides and low Z (Z<80) elements. Actinide chemistry research is concerned mostly with extraction, complexation and separation of actinide ions from aqueous media using a variety of organic reagents under different experimental conditions. Spectroscopic studies include development and optimisation of chemical/analytical methods for separation and determination of trace metallic impurities and rare earths in fuel materials and EPR and microwave studies on several compounds to understand their superconducting, structural and magnetic properties. A list of publications by the scientific staff of the Division during 1990 is also given in the report. (author). 45 figs., 44 tabs

NASA Lewis Research Center's materials and structures division

International Nuclear Information System (INIS)

Weymueller, C.R.

1976-01-01

Research activities at the NASA Lewis Research Center on materials and structures are discussed. Programs are noted on powder metallurgy superalloys, eutectic alloys, dispersion strengthened alloys and composite materials. Discussions are included on materials applications, coatings, fracture mechanics, and fatigue

Current neurotrauma treatment practice in secondary medical service centers

International Nuclear Information System (INIS)

Suehiro, Eiichi; Yoshino, Hiroko; Koizumi, Hiroyasu; Yoneda, Hiroshi; Suzuki, Michiyasu

2011-01-01

Despite neurotrauma treatment practices comprising a significant amount of neurosurgical work for secondary medical service centers, little attention has been placed on neurotrauma cases and evaluation of current neurotrauma treatment practices is limited. Therefore we investigated current neurotrauma practices in our hospital located in a Japanese suburban city. We analyzed 439 patients with traumatic brain injury (TBI) admitted to our hospital between April 2004 and October 2010. Patients were divided into three groups based on the Glasgow Coma Scale (GCS) score on admission: mild TBI (GCS 14-15) in 252 patients (57.4%), moderate TBI (GCS 9-13) in 116 patients (26.4%), and severe TBI (GCS 3-8) in 71 patients (16.2%). Age, gender, alcohol consumption, cause of injury, cranial CT findings, neurosurgical procedure, length of hospital stay, and clinical outcome were analyzed. The average age of the patients was 59.2 years old. Male patients comprised 65%. Alcohol consumption was reported in 81 cases (18.5%), most of them with moderate TBI. Fall (208 cases, 47.4%) was the most frequent cause of injury, followed by traffic accident (115 cases, 26.2%) and high fall (73 cases, 16.6%). Acute subdural hematoma (174 cases, 39.6%) was most frequently seen in cranial CT findings on admission, which significantly increased with severity. A neurosurgical procedure was performed for 70 cases (15.9%), of which 15 (6.0%) were mild TBI and 18 (15.5%) were moderate TBI. The average hospital stay was 20.8 days, which significantly increased with severity. The overall rate of favorable outcome was 82.7%, and mortality was 8.2%; outcome deteriorated with severity. Some mild and moderate TBI cases had deteriorated and required surgery or resulted in death. These findings suggest that cautious treatment is necessary even in mild to moderate TBI cases which are often encountered in secondary medical service centers. (author)

Impact of Mobile Dose-Tracking Technology on Medication Distribution at an Academic Medical Center.

Science.gov (United States)

Kelm, Matthew; Campbell, Udobi

2016-05-01

Medication dose-tracking technologies have the potential to improve efficiency and reduce costs associated with re-dispensing doses reported as missing. Data describing this technology and its impact on the medication use process are limited. The purpose of this study is to assess the impact of dose-tracking technology on pharmacy workload and drug expense at an academic, acute care medical center. Dose-tracking technology was implemented in June 2014. Pre-implementation data were collected from February to April 2014. Post-implementation data were collected from July to September 2014. The primary endpoint was the percent of re-dispensed oral syringe and compounded sterile product (CSP) doses within the pre- and post-implementation periods per 1,000 discharges. Secondary endpoints included pharmaceutical expense generated from re-dispensing doses, labor costs, and staff satisfaction with the medication distribution process. We observed an average 6% decrease in re-dispensing of oral syringe and CSP doses from pre- to post-implementation (15,440 vs 14,547 doses; p = .047). However, when values were adjusted per 1,000 discharges, this trend did not reach statistical significance (p = .074). Pharmaceutical expense generated from re-dispensing doses was significantly reduced from pre- to post-implementation ($834,830 vs $746,466 [savings of $88,364]; p = .047). We estimated that $2,563 worth of technician labor was avoided in re-dispensing missing doses. We also saw significant improvement in staff perception of technology assisting in reducing missing doses (p = .0003), as well as improvement in effectiveness of resolving or minimizing missing doses (p = .01). The use of mobile dose-tracking technology demonstrated meaningful reductions in both the number of doses re-dispensed and cost of pharmaceuticals dispensed.

The BMC ACCESS project: the development of a medically enhanced safe haven shelter.

Science.gov (United States)

Lincoln, Alisa; Johnson, Peggy; Espejo, Dennis; Plachta-Elliott, Sara; Lester, Peggy; Shanahan, Christopher; Abbott, Susan; Cabral, Howard; Jamanka, Amber; Delman, Jonathan; Kenny, Patty

2009-10-01

This paper describes the development and implementation of the Boston Medical Center (BMC) Advanced Clinical Capacity for Engagement, Safety, and Services Project. In October 2002, the BMC Division of Psychiatry became the first such entity to open a Safe Haven shelter for people who are chronically homeless, struggling with severe mental illness, and actively substance abusing. The low-demand Safe Haven model targets the most difficult to reach population and serves as a "portal of entry" to the mental health and addiction service systems. In this paper, the process by which this blended funded, multi-level collaboration, consisting of a medical center, state, city, local, and community-based consumer organizations, was created and is maintained, as well as the clinical model of care is described. Lessons learned from creating the Safe Haven Shelter and the development and implementation of the consumer-informed evaluation are discussed as well as implications for future work with this population.

Medical expenditures in division I collegiate athletics: an analysis by sport and gender.

Science.gov (United States)

Kaeding, Christopher C; Borchers, James; Oman, Janine; Pedroza, Angela

2014-09-01

Medical expenses for collegiate athletics include providing a training room with its supplies, equipment, personnel costs, and insurance coverage. Additional expenses beyond the training room include imaging, diagnostic testing, specialty consultations, and surgeries. We hypothesized that there would be no difference in average expenses or number of claims between male and female athletes over a 5-year period. Prospective patient cohort. A sports medicine center serving athletes in Big 10 Conference intercollegiate sports. All medical claims and charges for 36 varsity teams were analyzed from 2005 to 2010. The teams were categorized into 3 groups: female-only teams, male-only teams, and coed teams. Analysis of sports with corresponding male and female teams was also performed. Claims and charges for medical care for 36 intercollegiate athletic teams over 5 years. Individual team claims and charges were stable over the study period. In 11 of the 14 sex-matched sports, the female teams had higher average annual charges. After normalizing for roster size in the sex-matched sports, females had 0.97 more average annual claims (P sports with the highest average annual charges per athlete were softball, women's diving, men's basketball, wrestling, and men's gymnastics. Charges per claim were similar between the sex-matched sports, but the female sports had a higher number of annual claims per athlete and thus higher total charges per athlete/year. Football had the highest average annual total charges as a team, but when normalized for roster size football charges per athlete/year were similar to those of other sports.

MP-Division health and safety reference handbook. [Contains glossary

Energy Technology Data Exchange (ETDEWEB)

Putnam, T.M.

1987-09-01

This report presents the objectives, organization, policies, and essential rules and procedures that have been adopted by MP Division and that form the basis of the Health and Safety Program of the Clinton P. Anderson Meson Physics Facility (LAMPF). The facility includes the beam-delivery systems for the Los Alamos Neutron Scattering Center and the Weapons Neutron Research Facility (LANSCE/WNR). The program is designed not only to assure the health and safety of all personnel, including users, in their work at LAMPF, and of MP-Division staff in their work on the LANSCE/WNR beam lines, but also to protect the facility (buildings and equipment) and the environment. 33 refs., 18 figs., 2 tabs.

[Management of medical care for the victims of road accidents in traumatology centers of Saint-Petersburg].

Science.gov (United States)

Tulupov, A N; Afonchikov, V Iu; Chikin, A E; Taniia, S Sh; Ganin, A S

2014-01-01

The number of road accidents, fatal outcomes and victims exceeded in 1.5 times in Saint-Petersburg in comparison with Moscow. At the average, 600 victims were treated in each of 6 first-level traumatology centers every year. The quantity of patients, who were admitted to 3 second-level traumatology centers, numbered 10 times less. About 300 people entered to others hospitals. The lethality consisted of 15%, 20% and 37%, respectively. There are a lot of matters, that should be discussed, such as an importance of better treatment financing of multitrauma by using compulsory medical insurance system, an optimization of pre-admission treatment and a necessity of patient delivery by mobile medical team using the anaesthesiology and resuscitation.

Publications in academic medical centers: technology-facilitated culture clash.

Science.gov (United States)

Berner, Eta S

2014-05-01

Academic culture has a set of norms, expectations, and values that are sometimes tacit and sometimes very explicit. In medical school and other health professions educational settings, probably the most common norm includes placing a high value on peer-reviewed research publications, which are seen as the major evidence of scholarly productivity. Other features of academic culture include encouraging junior faculty and graduate students to share their research results at professional conferences and lecturing with slides as a major way to convey information. Major values that faculty share with journal editors include responsible conduct of research and proper attribution of others' words and ideas. Medical school faculty also value technology and are often quick to embrace technological advances that can assist them in their teaching and research. This article addresses the effects of technology on three aspects of academic culture: education, presentations at professional meetings, and research publications.The technologies discussed include online instruction, dissemination of conference proceedings on the Internet, plagiarism-detection software, and new technologies deployed by the National Center for Biotechnology Information, the home of PubMed. The author describes how the ease of deploying new technologies without faculty changing their norms and behavior in the areas of teaching and research can lead to conflicts of values among key stakeholders in the academic medical community, including faculty, journal editors, and professional associations. The implications of these conflicts and strategies for managing them are discussed.

Treatment of Post-Traumatic Stress Disorder Nightmares at a Veterans Affairs Medical Center

Science.gov (United States)

Detweiler, Mark B.; Pagadala, Bhuvaneshwar; Candelario, Joseph; Boyle, Jennifer S.; Detweiler, Jonna G.; Lutgens, Brian W.

2016-01-01

The effectiveness of medications for PTSD in general has been well studied, but the effectiveness of medicatio.ns prescribed specifically for post-traumatic stress disorder (PTSD) nightmares is less well known. This retrospective chart review examined the efficacy of various medications used in actual treatment of PTSD nightmares at one Veteran Affairs Hospital. Records at the Salem, VA Veterans Affairs Medical Center (VAMC) were examined from 2009 to 2013 to check for the efficacy of actual treatments used in comparis.on with treatments suggested in three main review articles. The final sample consisted of 327 patients and 478 separate medication trials involving 21 individual medications plus 13 different medication combinations. The three most frequently utilized medications were prazosin (107 trials), risperidone (81 trials), and quetiapine (72 trials). Five medications had 20 or more trials with successful results (partial to full nightmare cessation) in >50% of trials: risperidone (77%, 1.0–6.0 mg), clonidine (63%, 0.1–2.0 mg), quetiapine (50%, 12.5–800.0 mg), mirtazapine (50%; 7.5–30.0 mg), and terazosin (64%, 50.0–300.0 mg). Notably, olanzapine (2.5–10.0) was successful (full remission) in all five prescription trials in five separate patients. Based on the clinical results, the use of risperidone, clonidine, terazosin, and olanzapine warrants additional investigation in clinically controlled trials as medications prescribed specifically for PTSD nightmares. PMID:27999253

Leadership Primer for Current and Aspiring Pulmonary, Critical Care, and Sleep Medicine Academic Division Chiefs.

Science.gov (United States)

Nguyen, H Bryant; Thomson, Carey C; Kaminski, Naftali; Schnapp, Lynn M; Madison, J Mark; Glenny, Robb W; Dixon, Anne E

2018-02-27

An academic medical career traditionally revolves around patient care, teaching, and scholarly projects. Thus, when an opportunity for a leadership role arises, such as Division Chief, the new leader is often unprepared with little or no formal leadership training. In this article, academic leaders of the Association of Pulmonary, Critical Care and Sleep Division Directors reviewed several leadership concepts adapted from the business sector and applied years of their experience to aid new division chiefs with their first day on the job. The first 90 days are highlighted to include accomplishing the early wins, performing a division Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis, establishing division rapport, redefining the division infrastructure, avoiding conflicts, and managing their relationship with the department chair. The five levels of leadership applicable to academic medicine are discussed: position, permission, production, people, and pinnacle. Finally, emotional intelligence and behavior styles crucial to leadership success are reviewed.

Patient-Centered Medical Home and Family Burden in Attention-Deficit Hyperactivity Disorder.

Science.gov (United States)

Ronis, Sarah D; Baldwin, Constance D; Blumkin, Aaron; Kuhlthau, Karen; Szilagyi, Peter G

2015-01-01

Attention-deficit hyperactivity disorder (ADHD) can impair child health and functioning, but its effects on the family's economic burden are not well understood. The authors assessed this burden in US families of children with ADHD, and the degree to which access to a patient-centered medical home (PCMH) might reduce this burden. We conducted cross-sectional analyses of 2005-2006 and 2009-2010 National Surveys of Children with Special Health Care Needs, focusing on families of children with ADHD. They defined family economic burden as (1) family financial problems (annual expenses for the child's health care or illness-related financial problems for the family) and/or (2) family employment problems (job loss, work time loss, or failure to change jobs to avoid insurance loss). Relative risk models assessed associations between PCMH and family economic burden, adjusted for child age, sex, ethnicity, ADHD severity, poverty status, caregiver education, and insurance. In 2009, 26% of families reported financial problems because of the child's ADHD, 2.1% reported out-of-pocket expenses >5% of income, and 36% reported employment problems. Only 38% reported care that met all 5 criteria for a PCMH (similar to rates in 2005-2006). In multivariable analysis, care in a PCMH was associated with 48% lower relative risk (RR) of financial problems (RR = 0.52, p family-centered care and care coordination were more strongly associated with lower burden. The economic burdens of families with ADHD are significant but may be alleviated by family-centered care and care coordination in a medical home.

[Medical fault or professional negligence? Case studies in two recovery nutrition centers in Niger].

Science.gov (United States)

Halidou Doudou, M; Manzo, M L; Guero, D

2014-12-01

In developing countries such as Niger, the risk of medical malpractice is ubiquitous in health, jeopardizing patient safety. The aim of this work was to contribute to patients' safety and respect of code of ethics and conduct in the exercise of the medical profession. The reported cases involved two children under 5 years who were admitted to nutrition rehabilitation centers, died as a result of medical malpractice. In Niger, there are no statistics on this phenomenon and a few cases found have always been considered "accident" or "fate." The establishment of an observatory collections of such information should improve their frequency, consequences and propose a prevention plan. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Centers for Disease Control and Prevention

Science.gov (United States)

... PDF file Microsoft PowerPoint file Microsoft Word file Microsoft Excel ... Centers for Disease Control and Prevention Page maintained by: Office of Associate Director of Communication, Division of Public ...

Impact of a Patient-Centered Medical Home on Access, Quality, and Cost

Science.gov (United States)

2013-02-01

Effec- tiveness Data and Information Set metrics, and composite measures for access, patient satisfaction, provider communica- tion, and customer service...reduced health care costs. The patient -centered medical home (PCMH) concept is “an approach to providing comprehensive primary care [in] a health care... patient at the right place and right time” is vital to the appro- priate utilization of health care services across a broad spec- trum of patient needs

Comparative study on medical utilization and costs of chronic obstructive pulmonary disease with good lung function

Directory of Open Access Journals (Sweden)

Lim JU

2017-09-01

Full Text Available Jeong Uk Lim,1 Kyungjoo Kim,2 Sang Hyun Kim,3 Myung Goo Lee,4 Sang Yeub Lee,5 Kwang Ha Yoo,6 Sang Haak Lee,1 Ki-Suck Jung,7 Chin Kook Rhee,2 Yong Il Hwang7 1Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, St Paul’s Hospital, 2Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Seoul St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, 3Big Data Division, Health Insurance Review and Assessment Service, Wonju, 4Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, 5Department of Internal Medicine, Korea University, Anam Hospital, 6Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Konkuk University School of Medicine, Seoul, 7Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Anyang, Republic of Korea Introduction: Patients with mild to moderate chronic obstructive pulmonary disease (COPD are underdiagnosed and undertreated due to the asymptomatic nature of the disease. Previous studies on patients with mild COPD have focused on symptomatic patients. Therefore, in this study, we evaluated the treatment status of patients with early COPD in Korea.Materials and methods: We compared hospital visits, medical costs per person, and COPD medication use by patients with COPD screened from the general population and COPD cohort patients. Patients with COPD aged ≥40 years with the value of forced expiratory volume in 1 s (FEV1 ≥60% were selected from the 2007 to 2012 Korea National Health and Nutrition Examination Survey (KNHANES data. Data including the number of outpatient clinic visits, admission to hospitals, COPD-related medications, and medical

Measuring the Cost of the Patient-Centered Medical Home: A Cost-Accounting Approach.

Science.gov (United States)

Lieberthal, Robert D; Payton, Colleen; Sarfaty, Mona; Valko, George

To explore the cost for individual practices to become more patient-centered, we inventoried and calculated the cost of costly activities involved in implementing the Patient-Centered Medical Home (PCMH) as defined by the National Committee for Quality Assurance. There were 3 key findings. The cost of each PCMH-related clinical activity can be classified in 1 of 3 major categories. Cost offsets can be used to defray part of the cost recognition. The cost of PCMH transformation varied by practice with no clear level or pattern of costs. Our study suggests that small- and medium-sized practices may experience difficulty with the financial burden of PCMH recognition.

Radiochemistry Division biennial progress report: 1995-1996

International Nuclear Information System (INIS)

Tomar, B.S.; Pujari, P.K.; Mathur, J.N.; Mohapatra, P.K.; Murali, M.S.; Natarajan, V.; Jayanthakumar, M.L.

1997-01-01

The research and development activities of Radiochemistry Division during 1995-96 are briefly described under the headings : (1) nuclear chemistry; (2) actinide chemistry; (3) spectroscopy and (4) instrumentation. Nuclear chemistry work deals with the areas of nuclear reactions, nuclear spectroscopy, nuclear probes and radioanalytical techniques. The research programme in actinide chemistry centered on development of novel procedures for the separation of actinides, guest-host chemistry of lanthanides, actinides and fission products and extractants for solvent extraction. Spectroscopy section activities are summarised under (1) basic research in the solid state chemistry; (2) development of analytical spectroscopic methods for the trace metal determination in nuclear materials; (3) chemical quality control of plutonium 239, uranium 233 and thorium based nuclear fuels. Instrumentation group deals mainly with servicing and maintenance of electronic instruments and allied systems. A list of publications, by the scientific staff of the Divisions is also included. (author)

Radiochemistry Division biennial progress report: 1995-1996

Energy Technology Data Exchange (ETDEWEB)

Tomar, B S; Pujari, P K; Mathur, J N; Mohapatra, P K; Murali, M S; Natarajan, V; Jayanthakumar, M L [eds.; Radiochemistry Division, Bhabha Atomic Research Centre, Mumbai (India)

1998-12-31

The research and development activities of Radiochemistry Division during 1995-96 are briefly described under the headings : (1) nuclear chemistry; (2) actinide chemistry; (3) spectroscopy and (4) instrumentation. Nuclear chemistry work deals with the areas of nuclear reactions, nuclear spectroscopy, nuclear probes and radioanalytical techniques. The research programme in actinide chemistry centered on development of novel procedures for the separation of actinides, guest-host chemistry of lanthanides, actinides and fission products and extractants for solvent extraction. Spectroscopy section activities are summarised under (1) basic research in the solid state chemistry; (2) development of analytical spectroscopic methods for the trace metal determination in nuclear materials; (3) chemical quality control of plutonium 239, uranium 233 and thorium based nuclear fuels. Instrumentation group deals mainly with servicing and maintenance of electronic instruments and allied systems. A list of publications, by the scientific staff of the Divisions is also included. (author)

Barrett's Esophagus Translational Research Network (BETRNet) | Division of Cancer Prevention

Science.gov (United States)

The goal of BETRNet is to reduce the incidence, morbidity, and mortality of esophageal adenocarcinoma by answering key questions related to the progression of the disease, especially in the premalignant stage. In partnership with NCI’s Division of Cancer Biology, multidisciplinary translational research centers collaborate to better understand the biology of Barrett's

[Medical centers--methods, purpose and benefits].

Science.gov (United States)

Schrappe, Matthias

2007-01-01

The German hospital sector is characterized by a profound deficit in organizational integration. The implementation of centers as one way to improve the situation is complicated by the heterogeneity of the concept and understanding of the term "center". The author proposes to distinguish between functional, divisional and process-oriented centers. In German hospitals where the transition from functional to divisional organization is under way matrix elements can be expected to be introduced into organizational practice. Process-oriented centers like breast centers represent matrix components by simultaneously applying functional and process-oriented perspectives. Matrix components map the complexity of clinical structures, but increase coordination and management load and should be applied only to a limited number of care processes.

Detecting Postpartum Depression in Referents to Medical and Health Centers in Hamadan City

Directory of Open Access Journals (Sweden)

F. Shobeiri

2007-10-01

Full Text Available Introduction & Objective: Pregnancy and childbirth are significant developmental excitable for most women. Physical, intrapersonal and relational adaptations are needed to adjust successfully to pregnancy and delivery. Postpartum depression is a serious psychiatric disorder and the adverse impact on infants has been noted. The purpose of this study was to detect postpartum depression in referents to medical and health centers in Hamadan city.Materials & Methods: A descriptive and cross-sectional study involving 400 women completed the Beck Depression Inventory (BDI within 2-8 weeks of delivery was conducted in urban health centers in Hamadan city, Iran. Data were collected through interviews with women in the clinics in the health centers. Data processing and statistical analysis were performed using SPSS 10.0.Results: The results revealed that majority of women (68.0% were considered normal. Depression was detected in 32.0% of women. Out of these 19.0, 4.0 and 9.0% were mild, moderate and severe depression, respectively. There were statistically significant differences between postpartum depression and age, number of delivery, education, job and husband's job (P=0.000.Conclusion: Nearly 32.0% of selected women had depression. Therefore, it is important for medical personnel to be well versed in the course and treatment of postpartum depression. Post partum depression should be screened and treated as early as possible for several reasons. It can cause significant suffering for the woman who experiences it, and it can have deleterious consequences for the newborn.

Strategi Public Relations Dalam Membangun Branding Rumah Sakit Telogorejo Menjadi Semarang Medical Center

OpenAIRE

Pertiwi, Rifka Ayu; Naryoso, Agus; Luqman, Yanuar

2013-01-01

ViiiSTRATEGI PUBLIC RELATIONS DALAM MEMBANGUN BRANDINGRUMAH SAKIT TELOGOREJO MENJADI SEMARANG MEDICALCENTERAbstrakPerubahan brand merupakan hal yang sering terjadi pada sebuah institusi atauperusahaan. Hal ini menjadi salah satu pekerjaan humas yang bersangkutan dalammendapatkan kesadaran target audiens terhadap Perubahan brand tersebut.RS Telogorejo melakukan Perubahan brand menjadi Semarang MedicalCenter. Sedangkan brand RS Telogorejo sudah melekat di benak target audienssebagai rumah sakit...

STRESSFUL SITUATIONS IN THE WORK OF A MULTIPROFILE PEDIATRIC MEDICAL FACILITY'S CALL CENTER

Directory of Open Access Journals (Sweden)

I. M. Spivak

2015-01-01

Full Text Available Stressful situations in the work of a pediatric medical facility's call center are associated with patients' violation of social communication norms and aggressive behavior, as well as the operator's professional/maternal conflict. The following psychological resources facilitate better stress resistance of operators: self-confidence, mature and rational attitude, personal activity, inner satisfaction, optimism, emotional breadth and emotional colleague support. 

Building Technologies Research and Integration Center (BTRIC)

Data.gov (United States)

Federal Laboratory Consortium — The Building Technologies Research and Integration Center (BTRIC), in the Energy and Transportation Science Division (ETSD) of Oak Ridge National Laboratory (ORNL),...

Financial impact of hand surgery programs on academic medical centers.

Science.gov (United States)

Hasan, Jafar S; Chung, Kevin C; Storey, Amy F; Bolg, Mary L; Taheri, Paul A

2007-02-01

This study analyzes the financial performance of hand surgery in the Department of Surgery at the University of Michigan. This analysis can serve as a reference for other medical centers in the financial evaluation of a hand surgery program. Fiscal year 2004 billing records for all patients (n = 671) who underwent hand surgery procedures were examined. The financial data were separated into professional revenues and costs (relating to the hand surgery program in the Section of Plastic Surgery) and into facility revenues and costs (relating to the overall University of Michigan Health System). Professional net revenue was calculated by applying historical collection rates to procedural and clinic charges. Facility revenue was calculated by applying historical collection rates to the following charge categories: inpatient/operating room, clinic facility, neurology/electromyography, radiology facilities, and occupational therapy. Total professional costs were calculated by adding direct costs and allocated overhead costs. Facility costs were obtained from the hospital's cost accounting system. Professional and facility incomes were calculated by subtracting costs from revenues. The net professional revenue and total costs were 1,069,836 and 1,027,421 dollars, respectively. Professional operating income was 42,415 dollars, or 3.96 percent of net professional revenue. Net facility revenue and total costs were 5,500,606 and 4,592,534 dollars, respectively. Facility operating income was 908,071 dollars, or 16.51 percent of net facility revenues. While contributing to the academic mission of the institution, hand surgery is financially rewarding for the Department of Surgery. In addition, hand surgery activity contributes substantially to the financial well-being of the academic medical center.

Building Brains, Forging Futures: A Call to Action for the Family-Centered Medical Home

Science.gov (United States)

Kraft, Colleen

2013-01-01

The family-centered medical home describes an approach to providing comprehensive primary care. Research advances in developmental neuroscience, genetics, and epigenetics offer a framework for understanding the dynamic process of brain development. It is this process that sets the life-course trajectory for an individual; in turn, a child's…

Evaluation of recombinant activated protein C for severe sepsis at a tertiary academic medical center

Directory of Open Access Journals (Sweden)

Anger KE

2013-06-01

Full Text Available Kevin E Anger,1 Jeremy R DeGrado,1 Bonnie C Greenwood,1 Steven A Cohen,2 Paul M Szumita1 1Department of Pharmacy, Brigham and Women’s Hospital, Boston, MA, USA; 2Department of Family Medicine and Population Health, Division of Epidemiology, Virginia Commonwealth University, Richmond, VA, USA Purpose: Early clinical trials of recombinant human activated protein C (rhAPC for severe sepsis excluded patients at high risk of bleeding. Recent literature suggests bleeding rates are higher in clinical practice and may be associated with worsened outcomes. Our objective was to evaluate baseline demographics; incidence, and risk factors for major bleeding; and mortality of patients receiving rhAPC for severe sepsis at our institution. Methods: A retrospective study was performed for all patients receiving rhAPC for treatment of severe sepsis at a tertiary academic medical center from January 2002 to June 2009. Demographic information, clinical variables, intensive care unit, and hospital outcomes were recorded. Results: Of the 156 patients that received rhAPC, 54 (34.6% did not meet institutional criteria for safe use at baseline due to bleeding precaution or contraindication. Twenty-three (14.7% patients experienced a major bleeding event. Multivariate analysis demonstrated baseline International Normalized Ratio ≥2.5 (odds ratio [OR] 3.68, 95% confidence interval [CI]: 1.28–10.56; P = 0.03 and platelet count ≤100 × 103/mm3 (OR 2.86, 95% CI: 1.07–7.67; P = 0.01 as significant predictors of a major bleed. Overall hospital mortality was 57.7%. Multivariate analysis demonstrated the presence of ≥3 organ dysfunctions (OR 2.46, 95% CI: 1.19–5.09; P < 0.05 and medical intensive care unit admission (OR 1.99, 95% CI: 1.00–3.98; P = 0.05 were independent variables associated with hospital mortality. Conclusion: Patients receiving rhAPC at our institution had higher APACHE II scores, mortality, and major bleeding events than published

Nutrition and Cancer Prevention Research Practicum | Division of Cancer Prevention

Science.gov (United States)

The Nutritional Science Research Group in the Division of Cancer Prevention at the National Cancer Institute, National Institutes of Health and the Department of Nutrition at the Clinical Center, National Institutes of Health are offering a one week educational opportunity in "Nutrition and Cancer Prevention Research" for individuals with a sustained commitment to nutrition

Physics Division progress report for period ending September 30, 1987

International Nuclear Information System (INIS)

Livingston, A.B.

1988-03-01

The activities of this Division are concentrated in the areas of experimental nuclear physics, experimental atomic physics, and theoretical nuclear and atomic physics. A major activity within the Division is operation of the Holifield Heavy Ion Research Facility as a national user facility. Highlights for this year, which include a record number of beam hours provided for research, are summarized. The experimental nuclear physics program continues to be dominated by research utilizing heavy ions. These activities, while continuing to center largely on the Holifield Facility, have seen growth in the use of facilities that provide intermediate energies (GANIL) and ultrarelativistic beams (CERN). The UNISOR program, since its inception, has been intimately associated with the Division and, most particularly, with the Holifield Facility. The experimental nuclear structure research of this consortium is included. In addition to the Holifield Facility, the Division also operates two smaller facilities, the EN Tandem and the ECR Ion Source Facility, as /open quotes/User Resources/close quotes/. The tandem continues a long history of supporting research in accelerator-based atomic physics. During this past year, new beam lines have been added to the ECR ion source to create user opportunities for atomic physics experiments with this unique device. These two facilities and the experimental programs in atomic physics are discussed. The efforts in theoretical physics, covering both nuclear and atomic physics, are presented. Also included is the theory effort in support of the UNISOR structure program. In addition to research with multicharged heavy ions from the ECR source, the effort on atomic physics in support of the controlled fusion program includes a plasma diagnostics development program and operation of an atomic physics data center. The nuclear physics program also operates a compilation and evaluation effort; this work is also described

Physics Division progress report for period ending September 30, 1987

Energy Technology Data Exchange (ETDEWEB)

Livingston, A.B. (ed.)

1988-03-01

The activities of this Division are concentrated in the areas of experimental nuclear physics, experimental atomic physics, and theoretical nuclear and atomic physics. A major activity within the Division is operation of the Holifield Heavy Ion Research Facility as a national user facility. Highlights for this year, which include a record number of beam hours provided for research, are summarized. The experimental nuclear physics program continues to be dominated by research utilizing heavy ions. These activities, while continuing to center largely on the Holifield Facility, have seen growth in the use of facilities that provide intermediate energies (GANIL) and ultrarelativistic beams (CERN). The UNISOR program, since its inception, has been intimately associated with the Division and, most particularly, with the Holifield Facility. The experimental nuclear structure research of this consortium is included. In addition to the Holifield Facility, the Division also operates two smaller facilities, the EN Tandem and the ECR Ion Source Facility, as /open quotes/User Resources/close quotes/. The tandem continues a long history of supporting research in accelerator-based atomic physics. During this past year, new beam lines have been added to the ECR ion source to create user opportunities for atomic physics experiments with this unique device. These two facilities and the experimental programs in atomic physics are discussed. The efforts in theoretical physics, covering both nuclear and atomic physics, are presented. Also included is the theory effort in support of the UNISOR structure program. In addition to research with multicharged heavy ions from the ECR source, the effort on atomic physics in support of the controlled fusion program includes a plasma diagnostics development program and operation of an atomic physics data center. The nuclear physics program also operates a compilation and evaluation effort; this work is also described.

Opportunities for social workers in the patient centered medical home.

Science.gov (United States)

Hawk, Mary; Ricci, Edmund; Huber, George; Myers, Marcella

2015-01-01

The Patient Centered Medical Home (PCMH) has been hailed as one method of improving chronic care outcomes in the United States. A number of studies have underscored the importance of the social work role within the PCMH, yet little existing research explores the social worker as a driver of improved patient care. The Pennsylvania Chronic Care Initiative was created with a primary goal of increasing the number of practices that were recognized as PCMH by the National Committee for Quality Assurance. This article describes findings from in-depth qualitative interviews with representatives from seven primary care practices, in which the authors examined barriers and facilitators to implementation of the initiative. Barriers to implementation included small practice size, payer-driven care, not having a strong physician champion, variability within patient populations, and high implementation costs. Facilitators included having a social worker coordinate behavioral health services, clinical nurse case managers, preexisting models of outcomes-driven care, and being part of an integrated health delivery and financing system. Recommendations strengthening the role of medical social workers in primary care practices are discussed.

Collaboration between a college of pharmacy and a for-profit health system at an academic medical center.

Science.gov (United States)

Bird, Matthew L; Dunn, Rebecca L; Hagemann, Tracy M; Burton, Michael E; Britton, Mark L; St Cyr, Mark B

2012-07-01

The genesis and growth of a successful 14-year partnership between the University of Oklahoma (OU) college of pharmacy and the OU Medical Center (OUMC) department of pharmacy are described. Pursuant to a 1998 joint operating agreement, the medical center and pharmacy school have achieved a high degree of collaboration on a wide range of educational and clinical initiatives. The close relationship has conferred a number of benefits on both institutions, including (1) expanded experiential education opportunities for pharmacy students, (2) joint faculty and staff funding arrangements that have facilitated the development and accreditation of OU pharmacy residency programs, and (3) patient care initiatives that have increased awareness of pharmacists' important contributions in areas such as venous thromboembolism prophylaxis, antibiotic stewardship, and core measures compliance. In addition to the formal integration of the college of pharmacy into the OUMC organizational structure, ongoing teamwork by clinicians and administrators at the two institutions has strengthened the 14-year partnership while helping to identify creative solutions to evolving communications, technology, and reimbursement challenges. Potential growth opportunities include the expansion of pharmacy services into additional service areas and greater involvement by OU pharmacy school faculty in the training of medical, nursing, and allied health professionals. A large for-profit academic medical center and a college of pharmacy developed a successful collaboration that is mutually beneficial and provides increased clinical, educational, and scholarly opportunities, advancing the mission of both institutions.

Health physics division annual progress report for period ending June 30, 1977

Energy Technology Data Exchange (ETDEWEB)

1978-07-01

This annual progress report follows, as in the past, the organizational structure of the Health Physics Division. Each part is a report of work done by a section of the division: Assessment and Technology Section (Part I), headed by H.W. Dickson; Biological and Radiation Physics Section (Part II), H.A. Wright; Chemical Physics and Spectroscopy Section (Part III), W.R. Garrett; Emergency Technology Section (Part IV), C.V. Chester, Medical Physics and Internal Dosimetry Section (Part V), K.E. Cowser; and the Analytic Dosimetry and Education Group (Part VI), J.E. Turner.

Does the patient's inherent rating tendency influence reported satisfaction scores and affect division ranking?

Science.gov (United States)

Francis, Patricia; Agoritsas, Thomas; Chopard, Pierre; Perneger, Thomas

2016-04-01

To determine the impact of adjusting for rating tendency (RT) on patient satisfaction scores in a large teaching hospital and to assess the impact of adjustment on the ranking of divisions. Cross-sectional survey. Large 2200-bed university teaching hospital. All adult patients hospitalized during a 1-month period in one of 20 medical divisions. None. Patient experience of care measured by the Picker Patient Experience questionnaire and RT scores. Problem scores were weakly but significantly associated with RT. Division ranking was slightly modified in RT adjusted models. Division ranking changed substantially in case-mix adjusted models. Adjusting patient self-reported problem scores for RT did impact ranking of divisions, although marginally. Further studies are needed to determine the impact of RT when comparing different institutions, particularly across inter-cultural settings, where the difference in RT may be more substantial. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

Ontario pharmacists practicing in family health teams and the patient-centered medical home.

Science.gov (United States)

Dolovich, Lisa

2012-04-01

The patient-centered medical home (PCMH) approach continues to gather momentum in the United States and Canada as a broad approach to reform the delivery of the complete primary care system. The family health team (FHT) model implemented in Ontario, Canada, best mirrors the PCMH approach of the United States. The integration of pharmacists as key members of the health care team providing on-site, in-office coordinated care to FHT patients was included from the start of planning the FHT model and represents a substantial opportunity for pharmacists to realize their professional vision. Several research projects in Canada and elsewhere have contributed to providing evidence to support the integration of pharmacists into primary care practice sites. Two major research programs, the Seniors Medication Assessment Research Trial (SMART) cluster randomized controlled trial and the Integrating Family Medicine and Pharmacy to Advance Primary Care Therapeutics (IMPACT) multipronged demonstration project made substantial contributions to evidence-informed policy decisions supporting the integration of pharmacists into FHTs. These projects can provide useful information to support the integration of pharmacists into the PCMH and to encourage further research to better measure the effect of the pharmacist from the holistic patient-centered perspective.

[Medical equipment companies and their ties with technology development centers in Mexico].

Science.gov (United States)

Hernández, B; Arredondo, A; Cruz, C; Sánchez, E; Damián, T

1993-10-01

The purpose of this study was to determine the characteristics of the companies that produce, distribute, and service medical equipment in Mexico and the factors related to whether or not they had established ties with research and technology development centers. The data analyzed came from a survey of such companies carried out in Mexico City and environs in 1989. The information was updated in 1991. Multivariate analyses were carried out in order to identify the characteristics of companies that had established ties or wished to do so and the areas of interest of those companies. Of 208 companies surveyed, only 23% had ties with research centers. The companies that had such ties or were interested in establishing them tended to invest in research and to have made plans for expansion. The establishment of ties appeared to be a two-way process, with positive consequences for the companies involved, the research centers, and the health sector. It was concluded that it would be advantageous to design programs to promote ties with companies having the characteristics mentioned.

Putting patients first: a novel patient-centered model for medical enterprise success.

Science.gov (United States)

Dhawan, Naveen

2014-01-01

This article introduces a new way of viewing patient-customers. It encourages a greater emphasis on patients' needs and the importance of considering dimensions of the patient experience to better serve them. It also draws from examples in the general business world as they can be applied to medical enterprises. The author introduces a model that directs all business activities toward the end consumer with an underlying guidance by patient needs. A business is advised to understand its customer, design a patient-directed vision, and focus on creating a unique customer experience. The article delineates key action items for physicians and administrators that will allow them to better meet their patient-customers' needs and develop loyalty. By practicing a patient-centered approach and following these guidelines, one may ensure greater success of the medical enterprise.

PTSD: National Center for PTSD

Medline Plus

Full Text Available ... Publications Toolkits Videos Web Links Advanced Search About Us National Center for PTSD What We Do Mission and Overview Goals and Objectives Looking Ahead Annual Reports Research Initiatives Education Initiatives Advisory Boards History and Achievements Divisions and ...

Love, Legislation, and OSHA [Occupational Safety and Health Act]: Highlights from the Manpower Division

Science.gov (United States)

Vadnais, Arthur

1974-01-01

The conference of the Manpower Division of the American Vocational Association is summarized. Skill centers, relevant Federal legislation, student-instructor relationship, curriculum development, and organization business items were among the topics discussed. (AG)

76 FR 49781 - Fogarty International Center Notice of Meetings

Science.gov (United States)

2011-08-11

.... Agenda: Discussion of the role of Fogarty's Division of International Relations and health diplomacy... Person: Robert Eiss, Public Health Advisor, Fogarty International Center, National Institutes of Health... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Fogarty International Center...

Positioning academic medical centers and teaching hospitals to thrive in the next decade.

Science.gov (United States)

Morris, D E

1985-06-01

Market share for academic medical centers and teaching hospitals will decline over the next five years necessitating new strategies to ensure growth and profitability. These types of institutions are, however, in a strong position to compete and gain market share locally by building a defensible competitive advantage. This article offers three avenues for increasing market share: networking, brand name product differentiation, and business diversification.

Physics, Computer Science and Mathematics Division. Annual report, 1 January--31 December 1977

International Nuclear Information System (INIS)

Lepore, J.V.

1977-01-01

This annual report of the Physics, Computer Science and Mathematics Division describes the scientific research and other work carried out within the Division during 1977. The Division is concerned with work in experimental and theoretical physics, with computer science and applied mathematics, and with the operation of a computer center. The major physics research activity is in high-energy physics, although there is a relatively small program of medium-energy research. The High Energy Physics research program in the Physics Division is concerned with fundamental research which will enable man to comprehend the nature of the physical world. The major effort is now directed toward experiments with positron-electron colliding beam at PEP. The Medium Energy Physics program is concerned with research using mesons and nucleons to probe the properties of matter. This research is concerned with the study of nuclear structure, nuclear reactions, and the interactions between nuclei and electromagnetic radiation and mesons. The Computer Science and Applied Mathematics Department engages in research in a variety of computer science and mathematics disciplines. Work in computer science and applied mathematics includes construction of data bases, computer graphics, computational physics and data analysis, mathematical modeling, and mathematical analysis of differential and integral equations resulting from physical problems. The Computer Center provides large-scale computational support to LBL's scientific programs. Descriptions of the various activities are quite short; references to published results are given. 24 figures

Cerebral angioplasty practice at major medical centers in the United States

International Nuclear Information System (INIS)

Chaturvedi, S.; St Pierre, M.E.; Bertasio, B.

2000-01-01

Concern has been expressed recently regarding the proliferation of angioplasty and/or stenting of cerebral vessels. However, little is known about the volume of angioplasties being performed or the number of experienced interventionalists. A questionnaire was mailed to directors of accredited radiology residency programs in the United States, to define the level of expertise available at teaching hospitals in terms of angioplasty and/or stenting. Of 200 programs surveyed, 111 responded (56 %). Of 111 program directors 47 (42 %) indicated that cerebral angioplasty was being performed at their center. The greatest experience is currently for angioplasty of post-subarachnoid hemorrhage vasospasm (mean 16 procedures performed) and the least experience for dilation of basilar artery atherosclerosis (mean five procedures performed). The reported stroke and/or death rate in centers performing angioplasty of the extracranial carotid system is 1.5 %. Comparisons with other medical specialties (e. g., cardiologists, neurologists, neurosurgeons) are necessary to determine the full scope of extracranial neurovascular procedures being performed and the corresponding complication rates. (orig.)

Accelerator and Fusion Research Division: Summary of activities, 1986

International Nuclear Information System (INIS)

1987-01-01

This report contains a summary of activities at the Lawrence Berkeley Laboratory's Accelerator and Fusion Research Division for the year 1986. Topics and facilities investigated in individual papers are: 1-2 GeV Synchrotron Radiation Source, the Center for X-Ray Optics, Accelerator Operations, High-Energy Physics Technology, Heavy-Ion Fusion Accelerator Research and Magnetic Fusion Energy. Six individual papers have been indexed separately

100G shortwave wavelength division multiplexing solutions for multimode fiber data links

DEFF Research Database (Denmark)

Cimoli, Bruno; Estaran Tolosa, Jose Manuel; Rodes Lopez, Guillermo Arturo

2016-01-01

We investigate an alternative 100G solution for optical short-range data center links. The presented solution adopts wavelength division multiplexing technology to transmit four channels of 25G over a multimode fiber. A comparative performance analysis of the wavelength-grid selection for the wav...

Impact on Seniors of the Patient-Centered Medical Home: Evidence from a Pilot Study

Science.gov (United States)

Fishman, Paul A.; Johnson, Eric A.; Coleman, Kathryn; Larson, Eric B.; Hsu, Clarissa; Ross, Tyler R.; Liss, David; Tufano, James; Reid, Robert J.

2012-01-01

Purpose: To assess the impact on health care cost and quality among seniors of a patient-centered medical home (PCMH) pilot at Group Health Cooperative, an integrated health care system in Washington State. Design and Methods: A prospective before-and-after evaluation of the experience of seniors receiving primary care services at 1 pilot clinic…

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

Directory of Open Access Journals (Sweden)

Okayama M

2016-07-01

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

Real time medical learning using the WhatsApp cellular network: a cross sectional study following the experience of a division's medical officers in the Israel Defense Forces.

Science.gov (United States)

Blumenfeld, Ofer; Brand, Ronen

2016-01-01

Primary care medical officers (MOs) are expected to maintain self-education while serving in their units in order to maintain professional standards. With the rise of smartphone use in the Israel Defense Forces (IDF), the WhatsApp application can facilitate medical learning. To date, there has been no description of the use of this tool by MOs in a military setting. This paper aims to describe the pattern of use of a WhatsApp application group by IDF's MOs. We collected all the information (textual and visual) uploaded to a WhatsApp group called "The Division's Physicians", originally established two years earlier, during a randomly selected sample month. We analyzed the pattern of its use and explored the association between the number of questions and responses uploaded to the group and the duration of service of their senders. In December 2014, the "The Division's Physicians" WhatsApp group had 41 participants. We identified 478 messages classified as questions and 531 messages classified as responses. The number of questions asked by MOs in their first 2 months of service in the battalion (median = 14.5) and the number of questions asked by MOs with more than one year of their first assignment (median = 10.5) were significantly higher than the number of questions (median = 1.0) asked by MOs in their second assignment or later ( p values for comparisons were 0.008 and 0.012 respectively). We also found that both the number of responses provided by MOs with more than one year of service in the battalion (median = 21) and the number of responses provided by MOs in their second assignment or later (median = 5) were significantly higher than the number of responses (median = 1) provided by MOs within their first 2 months of service in the battalion ( p value for comparisons were 0.024 and 0.039 respectively). We conclude from our preliminary study that a WhatsApp group can facilitate the transfer of knowledge from more experienced MOs to those with

Radiation safety knowledge of medical center radiology technologists in southern Taiwan

Energy Technology Data Exchange (ETDEWEB)

Su Wen-Chuan; Huang Ying-Fong; Chen Cheng-Chung; Chang Pao-Shu [Kaohsiung Medical University, Taiwan (China)

2000-05-01

People who live in Taiwan are getting more and more afraid of radiation. Sometimes the phobia results from distorted knowledge. Radiology technologists, in one hand, are more well-educated in radiation and, in the other hand, have more chance to expose to radiation when they are operating radiation producing medical instruments in their daily life. So we are interested in whether they have enough knowledge to protect themselves. We pick up the radiology technology board examination to make the questionnaire for this study. The population is the radiology technologists who work at department of diagnostic radiology, of radiation therapy and nuclear medicine in medical centers. Statistics is then used to see the relationship between knowledge and the factors including gender, age and career period. Based on statistics, we find out that there is significant correlation between the knowledge with age or education level. Elder or lower education level ones has worse knowledge. Continued education may be highly recommended for radiology technologists to avoid occupational radiation injury. (author)

Radiation safety knowledge of medical center radiology technologists in southern Taiwan

International Nuclear Information System (INIS)

Su Wen-Chuan; Huang Ying-Fong; Chen Cheng-Chung; Chang Pao-Shu

2000-01-01

People who live in Taiwan are getting more and more afraid of radiation. Sometimes the phobia results from distorted knowledge. Radiology technologists, in one hand, are more well-educated in radiation and, in the other hand, have more chance to expose to radiation when they are operating radiation producing medical instruments in their daily life. So we are interested in whether they have enough knowledge to protect themselves. We pick up the radiology technology board examination to make the questionnaire for this study. The population is the radiology technologists who work at department of diagnostic radiology, of radiation therapy and nuclear medicine in medical centers. Statistics is then used to see the relationship between knowledge and the factors including gender, age and career period. Based on statistics, we find out that there is significant correlation between the knowledge with age or education level. Elder or lower education level ones has worse knowledge. Continued education may be highly recommended for radiology technologists to avoid occupational radiation injury. (author)

Division or department: a microeconomic analysis.

Science.gov (United States)

Mar, Philip L; Yu, Robert A; Yu, Jack C

2011-06-01

In this article, the authors present a microeconomic analysis of the effects of the administrative status on plastic surgery units within academic medical centers, comparing the departmental versus subdepartmental status. The objectives are to introduce decision-making tools of microeconomics and use them to explore the potential effects of administrative status on academic plastic surgery services. Real financial data over a decade were used to construct total cost (TC), average total cost (ATC), and total revenue (TR) curves. From these, the authors derive the efficiency scale and express the fiscal performance by examining profitability, and the commonly used ATC curve. Mathematical modeling is then used to examine the effects of departmental versus subdepartmental status, assuming that (1) a plastic surgery unit exists in a competitive market; and (2) TR > TC for the plastic surgery unit to self-sustain in the long term. The variables considered are total clinical production (Q), gross collection rates (GCR), personnel cost, and departmental tax. The sustainability (Q against GCR) is a hyperbolic curve with Q × GCR = TC at break-even. The TC/TR = f(TR) curve resembles the ATC curve. Sectional versus departmental status for a plastic surgery service in an academic medical center depends greatly on the shape of their TC/TR = f(TR) curve. With most competing clinical units within the same academic medical center having departmental status, and most competing private surgeons having no institutional "taxes," the essential requirement for academic medical center plastic surgery services is to ensure that their TC/TR = f(TR) curve is comparable to that of their competitors.

Computational Fair Division

DEFF Research Database (Denmark)

Branzei, Simina

Fair division is a fundamental problem in economic theory and one of the oldest questions faced through the history of human society. The high level scenario is that of several participants having to divide a collection of resources such that everyone is satisfied with their allocation -- e.g. two...... heirs dividing a car, house, and piece of land inherited. The literature on fair division was developed in the 20th century in mathematics and economics, but computational work on fair division is still sparse. This thesis can be seen as an excursion in computational fair division divided in two parts....... The first part tackles the cake cutting problem, where the cake is a metaphor for a heterogeneous divisible resource such as land, time, mineral deposits, and computer memory. We study the equilibria of classical protocols and design an algorithmic framework for reasoning about their game theoretic...

The John Milner Nutrition and Cancer Prevention Research Practicum | Division of Cancer Prevention

Science.gov (United States)

The Nutritional Science Research Group in the Division of Cancer Prevention at the National Cancer Institute, National Institutes of Health and the Department of Nutrition at the Clinical Center, National Institutes of Health, and the U.S. Department of Agriculture’s Beltsville Human Nutrition Research Center are offering a one-week educational opportunity in Nutrition and Cancer Prevention Research for individuals with a sustained commitment to nutrition and health promotion. |

Surgeon leadership in the coding, billing, and contractual negotiations for fenestrated endovascular aortic aneurysm repair increases medical center contribution margin and physician reimbursement.

Science.gov (United States)

Aiello, Francesco; Durgin, Jonathan; Daniel, Vijaya; Messina, Louis; Doucet, Danielle; Simons, Jessica; Jenkins, James; Schanzer, Andres

2017-10-01

Fenestrated endovascular aneurysm repair (FEVAR) allows endovascular treatment of thoracoabdominal and juxtarenal aneurysms previously outside the indications of use for standard devices. However, because of considerable device costs and increased procedure time, FEVAR is thought to result in financial losses for medical centers and physicians. We hypothesized that surgeon leadership in the coding, billing, and contractual negotiations for FEVAR procedures will increase medical center contribution margin (CM) and physician reimbursement. At the UMass Memorial Center for Complex Aortic Disease, a vascular surgeon with experience in medical finances is supported to manage the billing and coding of FEVAR procedures for medical center and physician reimbursement. A comprehensive financial analysis was performed for all FEVAR procedures (2011-2015), independent of insurance status, patient presentation, or type of device used. Medical center CM (actual reimbursement minus direct costs) was determined for each index FEVAR procedure and for all related subsequent procedures, inpatient or outpatient, 3 months before and 1 year subsequent to the index FEVAR procedure. Medical center CM for outpatient clinic visits, radiology examinations, vascular laboratory studies, and cardiology and pulmonary evaluations related to FEVAR were also determined. Surgeon reimbursement for index FEVAR procedure, related adjunct procedures, and assistant surgeon reimbursement were also calculated. All financial analyses were performed and adjudicated by the UMass Department of Finance. The index hospitalization for 63 FEVAR procedures incurred $2,776,726 of direct costs and generated $3,027,887 in reimbursement, resulting in a positive CM of $251,160. Subsequent related hospital procedures (n = 26) generated a CM of $144,473. Outpatient clinic visits, radiologic examinations, and vascular laboratory studies generated an additional CM of $96,888. Direct cost analysis revealed that grafts

TU-AB-204-03: Research Activities in Medical Physics

International Nuclear Information System (INIS)

Badano, A.

2016-01-01

The responsibilities of the Food and Drug Administration (FDA) have increased since the inception of the Food and Drugs Act in 1906. Medical devices first came under comprehensive regulation with the passage of the 1938 Food, Drug, and Cosmetic Act. In 1971 FDA also took on the responsibility for consumer protection against unnecessary exposure to radiation-emitting devices for home and occupational use. However it was not until 1976, under the Medical Device Regulation Act, that the FDA was responsible for the safety and effectiveness of medical devices. This session will be presented by the Division of Radiological Health (DRH) and the Division of Imaging, Diagnostics, and Software Reliability (DIDSR) from the Center for Devices and Radiological Health (CDRH) at the FDA. The symposium will discuss on how we protect and promote public health with a focus on medical physics applications organized into four areas: pre-market device review, post-market surveillance, device compliance, current regulatory research efforts and partnerships with other organizations. The pre-market session will summarize the pathways FDA uses to regulate the investigational use and commercialization of diagnostic imaging and radiation therapy medical devices in the US, highlighting resources available to assist investigators and manufacturers. The post-market session will explain the post-market surveillance and compliance activities FDA performs to monitor the safety and effectiveness of devices on the market. The third session will describe research efforts that support the regulatory mission of the Agency. An overview of our regulatory research portfolio to advance our understanding of medical physics and imaging technologies and approaches to their evaluation will be discussed. Lastly, mechanisms that FDA uses to seek public input and promote collaborations with professional, government, and international organizations, such as AAPM, International Electrotechnical Commission (IEC

TU-AB-204-03: Research Activities in Medical Physics

Energy Technology Data Exchange (ETDEWEB)

Badano, A. [Food & Drug Administration (United States)

2016-06-15

The responsibilities of the Food and Drug Administration (FDA) have increased since the inception of the Food and Drugs Act in 1906. Medical devices first came under comprehensive regulation with the passage of the 1938 Food, Drug, and Cosmetic Act. In 1971 FDA also took on the responsibility for consumer protection against unnecessary exposure to radiation-emitting devices for home and occupational use. However it was not until 1976, under the Medical Device Regulation Act, that the FDA was responsible for the safety and effectiveness of medical devices. This session will be presented by the Division of Radiological Health (DRH) and the Division of Imaging, Diagnostics, and Software Reliability (DIDSR) from the Center for Devices and Radiological Health (CDRH) at the FDA. The symposium will discuss on how we protect and promote public health with a focus on medical physics applications organized into four areas: pre-market device review, post-market surveillance, device compliance, current regulatory research efforts and partnerships with other organizations. The pre-market session will summarize the pathways FDA uses to regulate the investigational use and commercialization of diagnostic imaging and radiation therapy medical devices in the US, highlighting resources available to assist investigators and manufacturers. The post-market session will explain the post-market surveillance and compliance activities FDA performs to monitor the safety and effectiveness of devices on the market. The third session will describe research efforts that support the regulatory mission of the Agency. An overview of our regulatory research portfolio to advance our understanding of medical physics and imaging technologies and approaches to their evaluation will be discussed. Lastly, mechanisms that FDA uses to seek public input and promote collaborations with professional, government, and international organizations, such as AAPM, International Electrotechnical Commission (IEC

Surgery on Fetus Reduces Complications of Spina Bifida

Medline Plus

Full Text Available ... Division of Extramural Research (DER) National Center for Medical Rehabilitation Research (NCMRR) Supported Networks & Initiatives Datasets & Research ... Labs (AG&L) Scientists Emeriti National Center for Medical Rehabilitation Research (NCMRR) Center History Funding Opportunity Announcements ( ...

Factors affecting medication adherence in elderly people

Directory of Open Access Journals (Sweden)

Jin HK

2016-10-01

Full Text Available Hyekyung Jin,1 Yeonhee Kim,2 Sandy Jeong Rhie1,3 1College of Pharmacy, 2Center for Excellence in Teaching & Learning, 3Division of Life and Pharmaceutical Sciences, Ewha Womans University, Seoul, Republic of Korea Background: Little is known about the functional health literacy (FHL associated with medication adherence in elderly patients. The aim of this study was to examine the FHL among older adults and identify influencing factors that can predict medication adherence. Methods: This was a cross-sectional survey. Participants (n=160 aged 65 years and older were selected from outpatient clinics of 3 tertiary care hospitals, 6 community pharmacies, and 2 senior centers between November 1 and 30, 2014. The participants’ FHL was measured using the Korean Functional Health Literacy Test, which consists of 15 items including 8 numeracy and 7 reading comprehension items. Medication adherence was measured by the Adherence to Refills and Medication Scale. Descriptive statistics, chi-square or Fisher’s exact test, and multiple regression analyses were used to analyze the data. Results: The mean score of the total FHL was 7.72±3.51 (range 0–15. The percentage of the total number of correct answers for the reading comprehension subtest and numeracy subtest were 48.1% and 54.4%, respectively. Among 160 participants, 52.5% showed low adherence to medication. The factors affecting medication adherence included the patient’s degree of satisfaction with the service (β=-0.215, P=0.022, sufficient explanation of medication counseling (β=-0.335, P=0.000, education level (β=-0.153, P=0.045, health-related problems (β=-0.239, P=0.004, and dosing frequency (β=0.189, P=0.018. Conclusion: In this study, we found medication adherence of elderly patients was associated with education level, health-related problems, dosing frequency, satisfaction with patient counseling, and explanation of medication, but no association was found with FHL. Pharmacists

Engineering Physics and Mathematics Division progress report for period ending August 31, 1989

International Nuclear Information System (INIS)

1989-12-01

This paper contains abstracts on research performed at the Engineering Physics and Mathematics Division of Oak Ridge National Laboratory. The areas covered are: mathematical science; nuclear-data measurement and evaluation; intelligent systems; nuclear analysis and shielding; and Engineering Physics Information Center

Distribution center consolidation games

NARCIS (Netherlands)

Klijn, F.; Slikker, M.

2005-01-01

We study a location-inventory model to analyze the impact of consolidation of distribution centers on facility and inventory costs. We introduce a cooperative game and show that when demand processes are i.i.d. the core is non-empty, i.e., consolidation allows for a stable division of the minimal

A Study to Evaluate the Organization and the Operating Procedures of the Patient Assistance Function at Brooke Army Medical Center, Fort Sam Houston, Texas

Science.gov (United States)

1979-08-01

15 March 1979. 59Interview with Wendy L. Farace , Head Nurse, Obstetrics/Gynecology Clinic, Brooke Army Medical Center, Fort Sam Houston, Texas, 8...6 February 1979. Farace , Wendy L. Head Nurse, Obstetrica/Gynecology Clinic, Brooke Army Medical Center, Fort Sam Houston, Texas. Interview, 8 January

On infinitely divisible semimartingales

DEFF Research Database (Denmark)

Basse-O'Connor, Andreas; Rosiński, Jan

2015-01-01

to non Gaussian infinitely divisible processes. First we show that the class of infinitely divisible semimartingales is so large that the natural analog of Stricker's theorem fails to hold. Then, as the main result, we prove that an infinitely divisible semimartingale relative to the filtration generated...... by a random measure admits a unique decomposition into an independent increment process and an infinitely divisible process of finite variation. Consequently, the natural analog of Stricker's theorem holds for all strictly representable processes (as defined in this paper). Since Gaussian processes...... are strictly representable due to Hida's multiplicity theorem, the classical Stricker's theorem follows from our result. Another consequence is that the question when an infinitely divisible process is a semimartingale can often be reduced to a path property, when a certain associated infinitely divisible...

An Analysis of Information Technology Adoption by IRBs of Large Academic Medical Centers in the United States.

Science.gov (United States)

He, Shan; Botkin, Jeffrey R; Hurdle, John F

2015-02-01

The clinical research landscape has changed dramatically in recent years in terms of both volume and complexity. This poses new challenges for Institutional Review Boards' (IRBs) review efficiency and quality, especially at large academic medical centers. This article discusses the technical facets of IRB modernization. We analyzed the information technology used by IRBs in large academic institutions across the United States. We found that large academic medical centers have a high electronic IRB adoption rate; however, the capabilities of electronic IRB systems vary greatly. We discuss potential use-cases of a fully exploited electronic IRB system that promise to streamline the clinical research work flow. The key to that approach utilizes a structured and standardized information model for the IRB application. © The Author(s) 2014.

Improvements in self-efficacy for engaging in patient-centered communication following a course in peer-supervision and communication for medical students

DEFF Research Database (Denmark)

Lassesen, Berit; O Connor, Maja; Kjær, Louise Binow

and Department of Psychology and Behavioral Science, Aarhus University, Aarhus, Denmark; 3Center for Medical Education, Aarhus University, Aarhus, Denmark.; belas@clu.au.dk Aim: The aim was to evaluate the outcome of a training course in peer-supervision and communication with the aim of improving medical...... student self-efficacy for engaging in patient-centered communication and examine the influence of course-related motivation to learn, course-related self-efficacy, and medical student well-being at baseline. Methods: A total of 127 graduate school medical students in clinical clerkship who participated...... in a course in peer-supervision and communication completed a pre-course questionnaire package including: 1) The Patient-Centeredness Self-Efficacy Questionnaire (PCSEQ), 2) Course-Related Motivation to Learn (CRML), 3) Course-Related Self-Efficacy (CRSE), and 4) the Medical Student Well-Being Index (MSWBI...

Engineering Physics and Mathematics Division progress report for period ending August 31, 1989

Energy Technology Data Exchange (ETDEWEB)

1989-12-01

This paper contains abstracts on research performed at the Engineering Physics and Mathematics Division of Oak Ridge National Laboratory. The areas covered are: mathematical science; nuclear-data measurement and evaluation; intelligent systems; nuclear analysis and shielding; and Engineering Physics Information Center. (LSP)

Health information security: a case study of three selected medical centers in iran.

Science.gov (United States)

Hajrahimi, Nafiseh; Dehaghani, Sayed Mehdi Hejazi; Sheikhtaheri, Abbas

2013-03-01

Health Information System (HIS) is considered a unique factor in improving the quality of health care activities and cost reduction, but today with the development of information technology and use of internet and computer networks, patients' electronic records and health information systems have become a source for hackers. This study aims at checking health information security of three selected medical centers in Iran using AHP fuzzy and TOPSIS compound model. To achieve that security measures were identified, based on the research literature and decision making matrix using experts' points of view. Among the 27 indicators, seven indicators were selected as effective indicators and Fuzzy AHP technique was used to determine the importance of security indicators. Based on the comparisons made between the three selected medical centers to assess the security of health information, it is concluded that Chamran hospital has the most acceptable level of security and attention in three indicators of "verification and system design, user access management, access control system", Al Zahra Hospital in two indicators of "access management and network access control" and Amin Hospital in "equipment safety and system design". In terms of information security, Chamran Hospital ranked first, Al-Zahra Hospital ranked second and Al- Zahra hospital has the third place.

Survey on prevalence and causes of self-medication in women referring to health centers in Ahwaz, in 2013

Directory of Open Access Journals (Sweden)

Pourandoght Afshary

2015-11-01

Full Text Available Background: Today, considerable advances achieved in different scientific fields have led to an ever-increasing access of people to various medications and their unauthorized consumption, which negatively affects the healthcare and treatment system. Thus, this study was conducted to determine the Prevalence and causes of this phenomenon in the female population of Ahwaz. Material and Methods: In this Cross-sectional study364 Women referring to seven health centers in Ahwaz were selected randomly and based on the family medical file number and by proportional distribution to each center and semi-structured questionnaires were completed through interviews. The data were analyzed by Chi square test and logistic regression. P<0.05 was considered significant. Results: Self-medication was observed in 70.1% of women. The most frequent group  was those above the age of 30. The most common self-medication case was urogenitaldisorders (58.7%. there was a significant relation between education (p<0.003 and number of births (p=0.003 and unauthorized drug consumption. The most causes for synthetic drug use were previous illness background (48.6% and high medication costs (50.6%, and about herbal drugs were high medication costs (41.1%, and the effectiveness of these products about medicinal herbs (38.1 %. Conclusion: High rate of self-medication in the studied society necessitates training on proper use of drugs through the use of social media.

Division of Finance Homepage

Science.gov (United States)

Top Department of Administration logo Alaska Department of Administration Division of Finance Search Search the Division of Finance site DOF State of Alaska Finance Home Content Area Accounting Charge Cards You are here Administration / Finance Division of Finance Updates IRIS Expenditure Object Codes

Chemical Technology Division annual technical report, 1994

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-06-01

Highlights of the Chemical Technology (CMT) Division`s activities during 1994 are presented. In this period, CMT conducted research and development in the following areas: (1) electrochemical technology, including advanced batteries and fuel cells; (2) technology for fluidized-bed combustion; (3) methods for treatment of hazardous waste and mixed hazardous/radioactive waste; (4) the reaction of nuclear waste glass and spent fuel under conditions expected for an unsaturated repository; (5) processes for separating and recovering transuranic elements from waste streams, concentrating radioactive waste streams with advanced evaporator technology, and producing {sup 99}Mo from low-enriched uranium for medical applications; (6) electrometallurgical treatment of the many different types of spent nuclear fuel in storage at Department of Energy sites; and (8) physical chemistry of selected materials in environments simulating those of fission and fusion energy systems. The Division also conducts basic research in catalytic chemistry associated with molecular energy resources and novel ceramic precursors; materials chemistry of superconducting oxides, electrified metal/solution interfaces, molecular sieve structures, and impurities in scrap copper and steel; and the geochemical processes involved in mineral/fluid interfaces and water-rock interactions occurring in active hydrothermal systems. In addition, the Analytical Chemistry Laboratory in CMT provides a broad range of analytical chemistry support services to the technical programs at Argonne National Laboratory (ANL).

Cummings/Ju - Harvard; Emory | Division of Cancer Prevention

Science.gov (United States)

Principal Investigator: Richard D Cummings, PhDInstitution: Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA Principal Investigator: Tongzhong Ju, MD, PhDInstitution: Emory University, Atlanta, GA |

Learning from Primary Health Care Centers in Nepal: reflective writings on experiential learning of third year Nepalese medical students

OpenAIRE

Dhital, Rolina; Subedi, Madhusudan; Prasai, Neeti; Shrestha, Karun; Malla, Milan; Upadhyay, Shambhu

2015-01-01

Background Medical education can play important role in cultivating the willingness among the medical students to work in underprivileged areas after their graduation. Experiential learning through early exposure to primary health care centers could help students better understand the opportunities and challenges of such settings. However, the information on the real experiences and reflections of medical students on the rural primary health care settings from low-income countries like Nepal ...

Teaching Health Center Graduate Medical Education Locations Predominantly Located in Federally Designated Underserved Areas.

Science.gov (United States)

Barclift, Songhai C; Brown, Elizabeth J; Finnegan, Sean C; Cohen, Elena R; Klink, Kathleen

2016-05-01

Background The Teaching Health Center Graduate Medical Education (THCGME) program is an Affordable Care Act funding initiative designed to expand primary care residency training in community-based ambulatory settings. Statute suggests, but does not require, training in underserved settings. Residents who train in underserved settings are more likely to go on to practice in similar settings, and graduates more often than not practice near where they have trained. Objective The objective of this study was to describe and quantify federally designated clinical continuity training sites of the THCGME program. Methods Geographic locations of the training sites were collected and characterized as Health Professional Shortage Area, Medically Underserved Area, Population, or rural areas, and were compared with the distribution of Centers for Medicare and Medicaid Services (CMS)-funded training positions. Results More than half of the teaching health centers (57%) are located in states that are in the 4 quintiles with the lowest CMS-funded resident-to-population ratio. Of the 109 training sites identified, more than 70% are located in federally designated high-need areas. Conclusions The THCGME program is a model that funds residency training in community-based ambulatory settings. Statute suggests, but does not explicitly require, that training take place in underserved settings. Because the majority of the 109 clinical training sites of the 60 funded programs in 2014-2015 are located in federally designated underserved locations, the THCGME program deserves further study as a model to improve primary care distribution into high-need communities.

Systemic lupus erythematosus and thyroid disease - Experience in a single medical center in Taiwan.

Science.gov (United States)

Liu, Yu-Chuan; Lin, Wen-Ya; Tsai, Ming-Chin; Fu, Lin-Shien

2017-06-28

To investigate the association of systemic lupus erythematosus (SLE) with thyroid diseases in a medical center in central Taiwan. This is a retrospective cohort of 2796 SLE patients in a tertiary referral medical center from 2000 to 2013. We screened SLE by catastrophic illness registration from national insurance bureau; and thyroid diseases by ICD 9 codes, then confirmed by thyroid function test, auto-antibody, medical and/or surgical intervention. We compared the rate of hyperthyroidism, hypothyroidism and autoimmune thyroid disease (AITD) in SLE patients and the 11,184 match controls. We calculated the rate of these thyroid diseases and positive antibodies to thyroglobulin (ATGAb), thyroid peroxidase (TPOAb) in SLE patients grouped by the presence of overlap syndrome and anti-dsDNA antibody. We also compared the association of thyroid diseases to severe SLE conditions, including renal, central nervous system (CNS) involvement, and thrombocytopenia. Compared to the matched controls, the cumulative incidence of thyroid disease, including hyperthyroidism, hypothyroidism and AITD, were all higher in SLE patients (p hyperthyroidism. SLE patients with thyroid diseases also carry higher risk for severe complications such as renal involvement (p = 0.024) central nervous system involvement (p hyperthyroidism, hypothyroidism, and AITD than the matched control. Among lupus patients, the risks of thyroid diseases are even higher in the presence of overlap syndrome. SLE patients with thyroid diseases had higher risk of renal and CNS involvement. Copyright © 2017. Published by Elsevier B.V.

Holistic Health Care for the Medically Uninsured: The Church Health Center of Memphis

OpenAIRE

Morris, G. Scott

2015-01-01

The Church Health Center (CHC) in Memphis was founded in 1987 to provide quality, affordable health care for working, uninsured people and their families. With numerous, dedicated financial supporters and health care volunteers, CHC has become the largest faith-based health care organization of its type nationally, serving >61,000 patients. CHC embraces a holistic approach to health by promoting wellness in every dimension of life. It offers on-site services including medical care, dentistry,...

78 FR 784 - Entergy Nuclear Operations, Inc.; Pilgrim Nuclear Power Station; Exemption

Science.gov (United States)

2013-01-04

... Decontamination August 7, 2012. Center. Quincy Medical Center Medical October 5, 2011. Service Drill. KIDS Site..., Division of Operating Reactor Licensing, Office of Nuclear Reactor Regulation. [FR Doc. 2012-31709 Filed 1...

An intelligent algorithm for identification of optimum mix of demographic features for trust in medical centers in Iran.

Science.gov (United States)

Yazdanparast, R; Zadeh, S Abdolhossein; Dadras, D; Azadeh, A

2018-06-01

Healthcare quality is affected by various factors including trust. Patients' trust to healthcare providers is one of the most important factors for treatment outcomes. The presented study identifies optimum mixture of patient demographic features with respect to trust in three large and busy medical centers in Tehran, Iran. The presented algorithm is composed of adaptive neuro-fuzzy inference system and statistical methods. It is used to deal with data and environmental uncertainty. The required data are collected from three large hospitals using standard questionnaires. The reliability and validity of the collected data is evaluated using Cronbach's Alpha, factor analysis and statistical tests. The results of this study indicate that middle age patients with low level of education and moderate illness severity and young patients with high level of education, moderate illness severity and moderate to weak financial status have the highest trust to the considered medical centers. To the best of our knowledge this the first study that investigates patient demographic features using adaptive neuro-fuzzy inference system in healthcare sector. Second, it is a practical approach for continuous improvement of trust features in medical centers. Third, it deals with the existing uncertainty through the unique neuro-fuzzy approach. Copyright © 2018 Elsevier B.V. All rights reserved.

Cell Division Synchronization

Science.gov (United States)

The report summarizes the progress in the design and construction of automatic equipment for synchronizing cell division in culture by periodic...Concurrent experiments in hypothermic synchronization of algal cell division are reported.

Using Technology to Enhance Teaching of Patient-Centered Interviewing for Early Medical Students.

Science.gov (United States)

Kaltman, Stacey; Talisman, Nicholas; Pennestri, Susan; Syverson, Eleri; Arthur, Paige; Vovides, Yianna

2018-06-01

Effective strategies for teaching communication skills to health professions students are needed. This article describes the design and evaluation of immersive and interactive video simulations for medical students to practice basic communication skills. Three simulations were developed, focusing on patient-centered interviewing techniques such as using open-ended questions, reflections, and empathic responses while assessing a patient's history of present illness. First-year medical students were randomized to simulation or education-as-usual arms. Students in the simulation arm were given access to three interactive video simulations developed using Articulate Storyline, an e-learning authoring tool, to practice and receive feedback on patient-centered interviewing techniques to prepare for their Observed Structured Clinical Examination (OSCE). Trained raters evaluated videos of two OSCE cases for each participant to assess specific communication skills used during the history of present illness component of the interview. Eighty-seven percent of the students in the simulation arm interacted with at least one simulation during the history of present illness. For both OSCE cases, students in the simulation arm asked significantly more open-ended questions. Students in the simulation arm asked significantly fewer closed-ended questions and offered significantly more empathic responses in one OSCE case. No differences were found for reflections. Students reported that the simulations helped improve their communication skills. The use of interactive video simulations was found to be feasible to incorporate into the curriculum and was appealing to students. In addition, students in the simulation arm displayed more behaviors consistent with the patient-centered interviewing model practiced in the simulations. Continued development and research are warranted.

Physics Division Argonne National Laboratory description of the programs and facilities.

Energy Technology Data Exchange (ETDEWEB)

Thayer, K.J. [ed.

1999-05-24

The ANL Physics Division traces its roots to nuclear physics research at the University of Chicago around the time of the second world war. Following the move from the University of Chicago out to the present Argonne site and the formation of Argonne National Laboratory: the Physics Division has had a tradition of research into fundamental aspects of nuclear and atomic physics. Initially, the emphasis was on areas such as neutron physics, mass spectrometry, and theoretical studies of the nuclear shell model. Maria Goeppert Maier was an employee in the Physics Division during the time she did her Nobel-Prize-winning work on the nuclear shell model. These interests diversified and at the present time the research addresses a wide range of current problems in nuclear and atomic physics. The major emphasis of the current experimental nuclear physics research is in heavy-ion physics, centered around the ATLAS facility (Argonne Tandem-Linac Accelerator System) with its new injector providing intense, energetic ion beams over the fill mass range up to uranium. ATLAS is a designated National User Facility and is based on superconducting radio-frequency technology developed in the Physics Division. A small program continues in accelerator development. In addition, the Division has a strong program in medium-energy nuclear physics carried out at a variety of major national and international facilities. The nuclear theory research in the Division spans a wide range of interests including nuclear dynamics with subnucleonic degrees of freedom, dynamics of many-nucleon systems, nuclear structure, and heavy-ion interactions. This research makes contact with experimental research programs in intermediate-energy and heavy-ion physics, both within the Division and on the national and international scale. The Physics Division traditionally has strong connections with the nation's universities. We have many visiting faculty members and we encourage students to participate in our

Argonne Physics Division Colloquium

Science.gov (United States)

[Argonne Logo] [DOE Logo] Physics Division Home News Division Information Contact PHY Org Chart Physics Division Colloquium Auditorium, Building 203, Argonne National Laboratory Fridays at 11:00 AM 2017 : Sereres Johnston 15 Sep 2017 Joint Physics and Materials Science Colloquium J. C. Séamus Davis, Cornell

Multipayer patient-centered medical home implementation guided by the chronic care model.

Science.gov (United States)

Gabbay, Robert A; Bailit, Michael H; Mauger, David T; Wagner, Edward H; Siminerio, Linda

2011-06-01

A unique statewide multipayer ini Pennsylvania was undertaken to implement the Patient-Centered Medical Home (PCMH) guided by the Chronic Care Model (CCM) with diabetes as an initial target disease. This project represents the first broad-scale CCM implementation with payment reform across a diverse range of practice organizations and one of the largest PCMH multipayer initiatives. Practices implemented the CCM and PCMH through regional Breakthrough Series learning collaboratives, supported by Improving Performance in Practice (IPIP) practice coaches, with required monthly quality reporting enhanced by multipayer infrastructure payments. Some 105 practices, representing 382 primary care providers, were engaged in the four regional collaboratives. The practices from the Southeast region of Pennsylvania focused on diabetes patients (n = 10,016). During the first intervention year (May 2008-May 2009), all practices achieved at least Level 1 National Committee for Quality Assurance (NCQA) Physician Practice Connections Patient-Centered Medical Home (PPC-PCMH) recognition. There was significant improvement in the percentage of patients who had evidence-based complications screening and who were on therapies to reduce morbidity and mortality (statins, angiotensin-converting enzyme inhibitors). In addition, there were small but statistically significant improvements in key clinical parameters for blood pressure and cholesterol levels, with the greatest absolute improvement in the highest-risk patients. Transforming primary care delivery through implementation of the PCMH and CCM supported by multipayer infrastructure payments holds significant promise to improve diabetes care.

[Work satisfaction, quality of life and leisure time of residents at the Soroka University Medical Center, Beer Sheba, Israel].

Science.gov (United States)

Acker, Asaf; Perry, Zvi; Reuveni, Haim; Toker, Asaf

2009-02-01

Work dissatisfaction among physicians worldwide continues to rise over the last few decades, mainly due to declining professional prestige, tack of self fulfillment, time pressure and tack of leisure time. Physicians' burnout is a major result of dissatisfaction, causing doctors to leave the medical profession, and to provide lower quality of care. To examine the work satisfaction, quality of life and leisure time of residents in the Soroka University Medical Center. A validated questionnaire was delivered during the second half of 2004 to 252 residents in the Soroka University Medical Center The data was analyzed using the SPSS 12 for windows program. Descriptive analysis, parametric Students' T Test [where pleisure time. Further attention must be given to these matters--a step which will eventually improve patient care, and delay, to some extent, the burnout of physicians.

Walt Disney visited Marshall Space Flight Center (MSFC)

Science.gov (United States)

1965-01-01

Walt Disney toured the West Test Area during his visit to the Marshall Space Flight Center on April 13, 1965. The three in center foreground are Karl Heimburg, Director, Test Division; Dr. von Braun, Director, MSFC; and Walt Disney. The Dynamic Test Stand with the S-1C stage being installed is in the background.

Relationships among communication competence, self-efficacy, and job satisfaction in Korean nurses working in the emergency medical center setting.

Science.gov (United States)

Park, Min Sook; Jeoung, Yeonok; Lee, Hye Kyung; Sok, Sohyune R

2015-06-01

The communication competence of nurses working in emergency medical center settings is essential to establish a therapeutic nurse-patient relationship. Education and strategic development are required to improve the communication competence of emergency room (ER) nurses. This study was conducted to determine the relationships among individual communication competence, self-efficacy, and job satisfaction in Korean nurses in the emergency medical center setting. A cross-sectional descriptive design was adopted. The study sample included 214 nurses at 11 emergency medical centers in Seoul and Kyunggi-Do, Korea. Measures used included the Global Interpersonal Communication Competence, self-efficacy scale, and job satisfaction scale. The collected data were analyzed using the SPSS version 18.0 statistical software program and included descriptive statistics (frequency, percentage, mean, standard deviation, independent t test, analysis of variance, and Pearson's correlation coefficient). The degrees of communication competence and self-efficacy of ER nurses were good, with higher scores than the median values. However, the degree of job satisfaction was poor, indicating a lower score than the median value. Religious affiliation and previous participation in communication education each had a significant impact on communication competence. Religious affiliation and time of worse duty each had a significant impact on self-efficacy. Length of career (year) in the emergency medical center and type of hospital each had a significant impact on job satisfaction. Positive correlations were identified among communication competence, self-efficacy, and job satisfaction. This study supported the presence of significant correlations among communication competence, self-efficacy, and job satisfaction. Thus, it is necessary to develop training programs that are customized to individual characteristics such as self-efficacy and job satisfaction to improve the communicative competence

Using Learner-Centered, Simulation-Based Training to Improve Medical Students’ Procedural Skills

Directory of Open Access Journals (Sweden)

Serkan Toy

2017-03-01

Full Text Available Purpose: To evaluate the effectiveness of a learner-centered, simulation-based training developed to help medical students improve their procedural skills in intubation, arterial line placement, lumbar puncture, and central line insertion. Method: The study participants were second and third year medical students. Anesthesiology residents provided the training and evaluated students’ procedural skills. Two residents were present at each station to train the medical students who rotated through all 4 stations. Pre/posttraining assessment of confidence, knowledge, and procedural skills was done using a survey, a multiple-choice test, and procedural checklists, respectively. Results: In total, 24 students were trained in six 4-hour sessions. Students reported feeling significantly more confident, after training, in performing all 4 procedures on a real patient ( P < .001. Paired-samples t tests indicated statistically significant improvement in knowledge scores for intubation, t (23 = −2.92, P < .001, and arterial line placement, t (23 = −2.75, P < .001. Procedural performance scores for intubation ( t (23 = −17.29, P < .001, arterial line placement ( t (23 = −19.75, P < .001, lumbar puncture ( t (23 = −16.27, P < .001, and central line placement ( t (23 = −17.25, P < .001 showed significant improvement. Intraclass correlation coefficients indicated high reliability in checklist scores for all procedures. Conclusions: The simulation sessions allowed each medical student to receive individual attention from 2 residents for each procedure. Students’ written comments indicated that this training modality was well received. Results showed that medical students improved their self-confidence, knowledge, and skills in the aforementioned procedures.

Implementation of Epic Beaker Clinical Pathology at an academic medical center

Directory of Open Access Journals (Sweden)

Matthew D Krasowski

2016-01-01

Full Text Available Background: Epic Beaker Clinical Pathology (CP is a relatively new laboratory information system (LIS operating within the Epic suite of software applications. To date, there have not been any publications describing implementation of Beaker CP. In this report, we describe our experience in implementing Beaker CP version 2012 at a state academic medical center with a go-live of August 2014 and a subsequent upgrade to Beaker version 2014 in May 2015. The implementation of Beaker CP was concurrent with implementations of Epic modules for revenue cycle, patient scheduling, and patient registration. Methods: Our analysis covers approximately 3 years of time (2 years preimplementation of Beaker CP and roughly 1 year after using data summarized from pre- and post-implementation meetings, debriefings, and the closure document for the project. Results: We summarize positive aspects of, and key factors leading to, a successful implementation of Beaker CP. The early inclusion of subject matter experts in the design and validation of Beaker workflows was very helpful. Since Beaker CP does not directly interface with laboratory instrumentation, the clinical laboratories spent extensive preimplementation effort establishing middleware interfaces. Immediate challenges postimplementation included bar code scanning and nursing adaptation to Beaker CP specimen collection. The most substantial changes in laboratory workflow occurred with microbiology orders. This posed a considerable challenge with microbiology orders from the operating rooms and required intensive interventions in the weeks following go-live. In postimplementation surveys, pathology staff, informatics staff, and end-users expressed satisfaction with the new LIS. Conclusions: Beaker CP can serve as an effective LIS for an academic medical center. Careful planning and preparation aid the transition to this LIS.

Characteristics of American Psychological Association Division 40 (clinical neuropsychology) Fellows.

Science.gov (United States)

Johnson-Greene, Doug; Collins, K C

2011-11-01

Fellow status is an honor bestowed on American Psychological Association (APA) members who have made unusual and outstanding contributions to the field of psychology that have had a national impact. Thus far no studies have examined the characteristics of the individuals who have received this honor. This study examined publicly available data for 157 Division 40 Fellows. Fellows comprise 3.7% of the 4273 members of the division compared to 5.7% of the entire APA membership. Fellows are predominantly male (73%). All but two fellows had earned a Ph.D. with the average time since granting of the doctoral degree of 17.1 ± 6 years (median=16 years) with a range of 7-40 years post-degree. Slightly over half of the fellows hold board certification (53%) in the American Board of Professional Psychology. The largest group of fellows reports their primary employment currently as a university-affiliated medical setting (48%). These data serve to characterize current Division 40 Fellows for the field of neuropsychology and may provide useful information to assist prospective fellow applicants.

Patient-centered medical homes improve care for adults with chronic conditions.

Science.gov (United States)

Pourat, Nadereh; Lavarreda, Shana Alex; Snyder, Sophie

2013-05-01

The success of health care reform implementation in 2014 partly depends on more efficient delivery of care to the millions of California residents eligible to gain insurance. Emerging evidence supports the effectiveness of the patient-centered medical home (PCMH) as a potential model of care delivery, which improves health outcomes and reduces costs. Among other principles, PCMH entails receipt of care from a personal doctor, who coordinates the patient's care and develops an individualized treatment plan for the patient. These principles are particularly essential in delivery of care to those with chronic conditions who require more intensive care management. Using the 2009 California Health Interview Survey (CHIS 2009), this policy brief indicates that patients who reported meeting these fundamental PCMH principles were more likely to have visited the doctor and to have received flu shots, and they also had better communication with providers than those who did not report meeting these PCMH principles. The data also showed that uninsured individuals, Medi-Cal beneficiaries, those at or below 133% of the federal poverty level, Latinos, and Asian-Americans were less likely to report meeting all three PCMH principles. These findings highlight the population groups that would most benefit from the PCMH care delivery model, particularly Medi-Cal beneficiaries and those eligible for Covered California, the California health benefits exchange.

Using an expanded outcomes framework and continuing education evidence to improve facilitation of patient-centered medical home recognition and transformation.

Science.gov (United States)

Van Hoof, Thomas J; Kelvey-Albert, Michele; Katz, Matthew; Lalime, Ken; Sacks, Ken; Meehan, Thomas P

2014-01-01

The patient-centered medical home is a model for delivering primary care in the United States. Primary care clinicians and their staffs require assistance in understanding the innovation and in applying it to practice. The purpose of this article is to describe and to critique a continuing education program that is relevant to, and will become more common in, primary care. A multifaceted educational strategy prepared 20 primary care private practices to achieve National Committee for Quality Assurance Level 3 recognition as Patient-Centered Medical Homes. Eighteen (90%) practices submitted an application to the National Committee for Quality Assurance. On the first submission attempt, 13 of 18 (72%) achieved Level 3 recognition and 5 (28%) achieved Level 1 recognition. An interactive multifaceted educational strategy can be successful in preparing primary care practices for Patient-Centered Medical Homes recognition, but the strategy may not ensure transformation. Future educational activities should consider an expanded outcomes framework and the evidence of effective continuing education to be more successful with recognition and transformation.

Plastic Surgery Complications from Medical Tourism Treated in a U.S. Academic Medical Center.

Science.gov (United States)

Ross, Kimberly M; Moscoso, Andrea V; Bayer, Lauren R; Rosselli-Risal, Liliana; Orgill, Dennis P

2018-04-01

Medical tourism is a growing, multi-billion dollar industry fueled by improvements in the global transportation infrastructure. The authors studied patients living in the United States who travel to other countries for plastic surgical procedures and returned to have their complications treated in the authors' center. A retrospective patient evaluation was performed. Patients who had presented to an urban tertiary academic hospital plastic surgery service with complications or complaints associated with plastic surgery performed in a developing country were studied. The authors collected demographic information, types of surgery performed, destinations, insurance coverage, and complications. Seventy-eight patients were identified over 7 years. Most commonly, complications were seen following abdominoplasty (n = 35), breast augmentation (n = 25), and foreign body injections (n = 15). Eighteen patients underwent multiple procedures in one operative setting. The most common destination country was the Dominican Republic (n = 59). Complications included surgical-site infections (n = 14), pain (n = 14), and wound healing complications (n = 12). Eighty-six percent of patients (n = 67) relied on their medical insurance to pay for their follow-up care or manage their complications, with the most common type of health insurance coverage being Massachusetts Medicaid (n = 48). Cosmetic surgery performed in developing countries can carry substantial risks of complications that can be challenging to patients, primary care providers, insurers, and plastic surgical teams not associated with the original surgery. These complications pose significant burdens on our public health systems.

Divisible ℤ-modules

Directory of Open Access Journals (Sweden)

Futa Yuichi

2016-03-01

Full Text Available In this article, we formalize the definition of divisible ℤ-module and its properties in the Mizar system [3]. We formally prove that any non-trivial divisible ℤ-modules are not finitely-generated.We introduce a divisible ℤ-module, equivalent to a vector space of a torsion-free ℤ-module with a coefficient ring ℚ. ℤ-modules are important for lattice problems, LLL (Lenstra, Lenstra and Lovász base reduction algorithm [15], cryptographic systems with lattices [16] and coding theory [8].

DEVELOPMENT OF SIMULATION CENTER AND TRAINING PROGRAMMES IN IVANO-FRANKIVSK PERINATAL CENTER

Directory of Open Access Journals (Sweden)

Zoryana Kocherga

2017-06-01

Full Text Available Current system of medical education in Ukraine needs improvement and reforms in order to enhance the proficiency of doctors and paramedics. Training of practical/technical skills, communication, as well as teamwork skills is considerably important.The use of simulation techniques and methods in medical education is called simulation training in medicine. Medical skills are acquired through cognitive (knowledge and psychomotor (practice skills. The first medical simulation centers appeared in Ukraine in 2006 according to the order of the Ministry of Health Care of Ukraine.On June 20, 2013, a new simulation training center was opened in Ivano-Frankivsk on the base of Regional Perinatal Center. Similar medical simulation centers were opened in the second half of 2013 in Volyn and Vinnytsia regions under the Ukrainian-Swiss Mother and Child Health Programme, which started in the area of perinatology. Their goal is to improve the teamwork of all specialists involved in the process of delivery and neonatal intensive care,as well as to engage internship doctors and senior medical students in clinical skills training programmes.The use of simulation techniques and training programs offers a powerful platform to study and practice clinical reasoning behaviors and patterns.

CAPITAL STRUCTURE ANALYSIS OF THE MEDICAL DIAGNOSTIC-CONSULTATIVE CENTERS IN VARNA (absolute indicators

Directory of Open Access Journals (Sweden)

Lyubomira Koeva-Dimitrova

2016-08-01

Full Text Available The capital structure analysis of medical institutions is related to the assessment of their financial sustainability. The degree of their financial sustainability indicates the extent to which the medical institution is exposed to financial risk. This financial risk is related to the use of foreign capital (debts, loans, etc. and it is defined as the probability of insolvency and possible bankruptcy due to the existence of debts which could not be repaid at some point in the foreseeable future. Objective: To analyze the capital structure of the medical diagnostic-consultative centers in Varna city and on this basis to assess their long-term solvency and existence of financial risk. Materials and Methods: The materials for the study are the published annual financial statements (up to 05. 01. 2016 in the Commercial Register for the period from year 2008 to 2014 of all MDCCs (Medical Diagnostic Consultative centers, registered in Varna - 9 in total. In the study are applied logical-mathematical methods (comparison, grouping, detail, graphical method; financial and accounting analysis (balance sheet analysis; analysis of absolute ratios for financial sustainability. Results: Upon analysis of the capital structure of MDCC's are studied the main absolute indicators characterizing the conditions for financial sustainability and the existence of financial risk regarding the solvency. A table represents the overall assessment of the degree of financial sustainability of the companies according to the type and structure of the fulfilled criteria. It was ascertained that for year 2014, DCC 3, 4, 5 and 8 have met all the conditions and according to them these hospitals have very high financial sustainability. DCC 7 has an average financial sustainability, DCC 1 and 2 are in a financial crisis and DCC 6 and 9 are facing bankruptcy. It must be emphasized that nearly half of the studied health care organizations (DCC 1, 2, 6 and 9 need urgent intervention by

DEVELOPMENT OF CLINICAL SCENARIO’S INFORMATION MODEL IN THE MEDICAL SIMULATION CENTER

Directory of Open Access Journals (Sweden)

I. V. Tolmachyov

2014-01-01

Full Text Available There is the big issue in medical education which is students don’t have enough skills. Often even with theoretical knowledge graduate medical students need to improve their skills by working with patients. Obviously it can be a risk for patients and takes quite long time. This situation could be changed with applying simulation technologies in medical education. Medical education with virtual simulators allows reducing the time of skills development and improving the quality of training. The aims of this work are developing informational model and creating clinical scenarios of emergency states in the Medical Simulation Center.Objectives:– to analyze the process of scenario conducting;– to create clinical scenarios of emergency states (anaphylactic shock, hypovolemic shock, obstructive shock with specialist’s help.The scenarios consist of sections such as main aim, skills, required mannequins, preparation of the mannequins, preparation of medical equipment and instruments for the scenario, preparation of special materials, scenario description, guide for operator, information for trainees.By analyzing the process of scenario conducting the key participants were defined who are operator, assistant, trainer, trainees. Also the main scenario stages were defined. Based on the stages diagram of variants of scenario conducting was designed.As an example there are fragments of scenario “Obstructive shock – a pulmonary embolism” in this article. Learn skills are cognitive, technical, social ones.Results. This paper presents an analysis of the clinical scenario conducting. Information model was developed which based on object-oriented decomposition. The model is the diagram of variants of scenario conducting. Scenario’s structure for emergency states was formulated. The scenarios are anaphylactic shock, hypovolemic shock, obstructive shock (pulmonary embolism, tension pneumothorax, pulmonary edema, hypertensive crisis, respiratory

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.

75 FR 6401 - Medical Devices Regulated by the Center for Biologics Evaluation and Research; Availability of...

Science.gov (United States)

2010-02-09

... Biologics Evaluation and Research (HFM-17), Food and Drug Administration, suite 200N, 1401 Rockville Pike... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2009-M-0513] Medical Devices Regulated by the Center for Biologics Evaluation and Research; Availability of Summaries...

Usual Primary Care Provider Characteristics of a Patient-Centered Medical Home and Mental Health Service Use.

Science.gov (United States)

Jones, Audrey L; Cochran, Susan D; Leibowitz, Arleen; Wells, Kenneth B; Kominski, Gerald; Mays, Vickie M

2015-12-01

The benefits of the patient-centered medical home (PCMH) over and above that of a usual source of medical care have yet to be determined, particularly for adults with mental health disorders. To examine qualities of a usual provider that align with PCMH goals of access, comprehensiveness, and patient-centered care, and to determine whether PCMH qualities in a usual provider are associated with the use of mental health services (MHS). Using national data from the Medical Expenditure Panel Survey, we conducted a lagged cross-sectional study of MHS use subsequent to participant reports of psychological distress and usual provider and practice characteristics. A total of 2,358 adults, aged 18-64 years, met the criteria for serious psychological distress and reported on their usual provider and practice characteristics. We defined "usual provider" as a primary care provider/practice, and "PCMH provider" as a usual provider that delivered accessible, comprehensive, patient-centered care as determined by patient self-reporting. The dependent variable, MHS, included self-reported mental health visits to a primary care provider or mental health specialist, counseling, and psychiatric medication treatment over a period of 1 year. Participants with a usual provider were significantly more likely than those with no usual provider to have experienced a primary care mental health visit (marginal effect [ME] = 8.5, 95 % CI = 3.2-13.8) and to have received psychiatric medication (ME = 15.5, 95 % CI = 9.4-21.5). Participants with a PCMH were additionally more likely than those with no usual provider to visit a mental health specialist (ME = 7.6, 95 % CI = 0.7-14.4) and receive mental health counseling (ME = 8.5, 95 % CI = 1.5-15.6). Among those who reported having had any type of mental health visit, participants with a PCMH were more likely to have received mental health counseling than those with only a usual provider (ME = 10.0, 95 % CI�

Discharge against medical advice in a pediatric emergency center in the State of Qatar

Directory of Open Access Journals (Sweden)

Hala Abdulateef

2012-05-01

Full Text Available Objective: The objective of this study was to analyze cases that had left the Pediatric Emergency Center Al Sadd, Doha (PEC against medical advice, with the aim of developing policies to help reduce this occurrence. Methodology: All patients that were admitted to the main PEC observation room for treatment and/or investigation and subsequently left against medical advice from February 18, 2007 to June 18, 2007, were followed by a phone call, and a questionnaire, which was completed by the departmental patient representative. Results: 99,133 patients attended the facility during the study period. Of those, 106 left the facility against medical advice. Ninety-four guardians were successfully contacted. 90% of the cases were in children below 2 years of age. In 87% of the cases the mother was the main decision maker for leaving against medical advice. Domestic obligations were the leading cause of DAMA (discharge against medical advice, reported in 45% of the cases. Respondents reported that the consequences of DAMA were well explained by medical staff before they left the facility however, they had not met with the departmental patient representative during their stay. Conclusion:As the majority of DAMA cases occurred in infants, medical staff should address the concerns of this group early on in the course of treatment. Maintaining communication and providing support, in particular for mothers of higher risk groups may help to reduce the rate of DAMA cases.

Gatekeepers as Care Providers: The Care Work of Patient-centered Medical Home Clerical Staff.

Science.gov (United States)

Solimeo, Samantha L; Ono, Sarah S; Stewart, Kenda R; Lampman, Michelle A; Rosenthal, Gary E; Stewart, Greg L

2017-03-01

International implementation of the patient-centered medical home (PCMH) model for delivering primary care has dramatically increased in the last decade. A majority of research on PCMH's impact has emphasized the care provided by clinically trained staff. In this article, we report our ethnographic analysis of data collected from Department of Veterans Affairs staff implementing PACT, the VA version of PCMH. Teams were trained to use within-team delegation, largely accomplished through attention to clinical licensure, to differentiate staff in providing efficient, patient-centered care. In doing so, PACT may reinforce a clinically defined culture of care that countermands PCMH ideals. Such competing rubrics for care are brought into relief through a focus on the care work performed by clerks. Ethnographic analysis identifies clerks' care as a kind of emotional dirty work, signaling important areas for future anthropological study of the relationships among patient-centered care, stigma, and clinical authority. © 2016 by the American Anthropological Association.

Statement of the American Psychological Association in response to the "joint principles: integrating behavioral health care into the patient-centered medical home".

Science.gov (United States)

Anderson, Norman B; Belar, Cynthia D; Cubic, Barbara A; Garrison, Ellen G; Johnson, Suzanne Bennett; Kaslow, Nadine J

2014-06-01

Comments on the article "Joint principles: Integrating behavioral health care into the patient-centered medical home" (see record 2014-24217-011), presented by the Working Party Group on Integrated Behavioral Healthcare. The American Psychological Association (APA) shares concerns about the lack of reference to behavioral health care in the original 2007 Joint Principles of the Patient-Centered Medical Home for which this new document is intended to supplement but not replace. The decision to support the supplemental Joint Principles was not an easy one for APA, as there is one area of significant concern. That concern is related to the use of the term "physician-directed medical practice"

Radiological and Environmental Research Division annual report, July 1979-June 1980. [Lead abstract

Energy Technology Data Exchange (ETDEWEB)

Rowland, R.E.; Stehney, A.F.

1981-05-01

Separate abstracts were prepared for 19 of the 33 papers presented by the Center for Human Radiobiology for the Radiological and Environmental Research Division Annual Report. The 14 items not included are abstracts only and deal with the mechanisms and dosimetry for induction of malignancies by radium. (KRM)

76 FR 59166 - Navistar Truck Development and Technology Center, a Subsidiary of Navistar International...

Science.gov (United States)

2011-09-23

... Development and Technology Center, a Subsidiary of Navistar International Corporation Truck Division, Fort... International Corporation, Truck Division, Fort Wayne, Indiana (subject firm). The negative determination was... is a headcount reduction across the nation, made possible by the Global Outsourcing. * * * '' The...

Using a Lego-based communications simulation to introduce medical students to patient-centered interviewing.

Science.gov (United States)

Harding, S R; D'Eon, M F

2001-01-01

Teaching patient-centered interviewing skills to medical students can be challenging. We have observed that 1st-year medical students, in particular, do not feel free to concentrate on the interviewing skills because they are preoccupied with complicated technical medical knowledge. The Lego simulation we use with our 1st-year students as part of a professional-skills course overcomes that difficulty. The Lego activity is a role play analogous to a doctor-patient interview that uses identical sets of Legos for the "doctor" and for the "patients" and a small construction that represents a patient history. With a simple questionnaire, data were collected from students at different points during instruction. Results indicate that the Lego activity was very effective in helping students learn the importance of open-ended questioning. It also was rated as highly as the very dynamic interactive part of the instructional session. The effectiveness of the Lego activity may be due to the properties of analogies.

Set up and operation for medical radiation exposure quality control system of health promotion center

Energy Technology Data Exchange (ETDEWEB)

Kim, Jung Su; Kim, Jung Min [Korea University,Seoul (Korea, Republic of); Jung, Hae Kyoung [Dept. of Diagnostic Radiology, CHA Bundang Medical Center, CHA University, Sungnam (Korea, Republic of)

2016-03-15

In this study, standard model of medical radiation dosage quality control system will be suggested and the useful of this system in clinical field will be reviewed. Radiation dosage information of modalities are gathered from digital imaging and communications in medicine(DICOM) standard data(such as DICOM dose SR and DICOM header) and stored in database. One CT scan, two digital radiography modalities and two mammography modalities in one health promotion center in Seoul are used to derive clinical data for one month. After 1 months research with 703 CT scans, the study shows CT 357.9 mGy·cm in abdomen and pelvic CT, 572.4 mGy·cm in brain without CT, 55.9 mGy·cm in calcium score/heart CT, screening CT at 54 mGy·cm in chest screening CT(low dose screening CT scan), 284.99 mGy·cm in C-spine CT and 341.85 mGy·cm in L-spine CT as health promotion center reference level of each exam. And with 1955 digital radiography cases, it shows 274.0 mGy·cm{sup 2} and for mammography 6.09 mGy is shown based on 536 cases. The use of medical radiation shall comply with the principles of justification and optimization. This quality management of medical radiation exposure must be performed in order to follow the principle. And the procedure to reduce the radiation exposure of patients and staff can be achieved through this. The results of this study can be applied as a useful tool to perform the quality control of medical radiation exposure.

Set up and operation for medical radiation exposure quality control system of health promotion center

International Nuclear Information System (INIS)

Kim, Jung Su; Kim, Jung Min; Jung, Hae Kyoung

2016-01-01

In this study, standard model of medical radiation dosage quality control system will be suggested and the useful of this system in clinical field will be reviewed. Radiation dosage information of modalities are gathered from digital imaging and communications in medicine(DICOM) standard data(such as DICOM dose SR and DICOM header) and stored in database. One CT scan, two digital radiography modalities and two mammography modalities in one health promotion center in Seoul are used to derive clinical data for one month. After 1 months research with 703 CT scans, the study shows CT 357.9 mGy·cm in abdomen and pelvic CT, 572.4 mGy·cm in brain without CT, 55.9 mGy·cm in calcium score/heart CT, screening CT at 54 mGy·cm in chest screening CT(low dose screening CT scan), 284.99 mGy·cm in C-spine CT and 341.85 mGy·cm in L-spine CT as health promotion center reference level of each exam. And with 1955 digital radiography cases, it shows 274.0 mGy·cm"2 and for mammography 6.09 mGy is shown based on 536 cases. The use of medical radiation shall comply with the principles of justification and optimization. This quality management of medical radiation exposure must be performed in order to follow the principle. And the procedure to reduce the radiation exposure of patients and staff can be achieved through this. The results of this study can be applied as a useful tool to perform the quality control of medical radiation exposure

Physics, Computer Science and Mathematics Division. Annual report, 1 January--31 December 1977. [LBL, 1977

Energy Technology Data Exchange (ETDEWEB)

Lepore, J.V. (ed.)

1977-01-01

This annual report of the Physics, Computer Science and Mathematics Division describes the scientific research and other work carried out within the Division during 1977. The Division is concerned with work in experimental and theoretical physics, with computer science and applied mathematics, and with the operation of a computer center. The major physics research activity is in high-energy physics, although there is a relatively small program of medium-energy research. The High Energy Physics research program in the Physics Division is concerned with fundamental research which will enable man to comprehend the nature of the physical world. The major effort is now directed toward experiments with positron-electron colliding beam at PEP. The Medium Energy Physics program is concerned with research using mesons and nucleons to probe the properties of matter. This research is concerned with the study of nuclear structure, nuclear reactions, and the interactions between nuclei and electromagnetic radiation and mesons. The Computer Science and Applied Mathematics Department engages in research in a variety of computer science and mathematics disciplines. Work in computer science and applied mathematics includes construction of data bases, computer graphics, computational physics and data analysis, mathematical modeling, and mathematical analysis of differential and integral equations resulting from physical problems. The Computer Center provides large-scale computational support to LBL's scientific programs. Descriptions of the various activities are quite short; references to published results are given. 24 figures. (RWR)

Medical and Rehabilitation Centers in Children’s Houses — New Opportunities for Treatment and Rehabilitation of Children

Directory of Open Access Journals (Sweden)

I.V. Balychevtseva

2014-05-01

Full Text Available The article presents data on the opening of medical and rehabilitations centers at the children’s houses of Donetsk region. Approaches, terms, possibilities and methods of rehabilitations used during the treatment and restoration of disabled children are provided.

Medical devices and the Middle East: market, regulation, and reimbursement in Gulf Cooperation Council states

Directory of Open Access Journals (Sweden)

Howard JJ

2014-11-01

Full Text Available Jason J Howard Division of Paediatric Orthopaedics, Department of Surgery, Sidra Medical and Research Center, Doha, Qatar Abstract: With some of the richest economies in the world, the Gulf Cooperation Council (GCC is undergoing rapid growth not only in its population but also in health care expenditure. Despite the GCC's abundance of hydrocarbon-based wealth, the drivers of the medical device industry in the GCC are still in flux, with gains yet to be made in areas of infrastructure, regulation, and reimbursement. However, the regional disease burden, expanding health insurance penetration, increasing privatization, and a desire to attract skilled expatriate health care providers have led to favorable conditions for the medical device market in the GCC. The purpose of this article is to investigate the current state of the GCC medical device industry, with respect to market, regulation, and reimbursement, paying special attention to the three largest medical device markets: Saudi Arabia, the United Arab Emirates, and Qatar. The GCC would seem to represent fertile ground for the development of medical technologies, especially those in line with the regional health priorities of the respective member states. Keywords: medical devices, regulation, reimbursement, Middle East 

Excessive daytime sleepiness and adherence to antihypertensive medications among Blacks: analysis of the counseling African Americans to control hypertension (CAATCH trial

Directory of Open Access Journals (Sweden)

Williams NJ

2014-03-01

Full Text Available Natasha J Williams,1 Girardin Jean-Louis,1 Abhishek Pandey,2 Joseph Ravenell,1 Carla Boutin-Foster,3 Gbenga Ogedegbe1 1Center for Healthful Behavior Change, Division of Internal Medicine, NYU Medical Center, New York, 2Department of Family Medicine, SUNY Downstate Medical Center, Brooklyn, 3Center of Excellence in Disparities Research, Weill Cornell Medical College, New York, NY, USA Background: Excessive daytime sleepiness (EDS often occurs as a result of insufficient sleep, sleep apnea, illicit substance use, and other medical and psychiatric conditions. This study tested the hypothesis that blacks exhibiting EDS would have poorer self-reported adherence to hypertensive medication using cross-sectional data from the Counseling African-Americans to Control Hypertension (CAATCH trial. Methods: A total of 1,058 hypertensive blacks (average age 57±12 years participated in CAATCH, a randomized controlled trial evaluating the effectiveness of a multilevel intervention for participants who receive care from community health centers in New York City. Data analyzed in this study included baseline sociodemographics, medical history, EDS, and medication adherence. We used the Epworth Sleepiness Scale, with a cutoff score of ≥10, to define EDS. Medication adherence was measured using an abbreviated Morisky Medication Adherence scale, with a score >0 indicating nonadherence. Results: Of the sample, 71% were female, 72% received at least a high school education, 51% reported a history of smoking, and 33% had a history of alcohol consumption. Overall, 27% of the participants exhibited EDS, and 44% of those who exhibited EDS were classified as adherent to prescribed antihypertensive medications. Multivariable logistic regression analysis, adjusting for effects of age, body mass index, sex, education, and smoking and drinking history indicated that participants who exhibited EDS were more than twice as likely to be nonadherent (odds ratio 2.28, 95

Emergency Telemedicine: Achieving and Maintaining Compliance with the Emergency Medical Treatment and Labor Act.

Science.gov (United States)

Rockwell, Kimberly Lovett; Gilroy, Alexis

2018-03-12

Telemedicine is a growing and important platform for medical delivery in the emergency department. Emergency telemedicine outlays often confront and conflict with important federal healthcare regulations. Because of this, academic medical centers, critical access hospitals, and other providers interested in implementing emergency telemedicine have often delayed or forgone such services due to reasonable fears of falling out of compliance with regulatory restrictions imposed by the Emergency Medical Treatment and Labor Act ("EMTALA"). This article offers insights into methods for implementing emergency telemedicine services while maintaining EMTALA compliance. Critical analysis of EMTALA and its attendant regulations. The primary means of ensuring EMTALA compliance while implementing emergency telemedicine programs include incorporating critical clinical details into the services contracts and implementing robust written policies that anticipate division of labor issues, the need for backup coverage, triaging, patient transfer protocols, and credentialing issues. With adequate up-front due diligence and meaningful contracting, hospitals and telemedicine providers can avoid common EMTALA liability pitfalls.

Experimental Facilities Division/User Program Division technical progress report 1999-2000

International Nuclear Information System (INIS)

2001-01-01

In October 1999, the two divisions of the Advanced Photon Source (APS), the Accelerator Systems Division (ASD) and the Experimental Facilities Division (XFD), were reorganized into four divisions (see high-level APS organizational chart, Fig. 1.1). In addition to ASD and XFD, two new divisions were created, the APS Operations Division (AOD), to oversee APS operations, and the User Program Division (UPD), to serve the APS user community by developing and maintaining the highest quality user technical and administration support. Previous XFD Progress Reports (ANL/APS/TB-30 and ANL/APS/TB-34) covered a much broader base, including APS user administrative support and what was previously XFD operations (front ends, interlocks, etc.) This Progress Report summarizes the main scientific and technical activities of XFD, and the technical support, research and development (R and D) activities of UPD from October 1998 through November 2000. The report is divided into four major sections, (1) Introduction, (2) SRI-CAT Beamlines, Technical Developments, and Scientific Applications, (3) User Technical Support, and (4) Major Plans for the Future. Sections 2 and 3 describe the technical activities and research accomplishments of the XFD and UPD personnel in supporting the synchrotron radiation instrumentation (SRI) collaborative access team (CAT) and the general APS user community. Also included in this report is a comprehensive list of publications (Appendix 1) and presentations (Appendix 2) by XFD and UPD staff during the time period covered by this report. The organization of section 2, SRI CAT Beamlines, Technical Developments, and Scientific Applications has been made along scientific techniques/disciplines and not ''geographical'' boundaries of the sectors in which the work was performed. Therefore items under the subsection X-ray Imaging and Microfocusing could have been (and were) performed on several different beamlines by staff in different divisions. The management of

OPERATION OF THE CALL CENTER AT A HIGH-TECHNOLOGY PEDIATRIC MEDICAL INSTITUTION (WITH COMMENTARY BY A.A. MODESTOV

Directory of Open Access Journals (Sweden)

I. N. Chernomurov

2014-01-01

Full Text Available Introduction of modern information systems is one of the important objectives of medicine, as it contributes to higher availability of medical services for the population. Public relations of medical organizations involve websites of these organizations, outdoor advertising and other information sources. However, obtainment of competent inquiry answers by telephone remains a problem. People often choose between organizations depending on quality of the obtained information. Apparently, the issue can be resolved by establishing call centers that are not merely communications centers, but are staffed with competent trained personnel, who support the organization’s interaction with patients (or the legal representatives thereof. The article presents the authors’ experience of establishing a call center dedicated to the organization’s public image development, as well as higher demand of the available services and promotion thereof. The fulfilled modernization resulted in a sharp increase in the amount of calls received (1,500‑1,600 within the working hours; 900 – before modernization and reduction in the number of complaints of busy line. 

Nuclear Science Division 1994 annual report

International Nuclear Information System (INIS)

Myers, W.D.

1995-06-01

This report describes the activities of the Nuclear Science Division for the period of January 1, 1994, to December 31, 1994. This was a time of significant accomplishment for all of the programs in the Division. Assembly of the solar neutrino detector at the Sudbury Neutrino Observatory is well under way. All of the components fabricated by LBL were shipped to Sudbury early in the year and our efforts are now divided between assisting the assembly of the detector and preparing software for data analysis once the detector is operational in 1996. Much of the activity at the 88-Inch Cyclotron centered on Gammasphere. The open-quotes early implementationclose quotes phase of the detector ended in September. This phase was extremely successful, involving over 60 experiments with nearly 200 users from 37 institutions worldwide. The mechanical structure was installed and the final electronic system is expected to operate in March 1995. The Division concurrently hosted a conference on physics for large γ-ray detector arrays at the Clark Kerr Campus at UC Berkeley in August. This was a very successful meeting, reflecting the enthusiasm for this field worldwide. Also at the Cyclotron, the progress toward weak interaction experiments using ultra-thin sources passed a major milestone with the trapping of radioactive 21 Na atoms. We are now engaged in a major upgrade of the experimental area and the outlook is very promising for these novel experiments. Another highlight of research at the Cyclotron was the confirmation of element 106. This development allowed the original LLNL/LBL discovery team to move forward with their proposal to name this element seaborgium

Nuclear Science Division 1994 annual report

Energy Technology Data Exchange (ETDEWEB)

Myers, W.D. [ed.

1995-06-01

This report describes the activities of the Nuclear Science Division for the period of January 1, 1994, to December 31, 1994. This was a time of significant accomplishment for all of the programs in the Division. Assembly of the solar neutrino detector at the Sudbury Neutrino Observatory is well under way. All of the components fabricated by LBL were shipped to Sudbury early in the year and our efforts are now divided between assisting the assembly of the detector and preparing software for data analysis once the detector is operational in 1996. Much of the activity at the 88-Inch Cyclotron centered on Gammasphere. The {open_quotes}early implementation{close_quotes} phase of the detector ended in September. This phase was extremely successful, involving over 60 experiments with nearly 200 users from 37 institutions worldwide. The mechanical structure was installed and the final electronic system is expected to operate in March 1995. The Division concurrently hosted a conference on physics for large {gamma}-ray detector arrays at the Clark Kerr Campus at UC Berkeley in August. This was a very successful meeting, reflecting the enthusiasm for this field worldwide. Also at the Cyclotron, the progress toward weak interaction experiments using ultra-thin sources passed a major milestone with the trapping of radioactive {sup 21}Na atoms. We are now engaged in a major upgrade of the experimental area and the outlook is very promising for these novel experiments. Another highlight of research at the Cyclotron was the confirmation of element 106. This development allowed the original LLNL/LBL discovery team to move forward with their proposal to name this element seaborgium.

Chromosome replication, cell growth, division and shape: a personal perspective

Directory of Open Access Journals (Sweden)

Arieh eZaritsky

2015-08-01

Full Text Available The origins of Molecular Biology and Bacterial Physiology are reviewed, from our personal standpoints, emphasizing the coupling between bacterial growth, chromosome replication and cell division, dimensions and shape. Current knowledge is discussed with historical perspective, summarizing past and present achievements and enlightening ideas for future studies. An interactive simulation program of the Bacterial Cell Division Cycle (BCD, described as The Central Dogma in Bacteriology, is briefly represented. The coupled process of transcription/translation of genes encoding membrane proteins and insertion into the membrane (so-called transertion is invoked as the functional relationship between the only two unique macromolecules in the cell, DNA and peptidoglycan embodying the nucleoid and the sacculus respectively. We envision that nucleoid complexity, defined as the weighted-mean DNA content associated with the replication terminus, is directly related to cell shape through the transertion process. Accordingly, the primary signal for cell division transmitted by DNA dynamics (replication, transcription and segregation to the peptidoglycan biosynthetic machinery is of a physico-chemical nature, eg stress in the plasma membrane, relieving nucleoid occlusion in the cell's center hence enabling the divisome to assemble and function between segregated daughter nucleoids.

Division of atomic physics

International Nuclear Information System (INIS)

Kroell, S.

1994-01-01

The Division of Atomic Physics, Lund Institute of Technology (LTH), is responsible for the basic physics teaching in all subjects at LTH and for specialized teaching in Optics, Atomic Physics, Atomic and Molecular Spectroscopy and Laser Physics. The Division has research activities in basic and applied optical spectroscopy, to a large extent based on lasers. It is also part of the Physics Department, Lund University, where it forms one of eight divisions. Since the beginning of 1980 the research activities of our division have been centred around the use of lasers. The activities during the period 1991-1992 is described in this progress reports

Humanities mini-course curricula for midcareer health professionals at the Penn State Milton S. Hershey Medical Center.

Science.gov (United States)

Myers, Kimberly R; George, Daniel R

2012-08-01

The field of medical humanities has traditionally focused on medical students and, more recently, on premedical undergraduates. Comparatively little formal humanities pedagogy has been dedicated to midcareer health professionals. To address this lack, the Department of Humanities at the Pennsylvania State University College of Medicine and the Milton S. Hershey Medical Center designed eight annual humanities mini-courses for faculty and staff throughout the college and medical center.These mini-courses fell into four categories: reading, reflection, and discussion; creative expression; technology; and ethics. They were geared toward midcareer health professionals who were seeking new intellectual and creative stimulation and variety in daily routine. They also provided humanities faculty the opportunity to devote attention to topics that capitalize on their professional training and that interest them personally.Participants indicated a high degree of satisfaction with the mini-courses for four principal reasons: (1) learning the tools and methodologies of a new discipline or domain other than biomedicine, (2) using their minds and training in uncustomary ways, (3) forming new alliances with colleagues (which served to lessen the sense of professional isolation), and (4) enjoying a respite from the stressful flow of the workday. Humanities faculty facilitators provided more mixed responses but agreed that conducting the mini-courses had been a positive overall experience.Although this article provides a foundational framework for the development of a humanities mini-course series, the authors encourage others to replicate these curricula in other medical settings as an important step toward a robust pedagogy designed for midcareer health care professionals.

The patient-centered medical home in oncology: from concept to reality.

Science.gov (United States)

Page, Ray D; Newcomer, Lee N; Sprandio, John D; McAneny, Barbara L

2015-01-01

In recent years, the cost of providing quality cancer care has been subject to an epic escalation causing concerns on the verge of a health care crisis. Innovative patient-management models in oncology based on patient-centered medical home (PCMH) principles, coupled with alternative payments to traditional fee for service (FFS), such as bundled and episodes payment are now showing evidence of effectiveness. These efforts have the potential to bend the cost curve while also improving quality of care and patient satisfaction. However, going forward with FFS alternatives, there are several performance-based payment options with an array of financial risks and rewards. Most novel payment options convey a greater financial risk and accountability on the provider. Therefore, the oncology medical home (OMH) can be a way to mitigate some financial risks by sharing savings with the payer through better global care of the patient, proactively preventing complications, emergency department (ED) visits, and hospitalizations. However, much of the medical home infrastructure that is required to reduced total costs of cancer care comes as an added expense to the provider. As best-of-practice quality standards are being elucidated and refined, we are now at a juncture where payers, providers, policymakers, and other stakeholders should work in concert to expand and implement the OMH framework into the variety of oncology practice environments to better equip them to assimilate into the new payment reform configurations of the future.

Utilization of a Marketing Strategy at Naval Regional Medical Center Great Lakes, Great Lakes, Illinois

Science.gov (United States)

1983-06-01

22 Analysis of the Mare.....................22 Development of the Marketing Mix .. .......... 29 A Marketing Mix --Recommendations...problem. Marketing strategy, marketing mix and ultimately the marketing orientation will allow hospitals to persevere and possibly thrive in a somewhat...market are currently being met at Naval Regional Medical Center Great Lakes. The fourth objective is to demonstrate an appropriate marketing mix for

Disruptive innovation in academic medical centers: balancing accountable and academic care.

Science.gov (United States)

Stein, Daniel; Chen, Christopher; Ackerly, D Clay

2015-05-01

Numerous academic medicine leaders have argued that academic referral centers must prepare for the growing importance of accountability-driven payment models by adopting population health initiatives. Although this shift has merit, execution of this strategy will prove significantly more problematic than most observers have appreciated. The authors describe how successful implementation of an accountable care health strategy within a referral academic medical center (AMC) requires navigating a critical tension: The academic referral business model, driven by tertiary-level care, is fundamentally in conflict with population health. Referral AMCs that create successful value-driven population health systems within their organizations will in effect disrupt their own existing tertiary care businesses. The theory of disruptive innovation suggests that balancing the push and pull of academic and accountable care within a single organization is achievable. However, it will require significant shifts in resource allocation and changes in management structure to enable AMCs to make the inherent difficult choices and trade-offs that will ensue. On the basis of the theories of disruptive innovation, the authors present recommendations for how academic health systems can successfully navigate these issues as they transition toward accountability-driven care.

Progress report Health Sciences Division - 1984 July 01 to December 31

International Nuclear Information System (INIS)

1985-02-01

This progress report contains a topical summary of major research in the Health Sciences Division. Separate reports are included for each of the following branches: Health Physics, Environmental Research, Radiation Biology, Biomedical Research and Medical. Some of the main areas of interest discussed are health and safety aspects of tritium. This includes instrumentation, environmental studies, metabolism, dosimetry and health effects

Mandibular Fracture Patterns at a Medical Center in Central Taiwan: A 3-Year Epidemiological Review.

Science.gov (United States)

Lin, Fu-Yu; Wu, Chao-I; Cheng, Hsu-Tang

2017-12-01

Mandibular fractures constitute a major portion of maxillofacial trauma and may lead to considerable functional and aesthetic sequelae if treatment is inadequate or delayed. An epidemiology study on mandibular fractures may guide the preventive efforts of the Taiwan public health care system. Therefore, a retrospective review was conducted at a medical center in central Taiwan to evaluate the current mandibular fracture epidemiology.The medical records and digitized radiographs of 198 patients who received treatment for mandibular fractures during a 3-year period (from October 2010 to September 2013) at a medical center in central Taiwan were reviewed to obtain demographic and injury data.The average age was 29.4 years (3-82 years). Patients aged 21 to 30 years sustained the most mandibular fractures (62 patients, 31.3%). The overall sex distribution (male to female) ratio was 1.8. Motor-vehicle accidents (MVAs) were the most common mechanism of injury (162 patients, 82%), and scooter and motorcycle riders wearing partial-coverage helmets constituted the majority of patients. A chart review identified 198 patients with 335 mandibular fractures; 113 patients (57.1%) had multiple mandibular fractures. The most common fracture sites were the symphysis and parasymphysis regions (38.9%), followed by the condyle (26.0%), angle (14.3%), body (14.3%), and ramus (6.6%).MVAs are the major cause of mandibular fractures in central Taiwan, and patients aged Taiwan. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

77 FR 22519 - The Family and Medical Leave Act

Science.gov (United States)

2012-04-16

... Family and Medical Leave Act AGENCY: Wage and Hour Division, Department of Labor. ACTION: Extension of... on the proposed revisions to certain regulations of the Family and Medical Leave Act of 1993 (FMLA... Family and Medical Act (FMLA) regulations to implement amendments to the military leave provisions of the...

Progress report - Health Sciences Division - 1985 July 01 -December 31

International Nuclear Information System (INIS)

1986-02-01

This progress report contains a topical summary of major research in the Health Sciences Division. Separate reports are included for each of the following branches: Dosimetric Research, Environmental Research, Radiation Biology, and Medical. Some of the aspects discussed include measurement and application of environmental isotopes, dosimetry and employee monitoring, environmental processes of radioisotope transport, the effects of ionizing radiation on living cells (cancer, hyperthermia, DNA, etc.), and statistics of hospital procedures

Technical activities, 1990: Surface Science Division

International Nuclear Information System (INIS)

Powell, C.J.

1991-05-01

The report summarizes technical activities and accomplishments of the NIST Surface Science Division during Fiscal Year 1990. Overviews are presented of the Division and of its three constituent groups: Surface Dynamical Processes, Thin Films and Interfaces, and Surface Spectroscopies and Standards. These overviews are followed by reports of selected technical accomplishments during the year. A summary is given of Division outputs and interactions that includes lists of publications, talks, committee assignments, seminars (including both Division seminars and Interface Science seminars arranged through the Division), conferences organized, and a standard reference material certified. Finally, lists are given of Division staff and of guest scientists who have worked in the Division during the past year

Effects of internal marketing on nurse job satisfaction and organizational commitment: example of medical centers in Southern Taiwan.

Science.gov (United States)

Chang, Ching-Sheng; Chang, Hsin-Hsin

2007-12-01

As nurses typically represent the largest percentage of employees at medical centers, their role in medical care is exceptionally important and becoming more so over time. The quality and functions of nurses impact greatly on medical care quality. The concept of internal marketing, with origins in the field of market research, argues that enterprises should value and respect their employees by treating them as internal customers. Such a marketing concept challenges traditional marketing methods, which focus on serving external customers only. The main objective of internal marketing is to help internal customers (employees) gain greater job satisfaction, which should promote job performance and facilitate the organization accomplishing its ultimate business objectives. A question in the medical service industry is whether internal marketing can similarly increase the job satisfaction of nurses and enhance their commitment to the organization. This study aimed to explore the relational model of nurse perceptions related to internal marketing, job satisfaction, and organizational commitment by choosing nurses from two medical centers in Southern Taiwan as research subjects. Of 450 questionnaire distributed, 300 valid questionnaires were returned, giving a response rate of 66.7%. After conducting statistical analysis and estimation using structural equation modeling, findings included: (1) job satisfaction has positive effects on organizational commitment; (2) nurse perceptions of internal marketing have positive effects on job satisfaction; and (3) nurse perceptions of internal marketing have positive effects on organizational commitment.

A model for training medical student innovators: the Harvard Medical School Center for Primary Care Abundance Agents of Change program.

Science.gov (United States)

Duong, David B; Sullivan, Erin E; Minter-Jordan, Myechia; Giesen, Lindsay; Ellner, Andrew L

2016-01-01

In 2013, the Harvard Medical School Center for Primary Care established the Abundance Agents of Change (AoC) program to promote interprofessional learning and innovation, increase partnership between 15 academic and community health centers (CHCs) in Boston's most under-served communities, and increase medical student interest in primary care careers. The AoC is modeled in the form of a 'grants challenge', offering $20,000 to interprofessional student teams to develop an innovative solution that addresses a healthcare delivery need identified by CHCs. The program's initial two years were characterized by a four-stage process which included working with CHCs and crafting a request for proposals, forming interprofessional 20 student teams comprising students from across and outside of Harvard University, training students using a systems-based innovation curriculum, and performing program evaluation. Our evaluation data from cohorts 1 and 2 of the AoC program demonstrate that we succeeded in training students as innovators and members of interprofessional teams. We also learned valuable lessons regarding creating better alignment with CHC priorities, extending the program cycle from 12 to 18 months, and changing the way funding is disbursed to 25 students, which will be incorporated in later versions of the program. Based on our experience and evaluation data, we believe that this program is a replicable way to train students as innovators and members of interprofessional teams to address the current complex healthcare environment.

Improving access to care through the patient-centered medical home.

Science.gov (United States)

North, Stephen W; McElligot, James; Douglas, Gaye; Martin, Amanda

2014-02-01

School-based health centers (SBHCs) serve an essential role in providing access to high-quality, comprehensive care to underserved children and adolescents in more than 2,000 schools across the United States. SBHCs are an essential component of the health care safety net, and their role in the patient-centered medical home (PCMH) continues to evolve as both collaborating partners and, when fully functioning, independent PCMHs. The American Academy of Pediatrics (AAP) supports the use of SBHCs, citing the proven benefits and exciting potential as justification, but also offers caution and recommends a focus on communication within the community. Traditional "brick and mortar" SBHCs are more likely to be located in urban communities (54.2% urban versus 18.0% rural) and be in schools with more students, allowing for a greater return on investment. Current SBHCs are located in schools with an average population of 997 students. The need for a large school population to help an SBHC approach financial viability excludes children in rural communities who are more likely to attend a school with fewer than 500 students, be poor, and have difficulty accessing health care.2 The expansion of telehealth technologies allows the creation of solutions to decrease geographic barriers that have limited the growth of SBHCs in rural communities. Telehealth school-based health centers (tSBHCs) that exclusively provide services through telemedicine are operating and developing in communities where geographic barriers and financial challenges have prevented the establishment of brick and mortar SBHCs. TSBHCs are beginning to increase the number and variety of services they provide through the use of telehealth to include behavioral health, nutrition services, and pediatric specialists. Understanding the role of tSBHCs in the growth of the PCMH model is critical for using these tools to continue to improve child and adolescent health. Copyright 2014, SLACK Incorporated.

76 FR 20045 - The Ubs Group, a Division Of Ubs Ag, Also Known as Ubs Financial Services, Inc. and/or Ubs-Glb...

Science.gov (United States)

2011-04-11

... Division Of Ubs Ag, Also Known as Ubs Financial Services, Inc. and/or Ubs-Glb (Americas), Inc., Formerly... UBS AG, also known as UBS Financial Services, Inc., and/or UBS-GLB (Americas), Inc., Corporate Center... The UBS Group, a division of UBS AG, also known as UBS Financial Services, Inc., and/or UBS-GLB...

A nationwide survey of patient centered medical home demonstration projects.

Science.gov (United States)

Bitton, Asaf; Martin, Carina; Landon, Bruce E

2010-06-01

The patient centered medical home has received considerable attention as a potential way to improve primary care quality and limit cost growth. Little information exists that systematically compares PCMH pilot projects across the country. Cross-sectional key-informant interviews. Leaders from existing PCMH demonstration projects with external payment reform. We used a semi-structured interview tool with the following domains: project history, organization and participants, practice requirements and selection process, medical home recognition, payment structure, practice transformation, and evaluation design. A total of 26 demonstrations in 18 states were interviewed. Current demonstrations include over 14,000 physicians caring for nearly 5 million patients. A majority of demonstrations are single payer, and most utilize a three component payment model (traditional fee for service, per person per month fixed payments, and bonus performance payments). The median incremental revenue per physician per year was $22,834 (range $720 to $91,146). Two major practice transformation models were identified--consultative and implementation of the chronic care model. A majority of demonstrations did not have well-developed evaluation plans. Current PCMH demonstration projects with external payment reform include large numbers of patients and physicians as well as a wide spectrum of implementation models. Key questions exist around the adequacy of current payment mechanisms and evaluation plans as public and policy interest in the PCMH model grows.

The outcome of the first 1000 cases of LASIK performed at the king Hussein Medical Center

Energy Technology Data Exchange (ETDEWEB)

Abdallat, W [King Hussein Medical Centre, Amman (Jordan). Dept. of Ophthalmology

2011-07-01

The current study evaluates the refractive and visual outcome of patients who had laser in situ keratomileusis (LASIK) performed at the refractive center at King Hussein Medical centre in Jordan. The predictability of LASIK surgery in terms of refractive and visual outcome results is very good with mild regression in refraction over time. (author).

The outcome of the first 1000 cases of LASIK performed at the king Hussein Medical Center

International Nuclear Information System (INIS)

Abdallat, W

2011-01-01

The current study evaluates the refractive and visual outcome of patients who had laser in situ keratomileusis (LASIK) performed at the refractive center at King Hussein Medical centre in Jordan. The predictability of LASIK surgery in terms of refractive and visual outcome results is very good with mild regression in refraction over time. (author).

Teaching corner: an undergraduate medical education program comprehensively integrating global health and global health ethics as core curricula : student experiences of the medical school for international health in Israel.

Science.gov (United States)

Teichholtz, Sara; Kreniske, Jonah Susser; Morrison, Zachary; Shack, Avraham R; Dwolatzky, Tzvi

2015-03-01

The Medical School for International Health (MSIH) was created in 1996 by the Faculty of Health Sciences at Ben-Gurion University of the Negev in affiliation with Columbia University's Health Sciences division. It is accredited by the New York State Board of Education. Students complete the first three years of the program on the Ben-Gurion University campus in Be'er-Sheva, Israel, while fourth-year electives are completed mainly in the United States (at Columbia University Medical Center and affiliates as well as other institutions) along with a two-month global health elective at one of numerous sites located around the world (including Canada, Ethiopia, India, Israel, Kenya, Nepal, Peru, the Philippines, Sri Lanka, Uganda, the United States, and Vietnam). The unique four-year, American-style curriculum is designed not only to prepare physicians who will be able to work at both an individual and community level but also at both of these levels anywhere in the world. In this way, it combines elements of medical and public health curricula not limited to an American perspective.

Patient-centered medical home transformation with payment reform: patient experience outcomes.

Science.gov (United States)

Heyworth, Leonie; Bitton, Asaf; Lipsitz, Stuart R; Schilling, Thad; Schiff, Gordon D; Bates, David W; Simon, Steven R

2014-01-01

To examine changes in patient experience across key domains of the patient-centered medical home (PCMH) following practice transformation with Lean quality improvement methodology inclusive of payment reform. Pre-intervention/post-intervention analysis of intervention with a comparison group, a quasi-experimental design. We surveyed patients following office visits at the intervention (n = 2502) and control (n = 1622) practices during the 15-month period before and 14-month period after PCMH Lean transformation (April-October 2009). We measured and compared pre-intervention and post-intervention levels of patient satisfaction and other indicators of patient-centered care. Propensity weights adjusted for potential case-mix differences in intervention and control groups; propensity-adjusted proportions accounted for physician-level clustering. More intervention patients were very satisfied with their care after the PCMH Lean intervention (68%) compared with pre-intervention (62%). Among control patients, there was no corresponding increase in satisfaction (63% very satisfied pre-intervention vs 64% very satisfied post-intervention). This comparison resulted in a statistical trend (P = .10) toward greater overall satisfaction attributable to the intervention. Post-intervention, patients in the intervention practice consistently rated indicators of patient-centered care higher than patients in the control practice, particularly in the personal physician and communication domain. In this domain, intervention patients reported superior provider explanations, time spent, provider concern, and follow-up instructions compared with control participants, whereas control group ratings fell in the post-intervention period (P for difference Lean enhancement with payment reform, patient experience was sustained or improved across key PCMH domains.

Introducing quality assurance and medical audit into the UCSF medical center curriculum.

Science.gov (United States)

Barbaccia, J C

1976-05-01

The experience gained by a medical school faculty in developing and piloting a course for undergraduate medical students in medical care evaluation led to a similar effort for house staff. It is recognized that if the profession is to fulfill the demand by society for social accountability in the use of resources for health care, medical care assessment and quality assurance mechanisms must become an intimate part of the clinical experience of medical students and house officers. Teaching these subjects requires a theoretical framework; introduction of content and skills appropriate to the level of the student and continuation of progressively more advanced training throughout medical education; use of assessment and quality assurance techniques by clinician-teachers themselves to provide models for the student; and continued evolution of pedagogic approach and course content based on developments in the area.

Fall Injuries and Related Factors of Elderly Patients at a Medical Center in Taiwan

OpenAIRE

Tsai, Li-Yun; Tsay, Shiow-Luan; Hsieh, Ruey-Kuen; Yu, Shu; Tsai, Jung-Mei; Chien, Hui-Hsien; Liu, Shu-Jung

2014-01-01

Background: Elderly patients have a high incidence of falls and injuries in hospitals due to various reasons. The aims of this study were to explore the characteristics and factors associated with fall injuries among elderly patients. Methods: A retrospective survey study was conducted. Data were retrieved from the patient safety reporting system of a medical center in Taiwan query for patient fall incidents of elderly patients aged 65 years or older between 2010 and 2012. Statistics were ...

Progress report Health Sciences Division - 1984 January 1 to June 30

International Nuclear Information System (INIS)

1984-09-01

This progress report contains a topical summary of major research in the Health Sciences Division. Separate reports are included for each of the following branches: Health Physics, Environmental Research, Radiation Biology, Biomedical Research and Medical. Some of the main areas of interest discussed are research goals, radiation levels, biological end points, assessment of carcinogenic and genetic hazards, research on radiation effects. Practical applications of research are highlighted

"Bacterial infections in visceral leishmaniasis in Children’s Medical Center 1966-2000 "

Directory of Open Access Journals (Sweden)

"Tabatabaei P "

2002-07-01

Full Text Available Background: Bacterial infections are seen in patients with visceral leishmaniasis. This study was conducted to determine the incidence of such infections and the more common infections agents. Materials and Methods: During the 15-years period in a prospective study from 1986 to 2000, 123 patients with visceral leishmaniasis were studied in the Children Medical Center. Results: From all the cases, 41 (33 percent patients had Also bacterial infections. Respiratory tract, urinary system, Middle ear were the most common sites of infection. Conclusion: When bacterial Infection is suspected in these patients, empiric antibiotic therapy should be started immediately after appropriate diagnostic procedures are taken.

Establishment of exposure dose assessment laboratory in National Radiation Emergency Medical Center (NREMC)

Energy Technology Data Exchange (ETDEWEB)

Yoo, Jae Ryong; Ha, Wi Ho; Yoon, Seok Won; Han, Eun Ae; Lee, Seung Sook [Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of)

2011-10-15

As unclear industry grown, 432 of the nuclear power plants are operating and 52 of NPPs are under construction currently. Increasing use of radiation or radioisotopes in the field of industry, medical purpose and research such as non-destructive examination, computed tomography and x-ray, etc. constantly. With use of nuclear or radiation has incidence possibility for example the Fukushima NPP incident, the Goiania accident and the Chernobyl Nuclear accident. Also the risk of terror by radioactive material such as Radiological Dispersal Device(RDD) etc. In Korea, since the 'Law on protection of nuclear facilities and countermeasure for radioactive preparedness was enacted in 2003, the Korean institute of Radiological and Medical Sciences(KIRAMS) was established for the radiation emergency medical response in radiological disaster due to nuclear accident, radioactive terror and so on. Especially National Radiation Emergency Medical Center(NREMC) has the duty that is protect citizens from nuclear, radiological accidents or radiological terrors through the emergency medical preparedness. The NREMC was established by the 39-article law on physical protection of nuclear material and facilities and measures for radiological emergencies. Dose assessment or contamination survey should be performed which provide the radiological information for medical response. For this reason, the NREMC establish and re-organized dose assessment system based on the existing dose assessment system of the NREMC recently. The exposure dose could be measured by physical and biological method. With these two methods, we can have conservative dose assessment result. Therefore the NREMC established the exposure dose assessment laboratory which was re-organized laboratory space and introduced specialized equipment for dose assessment. This paper will report the establishment and operation of exposure dose assessment laboratory for radiological emergency response and discuss how to enhance

Physics Division progress report for period ending September 30, 1988

Energy Technology Data Exchange (ETDEWEB)

Livingston, A.B. (ed.)

1989-03-01

This report covers the research and development activities of the Physics Division for the 1988 fiscal year, beginning October 1, 1987, and ending September 30, 1988. The activities of this Division are concentrated in the areas of experimental nuclear physics, experimental atomic physics, and theoretical nuclear and atomic physics. Operation of the Holifield Heavy Ion Research Facility as a national user facility continues to represent the single largest activity within the Division. This year saw the completion of the acceleration tube upgrade of the 25-MV tandem electrostatic accelerator and the achievement of record terminal potentials, operation for an experiment with 25 million volts on terminal, and successful tests with beam at 25.5 MV. The experimental nuclear physics program continues to be dominated by research utilizing heavy ions. These activities, while continuing to center largely on the Holifield Facility, have seen significant growth in the use of facilities that provide intermediate energies and especially ultrarelativistic beams. The UNISOR program, since its inception, has been intimately associated with the Division and, most particularly, with the Holifield Facility. In addition to the Holifield Facility, the Division operates two smaller facilities, the EN Tandem and the ECR Ion Source Facility, as ''User Resources.'' The efforts in theoretical physics, covering both nuclear and atomic physics, are presented. In addition to research with multicharged heavy ions from the ECR source, the effort on atomic physics in support of the controlled fusion program includes a plasma diagnostics development program. The concentration of this program on optical and laser technology is marked by the change in designation to the Laser and Electro-Optics Lab. A small, continuing effort in elementary particle physics, carried out in collaboration with the University of Tennessee, is reported.

Physics Division progress report for period ending September 30, 1988

International Nuclear Information System (INIS)

Livingston, A.B.

1989-03-01

This report covers the research and development activities of the Physics Division for the 1988 fiscal year, beginning October 1, 1987, and ending September 30, 1988. The activities of this Division are concentrated in the areas of experimental nuclear physics, experimental atomic physics, and theoretical nuclear and atomic physics. Operation of the Holifield Heavy Ion Research Facility as a national user facility continues to represent the single largest activity within the Division. This year saw the completion of the acceleration tube upgrade of the 25-MV tandem electrostatic accelerator and the achievement of record terminal potentials, operation for an experiment with 25 million volts on terminal, and successful tests with beam at 25.5 MV. The experimental nuclear physics program continues to be dominated by research utilizing heavy ions. These activities, while continuing to center largely on the Holifield Facility, have seen significant growth in the use of facilities that provide intermediate energies and especially ultrarelativistic beams. The UNISOR program, since its inception, has been intimately associated with the Division and, most particularly, with the Holifield Facility. In addition to the Holifield Facility, the Division operates two smaller facilities, the EN Tandem and the ECR Ion Source Facility, as ''User Resources.'' The efforts in theoretical physics, covering both nuclear and atomic physics, are presented. In addition to research with multicharged heavy ions from the ECR source, the effort on atomic physics in support of the controlled fusion program includes a plasma diagnostics development program. The concentration of this program on optical and laser technology is marked by the change in designation to the Laser and Electro-Optics Lab. A small, continuing effort in elementary particle physics, carried out in collaboration with the University of Tennessee, is reported

Impact of type 1 diabetes mellitus on the family is reduced with the medical home, care coordination, and family-centered care.

Science.gov (United States)

Katz, Michelle L; Laffel, Lori M; Perrin, James M; Kuhlthau, Karen

2012-05-01

To examine whether the medical home, care coordination, or family-centered care was associated with less impact of type 1 diabetes mellitus (T1D) on families' work, finances, time, and school attendance. With the 2005 to 2006 National Survey of Children with Special Health Care Needs, we compared impact in children with T1D (n = 583) with that in children with other special health care needs (n = 39 944) and children without special health care needs (n = 4945). We modeled the associations of the medical home, care coordination, and family-centered care with family impact in T1D. Seventy-five percent of families of children with T1D reported a major impact compared with 45% of families of children with special health care needs (P families of children without special health care needs (P families of children with T1D, 35% reported restricting work, 38% reported financial impact, 41% reported medical expenses >$1000/year, 24% reported spending ≥11 hours/week caring or coordination care, and 20% reported ≥11 school absences/year. The medical home, care coordination, and family-centered care were associated with less work and financial impact. In childhood T1D, most families experience major impact. Better systems of health care delivery may help families reduce some of this impact. Copyright © 2012 Mosby, Inc. All rights reserved.

Commercial Crew Medical Ops

Science.gov (United States)

Heinbaugh, Randall; Cole, Richard

2016-01-01

Provide commercial partners with: center insight into NASA spaceflight medical experience center; information relative to both nominal and emergency care of the astronaut crew at landing site center; a basis for developing and sharing expertise in space medical factors associated with returning crew.

A Three-Year Experience of Medical Thoracoscopy at A Tertiary Care Center of Himalayan Region

Directory of Open Access Journals (Sweden)

Rakhee Sodhi

2016-03-01

Full Text Available Introduction: Medical thoracoscopy is a minimally invasive procedure for diagnosing and treating pleural diseases. Despite its proven role in diagnostic and therapeutic purposes, it is infrequently used, which could be because of cost of equipment and lack of training. We analyzed our initial 3 years record of thoracoscopy at Himalayan Institute of Medical Sciences, a tertiary care center in Himalayan region of north India. Materials and Methods: This cross-sectional study was to analyze our experience of medical thoracoscopy which was started in Jan 2011 at our center. All patients who underwent thoracoscopy during the period between Jan 2011 to Dec 2013 were included in the study. Thoracoscopy was performed for diagnosis of undiagnosed pleural effusions. Clinical, radiological, cytological & histopathological data of the patients were collected prospectively and analysed. Results: The diagnostic yield for a pleuroscopic pleural biopsy in our study was 87.23% (41/47. Malignancy was diagnosed histopathologically in 70.2% (33/47 patients (both primary & metastatic pleural carcinoma and tuberculosis in 10.6% (5/47. There was no mortality related to procedure. Only three patients had minor complications like subcutaneous emphysema which was mild and resolved by second post-procedure day. Pain at intercostal drain site was observed in some patients. Conclusion: Thoracoscopy is an easy outpatient procedure and an excellent diagnostic tool for pleural effusion of uncertain etiology. It has low complication rate even in settings where the procedure is just started. It should be included in the armamentarium of tools for management of pleural effusion.

Data-Driven Identification of Risk Factors of Patient Satisfaction at a Large Urban Academic Medical Center.

Science.gov (United States)

Li, Li; Lee, Nathan J; Glicksberg, Benjamin S; Radbill, Brian D; Dudley, Joel T

2016-01-01

The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey is the first publicly reported nationwide survey to evaluate and compare hospitals. Increasing patient satisfaction is an important goal as it aims to achieve a more effective and efficient healthcare delivery system. In this study, we develop and apply an integrative, data-driven approach to identify clinical risk factors that associate with patient satisfaction outcomes. We included 1,771 unique adult patients who completed the HCAHPS survey and were discharged from the inpatient Medicine service from 2010 to 2012. We collected 266 clinical features including patient demographics, lab measurements, medications, disease categories, and procedures. We developed and applied a data-driven approach to identify risk factors that associate with patient satisfaction outcomes. We identify 102 significant risk factors associating with 18 surveyed questions. The most significantly recurrent clinical risk factors were: self-evaluation of health, education level, Asian, White, treatment in BMT oncology division, being prescribed a new medication. Patients who were prescribed pregabalin were less satisfied particularly in relation to communication with nurses and pain management. Explanation of medication usage was associated with communication with nurses (q = 0.001); however, explanation of medication side effects was associated with communication with doctors (q = 0.003). Overall hospital rating was associated with hospital environment, communication with doctors, and communication about medicines. However, patient likelihood to recommend hospital was associated with hospital environment, communication about medicines, pain management, and communication with nurse. Our study identified a number of putatively novel clinical risk factors for patient satisfaction that suggest new opportunities to better understand and manage patient satisfaction. Hospitals can use a data-driven approach to

E-Division activities report

International Nuclear Information System (INIS)

Barschall, H.H.

1984-07-01

E (Experimental Physics) Division carries out basic and applied research in atomic and nuclear physics, in materials science, and in other areas related to the missions of the Laboratory. Some of the activities are cooperative efforts with other divisions of the Laboratory, and, in a few cases, with other laboratories. Many of the experiments are directly applicable to problems in weapons and energy, some have only potential applied uses, and others are in pure physics. This report presents abstracts of papers published by E (Experimental Physics) Division staff members between July 1983 and June 1984. In addition, it lists the members of the scientific staff of the division, including visitors and students, and some of the assignments of staff members on scientific committees. A brief summary of the budget is included

Progress report of Applied Physics Division. 1 October 1980 - 30 June 1981. Acting Division Chief - Dr. J. Parry

International Nuclear Information System (INIS)

2004-01-01

In September 1980, the Commission approved a reorganization of Physics Division, Engineering Research Division and Instrumentation and Control Division to form two new research divisions to be known as Applied Physics Division and Nuclear Technology Division. The Applied Physics Division will be responsible for applied science programs, particularly those concerned with nuclear techniques. The Division is organized as four sections with the following responsibilities: (1) Nuclear Applications and Energy Studies Section. Program includes studies in nuclear physics, nuclear applications, ion implantation and neutron scattering. (2) Semiconductor and Radiation Physics Section. Studies in semiconductor radiation detectors, radiation standards and laser applications. (3) Electronic Systems Section. This includes systems analysis, digital systems, instrument design, project instrumentation and instrument maintenance. (4) Fusion Physics Section. This covers work carried out by staff currently attached to university groups (author)

Photo-medical valley. 'Photo medical research center'

International Nuclear Information System (INIS)

Kawanishi, Shunichi; Daido, Hiroyuki; Tajima, Toshiki

2008-01-01

To develop a much more compact cancer diagnosis and therapeutic instrument using high intensity laser technology, Japan Atomic Energy Agency (JAEA) has successfully proposed this novel effort to the Ministry of Education, Culture, Sports, Science and Technology (MEXT) program as the creation of a 'photo-medical industrial valley' base in 2007 fiscal year. In this report, a new laser techniques to drive controlled ion beams is described. It is very important approach to realize a laser-driven ion accelerator. (author)

Patient experience in a coordinated care model featuring diabetes self-management education integrated into the patient-centered medical home.

Science.gov (United States)

Janiszewski, Debra; O'Brian, Catherine A; Lipman, Ruth D

2015-08-01

The purpose of this study is to gain insight about patient experience of diabetes self-management education in a patient-centered medical home. Six focus groups consisting of 37 people with diabetes, diverse in race and ethnicity, were conducted at 3 sites. Participants described their experience in the program and their challenges in diabetes self-management; they also suggested services to meet their diabetes care needs. The most common theme was ongoing concerns about care and support. There was much discussion about the value of the support provided by health navigators integrated in the diabetes health care team. Frequent concerns expressed by participants centered on personal challenges in engaging in healthy lifestyle behaviors. Ongoing programmatic support of self-management goals was widely valued. Individuals who received health care in a patient-centered medical home and could participate in diabetes self-management education with integrated support valued both activities. The qualitative results from this study suggest need for more formalized exploration of effective means to meet the ongoing support needs of people with diabetes. © 2015 The Author(s).

Performance test of electron cyclotron resonance ion sources for the Hyogo Ion Beam Medical Center

Science.gov (United States)

Sawada, K.; Sawada, J.; Sakata, T.; Uno, K.; Okanishi, K.; Harada, H.; Itano, A.; Higashi, A.; Akagi, T.; Yamada, S.; Noda, K.; Torikoshi, M.; Kitagawa, A.

2000-02-01

Two electron cyclotron resonance (ECR) ion sources were manufactured for the accelerator facility at the Hyogo Ion Beam Medical Center. H2+, He2+, and C4+ were chosen as the accelerating ions because they have the highest charge to mass ratio among ion states which satisfy the required intensity and quality. The sources have the same structure as the 10 GHz ECR source at the Heavy Ion Medical Accelerator in Chiba except for a few improvements in the magnetic structure. Their performance was investigated at the Sumitomo Heavy Industries factory before shipment. The maximum intensity was 1500 μA for H2+, 1320 μA for He2+, and 580 μA for C4+ at the end of the ion source beam transport line. These are several times higher than required. Sufficient performance was also observed in the flatness and long-term stability of the pulsed beams. These test results satisfy the requirements for medical use.

Characterizing complexity in socio-technical systems: a case study of a SAMU Medical Regulation Center.

Science.gov (United States)

Righi, Angela Weber; Wachs, Priscila; Saurin, Tarcísio Abreu

2012-01-01

Complexity theory has been adopted by a number of studies as a benchmark to investigate the performance of socio-technical systems, especially those that are characterized by relevant cognitive work. However, there is little guidance on how to assess, systematically, the extent to which a system is complex. The main objective of this study is to carry out a systematic analysis of a SAMU (Mobile Emergency Medical Service) Medical Regulation Center in Brazil, based on the core characteristics of complex systems presented by previous studies. The assessment was based on direct observations and nine interviews: three of them with regulator of emergencies medical doctor, three with radio operators and three with telephone attendants. The results indicated that, to a great extent, the core characteristics of complexity are magnified) due to basic shortcomings in the design of the work system. Thus, some recommendations are put forward with a view to reducing unnecessary complexity that hinders the performance of the socio-technical system.

Division Quilts: A Measurement Model

Science.gov (United States)

Pratt, Sarah S.; Lupton, Tina M.; Richardson, Kerri

2015-01-01

As teachers seek activities to assist students in understanding division as more than just the algorithm, they find many examples of division as fair sharing. However, teachers have few activities to engage students in a quotative (measurement) model of division. Efraim Fischbein and his colleagues (1985) defined two types of whole-number…

Impact of a reengineered electronic error-reporting system on medication event reporting and care process improvements at an urban medical center.

Science.gov (United States)

McKaig, Donald; Collins, Christine; Elsaid, Khaled A

2014-09-01

A study was conducted to evaluate the impact of a reengineered approach to electronic error reporting at a 719-bed multidisciplinary urban medical center. The main outcome of interest was the monthly reported medication errors during the preimplementation (20 months) and postimplementation (26 months) phases. An interrupted time series analysis was used to describe baseline errors, immediate change following implementation of the current electronic error-reporting system (e-ERS), and trend of error reporting during postimplementation. Errors were categorized according to severity using the National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) Medication Error Index classifications. Reported errors were further analyzed by reporter and error site. During preimplementation, the monthly reported errors mean was 40.0 (95% confidence interval [CI]: 36.3-43.7). Immediately following e-ERS implementation, monthly reported errors significantly increased by 19.4 errors (95% CI: 8.4-30.5). The change in slope of reported errors trend was estimated at 0.76 (95% CI: 0.07-1.22). Near misses and no-patient-harm errors accounted for 90% of all errors, while errors that caused increased patient monitoring or temporary harm accounted for 9% and 1%, respectively. Nurses were the most frequent reporters, while physicians were more likely to report high-severity errors. Medical care units accounted for approximately half of all reported errors. Following the intervention, there was a significant increase in reporting of prevented errors and errors that reached the patient with no resultant harm. This improvement in reporting was sustained for 26 months and has contributed to designing and implementing quality improvement initiatives to enhance the safety of the medication use process.

Lessons learned from a pharmacy practice model change at an academic medical center.

Science.gov (United States)

Knoer, Scott J; Pastor, John D; Phelps, Pamela K

2010-11-01

The development and implementation of a new pharmacy practice model at an academic medical center are described. Before the model change, decentralized pharmacists responsible for order entry and verification and clinical specialists were both present on the care units. Staff pharmacists were responsible for medication distribution and sterile product preparation. The decentralized pharmacists handling orders were not able to use their clinical training, the practice model was inefficient, and few clinical services were available during evenings and weekends. A task force representing all pharmacy department roles developed a process and guiding principles for the model change, collected data, and decided on a model. Teams consisting of decentralized pharmacists, decentralized pharmacy technicians, and team leaders now work together to meet patients' pharmacy needs and further departmental safety, quality, and cost-saving goals. Decentralized service hours have been expanded through operational efficiencies, including use of automation (e.g., computerized provider order entry, wireless computers on wheels used during rounds with physician teams). Nine clinical specialist positions were replaced by five team leader positions and four pharmacists functioning in decentralized roles. Additional staff pharmacist positions were shifted into decentralized roles, and the hospital was divided into areas served by teams including five to eight pharmacists. Technicians are directly responsible for medication distribution. No individual's job was eliminated. The new practice model allowed better alignment of staff with departmental goals, expanded pharmacy hours and services, more efficient medication distribution, improved employee engagement, and a staff succession plan.

The effect of work shift configurations on emergency medical dispatch center response.

Science.gov (United States)

Montassier, Emmanuel; Labady, Julien; Andre, Antoine; Potel, Gilles; Berthier, Frederic; Jenvrin, Joel; Penverne, Yann

2015-01-01

It has been proved that emergency medical dispatch centers (EMDC) save lives by promoting an appropriate allocation of emergency medical service resources. Indeed, optimal dispatcher call duration is pivotal to reduce the time gap between the time a call is placed and the delivery of medical care. However, little is known about the impact of work shift configurations (i.e., work shift duration and work shift rotation throughout the day) and dispatcher call duration. Thus, the objective of our study was to assess the effect of work shift configurations on dispatcher call duration. During a 1-year study period, we analyzed the dispatcher call durations for medical and trauma calls during the 4 different work shift rotations (day, morning, evening, and night) and during the 10-hour work shift of each dispatcher in the EMDC of Nantes. We extracted dispatcher call durations from our advanced telephone system, configured with CC Pulse + (Genesys, Alcatel Lucent), and collected them in a custom designed database (Excel, Microsoft). Afterward, we analyzed these data using linear mixed effects models. During the study period, our EMDC received 408,077 calls. Globally, the mean dispatcher call duration was 107 ± 45 seconds. Based on multivariate linear mixed effects models, the dispatcher call duration was affected by night work shift and work shift duration greater than 8 hours, increasing it by about 10 ± 1 seconds and 4 ± 1 seconds, respectively (both p work shift rotation and duration, with longer durations seen over night shifts and shifts over 8 hours. While these differences are small and may not have clinical significance, they may have implications for EMDC efficiency.

Patient-centered medical home cyberinfrastructure current and future landscape.

Science.gov (United States)

Finkelstein, Joseph; Barr, Michael S; Kothari, Pranav P; Nace, David K; Quinn, Matthew

2011-05-01

The patient-centered medical home (PCMH) is an approach that evolved from the understanding that a well-organized, proactive clinical team working in a tandem with well-informed patients is better able to address the preventive and disease management needs in a guideline-concordant manner. This approach represents a fundamental shift from episodic acute care models and has become an integral part of health reform supported on a federal level. The major aspects of PCMH, especially pertinent to its information infrastructure, have been discussed by an expert panel organized by the Agency for Healthcare Research and Quality at the Informatics for Consumer Health Summit. The goal of this article is to summarize the panel discussions along the four major domains presented at the summit: (1) PCMH as an Evolving Model of Healthcare Delivery; (2) Health Information Technology (HIT) Applications to Support the PCMH; (3) Current HIT Landscape of PCMH: Challenges and Opportunities; and (4) Future HIT Landscape of PCMH: Federal Initiatives on Health Informatics, Legislation, and Standardization. Copyright © 2011 American Journal of Preventive Medicine. All rights reserved.

Biodegradation of chloroethene compounds in groundwater at Operable Unit 1, Naval Undersea Warfare Center, Division Keyport, Washington, 1999-2010

Science.gov (United States)

Dinicola, R.S.; Huffman, R.L.

2012-01-01

The U.S. Geological Survey evaluated the biodegradation of chloroethene compounds in groundwater beneath the former landfill at Operable Unit 1 (OU 1) of the U.S. Naval Undersea Warfare Center (NUWC), Division Keyport. The predominant contaminants in groundwater are the chloroethene compounds trichloroethene, cis-1,2-dichloroethene, and vinyl chloride. The remedy selected for groundwater contamination at OU 1 includes phytoremediation and natural attenuation. In 1999, the U.S. Navy planted two hybrid poplar plantations, referred to as the northern and southern plantations, over the most contaminated parts of the landfill. The U.S. Navy monitors tree health, groundwater levels, and contaminant concentrations to assess the effectiveness of phytoremediation. The U.S. Geological Survey began a cooperative effort with the U.S. Navy in 1995 to monitor the effectiveness of natural attenuation processes for removing and controlling the migration of chloroethenes and chloroethanes. Field and laboratory studies from 1996 through 2000 demonstrated that biodegradation of chloroethenes and chloroethanes in shallow groundwater at OU 1 was substantial. The U.S. Geological Survey monitored geochemical and contaminant concentrations in groundwater annually from 2001 through 2010. This report presents groundwater geochemical and contaminant data collected by the U.S. Geological Survey during June 2010 and evaluates evidence for continued biodegradation of chloroethenes in groundwater.

1.114-gb/s time/space division switch system

Science.gov (United States)

Pawelski, Robert L.; Nordin, Ronald A.; Huisman, R. F.; Kelly, S.; Payne, William A.; Veach, R. S.

1990-10-01

Advanced digital communication services11 such as Broadband ISDN High Definition Television (HDTV) and enhanced data networking are expected to require high bandwidth and fast reconfiguration time switching centers available in the 1990''s. Digital GaAs IC''s can allow the implementation of these switching centers providing these services efficiently and at a low cost. The low cost arises from the reduction in hardware power maintenance etc. when the switch is designed to operate at the incoming data rate instead of at a lower rate. In order to utilize the capacity of a high bandwidth data link time division multiplexing is employed. This is a technique where multiple digital signals are interleaved (bit byte or block) on one data link. Clearly it is advantageous to have a switch that not only has a large bandwidth but can reconfigure at the data rate so as to provide bit byte or block switching functions thus being compatible with many different transmission formats. We present an experimental Time/Space Division Switch System capable of operating at over 1 Gb/s. Both custom and commercial Gallium Arsenide (GaAs) devices are used in the design of the various system functional blocks. These functional blocks include a Time Slot Interchanger (TSI) Time Multiplexed Switch (TMS) TMS Controller Multiplexer and Demultiplexers. In addition to the system overview we discuss such issues as printed circuit board microwave interconnections and CAD tools for high speed

Effects of a pain education program in Complementary and Alternative Medicine treatment utilization at a VA medical center.

Science.gov (United States)

Cosio, David; Lin, Erica H

2015-06-01

Past studies have shown that U.S. Veterans are consumers of CAM. However, more than 75% of Veteran non-users report they would utilize these treatment options if made available. Thus, Veterans may not be fully aware of the CAM options currently available to them in the current U.S. VA health care system. The current study tested the hypothesis that Veterans would report an increase in CAM utilization after completing a formal pain education program in a VA medical center. The study used a quasi-experimental, one-group, pre/post-test design. Midwestern, U.S. VA Medical Center. The responses from 103 Veterans who elected to participate in the program and the assessment measures were included in the outcome analyses. "Pain Education School" is a 12-week, educational program that is open to all Veterans and their families. It is a comprehensive program that introduces patients to 23 different disciplines at the VA Medical Center that deal with chronic, non-cancer pain. An adaptation of the Complementary and Alternative Medicine Questionnaire(©), SECTION A: Use of Alternative Health Care Providers. There was a significant difference found in overall utilization of CAM after completing the pain education program. The most utilized CAM modality was the chiropractor; the least utilized were hypnosis and aromatherapy. Not all health care systems or providers may have access to an education-focused, professionally driven program as an amenity. However, lessons can be learned from this study in terms of what pain providers may be able to accomplish in their practice. Published by Elsevier Ltd.

Environmental Sciences Division. Annual progress report for period ending September 30, 1975

Energy Technology Data Exchange (ETDEWEB)

1976-08-01

The energy crisis and creation of ERDA were dominant factors affecting the activities of the Environmental Sciences Division during the past year. Efforts primarily centered on coal conversion effluents, aquatic effects from power plants, terrestrial modeling of both radioactive and nonradioactive waste transport, mineral cycling, forest management, and information handling codes and techniques. A bibliography of publications, presentation, these, and other professional activities is included. (PCS)

[Causes of death in patients with HIV infection in two Tunisian medical centers].

Science.gov (United States)

Chelli, Jihène; Bellazreg, Foued; Aouem, Abir; Hattab, Zouhour; Mesmia, Hèla; Lasfar, Nadia Ben; Hachfi, Wissem; Masmoudi, Tasnim; Chakroun, Mohamed; Letaief, Amel

2016-01-01

Antiretroviral tritherapy has contributed to a considerable reduction in HIV-related mortality. The causes of death are dominated by opportunistic infections in developing countries and by cardiovascular diseases and cancer in developed countries. To determine the causes and risk factors associated with death in HIV-infected patients in two Tunisian medical centers. cross-sectional study of HIV-infected patients over 15 years treated at Sousse and Monastir medical centers between 2000 and 2014. Death was considered related to HIV if its primary cause was AIDS-defining illness or if it was due to an opportunistic infection of unknown etiology with CD4 cause wasn't an AIDS defining illness or if it was due to an unknown cause if no information was available. Two hundred thirteen patients, 130 men (61%) and 83 women (39%), average age 40 ± 11 years were enrolled in the study. Fifty four patients died, the mortality rate was 5.4/100 patients/year. Annual mortality rate decreased from 5.8% in 2000-2003 to 2.3% in 2012-2014. Survival was 72% at 5 years and 67% at 10 years. Death events were associated with HIV in 70.4% of cases. The leading causes of death were pneumocystis carinii pneumonia and cryptococcal meningitis in 6 cases (11%) each. Mortality risk factors were a personal history of opportunistic infections, duration of antiretroviral therapy < 12 months and smoking. Strengthening screening, early initiation of antiretroviral therapy and fight against tobacco are needed to reduce mortality in patients infected with HIV in Tunisia.

Comparison of Concussion Rates Between NCAA Division I and Division III Men's and Women's Ice Hockey Players.

Science.gov (United States)

Rosene, John M; Raksnis, Bryan; Silva, Brie; Woefel, Tyler; Visich, Paul S; Dompier, Thomas P; Kerr, Zachary Y

2017-09-01

Examinations related to divisional differences in the incidence of sports-related concussions (SRC) in collegiate ice hockey are limited. To compare the epidemiologic patterns of concussion in National Collegiate Athletic Association (NCAA) ice hockey by sex and division. Descriptive epidemiology study. A convenience sample of men's and women's ice hockey teams in Divisions I and III provided SRC data via the NCAA Injury Surveillance Program during the 2009-2010 to 2014-2015 academic years. Concussion counts, rates, and distributions were examined by factors including injury activity and position. Injury rate ratios (IRRs) and injury proportion ratios (IPRs) with 95% confidence intervals (CIs) were used to compare concussion rates and distributions, respectively. Overall, 415 concussions were reported for men's and women's ice hockey combined. The highest concussion rate was found in Division I men (0.83 per 1000 athlete-exposures [AEs]), followed by Division III women (0.78/1000 AEs), Division I women (0.65/1000 AEs), and Division III men (0.64/1000 AEs). However, the only significant IRR was that the concussion rate was higher in Division I men than Division III men (IRR = 1.29; 95% CI, 1.02-1.65). The proportion of concussions from checking was higher in men than women (28.5% vs 9.4%; IPR = 3.02; 95% CI, 1.63-5.59); however, this proportion was higher in Division I women than Division III women (18.4% vs 1.8%; IPR = 10.47; 95% CI, 1.37-79.75). The proportion of concussions sustained by goalkeepers was higher in women than men (14.2% vs 2.9%; IPR = 4.86; 95% CI, 2.19-10.77), with findings consistent within each division. Concussion rates did not vary by sex but differed by division among men. Checking-related concussions were less common in women than men overall but more common in Division I women than Division III women. Findings highlight the need to better understand the reasons underlying divisional differences within men's and women's ice hockey and the

PACS and its hospital-wide implementation: A case study at the Madigan Army Medical Center

International Nuclear Information System (INIS)

Choi, Hyung Sik; Kim, Yong Min; Smith, Donald V.; Bender, Gregory N.

1993-01-01

PACS represents the future of radiology in modern hospitals. Workstations and databases can be developed to substantially increase clinician's productivity, improve diagnostic accuracy, and make a large amount of knowledge and patient information available on-line to the physician. Currently, there are several hospitals in the process of implementing a total PACS system. They include Madigan Army Medical Center (Tacoma, Washington), VA Hospital in Baltimore, and Hammersmith Hospital in London (1). In order to provide the radiologist, the clinicians, and other health personnel in Korea with the general concept of PACS and its up-to-date status report, we describe the MDIS system being implemented in MAMC (Madigan Army Medical Center) which is the first hospital-wide large-scale PACS in the world. The major PACS components in MAMC have been installed since March 1992 and the full system implementation will be completed by summer 1993. The goal of the MDIS system in MAMC is to increase to more than 90% filmless by the end of 1993. In this paper, we discuss the introduction and background of PACS and its potential benefits, the current status of PACS installation in MAMC and the future plan, and the flow of image data and text information in MAMC

Assessment of diabetic teleretinal imaging program at the Portland Department of Veterans Affairs Medical Center.

Science.gov (United States)

Tsan, Grace L; Hoban, Keely L; Jun, Weon; Riedel, Kevin J; Pedersen, Amy L; Hayes, John

2015-01-01

We conducted a retrospective chart review of 200 diabetic patients who had teleretinal imaging performed between January 1, 2010, and January 1, 2011, at Portland Department of Veterans Affairs (VA) Medical Center outpatient clinics to assess the effectiveness of the diabetic teleretinal imaging program. Twenty patients (10%) had diabetic retinopathy. Ninety percent of the available teleretinal imaging studies were of adequate quality for interpretation. In accordance with local VA policy at that time, all teleretinal imaging patients should have been referred for a dilated retinal examination the following year. Image readers referred 97.5% of the patients to eye clinics for subsequent eye examinations, but the imagers scheduled appointments for only 80% of these patients. The redundancy rate, i.e., patients who had an eye examination within the past 6 mo, was 11%; the duplicate recall rate, i.e., patients who had a second teleretinal imaging performed within 1 yr of the eye examination, was 37%. Rates of timely diabetic eye examinations at clinics with teleretinal imaging programs, particularly when teleretinal imaging and eye clinics were colocated at the same community-based outpatient clinic, were higher than those without a teleretinal imaging program. We concluded that the Portland VA Medical Center's teleretinal imaging program was successful in increasing the screening rate for diabetic retinopathy.

Evaluation of functioning of ICDS project areas under Indore and Ujjain divisions of the state of Madhya Pradesh

Directory of Open Access Journals (Sweden)

Sanjay Dixit

2010-07-01

Full Text Available Background: Integrated Child Development Services (ICDS is recognized worldwide as one of the most efficient community based programmes promoting early childhood care. Regular evaluations of the programme have been conducted to make it more effective and adequate for the beneficiaries. Objectives: To evaluate the functioning of the Anganwadi Centers under different project areas of Indore and Ujjain Divisions. Methods: Under the present evaluation system one ICDS project and five Anganwadi Centers under the project area (AWCs were visited on a monthly basis and services provided reviewed. Findings reported are from nine project areas under Indore and Ujjain Divisions in the state of Madhya Pradesh from October 2008 – June 2009. Results: A total of 45 centers were evaluated. 29 centers were operating from rented buildings and storage facilities were lacking at 19 of the centers. Though the quality of food was acceptable to the beneficiaries shortage of food was a problem at the centers. Absence of Pre-School Education (PSE and Nutrition and Health Education (NHED Kits compromised PSE and NHED activities at the centers. Unavailability of medicine kits, lack of regular visits by the ANMs to the centers and absence of routine health check up of beneficiaries were other problems encountered under the project areas surveyed. Availability of a doctor under each project area was stated as a major need by the workers. Conclusion: Coordinated steps catering to different services provided at the centers are needed to optimize the functioning of the ICDS scheme.

Evaluation of Managerial Needs for Palliative Care Centers: Perspectives of Medical Directors.

Science.gov (United States)

Kafadar, Didem; Ince, Nurhan; Akcakaya, Adem; Gumus, Mahmut

2015-01-01

Palliative therapies have an important role in increasing the quality of healthcare and in dealing with physical and psychosocial problems due to cancer. We here aimed to evaluate the managerial perspectives and opinions of the hospital managers and clinical directors about specialized palliative care centers. This study was conducted in two large-scale hospitals in which oncology care is given with medical directors (n:70). A questionnaire developed by the researchers asking about demographic characteristics and professional experience, opinions and suggestions of medical directors about providing and integrating palliative care into healthcare was used and responses were analyzed. Potential barriers in providing palliative care (PC) and integrating PC into health systems were perceived as institutional by most of the doctors (97%) and nurses (96%). Social barriers were reported by 54% of doctors and 82% of nurses. Barriers due to interest and knowledge of health professionals about PC were reported by 76% of doctors and 75% of nurses. Among encouragement ideas to provide PC were dealing with staff educational needs (72%), improved working conditions (77%) and establishing a special PC unit (49)%. An independent PC unit was suggested by 27.7% of participants and there was no difference between the hospitals. To overcome the barriers for integration of PC into health systems, providing education for health professionals and patient relatives, raising awareness in society, financial arrangements and providing infrastructure were suggested. The necessity for planning and programming were emphasized. In our study, the opinions and perspectives of hospital managers and clinical directors were similar to current approaches. Managerial needs for treating cancer in efficient cancer centers, increasing the capacity of health professionals to provide care in every stage of cancer, effective education planning and patient care management were emphasized.

Veterinary Oncologist | Center for Cancer Research

Science.gov (United States)

The NCI is implementing a program intended to connect and closely coordinate the Division of Cancer Treatment and Diagnosis’ (DCTD’s) immunotherapeutics and other drug development activities with the translational oriented clinical trials of the Center for Cancer Research’s (CCR’s) Comparative Oncology Program (COP), especially the treatment of dogs with natural occurring

Extent and reasons for nonadherence to antihypertensive, cholesterol, and diabetes medications: the association with depressive symptom burden in a sample of American veterans

Directory of Open Access Journals (Sweden)

Weidenbacher HJ

2015-02-01

Full Text Available Hollis J Weidenbacher,1 Christopher A Beadles,1,2 Matthew L Maciejewski,1,3 Bryce B Reeve,2 Corrine I Voils1,3 1Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC, USA; 2Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC, USA; 3Division of General Internal Medicine, Department of Medicine, Duke University Medical Center, Durham, NC, USA Objective: Persons with depressive symptoms generally have higher rates of medication nonadherence than persons without depressive symptoms. However, little is known about whether this association differs by comorbid medical condition or whether reasons for nonadherence differ by depressive symptoms or comorbid medical condition. Methods: Self-reported extent of nonadherence, reasons for nonadherence, and depressive symptoms among 1,026 veterans prescribed medications for hypertension, dyslipidemia, and/or type 2 diabetes were assessed. Results: In multivariable logistic regression adjusted for clinical and demographic factors, the odds of nonadherence were higher among participants with high depressive symptom burden for dyslipidemia (n=848; odds ratio [OR]: 1.42, P=0.03 but not hypertension (n=916; OR: 1.24, P=0.15, or type 2 diabetes (n=447; OR: 1.15, P=0.51. Among participants reporting nonadherence to antihypertensive and antilipemic medications, those with greater depressive symptom burden had greater odds of endorsing medication nonadherence reasons related to negative expectations and excessive economic burden. Neither extent of nonadherence nor reasons for nonadherence differed by depressive symptom burden among patients with diabetes. Conclusion: These findings suggest that clinicians may consider tailoring interventions to improve adherence to antihypertensive and antilipemic medications to specific medication concerns of participants with depressive symptoms

Medication Errors in Hospitals: A Study of Factors Affecting Nursing Reporting in a Selected Center Affiliated with Shahid Beheshti University of Medical Sciences

Directory of Open Access Journals (Sweden)

HamidReza Mirzaee

2015-10-01

Full Text Available Background: Medication errors are mentioned as the most common important challenges threatening healthcare system in all countries worldwide. This study is conducted to investigate the most significant factors in refusal to report medication errors among nursing staff.Methods: The cross-sectional study was conducted on all nursing staff of a selected Education& Treatment Center in 2013. Data was collected through a teacher made questionnaire. The questionnaires’ face and content validity was confirmed by experts and for measuring its reliability test-retest was used. Data was analyzed by descriptive and analytic statistics. 16th  version of SPSS was also used for related statistics.Results: The most important factors in refusal to report medication errors respectively are: lack of reporting system in the hospital(3.3%, non-significance of reporting medication errors to hospital authorities and lack of appropriate feedback(3.1%, and lack of a clear definition for a medication error (3%. there was a significant relationship between the most important factors of refusal to report medication errors and work shift (p:0.002, age(p:0.003, gender(p:0.005, work experience(p<0.001 and employment type of nurses(p:0.002.Conclusion: Factors pertaining to management in hospitals as well as the fear of the consequences of reporting are two broad fields among the factors that make nurses not report their medication errors. In this regard, providing enough education to nurses, boosting the job security for nurses, management support and revising related processes and definitions are some factors that can help decreasing medication errors and increasing their report in case of occurrence.

The Comparison between Teacher Centered and Student Centered Educational Methods

Directory of Open Access Journals (Sweden)

M Anvar

2009-02-01

Full Text Available Background and Purpose: Various approaches to learning are suggested & practiced. The traditional medical education were more teacher centered oriented . In this method the students’ involvement in the process of learning is not remarkable, but the new approach to medical education supports the students involvement. This study evaluated the various method of lecturing considering students involvements.Methods: One hundred two first year medical and nursing students involved in this study and their opinion about these two methods of learning were obtained by filling of a questionnaire. The subject of the lectures was “general psychology” which was carried out 50% by the students and 50% by the teacher. The statistical analysis was carried out by SPSS program.Results: Considering students opinion in student-centered method the various aspect of learning such as mutual understanding, use of textbooks and references were significantly increased , whereasother aspects of learning such as self esteem, study time, innovation, and study attitude though were improved, but were not significant as compared with teacher centered method. In teacher-centeredmethod the understanding of the subjects was significantly increased .Other aspects of learning such as motivation and concentration were improved but not significantly as compared with studentcentered method.Conclusion: As the result showed student centered method was favored in several aspects of learning while in teacher centered method only understanding of the subject was better . Careful choice of teaching method to provide a comprehensive learning experience should take into account these differences.Key words: TEACHER CENTERED, STUDENT CENTERED, LEARNING

CCR Interns | Center for Cancer Research

Science.gov (United States)

The Cancer Research Interns (CRI) Summer Program was inaugurated in 2004 to provide an open door for students looking for an initial training opportunity. The goal is to enhance diversity within the CCR (Center for Cancer Research) training program and we have placed 338 students from 2004 to 2017, in labs and branches across the division.  The CCR and the Center for Cancer Training’s Office of Training and Education provide stipend support, some Service & Supply funds, and travel support for those students who meet the financial eligibility criteria (

Governing Academic Medical Center Systems: Evaluating and Choosing Among Alternative Governance Approaches.

Science.gov (United States)

Chari, Ramya; O'Hanlon, Claire; Chen, Peggy; Leuschner, Kristin; Nelson, Christopher

2018-02-01

The ability of academic medical centers (AMCs) to fulfill their triple mission of patient care, medical education, and research is increasingly being threatened by rising financial pressures and resource constraints. Many AMCs are, therefore, looking to expand into academic medical systems, increasing their scale through consolidation or affiliation with other health care systems. As clinical operations grow, though, the need for effective governance becomes even more critical to ensure that the business of patient care does not compromise the rest of the triple mission. Multi-AMC systems, a model in which multiple AMCs are governed by a single body, pose a particular challenge in balancing unity with the needs of component AMCs, and therefore offer lessons for designing AMC governance approaches. This article describes the development and application of a set of criteria to evaluate governance options for one multi-AMC system-the University of California (UC) and its five AMCs. Based on a literature review and key informant interviews, the authors identified criteria for evaluating governance approaches (structures and processes), assessed current governance approaches using the criteria, identified alternative governance options, and assessed each option using the identified criteria. The assessment aided UC in streamlining governance operations to enhance their ability to respond efficiently to change and to act collectively. Although designed for UC and a multi-AMC model, the criteria may provide a systematic way for any AMC to assess the strengths and weaknesses of its governance approaches.

Intestinal parasitism in preschool and school students treated in the EsSalud Medical Center of Celendín, Cajamarca

Directory of Open Access Journals (Sweden)

Jimmy Rinaldo Morales Del Pino

2016-03-01

Full Text Available OBJETIVES: Intestinal parasitism in preschool and school students treated in the EsSalud Medical Center of Celendín, Cajamarca MATERIAL AND METHODS: Observational, descriptive, cross-sectional research, conducted between July 2015 and January 2016 in the clinical laboratory service of EsSalud Medical Center of Celendín, Cajamarca. A data collection sheet was used for each participant to collect clinical data, demographic data and personal interaction. Parasitological samples of 96 children were processed by using direct examination, test of Graham and spontaneous sedimentation technique. Univariate analysis was used to find frequencies, percentages and standard deviations, and for the bivariate analysis we used Chi-square and Fisher's exact tests to associate the degree of parasitism with each variable obtained. RESULTS: The prevalence was 90.6% (87/96. Blastocystis hominis 81.2%, iodamoeba bütschlii 6.3%, Endolimax nana 19.8%, Entamoeba coli 35.4%, Chilomastix mesnilii 13.5%, Giardia lamblia 9.4%, Enterobius vermicularis 16.7% was found and Ascaris lumbricoides 1.0%. 20.8% (20/96 of the participants had similar structures to Urbanorum spp. Multiparasitism predominated (60.4% and there was a statistically significant association between the level of education and parasitical degree (p = 0.017. CONCLUSIONS: There was a high prevalence of parasitic infections in children in preschool and school age of Celendín district attended at the EsSalud medical center being Blastocystis hominis parasite the most predominant.

Transgender health care: improving medical students' and residents' training and awareness

Directory of Open Access Journals (Sweden)

Dubin SN

2018-05-01

Full Text Available Samuel N Dubin,1,* Ian T Nolan,1,* Carl G Streed Jr,2 Richard E Greene,3 Asa E Radix,4 Shane D Morrison5 1NYU School of Medicine, New York, NY, 2Department of Medicine, Division of General Internal Medicine and Primary Care, Brigham and Women’s Hospital, Boston, MA, 3Department of Internal Medicine, NYU School of Medicine, 4Callen-Lorde Community Health Center, New York, NY, 5Department of Surgery, Division of Plastic Surgery, University of Washington School of Medicine, Seattle, WA, USA *These authors contributed equally to this work Background: A growing body of research continues to elucidate health inequities experienced by transgender individuals and further underscores the need for medical providers to be appropriately trained to deliver care to this population. Medical education in transgender health can empower physicians to identify and change the systemic barriers to care that cause transgender health inequities as well as improve knowledge about transgender-specific care. Methods: We conducted structured searches of five databases to identify literature related to medical education and transgender health. Of the 1272 papers reviewed, 119 papers were deemed relevant to predefined criteria, medical education, and transgender health topics. Citation tracking was conducted on the 119 papers using Scopus to identify an additional 12 relevant citations (a total of 131 papers. Searches were completed on October 15, 2017 and updated on December 11, 2017. Results: Transgender health has yet to gain widespread curricular exposure, but efforts toward incorporating transgender health into both undergraduate and graduate medical educations are nascent. There is no consensus on the exact educational interventions that should be used to address transgender health. Barriers to increased transgender health exposure include limited curricular time, lack of topic-specific competency among faculty, and underwhelming institutional support. All published

How to market an affiliation. St. Elizabeth Hospital and Mercy Medical Center affiliate to create Affinity Health System.

Science.gov (United States)

1996-01-01

When Wisconsin's St. Elizabeth Hospital and Mercy Medical Center affiliated to create Affinity Health System, Inc., strategic planning and a solid marketing plan carefully executed were instrumental in its success. A corporate identity campaign and product line identification were follow-up phases to the merger approval.

Hospitalist and Internal Medicine Leaders' Perspectives of Early Discharge Challenges at Academic Medical Centers.