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Sample records for medical centre rotterdam

  1. Student diversity at Erasmus Medical Centre Rotterdam: does it make any difference?

    NARCIS (Netherlands)

    Selleger, V.; Bonke, B.; Leeman, Y.A.M.

    2006-01-01

    In an ethnically diverse society cultural competence is indispensable for medical doctors. At present 10% of the Dutch population are first- or second-generation non-Western immigrants. With 8% Western and 18% non-Western immigrants, originating from 30 different countries, the 2001 Rotterdam

  2. The Erasmus Computing Grid - Building a Super-Computer Virtually for Free at the Erasmus Medical Center and the Hogeschool Rotterdam

    NARCIS (Netherlands)

    T.A. Knoch (Tobias); L.V. de Zeeuw (Luc)

    2006-01-01

    textabstractThe Set-Up of the 20 Teraflop Erasmus Computing Grid: To meet the enormous computational needs of live- science research as well as clinical diagnostics and treatment the Hogeschool Rotterdam and the Erasmus Medical Center are currently setting up one of the largest desktop

  3. Port of Rotterdam

    NARCIS (Netherlands)

    Veenstra, A.W.

    2014-01-01

    The port of Rotterdam is one of the largest ports in the World and has great significance for the Dutch and European economy. Newly appointed TU/e professor Albert Veenstra explains if and how the Port of Rotterdam is affected by the economic crisis. With other European ports closing in, what can

  4. Jenseits der Beschwichtigungen: Lokale Integrationspolitik in Rotterdam

    NARCIS (Netherlands)

    E. Snel (Erik)

    2009-01-01

    textabstractEinleitung In den Jahren um die Jahrtausendwende steckte die Stadt Rotterdam in einer nicht zu übersehenden Krise. Oder, wie der Rotterdamer Bürgermeister Opstelten die prekäre Situation seiner Stadt kurz nach seinem Amtsantritt zusammenfasste: Rotterdam führt die ‚falschen Listen‘ an.

  5. Rotterdam Navel Gazing as Success Factor… (case)

    NARCIS (Netherlands)

    G.J. Van der Star; dr. A. Maas

    2016-01-01

    Case about Henk, sector manager Cleantech at Rotterdam Partners. His responsibility is to stimulate the Circular Economy of Rotterdam, this in cooperation with the “government” of Rotterdam. Of course he knows a lot about what a Circular Economy theoretically is and should be, but to put in the day

  6. Femininity as city marketing strategy: gender bending Rotterdam

    NARCIS (Netherlands)

    van den Berg, M.

    2012-01-01

    Rotterdam organised the festival ‘La City’ as an entrepreneurial strategy to upgrade the city’s class position, using femininity as a tool. ‘La City’ was an attempt to introduce a new economy in Rotterdam: one that is service-based and post-industrial. Rotterdam is a former industrial city and is

  7. The Pauluskerk: an unorthodox church in Rotterdam

    Directory of Open Access Journals (Sweden)

    Frank van der Hoeven

    2014-05-01

    Full Text Available The tale of the rebuilding of the Pauluskerk (St. Paul’s Church in the Dutch city of Rotterdam is a multilayered story that blurs the lines between architecture, societal issues, policymaking and urban redevelopment.The original Pauluskerk was built in the late 1950s in a city centre that was still recovering from the damage it suffered during the Second World War. The church may never have received the attention it has were it not for Reverend Visser, who developed the church into a refuge for the outcasts of Dutch society: asylum seekers, homeless people and drug addicts. Visser’s activism eventually evolved into the Perron Nul (Platform Zero initiative, through which he organized support for the addicted and indigent on a scale not seen before in the city.The close proximity of the Pauluskerk to Rotterdam Central Station and the controversy surrounding its mission brought it slowly but steadily onto a collision course with the renewal and redevelopment of the station area, which would eventually lead to the demolition of the original Pauluskerk in 2007 and the construction of a new church building as part of the CalypSO project, designed by British architect William Alsop.This article brings these story lines together to showcase the complex process involved in an inner-city urban development founded in the well-established practice of local democracy, where consensus-seeking is the norm, even when this crosses societal borders.

  8. The DIY Digital Medical Centre.

    Science.gov (United States)

    Timmis, James Kenneth; Timmis, Kenneth

    2017-09-01

    Healthcare systems worldwide are confronted with major economic, organizational and logistical challenges. Historic evolution of health care has led to significant healthcare sector fragmentation, resulting in systemic inefficiencies and suboptimal resource exploitation. To attain a sustainable healthcare model, fundamental, system-wide improvements that effectively network, and ensure fulfilment of potential synergies between sectors, and include and facilitate coherent strategic planning and organisation of healthcare infrastructure are needed. Critically, they must be specifically designed to sustainably achieve peak performance within the current policy environment for cost-control, and efficiency and quality improvement for service delivery. We propose creation of a new healthcare cluster, to be embedded in existing healthcare systems. It consists of (i) local 24/7 walk-in virtually autonomous do-it-yourself Digital Medical Centres performing routine diagnosis, monitoring, prevention, treatment and standardized documentation and health outcome assessment/reporting, which are online interfaced with (ii) regional 24/7 eClinician Centres providing on-demand clinical supervision/assistance to Digital Medical Centre patients. Both of these are, in turn, online interfaced with (iii) the National Clinical Informatics Centre, which houses the national patient data centre (cloud) and data analysis units that conduct patient- and population-level, personalized and predictive(-medicine) intervention optimization analyses. The National Clinical Informatics Centre also interfaces with biomedical research and prioritizes and accelerates the translation of new discoveries into clinical practice. The associated Health Policy Innovation and Evaluation Centre rapidly integrates new findings with health policy/regulatory discussions. This new cluster would synergistically link all health system components in a circular format, enable not only access by all arms of the health

  9. Medical applications in a nuclear research centre

    International Nuclear Information System (INIS)

    Vanhavere, F.; Eggermont, G.

    2001-01-01

    In these days of public aversion to nuclear power, it can be important to point at the medical applications of ionising radiation. Not only the general public, but also the authorities and research centres have to be aware of these medical applications, which are not without risk for public health. Now that funding for nuclear research is declining, an opening to the medical world can give new opportunities to a nuclear research centre. A lot of research could be done where the tools developed for the nuclear power world are very useful. Even new applications for the research reactors like BNCT (boron neutron capture therapy) can be envisaged for the near future. In this contribution an overview will be given of the different techniques used in the medical world with ionising radiation. The specific example of the Belgian Nuclear Research Centre will be given where the mission statement was changed to include a certain number of medical research topics. (authors)

  10. Explorative Observations of the Urban Climate System in the Rotterdam Metropolis

    Science.gov (United States)

    Jacobs, C. M.; van Hove, L. W.; Heusinkveld, B. G.; Steeneveld, G.; van Heerwaarden, C.; Elbers, J. A.

    2009-12-01

    °C. Data from the traverse measurements were compared with recordings from Zestienhoven, a nearby synoptic weather station outside the urban area. Satellite images and city maps were used to support the analyses. Furthermore, mesoscale model simulations for the Rotterdam area were performed. Preliminary results show that during daytime the city centre was 2 K warmer than Zestienhoven while the city park along the route was 2.4 K cooler. The air temperature perceived by humans was estimated to be 28°C at Zestienhoven and about 34°C in the city centre. During the late evening (22-24 LT), the city centre was ~5 K warmer than Zestienhoven and again, some locations near green spaces in the city were about 2 °C cooler. The difference in temperature between the city and the countryside amounted to more than 7 K during nocturnal hours. The preliminary results clearly demonstrate the existence of a considerable UHI in the city of Rotterdam and confirm the important role of green spaces in mitigating heat stress. The presentation will further highlight the measuring strategy and results from our analyses.

  11. Interdisciplinary Archaeological Research Programme Maasvlakte 2, Rotterdam : Twenty meters deep! The mesolithic period at the Yangtze Harbour site - Rotterdam Maasvlakte, the Netherlands

    NARCIS (Netherlands)

    Boon, J.J.; Brinkhuizen, D.C.; Bunnik, F.P.M.; Cohen, K.M.; Cremer, H.; Exaltus, R.P.; van Kappel, K.; Kooistra, L.I.; Koolmees, H.; de Kruyk, H.; Kubiak-Martens, L.; Moree, J.M.; Niekus, M.J.L.Th.; Peeters, J.H.M.; Schiltmans, D.E.A.; Verbaas, A.; Verbruggen, F.; Vos, P.C.; Zeiler, J.T.

    2015-01-01

    In 2011 a systematic underwater field survey and an invasive investigation were executed in the Yangtze Harbour planning area, Maasvlakte, Rotterdam, commissioned by Port of Rotterdam Authority. The aim of the work was to locate and document any archaeological remains in submerged Late Pleistocene

  12. Civilizing the city: populism and revanchist urbanism in Rotterdam

    NARCIS (Netherlands)

    Uitermark, J.; Duyvendak, J.W.

    2008-01-01

    This paper discusses the relevance of American literature on ‘revanchist urbanism’ for understanding the policies of the populist government that ruled Rotterdam between 2002 and 2006. It is suggested that revanchist urbanism in the European context in general and in the case of Rotterdam in

  13. 36th International Pyrotechnics Seminar 2009 in Rotterdam - Editorial

    NARCIS (Netherlands)

    Klerk, W.P.C. de; Lingen, J.L. van

    2010-01-01

    From August 23 to 28, 2009, TNO Defence, Security and Safety organized the 36th IPS Congress in De Doelen in Rotterdam. The program consisted of 4 days of scientific presentations, a tour of the ports of Rotterdam and a final tour at TNO Defence, Security and Safety in Rijswijk and Ypenburg. The

  14. A biorefinery in Rotterdam with isobutanol as platform molecule?

    NARCIS (Netherlands)

    Posada Duque, J.A.; Zirkzee, H.; Hellemond, van E.W.; Lopez Contreras, A.M.; Hal, van J.W.; Straathof, A.J.J.

    2014-01-01

    The port area of Rotterdam with its concentration of chemical and petrochemical
    industry is an important contributor to the emission of CO2 in this country. The
    Rotterdam Climate Initiative (RCI) aims to reduce the CO2 emission in 2025 by 50%
    compared to 1990 levels. The use of biomass

  15. Birth centre confinement at the Queen Victoria Medical Centre. I. Obstetric and neonatal outcome.

    Science.gov (United States)

    Campbell, J; Hudson, H; Lumley, J; Morris, N; Rao, J; Spensley, J

    1981-10-03

    A review of hte first 175 confinements at the Queen Victoria Medical Centre Birth Centre is presented. The design, structure and function of hte Birth Centre is described and the safety of the programme demonstrated. Seventy-four pregnancies (42%) accepted for Birth Centre confinement required transfer because of antepartum or intrapartum complications. There were satisfactory obstetric and neonatal outcomes in all pregnancies. The first year's experience has allowed a reassessment of the risk factors, which will permit greater use of the Birth Centre without any increases risk to mothers or babies.

  16. Birth centre confinement at the Queen Victoria Medical Centre: four years' experience.

    Science.gov (United States)

    Morris, N; Campbell, J; Biro, M A; Lumley, J; Rao, J; Spensley, J

    1986-06-09

    A review of the first four years of the functioning of the birth centre at the Queen Victoria Medical Centre is presented. In that time, 1040 pregnant women were accepted for confinement there. Of these, 52 withdrew for non-obstetric reasons, while 470 were transferred to alternative obstetrical care--274 because of antepartum complications and 196 because of intrapartum problems. Therefore, 518 women were delivered in the birth centre. The care of the women is entrusted almost entirely to a team of midwives and this review demonstrates an enviable safety record.

  17. Ondergronds Station Blijdorp, Rotterdam

    NARCIS (Netherlands)

    Hijma, M.P.|info:eu-repo/dai/nl/266562426; Cohen, K.M.|info:eu-repo/dai/nl/185633374

    2014-01-01

    Het is in de herfst van 2005. Een lief meisje, Marieke, rijdt op haar vouwfiets door Rotterdam. Bij het Centraal Station is het al tijden een grote bouwplaats. Onder de nieuwe hal komt een veel groter metrostation en ook onder de Statenweg in Blijdorp is een grote bouwput voor een nieuw station.

  18. Jaarverslag 2001: Erasmus Universiteit Rotterdam

    NARCIS (Netherlands)

    2002-01-01

    textabstractDe Erasmus Universiteit Rotterdam heeft in 2001 resultaten geboekt waar zij voor staat, zowel op het gebied van wetenschappelijk onderwijs, wetenschappelijk onderzoek als in de sfeer van maatschappelijke dienstverlening. Met genoegen presenteren we u daarom dit verslag. Daarin laten we

  19. Radicalisering moslimjongeren in Rotterdam?

    Directory of Open Access Journals (Sweden)

    Ton Notten

    2011-05-01

    Inlichtingen- en veiligheidsdiensten houden radicaliseringtendensen binnen de islamitische gemeenschappen scherp in de gaten. Het zijn vooral moslimjongeren die, volgens openbare verslagen van de Algemene Inlichtingen- en Veiligheidsdienst (AIVD, de Nationaal Coördinator Terrorismebestrijding (NCTb en het Informatie SchakelPunt Radicalisering (ISPR, ontvankelijk zijn voor radicale ideeën. Bij de juistheid en nauwkeurigheid van die rapportages plaatsen wij vraagtekens. Van radicalisering blijkt bijvoorbeeld in Rotterdam vrijwel geen sprake te zijn. Voor zover de problemen iets van doen hebben met radicalisering, lijken ze meer te liggen op het gebied van samenleven en opvoeding: de culturele en normatieve tegenstellingen tussen bevolkingsgroepen – moslims en niet-moslims – nemen toe. Polarisatie is het eigenlijke probleem en niet radicalisering. Wij stellen het diffuse begrip ‘radicalisering’ ter discussie zoals dat een belangrijke rol speelt in de veiligheidsrisicodebatten, bij wetenschappelijk onderzoek en binnen de kring van inlichtingen- en veiligheidsdiensten. Ter illustratie gaan we nader in op de feitelijke ontwikkelingen in Rotterdam. Op grond van onze verkenning bepleiten we andere vormen en aandachtsvelden in het onderzoek naar radicalisering.

  20. Jaarverslag 2003: Erasmus Universiteit Rotterdam

    NARCIS (Netherlands)

    2004-01-01

    textabstractDe Erasmus Universiteit Rotterdam heeft in 2003 resultaten ge- boekt waar zij voor staat, zowel op het gebied van wetenschap- pelijk onderwijs, wetenschappelijk onderzoek als in de sfeer van maatschappelijke dienstverlening. Daarvan kunt u in dit verslag kennisnemen. Veel aandacht is

  1. Developing the Rotterdam City Region Food System: acting and thinking at the same time

    NARCIS (Netherlands)

    Schans, van der J.W.

    2015-01-01

    The city region of Rotterdam is located in the western part of the Netherlands, bordering the North Sea. It contains the municipality of Rotterdam and several neighbouring municipalities, with about 1.2 million inhabitants. Rotterdam hosts Europe’s largest sea port as well as a large

  2. Medical applications of accelerators at Tata Memorial Centre

    International Nuclear Information System (INIS)

    Dinshaw, K.A.

    2003-01-01

    The Tata Memorial Centre constitutes the national comprehensive cancer centre for the prevention, diagnosis, treatment and research on cancer. It is well equipped with sophisticated state-of-the-art equipment capable of delivering External Beam Radiotherapy (Ebert) and Brachytherapy. Nearly 400 patients receive Ebert daily at the institute from a team of highly skilled and dedicated radiation oncologists, medical physicists and technologists, making it one of the busiest centres in the country

  3. Rotterdam Nuclear

    International Nuclear Information System (INIS)

    Anon.

    1975-01-01

    In 1965 Rotterdam Nuclear received an order for the design, supply of materials, manufacture, testing, inspection and preparation for shipment of one 450MW Boiling Water Reactor pressure vessel. This was one of the first orders for a reactor pressure vessel, ever obtained by a European Manufacturer. The Company has since supplied 19 reactor pressure vessels for nuclear power stations, having a total weight of about 10,000,000kg. The nuclear power stations in which these are installed represent an electrical output of about 15,000MW and they are located in seven different countries (USA, Spain, Switzerland, Argentina, Sweden, Germany and the Netherlands). (Auth.)

  4. The Adapting city. Resilience through water design in Rotterdam

    Directory of Open Access Journals (Sweden)

    Maurizio Francesco Errigo

    2018-04-01

    Full Text Available The Netherlands is a fragile and vulnerable land; dutch landscape consists of a dense network of polders characterized by key elements such as dams, windmills and farms; it is a unique landscape but, at the same time, is very fragile and constantly changing; spatial planning is very important, just as important is the resilience of the system and its adaptation to climate change. Rotterdam is a delta city and, in a period of heavy climate change, it will experiment more extreme weather conditions, such as heavier rainstorms, longer periods of drought and more heat waves, as well as higher water levels in the river Meuse; so is important to know that it is a deep vulnerable city and need right strategies to overcome the problem and to be adapted to conseguences of climate change. Resilience has been under the attention of the municipality for about fifteen years; Rotterdam is the inspiring example to other delta cities around the world going through a sustainability approach; as a green city is an attractive and resilient city where people love to live, work and relax; sustainability is an integral part of all area development projects in Rotterdam; sustainable areas are future-proof areas with good living conditions. In Rotterdam, architects and urban designers are finally responding to the threats of rising sea levels by "welcoming the water" into city, so the waterscape is becoming a new paradigm of spatial planning; Rotterdam is striving to become a climate proof city that will be safe and attractive to inhabitants, visitors and businesses, and will remain so in the future. A healthy delta city in which it is pleasant to live, work and spend leisure time.

  5. Evaluatie terugbrengen sluitingstijden coffeeshops Rotterdam

    NARCIS (Netherlands)

    Korf, D.J.; Liebregts, N.

    2015-01-01

    Vanaf oktober 2013 heeft de gemeente Rot-terdam in de loop van ongeveer een jaar de sluitingstijd van de meeste van de 40 coffee-shops vervroegd van 24:00 uur naar 22:00 uur, met uitzondering van 7 coffeeshops in het centrum. Onderzocht is welke gevolgen deze maatregel had voor de overlast,

  6. Outline for the Rotterdam Climate Initiative. CO2 emissions up to 2030; Verkenning voor Rotterdam Climate Initiative. CO2-emissies tot 2030

    Energy Technology Data Exchange (ETDEWEB)

    Plomp, A.J.; Wetzels, W.; Seebregts, A.J.; Kroon, P [ECN Beleidsstudies, Petten (Netherlands)

    2013-04-15

    The Rotterdam Climate Initiative (RCI) aims to reduce the CO2 emissions within the city and port of Rotterdam by 50% in 2025 as compared to 1990. This target translates into a total emission of 12 Mton of CO2. In this study, Rotterdam's CO2 emissions have been estimated for the future years 2015, 2020, 2025 and 2030 based on autonomous developments combined with a policy framework that is assumed to be fixed. This study only explores the sectors Energy and Industry and Freight transport within Rotterdam. The results demonstrate that: (a) CO2 emissions resulting from the sector Energy and Industry increase from 26.5 Mton CO2 in 2011 to 33.8 Mton CO2 in 2020, and slightly decrease afterwards to 29.4 Mton CO2 in 2025 and 2030; and (b) CO2 emissions resulting from Freight transport increase from 1.0 Mton CO2 in 2011 to 1.4 Mton CO2 in 2025 and increase further to 1.6 Mton in 2030. This means that these sectors alone already exceed the emission target, and that substantial additional effort will be needed to attain the 50% CO2 reduction target. The estimated CO2 emissions are lower than those reported in the previous study that was published in 2010. Differences are mainly due to lower CO2 emissions from power plants as compared to the study in 2010. These are influenced by many different developments, such as high gas prices, low electricity prices and low CO2 prices. These estimates have been calculated bottom-up as much as possible and with the help of sector models. The realisation of Maasvlakte 2 has been taken into account in these results, which means more space for chemical plants and substantially more freight transfer and transport in Rotterdam [Dutch] Het Rotterdam Climate Initiative (RCI) heeft als doel om de CO2-emissie van de gemeente Rotterdam, inclusief de haven, in 2025 met 50% te reduceren ten opzichte van het basisjaar 1990. Deze doelstelling betekent een emissieniveau van 12 Mton CO2 in 2025 binnen de gemeente Rotterdam. In deze studie is de CO2

  7. Learner-centred medical education: Improved learning or increased stress?

    Science.gov (United States)

    McLean, Michelle; Gibbs, Trevor J

    2009-12-01

    Globally, as medical education undergoes significant reform towards more "learner-centred" approaches, specific implications arise for medical educators and learners. Although this learner-centredness is grounded in educational theory, a point of discussion would be whether the application and practice of these new curricula alleviate or exacerbate student difficulties and levels of stress. This commentary will argue that while this reform in medical education is laudable, with positive implications for learning, medical educators may not have understood or perhaps not embraced "learner-centredness" in its entirety. During their training, medical students are expected to be "patient-centred". They are asked to apply a biopsychosocial model, which takes cognisance of all aspects of a patient's well-being. While many medical schools profess that their curricula reflect these principles, in reality, many may not always practice what they preach. Medical training all too often remains grounded in the biomedical model, with the cognitive domain overshadowing the psychosocial development and needs of learners. Entrusted by parents and society with the education and training of future healthcare professionals, medical education needs to move to a "learner-centred philosophy", in which the "whole" student is acknowledged. As undergraduate and post-graduate students increasingly apply their skills in an international arena, this learner-centredness should equally encapsulate the gender, cultural and religious diversity of both patients and students. Appropriate support structures, role models and faculty development are required to develop skills, attitudes and professional behaviour that will allow our graduates to become caring and sensitive healthcare providers.

  8. Regional economic impact of an event: the case of the Rotterdam Marathon

    NARCIS (Netherlands)

    Willem, Jan; Goedknegt, Bart; Heijman, W.J.M.

    2016-01-01

    The Rotterdam Marathon is an annual sports event in Rotterdam. This biggest one-day event in the Netherlands attracted around 925,000 visitors in 2014. This paper aims at evaluating its regional economic impact by way of input output analysis in terms of number of jobs.

  9. [Medical waste management in healthcare centres in the occupied Palestinian territory].

    Science.gov (United States)

    Al-Khatib, Issam A

    2007-01-01

    Medical waste management in primary and secondary healthcare centres in the occupied Palestinian territory was assessed. The overall monthly quantity of solid healthcare waste was estimated to be 512.6 tons. Only 10.8% of the centres completely segregated the different kinds of healthcare waste and only 15.7% treated their medical waste. In the centres that treated waste, open burning was the main method of treatment. The results indicate that Palestinians are exposed to health and environmental risks because of improper disposal of medical waste and steps are needed to improve the situation through the establishment and enforcement of laws, provision of the necessary infrastructure for proper waste management and training of healthcare workers and cleaners.

  10. Genito-Urinary Fistula Patients at Bugando Medical Centre ...

    African Journals Online (AJOL)

    Genito-Urinary Fistula Patients at Bugando Medical Centre. ... Interventions: A total of 1294 patients underwent surgical treatment of incontinence. ... study shows that low education and poverty were the key factors in the development of fistula.

  11. Registered nurses' experiences of their decision-making at an Emergency Medical Dispatch Centre.

    Science.gov (United States)

    Ek, Bosse; Svedlund, Marianne

    2015-04-01

    To describe registered nurses' experiences at an Emergency Medical Dispatch Centre. It is important that ambulances are urgently directed to patients who are in need of immediate help and of quick transportation to a hospital. Because resources are limited, Emergency Medical Dispatch centres cannot send ambulances with high priority to all callers. The efficiency of the system is therefore dependent on triage. Nurses worldwide are involved in patient triage, both before the patient's arrival to the hospital and in the subsequent emergency care. Ambulance dispatching is traditionally a duty for operators at Emergency Medical Dispatch centres, and in Sweden this duty has become increasingly performed by registered nurses. A qualitative design was used for this study. Fifteen registered nurses with experience at Emergency Medical Dispatch centres were interviewed. The participants were asked to describe the content of their work and their experiences. They also described the most challenging and difficult situations according to the critical incidence technique. Content analysis was used. Two themes emerged during the analysis: 'Having a profession with opportunities and obstacles' and 'Meeting serious and difficult situations', with eight sub-themes. The results showed that the decisions to dispatch ambulances were both challenging and difficult. Difficulties included conveying medical advice without seeing the patient, teaching cardio-pulmonary resuscitation via telephone and dealing with intoxicated and aggressive callers. Conflicts with colleagues and ambulance crews as well as fear of making wrong decisions were also mentioned. Work at Emergency Medical Dispatch centres is a demanding but stimulating duty for registered nurses. Great benefits can be achieved using experienced triage nurses, including increased patient safety and better use of medical resources. Improved internal support systems at Emergency Medical Dispatch centres and striving for a blame

  12. Paediatric medical emergency calls to a Danish Emergency Medical Dispatch Centre

    DEFF Research Database (Denmark)

    Andersen, Kasper; Mikkelsen, Søren; Jørgensen, Gitte

    2018-01-01

    with a supporting physician-manned mobile emergency care unit (56.4%). The classification of medical issues and the dispatched pre-hospital units varied with patient age. DISCUSSION: We believe our results might help focus the paediatric training received by emergency medical dispatch staff on commonly encountered......BACKGROUND: Little is known regarding paediatric medical emergency calls to Danish Emergency Medical Dispatch Centres (EMDC). This study aimed to investigate these calls, specifically the medical issues leading to them and the pre-hospital units dispatched to the paediatric emergencies. METHODS: We...... records to establish how the medical issues leading to these calls were classified and which pre-hospital units were dispatched to the paediatric emergencies. We analysed the data using descriptive statistics. RESULTS: Of a total of 7052 emergency calls in February 2016, 485 (6.9%) concerned patients ≤ 15...

  13. CAESAREAN SECTION RATE AT FEDERAL MEDICAL CENTRE ...

    African Journals Online (AJOL)

    EagleMarkRes

    Materials and Method: A three year retrospective study from January 2010 to December 2012 involving all women who had caesarean delivery at the Federal Medical ... knowledge of women and increase safety about the procedure; the CS rate .... centres in Nigeria, where resident doctors on training are allowed to perform ...

  14. Erasmus University Rotterdam Wrestles With Sustainability Strategy

    NARCIS (Netherlands)

    G. Coughlan (Geraldine); T. Yue (Tao); F.H. Wijen (Frank)

    2014-01-01

    textabstractErasmus University Rotterdam (EUR) is in the midst of a sustainability dilemma. The university is in a stage of transition, shifting focus from the city to the world stage. EUR’s current environmental sustainability policy needs more impetus. The university wants to incorporate

  15. Teaching and training programmes in nuclear medicine for medical and paramedical personnel at the Radiation Medicine Centre, Bhabha Atomic Research Centre

    International Nuclear Information System (INIS)

    Sharma, S.M.; Raikar, U.R.

    1986-01-01

    Prior to 1976, the Radiation Medicine Centre had conducted 12 short courses of five weeks' duration on medical uses of radioisotopes. A total of 162 medical and scientific personnel attended the courses from various parts of India. Owing to the rapid advances made in nuclear medicine these courses were becoming inadequate, and in 1973 the Centre introduced one-year full time training courses for doctors and science graduates, peparing them for examinations for the Diploma in Radiation Medicine (DRM) and the Diploma in Medical Radioisotope Techniques (DMRIT) of the University of Bombay. By March 1984, 64 doctors and 53 technologists had obtained the DRM and DMRIT. A recent survey indicated that 70% of the DRM physicians and 68% of the DMRIT technologists are employed in nuclear medicine departments. Besides the formal one-year training courses, the Centre has conducted advanced courses of two weeks' duration on scintigraphy and thyroid function tests. The Radiation Medicine Centre has been the regional reference centre in nuclear medicine for the World Health Organization and International Atomic Energy Agency for more than ten years. The Centre has trained sponsored personnel from other countries of the region. The Centre has also organized seven symposia, workshops and seminars, four of them in collaboration with WHO and one with the IAEA. (author)

  16. The academic medical centre and nongovernmental organisation partnership following a natural disaster.

    Science.gov (United States)

    Sarani, Babak; Mehta, Samir; Ashburn, Michael; Nakashima, Koji; Gupta, Rajan; Dombroski, Derek; Schwab, C William

    2012-10-01

    The global response to the 12 January 2010 earthquake in Haiti revealed the ability to mobilise medical teams quickly and effectively when academic medical centres partner non-governmental organisations (NGO) that already have a presence in a zone of devastation. Most established NGOs based in a certain region are accustomed to managing the medical conditions that are common to that area and will need additional and specialised support to treat the flux of myriad injured persons. Furthermore, an NGO with an established presence in a region prior to a disaster appears better positioned to provide sustained recovery and rehabilitation relief. Academic medical centres can supply these essential specialised resources for a prolonged time. This relationship between NGOs and academic medical centres should be further developed prior to another disaster response. This model has great potential with regard to the rapid preparation and worldwide deployment of skilled medical and surgical teams when needed following a disaster, as well as to the subsequent critical recovery phase. © 2012 The Author(s). Journal compilation © Overseas Development Institute, 2012.

  17. Resilient Rotterdam. Climate change as a challenge. Report of a workshop

    International Nuclear Information System (INIS)

    Wardekker, J.A.; De Jong, A.; Van der Sluijs, J.P.

    2008-12-01

    The objective of the study of the resilience of Rotterdam (the Netherlands) with regard to climate change is twofold: 1) to obtain insight in the concepts resilience and uncertainty; to gain insight in how a resilience oriented approach deals with uncertainties about the future; and (2) putting the resilience oriented approach into operation in a case: the area outside the dike of Rotterdam, the Netherlands, which is designated for new buildings. The objective of the workshop was manifold: Making a small inventory of problems that could arise in the area outside the dike of Rotterdam caused by climate change; thinking about working out the 'resilience approach' in concrete options for climate change adaptation in this area; making an inventory of knowledge questions that come from the people that are involved in the design of the area; applying, testing and assessing a number of 'frame-based methods' for structural thinking about such issues [nl

  18. Maternal Mortality at Federal Medical Centre Yola, Adamawa State ...

    African Journals Online (AJOL)

    the management of the Federal Medical centre Yola before the .... response to emergencies may help reduce deaths from obstetric ... HIV, anesthetic deaths and Diabetic ketoacidosis (DKA) were the indirect causes of maternal mortality.

  19. Scientific centres in Europe: An analysis of research strength and patterns of specialisation based on bibliometric indicators

    DEFF Research Database (Denmark)

    Matthiessen, C. W.; Schwarz, Annette Winkel

    1999-01-01

    This paper presents the first analysis of scientific strength by output (papers in the Science Citation Index 1994-96) produced by authors from the 'greater' urban regions of Europe, Top lists of European centres are indicated, Four agglomerations constitute the European super-league of science......: London, Paris, Moscow and the Dutch urban agglomeration of Amsterdam, the Hague, Rotterdam and Utrecht, The next layer could be named the primary league and comprises 19 large research centres, A third group of 16 cities forms a secondary league of 16 smaller research centres, These upper-level research...

  20. Patient-centred care: using online personal medical records in IVF practice.

    NARCIS (Netherlands)

    Tuil, W.S.; Hoopen, A.J. ten; Braat, D.D.M.; Vries Robbé, P.F. de; Kremer, J.A.M.

    2006-01-01

    BACKGROUND: Generic patient-accessible medical records have shown promise in enhancing patient-centred care for patients with chronic diseases. We sought to design, implement and evaluate a patient-accessible medical record specifically for patients undergoing a course of assisted reproduction (IVF

  1. Orthopaedic injuries in children: Federal Medical Centre, Umuahia ...

    African Journals Online (AJOL)

    Background: Worldwide, trauma is a recognized leading cause of childhood morbidity, mortality and disability. Aim: To review the causes and consequences of orthopaedic injuries in children. Methods: A retrospective study of all injuries in children 14 years and below seen at the Federal Medical Centre Umuahia from 1st ...

  2. A patient-centred team-coaching concept for medical rehabilitation.

    Science.gov (United States)

    Körner, M; Becker, S; Dinius, J; Müller, C; Zimmermann, L; Rundel, M

    2018-01-01

    Team coaching enhances teamwork and subsequently improves patient-centredness in medical rehabilitation clinics. Even though interprofessional teamwork is regarded as a crucial factor in medical rehabilitation, to date no evaluated team-coaching approaches are available for improving interprofessional teamwork in medical rehabilitation in Germany. Based on a systematic literature search and interviews with staff, managers, and patients of rehabilitation clinics, we developed a team-coaching approach that is standardized in its process but based on the individual needs and requests of each clinic. It takes a systemic perspective and is goal-oriented and solution-focused. The approach mainly serves to provide impulses to make use of resources within the team and to support a self-directed organisational learning process. It is manualized and can, therefore, be used by professionals aiming to improve interprofessional teamwork in their clinic. A multi-centre, cluster-randomized controlled study that was conducted to evaluate the team-coaching approach showed positive results. Team organization, knowledge integration, and responsibility can be improved, and, therefore, the implementation of the patient-centred team-coaching approach in interprofessional rehabilitation teams can be recommended.

  3. Medical data transmission system for remote healthcare centres

    International Nuclear Information System (INIS)

    Gonzalez, E A; Cagnolo, F J; Olmos, C E; Centeno, C A; Riva, G G; Zerbini, C A

    2007-01-01

    The main motivation of this project is to improve the healthcare centres equipment and human resources efficiency, enabling those centres for transmission of parameters of medical interest. This system facilitates remote consultation, in particular between specialists and remote healthcare centres. Likewise it contributes to the qualification of professionals. The electrocardiographic (ECG) and electroencephalographic (EEG) signals are acquired, processed and then sent, fulfilling the effective norms, for application in the hospital network of Cordoba Province, which has nodes interconnected by phone line. As innovative aspects we emphasized the low cost of development and maintenance, great versatility and handling simplicity with a modular design for interconnection with diverse data transmission media (Wi-Fi, GPRS, etc.). Successfully experiences were obtained during the acquisition of the signals and transmissions on wired LAN networks. As improvements, we can mention: energy consumption optimization and mobile communication systems usage, in order to offer more autonomy

  4. Proposed medical applications of the National Accelerator Centre facilities

    International Nuclear Information System (INIS)

    Jones, D.T.L.

    1982-01-01

    The National Accelerator Centre is at present under construction at Faure, near Cape Town. The complex will house a 200 MeV separated-sector cyclotron which will provide high quality beams for nuclear physics and related diciplines as well as high intensity beams for medical use. The medical aspects catered for will include particle radiotherapy, isotope production and possibly proton radiography. A 30-bed hospital is to be constructed on the site. Building operations are well advanced and the medical facilities should be available for use by the end of 1984

  5. The Rotterdam Rules from an Estonian perspective / Heiki Lindpere

    Index Scriptorium Estoniae

    Lindpere, Heiki, 1949-

    2010-01-01

    Rotterdami reeglite (Konventsioon lepingute kohta kaupade rahvusvaheliseks veoks täies ulatuses või osaliselt meritsi = Convention on Contracts for the International Carriage of Goods Wholly or Partly by Sea (Rotterdam Rules)) tähtsusest Eestile ja kaubaveo reguleerimisest Eesti õiguses

  6. Patient participation in the medical specialist encounter: does physicians' patient-centred communication matter?

    NARCIS (Netherlands)

    Zandbelt, Linda C.; Smets, Ellen M. A.; Oort, Frans J.; Godfried, Mieke H.; de Haes, Hanneke C. J. M.

    2007-01-01

    OBJECTIVE: Physicians' patient-centred communication is assumed to stimulate patients' active participation, thus leading to more effective and humane exchange in the medical consultation. We investigated the relationship between physicians' patient-centred communication and patient participation in

  7. Association of diabetes mellitus and dementia : The Rotterdam study

    NARCIS (Netherlands)

    Ott, A; Stolk, RP; Hofman, A; vanHarskamp, F; Grobbee, DE; Breteler, MMB

    1996-01-01

    Dementia and non-insulin-dependent diabetes mellitus (NIDDM) are highly prevalent disorders in the elderly. Diabetes has repeatedly been reported to affect cognition, but its relation with dementia is uncertain. We therefore studied the association between diabetes and dementia in the Rotterdam

  8. Particulates in the city background of Rotterdam, Netherlands; Fijn stof in de stadsachtergrond van Rotterdam

    Energy Technology Data Exchange (ETDEWEB)

    Voogt, M.; Keuken, M. [TNO Bouw en Ondergrond, Utrecht (Netherlands); Weijers, E.; Kraai, A. [ECN Biomassa, Kolen en Milieuonderzoek, Petten (Netherlands)

    2009-04-15

    The Dutch research programme particulate matter (Policy oriented research programme Particulate matter or BOP) has examined the city background of PM10 and PM2,5 in the Dutch city of Rotterdam. Currently, little is known about the variation in background concentrations among districts. The new European Directive has included an obligation to improve the city background in 2020 compared to 2010. It is not sufficiently clear, though, where the border lies between regional and urban background. Moreover, little is known about the uncertainties in the city background. In order to gain more insight, a study has been conducted of the spatial variability of the city background and the gradient of the regional background into the city background. This article presents the results of the study. [mk]. [Dutch] In het Nederlands onderzoeksprogramma fijn stof (Beleidsgeorienteerd Onderzoeksprogramma Particulate matter of BOP) is de stadsachtergrond van PM10 en PM2,5 in Rotterdam onderzocht. Er is echter nog weinig bekend over de variatie in de achtergrondconcentratie van wijk tot wijk. In de nieuwe Europese Richtlijn is een verplichting opgenomen om de stadsachtergrond in 2020 te verbeteren ten opzichte van 2010. Onvoldoende duidelijk is waar de grens tussen de regionale en stedelijke achtergrond ligt. Er is ook weinig bekend over de onzekerheid in de stadsachtergrond. Om meer inzicht te krijgen is onderzoek uitgevoerd naar de ruimtelijke variabiliteit van de stadsachtergrond en de gradient van de regionale achtergrond naar de stadsachtergrond. In dit artikel worden de resultaten van het onderzoek gepresenteerd.

  9. ASPECTS OF MULTIMODAL TRANSPORT IN THE ROTTERDAM RULES

    Directory of Open Access Journals (Sweden)

    Alina SULICU

    2012-11-01

    Full Text Available The United Nations Convention on Contracts for the International Carriage of Goods Wholly or Partly by Sea (hereinafter – The Rotterdam Rules or Convention signed on 23 September 2009 is taking a novel approach to international trade. It might be the reason why it has not received positive acknowledgement from the signatories, law experts and other interested parties. However, one might wonder whether the trade itself stayed novel-free during the past several decades. It should not come as a surprise that it has not. Tackle-to tackle approach is no longer applicable to a majority of contracts concluded that provide for delivery to the consignee’s doorstep, as of 1970 container ships and container terminals dominate cargo handling in ports and onboard the ship, electronic communication and documentation is becoming a common feature in the current trade. Even if there are more developments to be named, the aforementioned three make the regime under the Hague ,Hague-Visby and Hamburg Rules appear outdated. So is the unfamiliar approach as envisioned by the Rotterdam Rules really such a big failure?

  10. Theory-based practice in a major medical centre.

    Science.gov (United States)

    Alligood, Martha Raile

    2011-11-01

    This project was designed to improve care quality and nursing staff satisfaction. Nursing theory structures thought and action as demonstrated by evidence of improvement in complex health-care settings. Nursing administrators selected Modelling and Role-Modelling (MRM) for the theory-based practice goal in their strategic plan. An action research approach structured implementation of MRM in a 1-year consultation project in 2001-2002. Quality of health care improved according to national quality assessment ratings, as well as patient satisfaction and nurse satisfaction. Modelling and Role-Modelling demonstrated capacity to structure nursing thought and action in patient care in a major medical centre. Uniformity of patient care language was valued by nurses as well as by allied health providers who wished to learn the holistic MRM style of practice. The processes of MRM and action research contributed to project success. A positive health-care change project was carried out in a large medical centre with action research. Introducing MRM theory-based practice was a beneficial decision by nursing administration that improved care and nurse satisfaction. Attention to nursing practice stimulated career development among the nurses to pursue bachelors, masters, and doctoral degrees. © 2011 Blackwell Publishing Ltd.

  11. Isolates from wound infections at federal medical centre, bida ...

    African Journals Online (AJOL)

    A total of 589 wound swabs from 334 patients in Federal Medical Centre, Bida were studied. Samples were collected between Jan 2002 to Dec. 2003. Swabs were plated within one hour after collection unto blood, chocolate and Mac Conkey after plate, and incubated aerobically for 24hrs. The chocolate plated swabs were ...

  12. It's more than money: policy options to secure medical specialist workforce for regional centres.

    Science.gov (United States)

    May, Jennifer; Walker, Judi; McGrail, Mathew; Rolley, Fran

    2017-12-01

    Objectives Regional centres and their rural hinterlands support significant populations of non-metropolitan Australians. Despite their importance in the settlement hierarchy and the key medical services provided from these centres, little research has focused on their issues of workforce supply and long-term service requirements. In addition, they are a critical component of the recent growth of 'regional' hub-and-spoke specialist models of service delivery. Methods The present study interviewed 62 resident specialists in four regional centres, seeking to explore recruitment and retention factors important to their location decision making. The findings were used to develop a framework of possible evidence-informed policies. Results This article identifies key professional, social and locational factors, several of which are modifiable and amenable to policy redesign, including work variety, workplace culture, sense of community and spousal employment; these factors that can be targeted through initiatives in selection, training and incentives. Conclusions Commonwealth, state and local governments in collaboration with communities and specialist colleges can work synergistically, with a multiplicity of interdigitating strategies, to ensure a positive approach to the maintenance of a critical mass of long-term rural specialists. What is known about the topic? Rural origin increases likelihood of long-term retention to rural locations, with rural clinical school training associated with increased rural intent. Recruitment and retention policy has been directed at general practitioners in rural communities, with little focus on regional centres or medical specialists. What does this study add? Rural origin is associated with regional centre recruitment. Professional, social and locational factors are all moderately important in both recruitment and retention. Specialist medical training for regional centres ideally requires both generalist and subspecialist skills

  13. Multimodal Transportation: The Case of Laptop from Chongqing in China to Rotterdam in Europe

    Directory of Open Access Journals (Sweden)

    Young Joon Seo

    2017-09-01

    Full Text Available Multimodal transportation is a key component of modern logistics systems, especially for long-distance transnational transportation. This paper explores the various alternative routes for laptop exports from Chongqing, China to Rotterdam, the Netherlands. It selects seven available routes for laptop transportation from Chongqing to Rotterdam. The multimodal model was adopted to demonstrate alternative routes using various factors such as transport cost, transfer cost, transit time, transport distance, document charge, port congestion surcharge, customs charge, confidence index and so on. Among possible alternative routes, the results indicate that the route 6 was the fastest routes except for the air transport (route 7, while the route 1 was the cheapest and safest way. Nonetheless, route 1 may be not suitable for the laptop transport due to the importance of timeliness. The logisticians may able to utilize this research's findings to make a balance between transit time and transport cost for effective multimodal transport of laptops from Chongqing to Rotterdam.

  14. Performance Effects of the Corporatisation of Port of Rotterdam Authority

    NARCIS (Netherlands)

    P.W. de Langen (Peter); C. Heij (Christiaan)

    2013-01-01

    textabstractPort of Rotterdam Authority is a publicly owned but corporatized port development company. In 2004, this organisation was transformed from a municipal department to an independently operating company. The corporatisation intended to improve the overall performance of the port of

  15. 3D spatial information infrastructure : The case of Port Rotterdam

    NARCIS (Netherlands)

    Zlatanova, S.; Beetz, J.

    2012-01-01

    The development and maintenance of the infrastructure, facilities, logistics and other assets of the Port of Rotterdam requires a broad spectrum of heterogeneous information. This information concerns features, which are spatially distributed above ground, underground, in the air and in the water.

  16. 3D Spatial Information Infrastructure for the Port of Rotterdam

    NARCIS (Netherlands)

    Zlatanova, S.; Beetz, J.; Boersma, A.J.; Mulder, A.; Goos, J.

    2013-01-01

    The maintenance of the complex infrastructure and facilities of Port of Rotterdam is based on large amounts of heterogeneous information. Almost all activities of the Port require spatial information about features above- and under- ground. Current information systems are department and data

  17. Dietary patterns and changes in frailty status: the Rotterdam study

    NARCIS (Netherlands)

    de Haas, S.C.M. (Sandra C. M.); E.A.L. de Jonge (Ester); R.G. Voortman (Trudy); J.C.J. Steenweg-de Graaff (Jolien); Franco, O.H. (Oscar H.); M.A. Ikram (Arfan); Rivadeneira, F. (Fernando); J.C. Kiefte-de Jong (Jessica); J.D. Schoufour (Josje)

    2017-01-01

    textabstractPurpose: To determine the associations between a priori and a posteriori derived dietary patterns and a general state of health, measured as the accumulation of deficits in a frailty index. Methods: Cross-sectional and longitudinal analysis embedded in the population-based Rotterdam

  18. Statistical Modeling of the Trends Concerning the Number of Hospitals and Medical Centres in Romania

    Directory of Open Access Journals (Sweden)

    Gabriela OPAIT

    2017-04-01

    Full Text Available This study reveals the technique for to achive the shapes of the mathematical models which put in evidence the distributions of the values concerning the number of Hospitals, respectively Medical Centres, in our country, in the time horizon 2005-2014. In the same time, we can to observe the algorithm applied for to construct forecasts about the evolutions regarding the number of Hospitals and Medical Centres in Romania.

  19. Carnivalesque Enactment at the Children's Medical Centre of Rabin Hospital.

    Science.gov (United States)

    Lev-Aladgem, Shulamith

    2000-01-01

    Describes the basic characteristics of the "carnivalesque enactment" and its therapeutic potential. Explains a case study of the drama project at the Rabin Children's Medical Centre, how the carnivalesque enactment was developed step by step, and the kind of effect it stimulated among the children. Suggests new theatrical experiments with…

  20. Oil Pipelines, Politics and International Business : The Rotterdam Oil Port, Royal Dutch Shell and the German Hinterland, 1945-1975

    NARCIS (Netherlands)

    M. Boon (Marten)

    2014-01-01

    markdownabstractThe dissertation questions how and why the transition from coal to oil affected the economic relations between the Port of Rotterdam and its German hinterland between 1945 and 1975. From the 1880s onwards, Rotterdam had become the main seaport of the German industrial heartland in

  1. Medical Students and Patient-Centred Clinical Practice: The Case for More Critical Work in Medical Schools

    Science.gov (United States)

    Donetto, Sara

    2012-01-01

    In the last two decades, undergraduate medical education in the United Kingdom has undergone several important changes. Many of these have revolved around a paradigmatic shift from "paternalistic" to "patient-centred" approaches to healthcare. Adopting a Foucauldian understanding of power and borrowing from Freire's critical…

  2. Serum carotenoids and cerebral white matter lesions : The Rotterdam Scan Study

    NARCIS (Netherlands)

    den Heijer, T; Launer, LJ; de Groot, JG; de Leeuw, FE; Oudkerk, M; van Gijn, J; Hofman, A; Breteler, MMB

    OBJECTIVES: To study the relation between serum levels of carotenoids and white matter lesions (WMLs) on magnetic resonance imaging (MRI). DESIGN: Evaluation of cross-sectional data from a cohort study. SETTING: The Rotterdam Scan Study. PARTICIPANTS: Two hundred and three nondemented older persons,

  3. BONE-DENSITY IN NON-INSULIN-DEPENDENT DIABETES-MELLITUS - THE ROTTERDAM STUDY

    NARCIS (Netherlands)

    VANDAELE, PLA; STOLK, RP; BURGER, H; ALGRA, D; GROBBEE, DE; HOFMAN, A; BIRKENHAGER, JC; POLS, HAP

    1995-01-01

    Objective: To investigate the relation between noninsulin-dependent diabetes mellitus and bone mineral density at the lumbar spine and hip. Design: Population-based study with a cross-sectional survey, Setting: A district of Rotterdam, the Netherlands. Participants: 5931 residents (2481 men, 3450

  4. Person-centred interactions between nurses and patients during medication activities in an acute hospital setting: qualitative observation and interview study.

    Science.gov (United States)

    Bolster, Danielle; Manias, Elizabeth

    2010-02-01

    There is increasing emphasis on person-centred care within the literature and the health care context. It is suggested that a person-centred approach to medication activities has the potential to improve patient experiences and outcomes. This study set out to examine how nurses and patients interact with each other during medication activities in an acute care environment with an underlying philosophy of person-centred care. A qualitative approach was used comprising naturalistic observation and semi-structured interviews. The study setting was an acute care ward with a collaboratively developed philosophy of person-centre care, in an Australian metropolitan hospital. Eleven nurses of varying levels of experience were recruited to participate in observations and interviews. Nurses were eligible to participate if they were employed on the study ward in a role that incorporated direct patient care, including medication activities. A stratified sampling technique ensured that nurses with a range of years of clinical experience were represented. Patients who were being cared for by participating nurses during the observation period were recruited to participate unless they met the following exclusion criteria: those less than 18 years of age, non-English speaking patients, and those who were unable to give informed consent. Twenty-five patients were observed and 16 of those agreed to be interviewed. The results of the study generated insights into the nature of interactions between nurses and patients where person-centred care is the underlying philosophy of care. Three major themes emerged from the findings: provision of individualised care, patient participation and contextual barriers to providing person-centred care. While the participating nurses valued a person-centred approach and perceived that they were conducting medication activities in a person-centred way, some nurse-patient interactions during medication activities were centred on routines rather than

  5. Corrigendum to: It's more than money: policy options to secure medical specialist workforce for regional centres.

    Science.gov (United States)

    May, Jennifer; Walker, Judi; McGrail, Mathew; Rolley, Fran

    2017-12-01

    Objectives Regional centres and their rural hinterlands support significant populations of non-metropolitan Australians. Despite their importance in the settlement hierarchy and the key medical services provided from these centres, little research has focused on their issues of workforce supply and long-term service requirements. In addition, they are a critical component of the recent growth of 'regional' hub-and-spoke specialist models of service delivery. Methods The present study interviewed 62 resident specialists in four regional centres, seeking to explore recruitment and retention factors important to their location decision making. The findings were used to develop a framework of possible evidence-informed policies. Results This article identifies key professional, social and locational factors, several of which are modifiable and amenable to policy redesign, including work variety, workplace culture, sense of community and spousal employment; these factors that can be targeted through initiatives in selection, training and incentives. Conclusions Commonwealth, state and local governments in collaboration with communities and specialist colleges can work synergistically, with a multiplicity of interdigitating strategies, to ensure a positive approach to the maintenance of a critical mass of long-term rural specialists. What is known about the topic? Rural origin increases likelihood of long-term retention to rural locations, with rural clinical school training associated with increased rural intent. Recruitment and retention policy has been directed at general practitioners in rural communities, with little focus on regional centres or medical specialists. What does this study add? Rural origin is associated with regional centre recruitment. Professional, social and locational factors are all moderately important in both recruitment and retention. Specialist medical training for regional centres ideally requires both generalist and subspecialist skills

  6. Is open-angle glaucoma associated with early menopause? The Rotterdam Study

    NARCIS (Netherlands)

    Hulsman, C. A.; Westendorp, I. C.; Ramrattan, R. S.; Wolfs, R. C.; Witteman, J. C.; Vingerling, J. R.; Hofman, A.; de Jong, P. T.

    2001-01-01

    The authors examined the association between age at menopause and open-angle glaucoma among women aged > or = 55 years in the population-based Rotterdam Study (1990--1993). Information on age and type of menopause was obtained by interview. Subjects (n = 3,078) were stratified into three categories

  7. Tetanus in adult males, Bugando Medical Centre, United Republic of Tanzania.

    Science.gov (United States)

    Aziz, Riaz; Peck, Robert N; Kalluvya, Samuel; Kenemo, Bernard; Chandika, Alphonce; Downs, Jennifer A

    2017-11-01

    In the United Republic of Tanzania, the incidence of non-neonatal circumcision-related tetanus is probably underreported. We analysed charts and extracted information on outcome and wound location for non-neonatal cases of tetanus admitted to the intensive care unit of Bugando Medical Centre between 2001 and 2016. Bugando Medical Centre, which is one of four teaching referral hospitals in the United Republic of Tanzania, has a 13-bed intensive care unit that manages all admitted patients with tetanus. Within the United Republic of Tanzania, formal programmes of tetanus immunization are targeted at infants or women. From our inpatient logs, we identified six patients with non-neonatal tetanus among male patients with a recent history of circumcision. Only one of these patients had been circumcised within a subnational programme of voluntary medical male circumcision. The other five had been circumcised outside of the programme - e.g. at small rural dispensaries or by a traditional provider with no formal medical training. The six patients were aged 11-55 years and five (83%) of them died in hospital - all of overwhelming sepsis. Within the Tanzanian programme of voluntary medical male circumcision, education on wound hygiene probably helps to reduce the incidence of non-neonatal circumcision-related tetanus. The corresponding incidence among the boys and men who are circumcised beyond this subnational programme is probably higher. The training of all circumcision providers in wound care and a vaccination programme to ensure that male Tanzanians receive tetanus immunization post-infancy are recommended.

  8. The effect of introducing a helicopter trauma team to assist accident victims : a summary with conclusions and recommendations for further study. On behalf of the National Health Insurance Council.

    NARCIS (Netherlands)

    de Charro, F.T. & Oppe, S.

    1998-01-01

    An experiment involving the sending of emergency medical help by helicopter was started in The Netherlands on 1 May 1995. The SWOV Institute for Road Safety Research and the Centre for Health Policy and Law (CGBR) of the Erasmus University, Rotterdam, have investigated the effectiveness of a

  9. The epidemiology and type of medication errors reported to the National Poisons Information Centre of Ireland.

    Science.gov (United States)

    Cassidy, Nicola; Duggan, Edel; Williams, David J P; Tracey, Joseph A

    2011-07-01

    Medication errors are widely reported for hospitalised patients, but limited data are available for medication errors that occur in community-based and clinical settings. Epidemiological data from poisons information centres enable characterisation of trends in medication errors occurring across the healthcare spectrum. The objective of this study was to characterise the epidemiology and type of medication errors reported to the National Poisons Information Centre (NPIC) of Ireland. A 3-year prospective study on medication errors reported to the NPIC was conducted from 1 January 2007 to 31 December 2009 inclusive. Data on patient demographics, enquiry source, location, pharmaceutical agent(s), type of medication error, and treatment advice were collated from standardised call report forms. Medication errors were categorised as (i) prescribing error (i.e. physician error), (ii) dispensing error (i.e. pharmacy error), and (iii) administration error involving the wrong medication, the wrong dose, wrong route, or the wrong time. Medication errors were reported for 2348 individuals, representing 9.56% of total enquiries to the NPIC over 3 years. In total, 1220 children and adolescents under 18 years of age and 1128 adults (≥ 18 years old) experienced a medication error. The majority of enquiries were received from healthcare professionals, but members of the public accounted for 31.3% (n = 736) of enquiries. Most medication errors occurred in a domestic setting (n = 2135), but a small number occurred in healthcare facilities: nursing homes (n = 110, 4.68%), hospitals (n = 53, 2.26%), and general practitioner surgeries (n = 32, 1.36%). In children, medication errors with non-prescription pharmaceuticals predominated (n = 722) and anti-pyretics and non-opioid analgesics, anti-bacterials, and cough and cold preparations were the main pharmaceutical classes involved. Medication errors with prescription medication predominated for adults (n = 866) and the major medication

  10. The epidemiology and type of medication errors reported to the National Poisons Information Centre of Ireland.

    LENUS (Irish Health Repository)

    Cassidy, Nicola

    2012-02-01

    INTRODUCTION: Medication errors are widely reported for hospitalised patients, but limited data are available for medication errors that occur in community-based and clinical settings. Epidemiological data from poisons information centres enable characterisation of trends in medication errors occurring across the healthcare spectrum. AIM: The objective of this study was to characterise the epidemiology and type of medication errors reported to the National Poisons Information Centre (NPIC) of Ireland. METHODS: A 3-year prospective study on medication errors reported to the NPIC was conducted from 1 January 2007 to 31 December 2009 inclusive. Data on patient demographics, enquiry source, location, pharmaceutical agent(s), type of medication error, and treatment advice were collated from standardised call report forms. Medication errors were categorised as (i) prescribing error (i.e. physician error), (ii) dispensing error (i.e. pharmacy error), and (iii) administration error involving the wrong medication, the wrong dose, wrong route, or the wrong time. RESULTS: Medication errors were reported for 2348 individuals, representing 9.56% of total enquiries to the NPIC over 3 years. In total, 1220 children and adolescents under 18 years of age and 1128 adults (>\\/= 18 years old) experienced a medication error. The majority of enquiries were received from healthcare professionals, but members of the public accounted for 31.3% (n = 736) of enquiries. Most medication errors occurred in a domestic setting (n = 2135), but a small number occurred in healthcare facilities: nursing homes (n = 110, 4.68%), hospitals (n = 53, 2.26%), and general practitioner surgeries (n = 32, 1.36%). In children, medication errors with non-prescription pharmaceuticals predominated (n = 722) and anti-pyretics and non-opioid analgesics, anti-bacterials, and cough and cold preparations were the main pharmaceutical classes involved. Medication errors with prescription medication predominated for

  11. Experiences of violence, burnout and job satisfaction in Korean nurses in the emergency medical centre setting.

    Science.gov (United States)

    Yoon, Hee Sook; Sok, Sohyune R

    2016-12-01

    The aim of this study was to examine the experience of violence in relation to burnout and job satisfaction in Korean nurses in the emergency medical centre setting. Participants were 236 nurses in the emergency medical centre setting of three metropolitan areas in Korea. Measures included a general characteristics form, characteristics related to experiences of violence, the Maslach Burnout Inventory and the Minnesota Satisfaction Questionnaire. Data were collected from June 2013 to February 2014. In the prediction model, 33.4% of burnout was explained and 35.7% for job satisfaction. The greatest influence on burnout was handling violence, followed by verbal abuse. The greatest influence on job satisfaction was physical threat, followed by handling violence. The study shows that burnout and job satisfaction of Korean nurses in the emergency medical centre setting are related to experiences of violence such as verbal abuse, physical threat and physical violence, as well as handling violence. © 2016 John Wiley & Sons Australia, Ltd.

  12. Cataract surgery and the risk of aging macula disorder: The Rotterdam study

    NARCIS (Netherlands)

    L. Ho (Lintje); S. Boekhoorn (Sharmila); A. Liana (Alin); P. Tikka-Kleemola (Päivi); A.G. Uitterlinden (André); A. Hofman (Albert); P.T.V.M. de Jong (Paulus); Th. Stijnen (Theo); J.R. Vingerling (Hans)

    2008-01-01

    textabstractPURPOSE. To investigate still-controversial associations between prior cataract surgery and aging macula disorder (AMD) in a general population. METHODS. Baseline lens status and risk of incident AMD (iAMD) were examined in participants of the prospective population-based Rotterdam Study

  13. Erasmus of Rotterdam (1466-1536): renaissance advocate of the public role of medicine.

    Science.gov (United States)

    Albury, W R; Weisz, G M

    2003-08-01

    The great Renaissance scholar Erasmus of Rotterdam was a pioneering advocate of the importance of medicine for social as well as individual welfare. Erasmus' "Oration in praise of the art of medicine" (1518) illustrates his literary approach to this topic. Although the original version of his text did not address the state's role in promoting the health of the populace, Erasmus inserted new material on this topic into the "Oration" for a 1529 edition. This new material and references in some of his other writings from the same period indicate that it was in the 1520s that Erasmus first became a strong advocate of government intervention in public health matters. It is suggested that medical events in Erasmus' own life-his experiences both as a patient and as an observer of diseases-may explain why his interest in public health legislation increased significantly around this time.

  14. The medical social centres in support of Roma in Greece

    DEFF Research Database (Denmark)

    Andrioti, Despena; Kotrotsou, Christina; Tsakatara, Vanta

    2013-01-01

    . Medical social centres operate in 33 Roma settlements all over the country. These centres provide vaccination, health promotion, disease prevention and health education services, as well as support in issuing documents and making appointments with health and social services. We recommend that the National......Roma people form the largest ethnic-minority group in Europe. They account for around 10 to 12 million people, and they face racism, discrimination and social exclusion in most countries. The Roma population of Greece currently numbers around 250 000 individuals. They have Greek nationality...... and enjoy the same rights, privileges and responsibilities as any other Greek citizens. Nevertheless, Roma in Greece face multiple inequalities and social exclusion in terms of housing, employment, education, and health and social services. In this report we present the outcome of a bestpractice initiative...

  15. Prevalence and incidence of COPD in smokers and non-smokers: the Rotterdam Study.

    Science.gov (United States)

    Terzikhan, Natalie; Verhamme, Katia M C; Hofman, Albert; Stricker, Bruno H; Brusselle, Guy G; Lahousse, Lies

    2016-08-01

    COPD is the third leading cause of death in the world and its global burden is predicted to increase further. Even though the prevalence of COPD is well studied, only few studies examined the incidence of COPD in a prospective and standardized manner. In a prospective population-based cohort study (Rotterdam Study) enrolling subjects aged ≥45, COPD was diagnosed based on a pre-bronchodilator obstructive spirometry (FEV1/FVC smokers. The proportion of female COPD participants without a history of smoking was 27.2 %, while this proportion was 7.3 % in males. The prevalence of COPD in the Rotterdam Study is 4.7 % and the overall incidence is approximately 9/1000 PY, with a higher incidence in males and in smokers. The proportion of never-smokers among female COPD cases is substantial.

  16. A very large proportion of young Danish women have polycystic ovaries: is a revision of the Rotterdam criteria needed?

    DEFF Research Database (Denmark)

    Kristensen, Susanne Lund; Ramlau-Hansen, Cecilia; Ernst, Erik

    2010-01-01

    According to the Rotterdam 2003 criteria, an ovary is defined as polycystic if 12 or more follicles of 2-9 mm are present, when evaluating the ovary by ultrasonography on Days 3-5 of the menstrual cycle in women not using hormonal contraceptives. The aim of this population-based study...... was to estimate the prevalence of polycystic ovaries (PCO) in a representative sample of young Danish women according to the Rotterdam criteria....

  17. Bodies or organisms? Medical encounter as a control apparatus at a primary care centre in Barcelona

    Directory of Open Access Journals (Sweden)

    Alejandro Zaballos Samper

    2013-07-01

    Full Text Available Medical practice is driven by technology, discourses, and knowledge about health and illness. This has resulted in its gaining a dominating position in power relations achieved by means of diagnosis, medicalization, and habit and conduct creation and maintenance. Interaction at primary care centres is built on mainstream biomedical views of both the medical discourse and the social practices related to health, illness and the human body. Moreover, it is also rooted on the ideologies conveyed by those social concepts, which in turn, permeate interaction all through with power relations. The present paper takes ethnographic data and in-depth interviews as a departing point to analyse how diagnosis, medicalization, and biopolicies for health prevention and improvement carried out in primary care centres in Barcelona make up a control apparatus. Furthermore, this essay also explores how the apparatus is developed in the medical encounter and turns the body into an organism.

  18. Assessing Public Leadership Styles for Innovation: A Comparison of Copenhagen, Rotterdam and Barcelona

    NARCIS (Netherlands)

    L.M. Ricard (Lykke Margot); E-H. Klijn (Erik-Hans); J.M. Lewis (Jenny M.); T. Ysa (Tamyko)

    2017-01-01

    textabstractThis article explores which leadership qualities public managers regard as important for public innovation. It is based on a survey of 365 senior public managers in Copenhagen, Rotterdam and Barcelona. Five perspectives on leadership were identified and tested using a number of items.

  19. Recognition of out-of-hospital cardiac arrest by medical dispatchers in emergency medical dispatch centres in two countries

    DEFF Research Database (Denmark)

    Møller, Thea Palsgaard; Andréll, Cecilia; Viereck, Søren

    2016-01-01

    in two steps; registry data were merged with electronically registered emergency call data from the emergency medical dispatch centres in the two regions. Cases with missing or non-OHCA dispatch codes were analysed further by auditing emergency call recordings using a uniform data collection template......INTRODUCTION: Survival after out-of-hospital cardiac arrest (OHCA) remains low. Early recognition by emergency medical dispatchers is essential for an effective chain of actions, leading to early cardiopulmonary resuscitation, use of an automated external defibrillator and rapid dispatching...... of the emergency medical services. AIM: To analyse and compare the accuracy of OHCA recognition by medical dispatchers in two countries. METHOD: An observational register-based study collecting data from national cardiac arrest registers in Denmark and Sweden during a six-month period in 2013. Data were analysed...

  20. Meditation and yoga practice are associated with smaller right amygdala volume: the Rotterdam study

    NARCIS (Netherlands)

    R.A. Gotink (Rinske); M.W. Vernooij (Meike); M.K. Ikram (Kamran); W.J. Niessen (Wiro); Krestin, G.P. (Gabriel P.); A. Hofman (Albert); H.W. Tiemeier (Henning); M.G.M. Hunink (Myriam)

    2018-01-01

    textabstractTo determine the association between meditation and yoga practice, experienced stress, and amygdala and hippocampal volume in a large population-based study. This study was embedded within the population-based Rotterdam Study and included 3742 participants for cross-sectional

  1. A step towards functional integration : Reflection program case ‘Rotterdam roof park’

    NARCIS (Netherlands)

    Kok, M.; Kothuis, Baukje; Kok, Matthijs

    2017-01-01

    Many functions are combined in the Rotterdam Roof Park project: It is a shopping mall, a parking garage, a park on the roof, and last but not least, a flood defense. The research in our program was done after the buildings and structures had been built. So the

  2. Line and Form: linear, areal, inclusive and accessible public spaces. Hoofbogen in Rotterdam

    Directory of Open Access Journals (Sweden)

    Maurizio Francesco Errigo

    2013-06-01

    Full Text Available In the contemporary city places more and more lose their character of physical stock and became space of flow; the city isn’t characterized by its immobile uniqueness, but is modified and reassembled at the rate of circulation in it comes to life. Today the city is presented as a set of discontinuous fragments, which return an image of plural spaces, places and non-places, past and present. Disappearing borders, perimeters, which marked the places, neighborhoods are uncommon spaces, undefined areas between built and unbuilt. The square is the gap in the building density; it has lost its significance as a place of socialization. The recent planning instruments (plans and programs that belong to the city of Rotterdam are geared to transform the city into a “child-friendly city" (city suitable for children, the city attracts young couples and middle-class families just for the fact that the city is distancing itself from the modernist planning based on the zoning and is encouraging the mix of urban functions; particular emphasis in this phase of planning and urban design is given by the statement of the urban Vision Rotterdam 2030. The case dealt with in the article is related to the area of ​​Bergpolder, in the north of Rotterdam, an area affected by a strong identity disposed element, a railway viaduct, and is characterized by a strong strategic value for the location and proximity with the urban center and is affected by both social and economic problem due to the insufficiency of public spaces, the use of spaces and public facilities, to the social mixité, characterized by the mixture of different ethnic groups.

  3. Put the plug in. Shore-side electricity for moored sea ships can improve environmental quality in Rotterdam, Netherlands; Of je stopt de stekker erin. Walstroom voor afgemeerde zeeschepen kan de omgevingskwaliteit in Rotterdam verbeteren

    Energy Technology Data Exchange (ETDEWEB)

    Okkerse, W.J.; Molenaar, R. [DCMR Milieudienst Rijnmond, Schiedam (Netherlands)

    2011-10-15

    Moored vessels consume much energy for their 'hotel' function: heating, cooling and lighting. Containers with perishable goods are cooled. Mammoth oil tankers unload oil onshore. That takes a lot of energy and cause much emissions to the air. Use of quay-side electricity can reduce such emissions considerably. Global developments bring the use of onshore power a step closer. This article discusses the environmental benefits for Rotterdam, Netherlands. [Dutch] Afgemeerde zeeschepen verbruiken veel energie voor hun 'hotel' functie: verwarming, verlichting en koeling. Containers met bederfelijke goederen worden gekoeld. Mammoettankers Iossen olie naar de wal. Dat kost veel energie en de bijbehorende emissies zijn groot. Toepassing van walstroom kan deze emissies sterk verminderen. Mondiale ontwikkelingen zorgen ervoor dat toepassing van walstroom een stapje dichterbij is gekomen. In dit artikel wordt de milieuwinst berekend voor Rotterdam.

  4. The role of marshall and rotterdam score in predicting 30-day outcome of traumatic brain injury

    Science.gov (United States)

    Siahaan, A. M. P.; Akbar, T. Y. M.; Nasution, M. D.

    2018-03-01

    Traumatic brain injury (TBI) remains one of the leading causes of mortality and morbidity, especially in the young population. To predict the outcome of TBI, Marshall, and Rotterdam–CT Scan based scoring was mostly used. As many studies showed conflicting results regarding of the usage of both scoring, this study aims to determine the correlation between Rotterdam and Marshall scoring system with outcome in 30 days and found correlation among them. In 120 subjects with TBI that admitted to Adam Malik General Hospital, we found a significant association of both scorings with the 30-day Glasgow Outcome Score. Therefore, we recommend the use of Marshall and Rotterdam CT Score in initial assessment as a good predictor for patients with TBI.

  5. Paediatric medical emergency calls to a Danish Emergency Medical Dispatch Centre: a retrospective, observational study.

    Science.gov (United States)

    Andersen, Kasper; Mikkelsen, Søren; Jørgensen, Gitte; Zwisler, Stine Thorhauge

    2018-01-05

    Little is known regarding paediatric medical emergency calls to Danish Emergency Medical Dispatch Centres (EMDC). This study aimed to investigate these calls, specifically the medical issues leading to them and the pre-hospital units dispatched to the paediatric emergencies. We performed a retrospective, observational study on paediatric medical emergency calls managed by the EMDC in the Region of Southern Denmark in February 2016. We reviewed audio recordings of emergency calls and ambulance records to identify calls concerning patients ≤ 15 years. We examined EMDC dispatch records to establish how the medical issues leading to these calls were classified and which pre-hospital units were dispatched to the paediatric emergencies. We analysed the data using descriptive statistics. Of a total of 7052 emergency calls in February 2016, 485 (6.9%) concerned patients ≤ 15 years. We excluded 19 and analysed the remaining 466. The reported medical issues were commonly classified as: "seizures" (22.1%), "sick child" (18.9%) and "unclear problem" (12.9%). The overall most common pre-hospital response was immediate dispatch of an ambulance with sirens and lights with a supporting physician-manned mobile emergency care unit (56.4%). The classification of medical issues and the dispatched pre-hospital units varied with patient age. We believe our results might help focus the paediatric training received by emergency medical dispatch staff on commonly encountered medical issues, such as the symptoms and conditions pertaining to the symptom categories "seizures" and "sick child". Furthermore, the results could prove useful in hypothesis generation for future studies examining paediatric medical emergency calls. Almost 7% of all calls concerned patients ≤ 15 years. Medical issues pertaining to the symptom categories "seizures", "sick child" and "unclear problem" were common and the calls commonly resulted in urgent pre-hospital responses.

  6. Knowledge and perceptions of physicians from private medical centres towards generic medicines: a nationwide survey from Malaysia.

    Science.gov (United States)

    Kumar, Rohit; Hassali, Mohamed Azmi; Saleem, Fahad; Alrasheedy, Alian A; Kaur, Navneet; Wong, Zhi Yen; Kader, Muhamad Ali Sk Abdul

    2015-01-01

    Generic medicine prescribing has become a common practice in public hospitals. However, the trend in private medical centres seems to be different. The objective of this study was to investigate knowledge, perceptions and behavior of physicians from private medical centres in Malaysia regarding generic medicines. This study was a cross-sectional nationwide survey targeting physicians from private medical centres in Malaysia. The survey was conducted using questionnaire having (i) background and demographic data of the physicians, volume of prescription in a day, stock of generic medicines in their hospital pharmacy etc. (ii) their knowledge about bioequivalence (iii) prescribing behavior (iv) physicians' knowledge of quality, safety and efficacy of generic medicines, and their cost (v) perceptions of physicians towards issues pertaining to generic medicines utilization. A total of 263 questionnaires out of 735 were received, giving a response rate of 35.8%. Of the respondents, 214 (81.4%) were male and 49 (18.6%) were females. The majority of the participants were in the age range of 41-50 years and comprised 49.0% of the respondents. Only 2.3% of physicians were aware of the regulatory limits of bioequivalence standards in Malaysia. Of the respondents, 23.2% agreed that they 'always' write their prescriptions using originator product name whereas 50.2% do it 'usually'. A number of significant associations were found between their knowledge, perceptions about generic medicines and their demographic characteristics. The majority of the physicians from private medical centres in Malaysia had negative perceptions about safety, quality and the efficacy of generic medicines. These negative perceptions could be the cause of the limited use of generic medicines in the private medical centres. Therefore, in order to facilitate their use, it is recommended that the physicians need to be reassured and educated about the drug regulatory authority approval system of generic

  7. Investigating Multiculturalism and Mono-Culturalism through the Infrastructure of Integration in Rotterdam, the Netherlands

    Science.gov (United States)

    Long, Jennifer

    2015-01-01

    This paper explores first-hand experiences of citizenship education specifically-designed for immigrants from the perspective of native Dutch settlement workers and volunteers in Rotterdam, the Netherlands. Based on eight months of ethnographic research and in-depth interviews with settlement workers, this article explores how these "minor…

  8. Mortality and life expectancy in homeless men and women in Rotterdam: 2001-2010.

    Directory of Open Access Journals (Sweden)

    Wilma J Nusselder

    Full Text Available BACKGROUND: Data on mortality among homeless people are limited. Therefore, this study aimed to describe mortality patterns within a cohort of homeless adults in Rotterdam (the Netherlands and to assess excess mortality as compared to the general population in that city. METHODS: Based on 10-year follow-up of homeless adults aged ≥ 20 years who visited services for homeless people in Rotterdam in 2001, and on vital statistics, we assessed the association of mortality with age, sex and type of service used (e.g. only day care, convalescence care, other within the homeless cohort, and also compared mortality between the homeless and general population using Poisson regression. Life tables and decomposition methods were used to examine differences in life expectancy. RESULTS: During follow-up, of the 2096 adult homeless 265 died. Among the homeless, at age 30 years no significant sex differences were found in overall mortality rates and life expectancy. Compared with the general Rotterdam population, mortality rates were 3.5 times higher in the homeless cohort. Excess mortality was larger in women (rate ratio [RR] RR 5.56, 95% CI 3.95-7.82 as compared to men (RR 3.31, 95% CI 2.91-3.77, and decreased with age (RR 7.67, 95% CI 6.87-8.56 for the age group 20-44 and RR 1.63, 95% CI 1.41-1.88 for the age group 60+ years. Life expectancy at age 30 years was 11.0 (95% CI 9.1-12.9 and 15.9 (95% CI 10.3-21.5 years lower for homeless men and women compared to men and women in the general population respectively. CONCLUSION: Homeless adults face excessive losses in life expectancy, with greatest disadvantages among homeless women and the younger age groups.

  9. Teachers' conceptions of learning and teaching in student-centred medical curricula: the impact of context and personal characteristics

    NARCIS (Netherlands)

    Jacobs, J.C.G.; Luijk, S.J. van; Vleuten, C.P.M. van der; Kusurkar, R.A.; Croiset, G.; Scheele, F.

    2016-01-01

    BACKGROUND: Gibbs and Coffey (2004) have reported that teaching practices are influenced by teachers' conceptions of learning and teaching. In our previous research we found significant differences between teachers' conceptions in two medical schools with student-centred education. Medical school

  10. Environmental impacts of international shipping. A case study of the port of Rotterdam

    International Nuclear Information System (INIS)

    Den Boer, E.; Verbraak, G.

    2010-01-01

    As part of the project 'Environmental Impacts of International Shipping: the role of ports' of the Working Group on Transport under OECD's Environment Policy Committee, CE Delft carried out this case study focusing on how the port of Rotterdam and the Dutch authorities address the environmental impacts of the port and its interactions with the hinterlands.

  11. Enkele hydrologische aspecten van een bodem- en grondwaterverontreiniging op het fabrieksterrein van Nestle te Rotterdam

    NARCIS (Netherlands)

    Mulschlegel; J.; Kusse; A.A.M.

    1984-01-01

    De Regionaal Inspecteur van de Volksgezondheid voor de Milieuhygiene voor Zuid-Holland verzocht RIVM-LBG inzicht te geven in de eventuele verbreiding van een verontreiniging op het fabrieksterrein van Nestle te Rotterdam. Bij het uitgevoerde onderzoek is gebruik gemaakt van een 3-dimensionaal

  12. A Local Dimension of Integration Policies? A Comparative Study of Berlin, Malmö, and Rotterdam

    NARCIS (Netherlands)

    R. Dekker (Rianne); H. Emilsson (Henrik); B. Krieger (Bernhard); P.W.A. Scholten (Peter)

    2015-01-01

    textabstractThis study examines three theses on local integration policies by a qualitative comparative case study of integration policies in three cities in three different countries (Berlin, Malmö, and Rotterdam). We found little evidence of a congruent local dimension of integration policies.

  13. Acute care in Tanzania: Epidemiology of acute care in a small community medical centre

    Directory of Open Access Journals (Sweden)

    Rachel M. Little

    2013-12-01

    Discussion: Respiratory infections, malaria, and skin or soft tissue infections are leading reasons for seeking medical care at a small community medical centre in Arusha, Tanzania, highlighting the burden of infectious diseases in this type of facility. Males may be more likely to present with trauma, burns, and laceration injuries than females. Many patients required one or no procedures to determine their diagnosis, most treatments administered were inexpensive, and most patients were discharged home, suggesting that providing acute care in this setting could be accomplished with limited resources.

  14. Enhancing of Carriers’ Liabilities in the Rotterdam Rules – Too Expensive Costs for Navigational Safety?

    Directory of Open Access Journals (Sweden)

    P. Sooksripaisarnkit

    2014-06-01

    Full Text Available The United Nations Convention on Contracts for the International Carriage of Goods Wholly or Partly by Sea (the ‘Rotterdam Rules’ was adopted by the General Assembly of the United Nations on 11 December 2008. The Rotterdam Rules contain two oft-criticised changes from the existing regime governing international carriage of goods widely adopted among maritime nations, namely the International Convention for the Unification of Certain Rules Relating to Bills of Lading, Brussels, 25 August 1924 (the ‘Hague Rules’ and its subsequent Protocol in 1968 (the ‘Visby Protocol’ or the ‘Hague-Visby Rules’. These changes are, namely, an extension of the carrier’s obligations to maintain seaworthy vessel throughout the voyage (Article 14 and a deletion of an exclusion of carrier’s liabilities due to negligent navigation (Article 17. This paper addresses implications of these changes and assess whether ship-owners and ship-operators can comply with these without having to incur excessive additional expenses.

  15. A Modelling Approach for Integrated Planning of Port Capacity- Trade-Offs in Rotterdam Investment Planning

    Directory of Open Access Journals (Sweden)

    Sander Dekker

    2006-03-01

    Full Text Available This paper presents a modelling approach for planning ofport capacity. The approach integrates port commercial andpublic interests. It further incorporates route competition andautonomous demand growth. It is applied to port expansion,which can be considered as a strategy for an individual port todeal with route competition. The basis for solving this planningproblem comprises an analysis of port demand and supply in apartial equilibrium model. With such an approach, the reactionof a single port on the change in a transport network comprisingalternative routes to a hinterland destination can be simulated.To establish the optimal expansion strategy, port expansion iscombined with congestion pricing. This is used for the simultaneousdetermination of 1 optimal expansion size, and 2 investmentrecovery period. The modelling approach will be appliedto Rotterdam port focusing on port expansion by means ofland reclamation. The scenmio of the entry of a new competingroute via the Italian port Gioia Tauro is used to address sometrade-offs in Rotterdam investment planning.

  16. Rising incidence of chancroid in Rotterdam. Epidemiological, clinical, diagnostic, and therapeutic aspects.

    Science.gov (United States)

    Nayyar, K C; Stolz, E; Michel, M F

    1979-01-01

    The incidence of chancroid in Rotterdam has increased by more than five-fold during 1977-78. In a retrospective study of 53 patients with chancroid seen at this clinic during this period, the results of smears were positive in 82% and of cultures in 84% (of those for whom cultures had been performed). Symptoms were generally mild. Treatment with co-trimoxazole was highly effective clinically, as confirmed by in-vitro sensitivity studies. PMID:526847

  17. Needlestick injuries and infectious patients in a major academic medical centre from 2003 to 2010

    NARCIS (Netherlands)

    Frijstein, G.; Hortensius, J.; Zaaijer, H. L.

    2011-01-01

    To implement adequate preventive measures in a hospital, the number and nature of occupational exposures to blood must be known. In the Amsterdam Academic Medical Centre a standardised procedure was used to assess all reported occupational exposures to blood from 2003 to 2010. 1601 incidents were

  18. Sport as a vehicle for social mobility and regulation of disadvantaged urban youth: lessons from Rotterdam

    NARCIS (Netherlands)

    Spaaij, R.

    2009-01-01

    This article addresses sport's contribution to social mobility of disadvantaged urban youth through an analysis of the Sport Steward Program in Rotterdam, the Netherlands. Sport-based social intervention programs are conceptualized as potential vehicles for the creation of different forms of capital

  19. Improving A Priori Demand Estimates Transport Models using Mobile Phone Data : A Rotterdam-Region Case

    NARCIS (Netherlands)

    Wismans, Luc Johannes Josephus; Friso, K.; Rijsdijk, J.; de Graaf, S.W.; Keij, J.

    2018-01-01

    Mobile phone data are a rich source to infer all kinds of mobility- related information. In this research, we present an approach where mobile phone data are used and analyzed for enriching the transport model of the region of Rotterdam. In this research Call Detail Records (CDR) are used from a

  20. MR guided applicator reconstruction for brachytherapy of cervical cancer using the novel titanium Rotterdam applicator

    International Nuclear Information System (INIS)

    Petit, Steven; Wielopolski, Piotr; Rijnsdorp, Reneé; Mens, Jan-Willem; Kolkman-Deurloo, Inger-Karine

    2013-01-01

    A novel model of the titanium Rotterdam tandem and ovoid applicator is presented. As titanium produces artefacts in MR images, an MR sequence was sought and optimised for visualisation and accurate applicator reconstruction. The mean inter-observer (8 observers) variability for four patients was only 0.7 mm (maximum 1.7 mm)

  1. Improving A Priori Demand Estimates Transport Models using Mobile Phone Data : A Rotterdam-Region Case

    NARCIS (Netherlands)

    Wismans, Luc Johannes Josephus; Friso, K.; Rijsdijk, J.; de Graaf, S.W.; Keij, J.

    2016-01-01

    Mobile phone data are a rich source to infer all kinds of mobility related information. In this research we present an approach where mobile phone data is used and analysed for enriching the transport model of the region of Rotterdam. In our research we used Call Detail Records (CDR) from one of the

  2. Early CT findings to predict early death in patients with traumatic brain injury: Marshall and Rotterdam CT scoring systems compared in the major academic tertiary care hospital in northeastern Japan.

    Science.gov (United States)

    Mata-Mbemba, Daddy; Mugikura, Shunji; Nakagawa, Atsuhiro; Murata, Takaki; Ishii, Kiyoshi; Li, Li; Takase, Kei; Kushimoto, Shigeki; Takahashi, Shoki

    2014-05-01

    Computed tomography (CT) plays a crucial role in early assessment of patients with traumatic brain injury (TBI). Marshall and Rotterdam are the mostly used scoring systems, in which CT findings are grouped differently. We sought to determine the scoring system and initial CT findings predicting the death at hospital discharge (early death) in patients with TBI. We included 245 consecutive adult patients with mild-to-severe TBI. Their initial CT and status at hospital discharge (dead or alive) were reviewed, and both CT scores were calculated. We examined whether each score was related to early death; compared the two scoring systems' performance in predicting early death, and identified the CT findings that are independent predictors of early death. More deaths occurred among patients with higher Marshall and Rotterdam scores (both P death (Marshall, AUC = 0. 85 vs. Rotterdam, AUC = 0.85). Basal cistern absence (odds ratio [OR] = 771.5, P death. Both Marshall and Rotterdam scoring systems can be used to predict early death in patients with TBI. The performance of the Marshall score is at least equal to that of the Rotterdam score. Thus, although older, the Marshall score remains useful in predicting patients' prognosis. Copyright © 2014 AUR. Published by Elsevier Inc. All rights reserved.

  3. The joint cardiovascular research profile of the university medical centres in the Netherlands.

    Science.gov (United States)

    van Welie, S D; van Leeuwen, T N; Bouma, C J; Klaassen, A B M

    2016-05-01

    Biomedical scientific research in the Netherlands has a good reputation worldwide. Quantitatively, the university medical centres (UMCs) deliver about 40 % of the total number of scientific publications of this research. Analysis of the bibliometric output data of the UMCs shows that their research is highly cited. These output-based analyses also indicate the high impact of cardiovascular scientific research in these centres, illustrating the strength of this research in the Netherlands. A set of six joint national cardiovascular research topics selected by the UMCs can be recognised. At the top are heart failure, rhythm disorder research and atherosclerosis. National collaboration of top scientists in consortia in these three areas is successful in acquiring funding of large-scale programs. Our observations suggest that funding national consortia of experts focused on a few selected research topics may increase the international competitiveness of cardiovascular research in the Netherlands.

  4. Ideas that persist for centuries - by Erasmus of Rotterdam, the prince of humanists.

    Science.gov (United States)

    Brucknerova, Ingrid; Holomanova, Anna; Mach, Mojmir; Ujhazy, Eduard

    2013-01-01

    The paper highlights the personality of the founder of European student exchange program ERASMUS (EuRopean Community Action Scheme for the Mobility of University Students) Erasmus of Rotterdam. He was one of the leading European humanists and has left a literary legacy of large dimensions. His thoughts, ideas, opinions, and mainly the works have a great benefit for society even today. From 16th century to the present time they are the subject of unchanged interest.

  5. CLINICIAN SENSITIZATION ON INTEGRATED DISEASE SURVEILLANCE AND RESPONSE IN FEDERAL MEDICAL CENTRE OWO, ONDO STATE, NIGERIA, 2016

    Directory of Open Access Journals (Sweden)

    Olayinka Stephen Ilesanmi

    2017-06-01

    Full Text Available Background: For effective Integrated Disease Surveillance and Response (IDSR all health care workers involvement is required. Most trainings have often neglected the clinicians. Aim: This study aimed to identify gaps requiring capacity building in preventing infectious disease outbreak among health care workers in Federal Medical Centre, Owo, Ondo State. Methods: A cross sectional study of clinicians at the Federal Medical Centre, Owo was done. Data was collected using semi structured interviewer administered questionnaire. Data collected were analysed with SPSS version 21. Summary statistics was conducted to identify training need requirements. Results: The mean age of participant was 43 ± 5.9 years, 14(70% were male. Respondents who have worked for 10 years and above were 12(60%. In all, 5(25% respondent understood disease surveillance to be systematic collection of data and analysis in order to prevent diseases. Regarding respondent’s knowledge of notifiable diseases. Only 4(20% of the respondents knew malaria as a notifiable disease, Cholera knew by 11(55%, Ebola by 15(75% and Lassa by 13(65%. The main factor identified to be affecting prompt disease notification in Federal Medical Centre, Owo was lack of adequate training 12(60% while communication gap was identified by 7(35%. In all, 18(90% felt they do not know all that they needed about disease surveillance. Conclusion: Rapid notification of infectious diseases is essential for prompt public health action and for monitoring of disease trends. Trainings that will improve the level of knowledge of clinician and communication channels will improve disease surveillance and notification.

  6. High Prevalence of Polycystic Ovary Syndrome in Type 1 Diabetes Mellitus Adolescents: Is There a Difference Depending on the NIH and Rotterdam Criteria?

    Science.gov (United States)

    Busiah, Kanetee; Colmenares, Ana; Bidet, Maud; Tubiana-Rufi, Nadia; Levy-Marchal, Claire; Delcroix, Christine; Jacquin, Paul; Martin, Delphine; Benadjaoud, Lila; Jacqz-Aigrain, Evelyne; Laborde, Kathleen; Robert, Jean-Jacques; Samara-Boustani, Dinane; Polak, Michel

    2017-01-01

    Polycystic ovary syndrome (PCOS) is more frequently observed in type 1 diabetes mellitus (T1DM) adult women than in nondiabetic women. No such prevalence has yet been studied in adolescent girls with T1DM. The aim of this study was to evaluate the prevalence of PCOS in adolescent girls with T1DM and to determine the clinical and hormonal features associated with the disorder. A cross-sectional study of 53 adolescent girls (gynecological age >2 years) referred for routine evaluation for T1DM was conducted. We diagnosed PCOS using the National Institutes of Health (NIH) and Rotterdam criteria. 26.4 and 47.9% of adolescents had PCOS according to NIH (NIH-PCOS) and Rotterdam (Rotterdam-PCOS) criteria. 66.7% of NIH-PCOS adolescents had a complete phenotype associated with hyperandrogenism, oligomenorrhea, and polycystic ovarian morphology, unlike only 33.3% of the Rotterdam-PCOS adolescents. A family history of type 2 diabetes mellitus (T2DM) was more frequent in PCOS than in non-PCOS girls, whichever criteria were used. Late pubertal development and a T1DM diagnosis close to puberty were factors associated with NIH-PCOS. Adolescents with T1DM had a high prevalence of PCOS. More differences between PCOS and non-PCOS patients were found using the NIH criteria, suggesting that clinical characteristics might be more accurate for diagnosing PCOS in girls with T1DM. A family history of T2DM is associated with a high risk of PCOS. © 2017 S. Karger AG, Basel.

  7. Is cost-effective healthcare compatible with publicly financed academic medical centres?

    Science.gov (United States)

    Chia, Whay Kuang; Toh, Han Chong

    2013-01-01

    Probably more than any country, Singapore has made significant investment into the biomedical enterprise as a proportion of its economy and size. This focus recently witnessed a shift towards a greater emphasis on translational and clinical development. Key to the realisation of this strategy will be Academic Medical Centres (AMCs), as a principal tool to developing and applying useful products for the market and further improving health outcomes. Here, we explore the principal value proposition of the AMC to Singapore society and its healthcare system. We question if the values inherent within academic medicine--that of inquiry, innovation, pedagogy and clinical exceptionalism--can be compatible with the seemingly paradoxical mandate of providing cost-effective or rationed healthcare.

  8. Contributing Determinants to Hearing Loss in Elderly Men and Women: Results from the Population-Based Rotterdam Study

    NARCIS (Netherlands)

    S.C. Rigters (Stephanie); R.M. Metselaar (Mick); Wieringa, M.H. (Marjan H.); De Jong, R.J.B. (Robert J. Baatenburg); A. Hofman (Albert); A. Goedegebure (Andre)

    2016-01-01

    textabstractTo contribute to a better understanding of the etiology in age-related hearing loss, we carried out a cross-sectional study of 3,315 participants (aged 52-99 years) in the Rotterdam Study, to analyze both low- and high-frequency hearing loss in men and women. Hearing thresholds with

  9. An antenatal prediction model for adverse birth outcomes in an urban population: The contribution of medical and non-medical risks.

    Science.gov (United States)

    Posthumus, A G; Birnie, E; van Veen, M J; Steegers, E A P; Bonsel, G J

    2016-07-01

    in the Netherlands the perinatal mortality rate is high compared to other European countries. Around eighty percent of perinatal mortality cases is preceded by being small for gestational age (SGA), preterm birth and/or having a low Apgar-score at 5 minutes after birth. Current risk detection in pregnancy focusses primarily on medical risks. However, non-medical risk factors may be relevant too. Both non-medical and medical risk factors are incorporated in the Rotterdam Reproductive Risk Reduction (R4U) scorecard. We investigated the associations between R4U risk factors and preterm birth, SGA and a low Apgar score. a prospective cohort study under routine practice conditions. six midwifery practices and two hospitals in Rotterdam, the Netherlands. 836 pregnant women. the R4U scorecard was filled out at the booking visit. after birth, the follow-up data on pregnancy outcomes were collected. Multivariate logistic regression was used to fit models for the prediction of any adverse outcome (preterm birth, SGA and/or a low Apgar score), stratified for ethnicity and socio-economic status (SES). factors predicting any adverse outcome for Western women were smoking during the first trimester and over-the-counter medication. For non-Western women risk factors were teenage pregnancy, advanced maternal age and an obstetric history of SGA. Risk factors for high SES women were low family income, no daily intake of vegetables and a history of preterm birth. For low SES women risk factors appeared to be low family income, non-Western ethnicity, smoking during the first trimester and a history of SGA. the presence of both medical and non-medical risk factors early in pregnancy predict the occurrence of adverse outcomes at birth. Furthermore the risk profiles for adverse outcomes differed according to SES and ethnicity. to optimise effective risk selection, both medical and non-medical risk factors should be taken into account in midwifery and obstetric care at the booking visit

  10. Clinical and molecular characteristics of extended-spectrum-β- lactamase-producing Escherichia coli causing bacteremia in the Rotterdam Area, Netherlands

    NARCIS (Netherlands)

    A.K. van der Bij (Akke); G. Peirano (G.); W.H.F. Goessens (Wil); E.R. van der Vorm (Eric); M. van Westreenen (Mireille); J.D.D. Pitout (J. D D)

    2011-01-01

    textabstractWe investigated the clinical and molecular characteristics of bacteremia caused by extended-spectrum-β-lactamase (ESBL)-producing Escherichia coli over a 2-year period (2008 to 2009) in the Rotterdam region (including 1 teaching hospital and 2 community hospitals) of Netherlands. The

  11. Educational Research Centre of the Joint Institute for Nuclear Research and students training on the 'Medical Physics' speciality

    International Nuclear Information System (INIS)

    Ivanova, S.P.; )

    2005-01-01

    The Educational Research Centre (ERC) of the Joint Institute for Nuclear Research is the place of joint activity of the JINR, Moscow State University (MSU) and Moscow Engineering Physical Institute (MEFI) on students training by a broadened circle of specialities with introduction of new educational forms. Active application of medical accelerator beams of the JINR Laboratory of Nuclear Beams becomes a reason for implementation of a new training chair in the MEFI on the JINR base - the Physical methods in applied studies in the medicine chair. For the 'medical physics' trend development in 2003 the workshop on discussion both curricula and teaching methodic by the speciality was held. One the Educational Research Centre main activities is both organization and conducting an international scientific schools and training courses. The International student School 'Nuclear-Physical Methods and Accelerators is the most popular and traditional. The principal aim of these schools and courses is familiarization of students and postgraduates with last achievement and and contemporary problems of applied medical physics. The school audience is a students and postgraduates of ERC, MSU, MEFI, and an institutes of Poland, Hungary, Slovakia, France, Czech and Bulgaria

  12. Vitamin D and the risk of atrial fibrillation--the Rotterdam Study.

    Directory of Open Access Journals (Sweden)

    Anna Vitezova

    Full Text Available Atrial fibrillation (AF is the most common chronic arrhythmia and it increases the risk of cardiovascular morbidity and mortality. Still there is not a complete understanding of its etiology and underlying pathways. Vitamin D might regulate renin-angiotensin-aldosterone system and might be involved in inflammation, both implicated in the pathophysiology of AF. The objective of this work was to investigate the association between vitamin D status with the risk of AF in the elderly. This study was conducted within the Rotterdam Study, a community-based cohort of middle-aged and elderly participants in Rotterdam, The Netherlands. We had 3,395 participants who were free of AF diagnosis at the start of our study and who had vitamin D data available. We analyzed the association between serum 25-hydroxivitamin D (25(OHD and incidence of AF using Cox regression models. Vitamin D deficiency was defined as serum 25(OHD concentrations <50 nmol/l, insufficiency between 50 nmol/l and 75 nmol/l, while serum 25(OHD concentrations equal to and above 75 nmol/l were considered as adequate. After mean follow-up of 12.0 years 263 (7.7% participants were diagnosed with incident AF. Vitamin D status was not associated with AF in any of the 3 multivariate models tested (model adjusted for socio-demographic factors and life-style factors: HR per 10 unit increment in serum 25(OHD 0.96, 95% CI: 0.91-1.02; HR for insufficiency: 0.82, 95%CI: 0.60-1.11,and HR for adequate status: 0.76, 95%CI: 0.52-1.12 compared to deficiency. This prospective cohort study does not support the hypothesis that vitamin D status is associated with AF.

  13. Frequency of ectopic pregnancy in a medical centre, Kingdom of Saudi Arabia

    International Nuclear Information System (INIS)

    Aziz, S.; Wafi, B.A.; Swadi, H.A.

    2011-01-01

    To asses the frequency of ectopic pregnancy and to evaluate the relevance of the risk factors in a Medical Center, Kingdom of Saudi Arabia (KSA). This retrospective study was done in Royal Commission Medical Centre, Yanbu Industrial City, KSA over a period of four years, where the medical records of patients with the diagnosis of ectopic pregnancy were reviewed. Data was collected on initial presentation, chief medical complaints, socio demographic characteristics, past obstetrics and gynaecological history, history of previous surgeries (tubal, ovarian and/or uterine), history of infertility and use of ovulation induction and history of contraception was obtained. A total of 66 cases were included in the study. Results: The frequency of ectopic pregnancy was 0.58% .Mean age was 30 +- 4 years. Multiparous women were found to be more prone to ectopic pregnancy (64%).Most frequent gestational age was 6-8 weeks. Majority (37.8%) of the patients had previous medical induced or spontaneous abortion. 18% had previous pelvic surgery, 15% used different treatments for infertility including ovulation induction, Intrauterine Insemination (IUI), and In vitro Fertilization (IVF) and 9% of patients had history of ectopic pregnancy, 4.5% of patients had Intrautrine Contraceptive Device (IUCD) in situ. 3% of patients had uterine fibroids. Conclusion: Study has found that previous abortions are major etiological factor for ectopic pregnancy. Further more the other factors were IUCD use, previous pelvic surgeries, infertility, previous ectopic and induced conception cycles which may be the result of a previous pelvic infection that may cause tubal sequelae. (author)

  14. Adherence to the 2015 Dutch dietary guidelines and risk of non-communicable diseases and mortality in the Rotterdam Study

    NARCIS (Netherlands)

    R.G. Voortman (Trudy); J.C. Kiefte-de Jong (Jessica); M.A. Ikram (Arfan); B.H.Ch. Stricker (Bruno); F.J.A. van Rooij (Frank); L. Lahousse (Lies); H.W. Tiemeier (Henning); G.G. Brusselle (Guy); O.H. Franco (Oscar); J.D. Schoufour (Josje)

    2017-01-01

    textabstractWe aimed to evaluate the criterion validity of the 2015 food-based Dutch dietary guidelines, which were formulated based on evidence on the relation between diet and major chronic diseases. We studied 9701 participants of the Rotterdam Study, a population-based prospective cohort in

  15. A Local Dimension of Integration Policies? A Comparative Study of Berlin, Malmö, and Rotterdam

    OpenAIRE

    Dekker, Rianne; Emilsson, Henrik; Krieger, Bernhard; Scholten, Peter

    2015-01-01

    textabstractThis study examines three theses on local integration policies by a qualitative comparative case study of integration policies in three cities in three different countries (Berlin, Malmö, and Rotterdam). We found little evidence of a congruent local dimension of integration policies. Local policies resemble their national policy frameworks fairly well in terms of policy approaches and domains. Our multi-level perspective shows that this is not the result of top-down hierarchical g...

  16. Discussion on the Implementation of the Patient Centred Medical Home model - Experiences from Australia

    Directory of Open Access Journals (Sweden)

    Safa Majidi Rahbar

    2017-07-01

    Full Text Available Introduction: Different practitioners and academics have been working on the application of the Patient Centred Medical Home (PCMH model within the Australian context for many years. In early 2016, the Commonwealth government of Australia announced plans to establish Health Care Homes throughout the country based off the PCMH model, beginning with trial sites focused on the bundling of payments. As a result, the number of Primary Health Networks, policy makers and general practices receptive to establishing Health Care Homes is growing rapidly. The time is ripe to identify how best the elements of the model translate into the Australian context and how to implement its elements with success. As a contribution to the opportunity for a widespread implementation, the North Coast Primary Health Network is engaged in a project to build capacity in general practices to transition into Health Care Homes. The main outcomes of this project include: 1. Preparing “The Australian Handbook for Transitioning to Health Care Homes” A resource which will provide a rationale for transitioning to a HCH, milestones for transitioning along a continuum and tools for practice and practice support for establishing the model in general practice. Thus developing capacity to train ‘change facilitators’ to work to accompany transitioning practices. 2. Establishment of a National Network of Patient Centred HCH Collaborators Made up of PHN representatives, experts and policy makers working in the PCMH development space. Focused on improving advocacy effectiveness, knowledge sharing and keeping stakeholders up to date with unfolding developments. 3. Increasing local preparedness and interest for establishing HCHs Focused on propagation of development of interest locally for transitioning practices into HCHs. A local network of practitioners and collaborators informed of project updates and HCH learning and development opportunities in the region. 4. Local trial and

  17. Flux Festival - nieuwste muziek en anti-muziek - het instrumentale theater, Scheveningen, 13 November 1964 and Rotterdam, 23 November 1964

    DEFF Research Database (Denmark)

    van der Meijden, Peter Alexander

    2012-01-01

    Artiklen skitserer omstændighederne for tilblivelsen af en Fluxusfestival med titel "Flux Festival - nieuwste muziek en anti-muziek - het instrumentale theater" på Kurzaal-teateret i Scheveningen, nær Den Haag, d. 13. november 1964 og De Lantaren-teateret i Rotterdam d. 23. november 1964, samt...

  18. Discharged of the nuclear wastes by health service centres

    International Nuclear Information System (INIS)

    Mazur, G.; Jednorog, S.

    1993-01-01

    In this paper Polish national regulation in radiation protection on nuclear medical domain was discussed. The method of utilized nuclear wastes in medical and science centres was deliberate. From many years activity of wastes from Nuclear Medicine Department of Central Clinical Hospital Armed Forces Medical Academy and Radiation Protection Department of Armed Forces Institute of Hygiene and Epidemiology was measured. In debate centres radiation monitoring was performed. In this purpose the beta global activity and gamma spectrometry measurement of discharged wastes occurred. From last year in discussed centres wastes activity do not increased permissible levels. (author). 3 refs, 5 tabs

  19. The prevalence of polycystic ovary syndrome in a normal population according to the Rotterdam criteria versus revised criteria including anti-Mullerian hormone.

    Science.gov (United States)

    Lauritsen, M P; Bentzen, J G; Pinborg, A; Loft, A; Forman, J L; Thuesen, L L; Cohen, A; Hougaard, D M; Nyboe Andersen, A

    2014-04-01

    What is the prevalence in a normal population of polycystic ovary syndrome (PCOS) according to the Rotterdam criteria versus revised criteria including anti-Müllerian hormone (AMH)? The prevalence of PCOS was 16.6% according to the Rotterdam criteria. When replacing the criterion for polycystic ovaries by antral follicle count (AFC) > 19 or AMH > 35 pmol/l, the prevalence of PCOS was 6.3 and 8.5%, respectively. WHAT IS KNOWN ALREADY?: The Rotterdam criteria state that two out of the following three criteria should be present in the diagnosis of PCOS: oligo-anovulation, clinical and/or biochemical hyperandrogenism and polycystic ovaries (AFC ≥ 12 and/or ovarian volume >10 ml). However, with the advances in sonography, the relevance of the AFC threshold in the definition of polycystic ovaries has been challenged, and AMH has been proposed as a marker of polycystic ovaries in PCOS. From 2008 to 2010, a prospective, cross-sectional study was performed including 863 women aged 20-40 years and employed at Copenhagen University Hospital, Rigshospitalet, Denmark. We studied a subgroup of 447 women with a mean (±SD) age of 33.5 (±4.0) years who were all non-users of hormonal contraception. Data on menstrual cycle disorder and the presence of hirsutism were obtained. On cycle Days 2-5, or on a random day in the case of oligo- or amenorrhoea, sonographic and endocrine parameters were measured. The prevalence of PCOS was 16.6% according to the Rotterdam criteria. PCOS prevalence significantly decreased with age from 33.3% in women polycystic ovaries with a significant age-related decrease from 69.0% in women polycystic ovaries in women with PCOS according to the Rotterdam criteria [area under the curve (AUC) 0.994; 95% confidence interval (CI): 0.990-0.999] and AUC 0.992 (95% CI: 0.987-0.998), respectively], and an AMH cut-off value of 18 pmol/l and AMH Z-score of -0.2 showed the best compromise between sensitivity (91.8 and 90.4%, respectively) and specificity (98.1 and

  20. Resilience as strategy for climate adaptation under uncertainty. Case study on the area outside the dike of Rotterdam

    International Nuclear Information System (INIS)

    De Jong, A.

    2008-07-01

    This study has two aims; (1) to obtain insight in the concepts resilience and uncertainty; to gain insight in how a resilience oriented approach deals with uncertainties about the future; and (2) putting the resilience oriented approach into operation in a case: the area outside the dike of Rotterdam, the Netherlands, which is designated for new buildings [nl

  1. Nuclear research centres - The Egyptian experiment

    International Nuclear Information System (INIS)

    Abdelrazek, I.D.

    2001-01-01

    The Atomic Energy Authority of Egypt has four research centres located at two sites. Its research reactors are devoted to the production of isotopes, neutron beam experiments, activation analysis and materials research. The accelerators are devoted to the production of short lived isotopes for medical applications and materials R and D. Irradiation technology is used for sterilization of medical supplies and food preservation. High level of expertise in those centres is also useful for other developmental activities in Egypt. (author)

  2. Strengthening patient safety in transitions of care: an emerging role for local medical centres in Norway.

    Science.gov (United States)

    Kongsvik, Trond; Halvorsen, Kristin; Osmundsen, Tonje; Gjøsund, Gudveig

    2016-08-30

    Patient safety has gained less attention in primary care in comparison to specialised care. We explore how local medical centres (LMCs) can play a role in strengthening patient safety, both locally and in transitions between care levels. LMCs represent a form of intermediate care organisation in Norway that is increasingly used as a strategy for integrated care policies. The analysis is based on institutional theory and general safety theories. A qualitative design was applied, involving 20 interviews of nursing home managers, managers at local medical centres and administrative personnel. The LMCs mediate important information between care levels, partly by means of workarounds, but also as a result of having access to the different information and communications technology (ICT) systems in use. Their knowledge of local conditions is found to be a key asset. LMCs are providers of competence and training for the local level, as well as serving as quality assurers. As a growing organisational form in Norway, LMCs have to legitimise their role in the health care system. They represent an asset to the local level in terms of information, competence and quality assurance. As they have overlapping competencies, tasks and responsibilities with other parts of the health care system, they add to organisational redundancy and strengthen patient safety.

  3. Integration in urban climate adaptation: Lessons from Rotterdam on integration between scientific disciplines and integration between scientific and stakeholder knowledge

    NARCIS (Netherlands)

    Groot, A.M.E.; Bosch, P.R.; Buijs, S.; Jacobs, C.M.J.; Moors, E.J.

    2015-01-01

    Based on the experience acquired in the Bergpolder Zuid district in the city of Rotterdam, The Netherlands, this paper presents lessons learned so far on science-policy interactions supporting the adaptation to climate change in an urban district. Two types of integration issues were considered: (1)

  4. The role of the sexual assault centre.

    LENUS (Irish Health Repository)

    Eogan, Maeve

    2013-02-01

    Sexual Assault Centres provide multidisciplinary care for men and women who have experienced sexual crime. These centres enable provision of medical, forensic, psychological support and follow-up care, even if patients chose not to report the incident to the police service. Sexual Support Centres need to provide a ring-fenced, forensically clean environment. They need to be appropriately staffed and available 24 hours a day, 7 days a week to allow prompt provision of medical and supportive care and collection of forensic evidence. Sexual Assault Centres work best within the context of a core agreed model of care, which includes defined multi-agency guidelines and care pathways, close links with forensic science and police services, and designated and sustainable funding arrangements. Additionally, Sexual Assault Centres also participate in patient, staff and community education and risk reduction. Furthermore, they contribute to the development, evaluation and implementation of national strategies on domestic, sexual and gender-based violence.

  5. Key performance indicators' assessment to develop best practices in an Emergency Medical Communication Centre.

    Science.gov (United States)

    Penverne, Yann; Leclere, Brice; Labady, Julien; Berthier, Frederic; Jenvrin, Joel; Javaudin, Francois; Batard, Eric; Montassier, Emmanuel

    2017-05-17

    Emergency Medical Communication Centre (EMCC) represents a pivotal link in the chain of survival for those requiring rapid response for out-of-hospital medical emergencies. Assessing and grading the performance of EMCCs are warranted as it can affect the health and safety of the served population. The aim of our work was to describe the activity on an EMCC and to explore the associations between different key performance indicators. We carried out our prospective observational study in the EMCC of Nantes, France, from 6 June 2011 to 6 June 2015. The EMCC performance was assessed with the following key performance indicators: answered calls, Quality of Service 20 s (QS20), occupation rate and average call duration. A total of 35 073 h of dispatch activity were analysed. 1 488 998 emergency calls were answered. The emergency call incidence varied slightly from 274 to 284 calls/1000 citizens/year between 2011 and 2015. The median occupation rate was 35% (25-44). QS20 was correlated negatively with the occupation rate (Spearman's ρ: -0.78). The structural equation model confirmed that the occupation rate was highly correlated with the QS20 (standardized coefficient: -0.89). For an occupation rate of 26%, the target value estimated by our polynomial model, the probability of achieving a QS20 superior or equal to 95% varied between 56 and 84%. The occupation rate appeared to be the most important factor contributing towards the QS20. Our data will be useful to develop best practices and guidelines in the field of emergency medicine communication centres.

  6. Medication overuse headache and chronic migraine in a specialized headache centre: field-testing proposed new appendix criteria

    DEFF Research Database (Denmark)

    Zeeberg, P; Olesen, Jes; Jensen, R

    2009-01-01

    The classification subcommittee of the International Headache Society (IHS) has recently suggested revised criteria for medication overuse headache (MOH) and chronic migraine (CM). We field tested these revised criteria by applying them to the headache population at the Danish Headache Centre...... suggest that the IHS has succeeded in choosing new criteria for CM which are neither too strict, nor too loose. For MOH, a shift to the appendix criteria will increase the number of MOH patients, but take into account the possibility of permanent changes in pain perception due to medication overuse...... and the possibility of a renewed effect of prophylactic drugs due to medication withdrawal. We therefore recommend the implementation of the appendix criteria for both MOH and CM into the main body of the International Classification of Headache Disorders....

  7. Childhood Mortality in Federal Medical Centre Umuahia, South Eastern Nigeria

    Science.gov (United States)

    Charles, Nwafor Chukwuemeka; Chuku, Abali; Anazodo, Nnoli Martin

    2014-01-01

    Objectives This study aimed to evaluate the mortality pattern in children seen at Federal Medical Centre Umuahia (FMCU) Abia state, South Eastern Nigeria. Methods A retrospective cross sectional descriptive study over a 5-year period from January 1, 2004 to December 31, 2008 using data retrieved from the hospital’s medical records department. Results A total of 3,814 children were admitted in the hospital and 434 of them died giving a mortality rate of 11%. The mean age was 1.7 (Std D of 3.19). Two hundred and thirty eight of them were males while 196 of them were females giving a sex ratio of 1.2:1. Majority of the mortality (49%) occurred within 24 hours of admission. The major causes of death during neonatal period were birth asphyxia (34%), prematurity (24%) and neonatal sepsis (24%). Malaria was the leading cause of death beyond the neonatal period accounting for 42% of cases. Other common mortality causes were pneumonia, septicaemia, diarrhea, HIV AIDS and meningitis each accounting for 10%, 10%, 7%, 7% and 5% respectively. The months of July, May and March accounted for most deaths (12%, 12% and 11% respectively). Conclusion Birth asphyxia and malaria associated deaths were responsible for most deaths during neonatal and beyond neonatal periods respectively. Presence of trained personal at all deliveries will help to reduce neonatal asphyxia. Efforts should be made to reinforce the existing effective malaria control tools. PMID:25337306

  8. Childhood Mortality in Federal Medical Centre Umuahia, South Eastern Nigeria

    Directory of Open Access Journals (Sweden)

    Nwafor Chukwuemeka Charles

    2014-09-01

    Full Text Available Objective: This study aimed to evaluate the mortality pattern in children seen at Federal Medical Centre Umuahia (FMCU Abia state, South Eastern Nigeria. Methods: A retrospective cross sectional descriptive study over a 5-year period from January 1, 2004 to December 31, 2008 using data retrieved from the hospital’s medical records department. Results: A total of 3,814 children were admitted in the hospital and 434 of them died giving a mortality rate of 11%. The mean age was 1.7 (Std D of 3.19. Two hundred and thirty eight of them were males while 196 of them were females giving a sex ratio of 1.2:1. Majority of the mortality (49% occurred within 24 hours of admission. The major causes of death during neonatal period were birth asphyxia (34%, prematurity (24% and neonatal sepsis (24%. Malaria was the leading cause of death beyond the neonatal period accounting for 42% of cases. Other common mortality causes were pneumonia, septicaemia, diarrhea, HIV AIDS and meningitis each accounting for 10%, 10%, 7%, 7% and 5% respectively. The months of July, May and March accounted for most deaths (12%, 12% and 11% respectively. Conclusion: Birth asphyxia and malaria associated deaths were responsible for most deaths during neonatal and beyond neonatal periods respectively. Presence of trained personal at all deliveries will help to reduce neonatal asphyxia. Efforts should be made to reinforce the existing effective malaria control tools.

  9. MO-DE-BRA-03: The Ottawa Medical Physics Institute (OMPI): A Practical Model for Academic Program Collaboration in a Multi-Centre City

    Energy Technology Data Exchange (ETDEWEB)

    McEwen, M [National Research Council Canada, Ottawa, ON (Canada); Rogers, D [Carleton University, Ottawa, ON (Canada); Johns, P

    2016-06-15

    Purpose: To build a world-class medical physics educational program that capitalizes on expertise distributed over several clinical, government, and academic centres. Few if any of these centres would have the critical mass to solely resource a program. Methods: In order to enable an academic program, stakeholders from five institutions made a proposal to Carleton University for a) a research network with defined membership requirements and a process for accepting new members, and b) a graduate specialization (MSc and PhD) in medical physics. Both proposals were accepted and the program has grown steadily. Our courses are taught by medical physicists from across the collaboration. Our students have access to physicists in: clinical radiotherapy (the Ottawa Cancer Centre treats 4500 new patients/y), radiology, cardiology and nuclear medicine, Canada’s primary standards dosimetry laboratory, radiobiology, and university-based medical physics research. Our graduate courses emphasize the foundational physics plus applied aspects of imaging, radiotherapy, and radiobiology. Active researchers in the city-wide volunteer-run network are appointed as adjunct professors by Physics, giving them access to national funding competitions and partial student funding through teaching assistantships while opening up facilities in their institutions for student thesis research. Results: The medical physics network has grown to ∼40 members from eight institutions and includes five full-time faculty in Physics and 17 adjunct research professors. The graduate student population is ∼20. Our graduates have proceeded to a spectrum of careers. Our alumni list includes a CCPM Past-President, the current COMP President, many clinical physicists, and the heads of at least three major clinical medical physics departments. Our PhD was Ontario’s first CAMPEP-accredited program. Conclusion: A self-governing volunteer network is the foundational element that enables an MSc/PhD medical

  10. MO-DE-BRA-03: The Ottawa Medical Physics Institute (OMPI): A Practical Model for Academic Program Collaboration in a Multi-Centre City

    International Nuclear Information System (INIS)

    McEwen, M; Rogers, D; Johns, P

    2016-01-01

    Purpose: To build a world-class medical physics educational program that capitalizes on expertise distributed over several clinical, government, and academic centres. Few if any of these centres would have the critical mass to solely resource a program. Methods: In order to enable an academic program, stakeholders from five institutions made a proposal to Carleton University for a) a research network with defined membership requirements and a process for accepting new members, and b) a graduate specialization (MSc and PhD) in medical physics. Both proposals were accepted and the program has grown steadily. Our courses are taught by medical physicists from across the collaboration. Our students have access to physicists in: clinical radiotherapy (the Ottawa Cancer Centre treats 4500 new patients/y), radiology, cardiology and nuclear medicine, Canada’s primary standards dosimetry laboratory, radiobiology, and university-based medical physics research. Our graduate courses emphasize the foundational physics plus applied aspects of imaging, radiotherapy, and radiobiology. Active researchers in the city-wide volunteer-run network are appointed as adjunct professors by Physics, giving them access to national funding competitions and partial student funding through teaching assistantships while opening up facilities in their institutions for student thesis research. Results: The medical physics network has grown to ∼40 members from eight institutions and includes five full-time faculty in Physics and 17 adjunct research professors. The graduate student population is ∼20. Our graduates have proceeded to a spectrum of careers. Our alumni list includes a CCPM Past-President, the current COMP President, many clinical physicists, and the heads of at least three major clinical medical physics departments. Our PhD was Ontario’s first CAMPEP-accredited program. Conclusion: A self-governing volunteer network is the foundational element that enables an MSc/PhD medical

  11. PROSPECTIVE ANALYTICAL STUDY ON THE MEDICAL TERMINATION OF PREGNANCIES IN A TERTIARY CARE CENTRE

    Directory of Open Access Journals (Sweden)

    S. Gayathriedevi Sellathamby

    2017-06-01

    Full Text Available BACKGROUND This study is carried out to estimate incidence of medical termination of pregnancies in a tertiary care centre, to analyse the causes of medical termination of pregnancies, to analyse the success of the methods of abortion and adoption family planning procedures in a tertiary care centre (Government Rajaji Hospital, Madurai. This may provide the baseline measures for safe abortion practices and to increase the awareness among men and women of reproductive age, the availability of safe abortion services at locality. The aim of the study is to know the incidence of medical termination of pregnancies in a tertiary level hospital, to study the causes for seeking MTP, to analyse the success of the methods of abortion and adoption of family planning methods. MATERIALS AND METHODS This study was carried out in Government Rajaji Hospital, Madurai, during the period of 12 months from September 2011- August 2012. Of 3516 patients attending the family planning OP, 496 women seek MTP. Among them, every 5 th women were selected and thus 100 cases were included in this study. Social parameters like age, education, residence, marital status, family pattern, number of living children, sex of the living children, obstetric parameters like parity, trimester of abortion, methods of abortion, causes for MTP, adoption of family planning methods, basic investigation like Hb%, BT, CT, urine albumin, RFT, blood sugar, blood grouping and typing and VCTC were included. RESULTS Induced abortions were common in women in 20-29-year age group, more in third gravid, Hindus, from rural areas, living in nuclear family, married and educated. Most of the women seek 1 st trimester abortion with underlying social cause. Majority had surgical abortion. Majority adopted transabdominal tubectomy as the concurrent family planning method. Second trimester abortions common in unmarried, uneducated women. CONCLUSION The variables analysed in this study bring into light the

  12. Safety and immunogenicity of the RIVM hexavalent meningococcal B vesicle vaccine for Rotterdam children aged 2-3 and 7-8

    NARCIS (Netherlands)

    Labadie J; de Kleijn ED; Lafeber AB; Mees MMM; Booy K; de Groot R; van Omme GW; van Dijken H; Kuipers AJ; van den Dobbelsteen G; Juttmann RE; Wala M; van Alphen AJW; Rumke HC; LVO

    2000-01-01

    In dit rapport wordt verslag gedaan van een gerandomiseerde gecontroleerd fase-II klinische studie naar de veiligheid en immunogeniciteit van het RIVM hexavalente MenB vesicle vaccin in 189 kinderen van 2-3 jaar en 168 kinderen van 7-8 jaar in de stad Rotterdam. Twee concentraties van het MenB

  13. Reach and effectiveness of a community program to reduce smoking among ethnic Turkish residents in Rotterdam, the Netherlands: a quasi-experimental design

    NARCIS (Netherlands)

    Nierkens, Vera; Kunst, Anton E.; de Vries, Hein; Voorham, Toon A. J.; Stronks, Karien

    2013-01-01

    Community interventions have been considered promising strategies to reduce smoking prevalence among ethnic minority populations. We assessed the reach and effectiveness of a community program targeted at the Turkish population in Rotterdam, the Netherlands. The study had a quasi-experimental

  14. Transmitting Memory between and beyond Generations: The Rotterdam Bombardment in Local Memory Culture and Education from 1980 to 2015

    Science.gov (United States)

    Hogervorst, Susan

    2015-01-01

    This article analyses three local educational projects about the Nazi bombing of Rotterdam in May 1940, all of which took place from 1980 to the present day in the context of the dynamic memory culture of the bombardment. These three contexts testify to a process by which memory, increasingly derived from authentic locations and objects instead of…

  15. Safety and immunogenicity of the RIVM hexavalent meningococcal B vesicle vaccine for Rotterdam children aged 2-3 and 7-8

    NARCIS (Netherlands)

    Labadie J; Kleijn ED de; Lafeber AB; Mees MMM; Booy K; Groot R de; Omme GW van; Dijken H van; Kuipers AJ; Dobbelsteen G van den; Juttmann RE; Wala M; Alphen AJW van; Rumke HC; Sophia Kinderziekenhuis /; LVO

    2000-01-01

    This report documents the results of a randomised controlled phase-II clinical study into the safety and immunogenicity of the RIVM hexavalent MenB vesicle vaccine among 189 children aged 2-3 and 168 children aged 7-8 in the city of Rotterdam, the Netherlands. Two concentrations of the MenB vesicle

  16. CSO’s and Businesses; joint agents for change

    NARCIS (Netherlands)

    B. Posthumus (Bram)

    2012-01-01

    textabstractPSO, ICCO, Centre for Development Innovation (Wageningen University) and the Partnership Resource Centre (Erasmus University, Rotterdam) proudly present a joint publication with the latest insights on cooperation between Business and Civil Society actors for development. This digital

  17. Occupational radiation exposure at the self-shielded IBA CYCLONE 10/5, cyclotron of the Austin and Repatriation Medical Centre, Melbourne, Australia

    International Nuclear Information System (INIS)

    Tochon-Danguy, H.; Sachinidis, J.I.; U, P.; Egan, G.; Mukherjee, B.

    1999-01-01

    A series of health physics measurements was carried out at the IBA CYCLONE 10/5 Medical Cyclotron of the Austin and Repatriation Medical Centre, Melbourne. The neutron attenuation factor of the cyclotron shielding was estimated using the Superheated Bubble dosimeters. The neutron and gamma dose rates at various public access and radiation worker's area in the vicinity of the cyclotron facility were evaluated during the 11 C, 18 F, 13 N and 15 O production conditions. (authors)

  18. Impact on air quality of measures to reduce CO2 emissions from road traffic in Basel, Rotterdam, Xi'an and Suzhou

    NARCIS (Netherlands)

    Keuken, M.P.; Jonkers, S.; Verhagen, H.L.M.; Perez, L.; Truëb, S.; Okkerse, W.J.; Liu, J.; Pan, X.C.; Zheng, L.; Wang, H.; Xu, R.; Sabel, C.E.

    2014-01-01

    Two traffic scenarios to reduce CO2 emissions from road traffic in two European cities (Basel and Rotterdam) and two Chinese cities (Xi'an and Suzhou) were evaluated in terms of their impact on air quality. The two scenarios, one modelling a reduction of private vehicle kilometres driven by 10% on

  19. Knowledge and Prevention of Nosocomial Infection among Ward Nurses at Federal Medical Centre, Umuahia, Nigeria

    Directory of Open Access Journals (Sweden)

    Oti A. Aja

    2017-08-01

    Full Text Available This research was conducted for estimating the knowledge and prevention of nosocomial infection among ward nurses at Federal Medical Centre (FMC, Umuahia Abia state. Four objectives were set, and four questions were formulated. A descriptive survey research method was used for the study. A sample size of one hundred and fifty (150 nurses was drawn from eight wards (medical and surgical, at FMC, Umuahia. A self-developed questionnaire with seventeen (17 structured questions was the instrument of data collection. Data were collected, analyzed, and presented in tables, pie chart, bar chart, histogram, and percentages. The results revealed that the nurses were well knowledgeable about nosocomial infection, although little deficiencies existed in the area of infection control practice and compliance, such as hand washing frequency. This study therefore recommends continuing education/seminar/workshop for all health care givers, to sensitize them with the knowledge and practice of nosocomial infection.

  20. Diagnostic x-ray in use in federal medical centre, case study Makurdi metropolis

    International Nuclear Information System (INIS)

    Onoja, R.A.; Fiase, J.O.

    2009-01-01

    Every year more than two thousand patients go for routine medical check-up at the Federal Medical Centre using diagnostic x-rays. This paper is based on a study to determine the entrance surface doses per radiograph of 108 patients that had diagnostic examinations at the Federal Medical Centre Makurdi. The examinations considered in this study are chest x-ray examinations, abdomen, skull and other extremities, for both adults and children. The results show that the mean entrance surface doses of PA chest x-ray for female range between 237-275μGy, for male is between 1183-297μGy, and for children range between 47-237μGy. The AP chest x-ray for female range between 1943-3440μGy, for male is between 1583-3484μGy and for children it ranges between 177-451μGy. The PA examination of the skull for adult female ranged between 117-787μGy, for male it ranged between 117-532μGy and children from 472-948μGy. Also for the AP examination for skull the adult female mean entrance surface doses range from 129-798μGy, for the male it range from 145-178μGy and for children 138-650μGy. The AP abdomen for adult female produces a mean entrance surface doses range between 620-682μGy, for the male is between 105-930μGy, and children it range between 144-398μGy. In the case of extremities AP examination are between the range of 173-468μGy for adult female, 300-595μGy for adult male and between 254-887μGy for the children. In the case of extremities PA examination mean entrance surface doses are between the range of 145-517μGy for adult female, 363-517μGy for adult male and between 130-566μGy for the children. The data shows that the entrance surface doses due to the x-ray examination for adult and children are within the ICRP guidance levels. These guidance levels of dose for diagnostic radiography for a typical adult patient are 10 mGy for AP abdomen, 0.4 mGy PA chest, 7 mGy for AP chest and 5 mGy for PA skull

  1. Radiopharmaceuticals in positron emission tomography: Radioisotope productions and radiolabelling procedures at the Austin and Repatriation Medical Centre

    International Nuclear Information System (INIS)

    Tochon-Danguy, H.J.; Sachinidis, J.I.; Chan, J.G.; Cook, M.

    1997-01-01

    Positron Emission Tomography (PET) is a technique that utilizes positron-emitting radiopharmaceuticals to map the physiology, biochemistry and pharmacology of the human body. Positron-emitting radioisotopes produced in a medical cyclotron are incorporated into compounds that are biologically active in the body. A scanner measures radioactivity emitted from a patient's body and provides cross-sectional images of the distribution of these radiolabelled compounds in the body. It is the purpose of this paper to review the variety of PET radiopharmaceuticals currently produced at the Austin and Repatriation Medical Centre in Melbourne. Radioisotope production, radiolabelling of molecules and quality control of radiopharmaceuticals will be discussed. A few examples of their clinical applications will be shown as well. During the last five years we achieved a reliable routine production of various radiopharmaceuticals labelled with the four most important positron-emitters: oxygen-15 (t, 1/2 =2min), nitrogen-13 (t 1/2 = 10 min), carbon-11 (t 1/2 =20 min) and fluorine-18 (t 1/2 = 110 min). These radiopharmaceuticals include [ 15 O]oxygen, [ 15 O]carbon monoxide, [ 15 O]carbon dioxide, [ 15 O]water, [ 13 N]ammonia, [ 11 C]flumazenil, [ 11 C]SCH23390, [ 18 F]fluoromisonidazole and [ 18 F]fluoro-deoxy-glucose ([ 18 F]FDG). In addition, since the half life of [ 18 F] is almost two hours, regional distribution can be done, and the Austin and Repatriation Medical Centre is currently supplying [ 18 F]FDG in routine to other hospitals. Future new radiopharmaceuticals development include a [ 18 F]thymidine analog to measure cell proliferation and a [ 11 C]pyrroloisoquinoline to visualize serotonergic neuron abnormalities. (authors)

  2. REAL PRACTICE OF STATINS USE AND ITS DEPENDENCE ON FOLLOW-UP IN THE SPECIALIZED MEDICAL CENTRE IN PATIENTS WITH HIGH CARDIOVASCULAR RISK (ACCORDING TO THE PROFILE REGISTER

    Directory of Open Access Journals (Sweden)

    S. Yu. Martsevich

    2015-09-01

    Full Text Available Aim. To analyze tactics of statins use in patients with high cardiovascular risk on the base of the PROFILE register data.Material and methods. Patients (n=274 who were enrolled into the PROFILE register from May, 1st till December, 31st, 2011 were divided into 3 groups: a control group (82 patients who sought medical care in the medical centre for the first time, the main group A (167 patients who were regularly followed-up in the medical centre and the main group B (25 patients who stopped follow-up in the medical centre over 2 years ago. The incidence rates of statins use and lipid target level achievement, as well as safety of statin therapy were studied in the groups.Results. 25.6, 70.7 and 52% of patients received statins in control group, main group A, and main group B, respectively. Target levels (according to the clinical guidelines of the low density cholesterol (LDC had been reached in 26.3% of patients in the main group A. This characteristic was not valid in the patients of control and main group B because of small size of these groups. Achievement of target LDC level was observed more often in use of statins in moderate and high doses, use of the original drugs, and use of rosu- vastatin. Safety of statin therapy (aspartate and alanine transaminases, creatine kinase activity, and total bilirubin was comparable in the groups of patients who reached or did not reach target LDC levels.Conclusion. High cardiovascular risk patients who were regularly followed-up in the specialized medical centre received statins therapy significantly more often. However statins use is often not correspond to the modern clinical guidelines.

  3. PENGARUH KARAKTERISTIK BUDAYA ORGANISASI TERHADAP ORGANIZATIONAL CITIZENSHIP BEHAVIOR (Studi Kasus Rumah Sakit Umum Citra Bunda Medical Centre Padang

    Directory of Open Access Journals (Sweden)

    Mareta Kemala Sari

    2015-07-01

    Full Text Available This study aimed to analyze the influence of organizational culture characteristic measured from the professionalism, the distance of the management, trust in colleagues, regularity, hostility and integration of the employees of the organization Behavior / Organizational Citizenship Behavior (OCB employees Citra Bunda Hospital Medical Centre Padang. OCB important to investigate the behavior of health workers due to the organization of health workers led to the success of public health care. All employees RSU Citra Bunda Medical Centre Padang many as 177 people are in this study population. The results showed that there was a significant positive influence and not variable professionalism of 0.184 with a significant value of 0.086> 0.05 and a variable distance from the management of a significant value of 0.089 with 0.286> 0.05 on OCB, there is a positive and significant impact on the trust variable associates amounted to 0467 with a significant value of 0.028 0.05 on OCB, there is a positive and significant influence amounted to 0.526 hostility variable with significant value 0.045 <0.05 against the OCB and there are positive influence and no significant integration variable of 0.207 with significant

  4. Comprehension through cooperation: Medical students and physiotherapy apprentices learn in teams - Introducing interprofessional learning at the University Medical Centre Mannheim, Germany.

    Science.gov (United States)

    Mette, Mira; Dölken, Mechthild; Hinrichs, Jutta; Narciß, Elisabeth; Schüttpelz-Brauns, Katrin; Weihrauch, Ute; Fritz, Harald M

    2016-01-01

    In order to better prepare future health care professionals for interprofessional cooperation, interprofessional learning sessions for medical students and physiotherapy apprentices were developed at the University Medical Centre Mannheim, Germany. The experience gained from designing, implementing and evaluating these learning sessions is presented and discussed. A total of 265 medical students and 43 physiotherapy apprentices attended five interprofessional learning sessions. Of these, 87-100% responded to closed and open-ended questions on a self-developed questionnaire (24 items). The responses regarding self-reported learning gains, benefit, motivation and satisfaction with the sessions were analyzed separately by professions. The learning sessions were well received by both groups. More than 75% of all participants were of the opinion that they could not have learned the new material in a better way. Significant differences between the medical students and the physiotherapy apprentices were mainly found with regard to perceived learning gains, which physiotherapy apprentices reported as being lower. Positive aspects of interprofessionalism were most often emphasized in the responses to the open-ended questions. Most frequently criticized were organizational aspects and a lack of perceived learning gains. The introduction of interprofessional learning entails great effort in terms of organizational and administrative challenges. However, the project is considered worthwhile because the interprofessional aspects of the learning sessions were indeed valued by the participants. Permanently including and expanding interprofessional learning in the curricula of both professions longitudinally is therefore something to strive for.

  5. Patients' attitudes to medical and psychosocial aspects of care in fertility clinics: Findings from the Copenhagen Multi-centre Psychosocial Infertility (COMPI) Research Programme

    DEFF Research Database (Denmark)

    Schmidt, L; Holstein, B E; Boivin, J

    2003-01-01

    among infertile people. METHODS: We conducted an epidemiological study based on questionnaires among all new couples attending five fertility clinics with a response rate of 80.0% and a total of 2250 patients. RESULTS: The vast majority of both men and women considered a high level of medical......BACKGROUND: The aims were (i) to identify gender differences in motivations to seek assisted reproduction and gender differences in expectations about medical and psychosocial services and (ii) to examine factors that predict the perceived importance of, and intention to use, psychosocial services...... information and patient-centred care as important. Fewer respondents (women 10.0-20.8%, men 4.1-8.9%) felt that professional psychosocial services were important and/or had the intention to use these services. The main predictor of perceived importance of patient-centred care and professional psychosocial...

  6. Medical assistance in case of nuclear accident

    International Nuclear Information System (INIS)

    Dodig, D.; Tezak, S.; Kasal, B.; Huic, D.; Medvedec, M.; Loncaric, S.; Grosev, D.; Rozman, B.; Popovic, S.

    1996-01-01

    Medical service is a prerequisite for work license of nuclear installation. Every nuclear installation incorporate in their safety procedure also medical emergency plan. Usually the medical emergency plan consists of several degrees of action: 1. First aid, 2. First medical treatment, 3. Treatment in regional hospital, 4. Treatment in special institution (centre for radiation medicine). This paper discusses organization and activities of Centre for Radiation Medicine and Protection - Clinical Hospital Centre Zagreb

  7. Radiopharmaceuticals in positron emission tomography: Radioisotope productions and radiolabelling procedures at the Austin and Repatriation Medical Centre

    Energy Technology Data Exchange (ETDEWEB)

    Tochon-Danguy, H.J.; Sachinidis, J.I.; Chan, J.G.; Cook, M. [Austin and Repatriation Medical Centre, Melbourne, VIC (Australia). Centre for Positron Emission Tomography

    1997-10-01

    Positron Emission Tomography (PET) is a technique that utilizes positron-emitting radiopharmaceuticals to map the physiology, biochemistry and pharmacology of the human body. Positron-emitting radioisotopes produced in a medical cyclotron are incorporated into compounds that are biologically active in the body. A scanner measures radioactivity emitted from a patient`s body and provides cross-sectional images of the distribution of these radiolabelled compounds in the body. It is the purpose of this paper to review the variety of PET radiopharmaceuticals currently produced at the Austin and Repatriation Medical Centre in Melbourne. Radioisotope production, radiolabelling of molecules and quality control of radiopharmaceuticals will be discussed. A few examples of their clinical applications will be shown as well. During the last five years we achieved a reliable routine production of various radiopharmaceuticals labelled with the four most important positron-emitters: oxygen-15 (t,{sub 1/2}=2min), nitrogen-13 (t{sub 1/2}= 10 min), carbon-11 (t{sub 1/2}=20 min) and fluorine-18 (t{sub 1/2}= 110 min). These radiopharmaceuticals include [{sup 15}O]oxygen, [{sup 15}O]carbon monoxide, [{sup 15}O]carbon dioxide, [{sup 15}O]water, [{sup 13}N]ammonia, [{sup 11}C]flumazenil, [{sup 11}C]SCH23390, [{sup 18}F]fluoromisonidazole and [{sup 18}F]fluoro-deoxy-glucose ([{sup 18}F]FDG). In addition, since the half life of [{sup 18}F] is almost two hours, regional distribution can be done, and the Austin and Repatriation Medical Centre is currently supplying [{sup 18}F]FDG in routine to other hospitals. Future new radiopharmaceuticals development include a [{sup 18}F]thymidine analog to measure cell proliferation and a [{sup 11}C]pyrroloisoquinoline to visualize serotonergic neuron abnormalities. (authors) 23 refs., 2 tabs.

  8. Radiological work in a university centre

    International Nuclear Information System (INIS)

    Westerman, B.

    1982-01-01

    In this paper the author outlines the problems of the industrial doctor's tasks in a university centre with physics laboratories and a hospital with medical laboratories. An inventory of problems is presented. The solutions are not easy because of the interdependence of medical, physical and technical inspectors. The health hazards appear to be low. (Auth.)

  9. Victims' use of professional services in a Dutch sexual assault centre

    NARCIS (Netherlands)

    Bicanic, I.; Snetselaar, H.; de Jongh, A.; van de Putte, E.

    2014-01-01

    Background: Prior research endorsed the establishment of sexual assault centres in the Netherlands because of the potential benefit for victims’ mental recovery. In 2012, the first Dutch sexual assault centre was founded at the University Medical Center Utrecht. The aim of the centre is to provide

  10. Comprehension through cooperation: Medical students and physiotherapy apprentices learn in teams – Introducing interprofessional learning at the University Medical Centre Mannheim, Germany

    Science.gov (United States)

    Mette, Mira; Dölken, Mechthild; Hinrichs, Jutta; Narciß, Elisabeth; Schüttpelz-Brauns, Katrin; Weihrauch, Ute; Fritz, Harald M.

    2016-01-01

    Aim: In order to better prepare future health care professionals for interprofessional cooperation, interprofessional learning sessions for medical students and physiotherapy apprentices were developed at the University Medical Centre Mannheim, Germany. The experience gained from designing, implementing and evaluating these learning sessions is presented and discussed. Method: A total of 265 medical students and 43 physiotherapy apprentices attended five interprofessional learning sessions. Of these, 87-100% responded to closed and open-ended questions on a self-developed questionnaire (24 items). The responses regarding self-reported learning gains, benefit, motivation and satisfaction with the sessions were analyzed separately by professions. Results: The learning sessions were well received by both groups. More than 75% of all participants were of the opinion that they could not have learned the new material in a better way. Significant differences between the medical students and the physiotherapy apprentices were mainly found with regard to perceived learning gains, which physiotherapy apprentices reported as being lower. Positive aspects of interprofessionalism were most often emphasized in the responses to the open-ended questions. Most frequently criticized were organizational aspects and a lack of perceived learning gains. Conclusion: The introduction of interprofessional learning entails great effort in terms of organizational and administrative challenges. However, the project is considered worthwhile because the interprofessional aspects of the learning sessions were indeed valued by the participants. Permanently including and expanding interprofessional learning in the curricula of both professions longitudinally is therefore something to strive for. PMID:27280142

  11. Activities of the International Radio Medical Centre (C.I.R.M.) in Rome during the last five years (1996-2000). Centro Internazionale Radio Medico.

    Science.gov (United States)

    Amenta, F; Dauri, A

    2001-01-01

    This paper reviews medical activity provided from 1996 to 2000 by the International Radio Medical Centre (Centro Internazionale Radio Medico, C.I.R.M.). C.I.R.M. is a non-profit organization headquartered in Rome and providing freely telemedical advice to ships flying of any flag navigating on all seas of the world, to civil airplanes and to small Italian islands. From 1996 to 2000 C.I.R.M. has assisted 4,982 patients, 4,686 of which (94%) on board ships, 85 on airplanes and 206 on small Italian islands. More than 65% of requests of telemedical advice received by C.I.R.M. were from non-Italian ships. This indicates the really international nature of C.I.R.M.'s activity. The largest number of medical requests come from the Atlantic Ocean, followed by the Mediterranean sea, Indian Ocean and Pacific Ocean. In terms of pathologies assisted, accidents took the first place, followed as main pathologies by gastrointestinal disorders, cardiovascular pathologies, respiratory disorders, infectious and parasitic diseases and nervous system complaints. Analysis of the outcome of C.I.R.M.'s medical activity showed that more than 50% of patients assisted were recovered or improved while assisted by the Centre.

  12. Examining patterns in medication documentation of trade and generic names in an academic family practice training centre.

    Science.gov (United States)

    Summers, Alexander; Ruderman, Carly; Leung, Fok-Han; Slater, Morgan

    2017-09-22

    Studies in the United States have shown that physicians commonly use brand names when documenting medications in an outpatient setting. However, the prevalence of prescribing and documenting brand name medication has not been assessed in a clinical teaching environment. The purpose of this study was to describe the use of generic versus brand names for a select number of pharmaceutical products in clinical documentation in a large, urban academic family practice centre. A retrospective chart review of the electronic medical records of the St. Michael's Hospital Academic Family Health Team (SMHAFHT). Data for twenty commonly prescribed medications were collected from the Cumulative Patient Profile as of August 1, 2014. Each medication name was classified as generic or trade. Associations between documentation patterns and physician characteristics were assessed. Among 9763 patients prescribed any of the twenty medications of interest, 45% of patient charts contained trade nomenclature exclusively. 32% of charts contained only generic nomenclature, and 23% contained a mix of generic and trade nomenclature. There was large variation in use of generic nomenclature amongst physicians, ranging from 19% to 93%. Trade names in clinical documentation, which likely reflect prescribing habits, continue to be used abundantly in the academic setting. This may become part of the informal curriculum, potentially facilitating undue bias in trainees. Further study is needed to determine characteristics which influence use of generic or trade nomenclature and the impact of this trend on trainees' clinical knowledge and decision-making.

  13. Radiation safety status at a bio medical research centre

    International Nuclear Information System (INIS)

    Mishra, S.K.

    1998-01-01

    Radioisotopes are being used for biomedical research purpose at School of Life Science, Jawaharlal Nehru University for the last twenty five years. Present paper analyses the overall status of radiation safety at this Centre

  14. A guideline to medical photography: a perspective on digital photography in an orthopaedic setting.

    Science.gov (United States)

    de Meijer, P P G; Karlsson, J; LaPrade, R F; Verhaar, J A N; Wijdicks, C A

    2012-12-01

    Quality photographs are essential for clinical documentation, research, and publication in scientific journals and teaching. Oftentimes, non-ideal lighting and a sterile environment restrict the medical photographer, resulting in lower-quality photographs. This article aims to provide a clear and comprehensible guideline for medical photography in an orthopaedic setting. This article is based on extensive photographic involvement in operating and laboratory settings, in close collaboration with medical professionals from the Steadman Clinic (Vail, Colorado, USA), Gothenburg University (Göteborg, Sweden) and Erasmus MC (Rotterdam, the Netherlands). Background literature was searched through Google Scholar and PubMed. Three relevant journal articles, and one book on medical photography, were used to write this paper. Seventeen Internet articles were used for background information. A relevant, up-to-date and comprehensive guideline to medical photography for medical professionals, with or without photographic experience, is provided. Expert opinion, Level V.

  15. Epidemiology of burns

    NARCIS (Netherlands)

    Dokter, Jan

    2016-01-01

    The aim of this thesis is to understand the epidemiology, treatment and outcomes of specialized burn care in The Netherlands. This thesis is mainly based on historical data of the burn centre in Rotterdam from 1986, combined with historical data from the burn centres in Groningen and Beverwijk from

  16. Communication between general practitioners and the emergency medical dispatch centre in urgent cases

    DEFF Research Database (Denmark)

    Mieritz, Hanne Beck; Rønnow, Camilla; Jørgensen, Gitte

    2018-01-01

    , and we found that these calls were more likely to contain problematic communication (odds ratio = 5.1). In 18% (n = 236) of the cases, there was not sufficient information to assess if the physician-manned mobile emergency care unit (MECU) should have been dispatched along with the ambulance......INTRODUCTION: When general practitioners (GPs) order an ambulance, their calls are handled by staff at the emergency medical dispatch centre (EMDC) who then select an appropriate response. There are currently no data evaluating this mode of communication between the GPs and the staff at the EMDC....... 
RESULTS: We found problematic communication in less than 2% (n = 25) of the evaluated calls. In 68% of the 25 problematic cases transactional analysis showed that the staff at the EMDC initiated the problematic communication. In 4% (n = 51) of the calls, the GP delegated the call to a secretary or nurse...

  17. Type, severity, management and outcome of ocular and adnexal firework-related injuries: the Rotterdam experience.

    Science.gov (United States)

    Frimmel, Sonja; de Faber, J Tjeerd; Wubbels, Rene J; Kniestedt, Christoph; Paridaens, Dion

    2018-03-13

    To study the type, severity, management and outcome of firework-related adnexal and ocular injuries during New Year's Eve festivities. A retrospective analysis of 123 injured patients (143 eyes) treated at the Rotterdam Eye Hospital between 2009 and 2013. All ages were included and analysed according to age, gender, active participant or bystander, laterality, location, dimension and severity of injury. Outcome parameter was the final best-corrected visual acuity. The mean age was 22 ± 13 years with 87% males and 53% bystanders. 52% were ≤18 years. There was a higher number of female than male bystanders (63% versus 51%, p = 0.30). 50% of the eyes sustained mild, 13% moderate and 37% severe trauma. Adults suffered more from severe injuries compared to children (42% versus 31%). The most frequent intervention was gunpowder removal (20%), followed by traumatic cataract surgery (12%) and amniotic membrane grafting (8%). 76% of patients were followed over 1 year. At the end of follow-up, 88 (61.5%) eyes had recovered fully, while 55 (38.5%) eyes suffered from persistent complications with reduced vision ≤0.8 in 30% of injured eyes. 15 patients (12%, 10 adults, five children) were considered legally blind (vision ≤0.1). Three (2%) eyes were subject to evisceration. Every year, around New Year's Eve 30-45 victims were referred to the Rotterdam Eye Hospital; 50% sustained moderate-to-severe trauma. In severe firework injuries, patients required multiple treatments that may not prevent permanent blindness and/or functional/cosmetic disfigurement. The majority was bystander and younger than 18 years. © 2018 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  18. Papel do professor: de Erasmo de Rotterdam a Vygotsky - Teacher's role: of Rotterdam Erasmo the Vygotsky

    Directory of Open Access Journals (Sweden)

    Ada Augusta Celestino Bezerra

    2016-09-01

    Full Text Available ResumoO artigo analisa o circuito de ideias pedagógicas sobre a função e preparação do professor ao longo da história, sob o recorte do século XVI ao século XX, a partir das contribuições de doze teóricos/filósofos da educação, do Manifesto dos Pioneiros da Educação Nova no Brasil (1932 e do Manifesto dos Educadores. O diálogo com os teóricos estabeleceu-se cronologicamente, considerando os contextos em que as obras foram publicadas e/ou difundidas, com suas implicações no papel do professor. A metodologia adotada foi a revisão bibliográfica que permitiu o retorno aos clássicos que evocaram para si o pensar sobre o processo educativo e suas relações com a sociedade. O estudo partiu de Erasmo de Rotterdam (séc. XVI até alcançar o pensamento de Vygotsky (século XX. Nas considerações finais destaca afinidades e avanços em torno da função docente, reconhecendo que está concretamente colocado à consideração e criatividade dos educadores na contemporaneidade o desafio da construção de uma educação que, mesmo situada no contexto das determinações capitalistas, forme o aluno para o exercício pleno da cidadania a partir da apropriação da cultura produzida social e historicamente pela humanidade e da radicalização do discurso neoliberal dos governos. Para esse fim aponta como componentes da formação do professor: o conhecimento científico-cultural, o conhecimento pedagógico e didático, ao lado do conhecimento profissional docente, requeridos para a inscrição na profissão de professor.    

  19. Analysis of an infill scenario for Rotterdam. Traffic noise, air pollution, and public health in relation to urban density and traffic of cars and bicycles

    NARCIS (Netherlands)

    Schaminée, S.; Rietveld, E.; Salomons, E.; Kluizenaar, Y. de; Borsboom, J.; Borst, H.; Guit, M.

    2012-01-01

    An analysis is presented of various elements of an infill scenario for the center of Rotterdam in the year 2030, corresponding to a population increase from about 30,000 to 60,000 inhabitants. We have implemented detailed future building designs in our software instrument Urban Strategy, and

  20. Rapid health assessments of evacuation centres in areas affected by Typhoon Haiyan

    Directory of Open Access Journals (Sweden)

    Ruth Alma Ramos

    2015-11-01

    Full Text Available Introduction: Typhoon Haiyan caused thousands of deaths and catastrophic destruction, leaving many homeless in Region 8 of the Philippines. A team from the Philippine Field Epidemiology Training Program conducted a rapid health assessment survey of evacuation centres severely affected by Haiyan. Methods: A descriptive study was conducted whereby a convenience sample of evacuation centres were assessed on the number of toilets per evacuee, sanitation, drinking-water, food supply source and medical services. Results: Of the 20 evacuation centres assessed, none had a designated manager. Most were located in schools (70% with the estimated number of evacuees ranging from 15 to 5000 per centre. Only four (20% met the World Health Organization standard for number of toilets per evacuee; none of the large evacuation centres had even half the recommended number of toilets. All of the evacuation centres had available drinking-water. None of the evacuation centres had garbage collection, vector control activities or standby medical teams. Fourteen (70% evacuation centres had onsite vaccination activities for measles, tetanus and polio virus. Many evacuation centres were overcrowded. Conclusion: Evacuation centres are needed in almost every disaster. They should be safely located and equipped with the required amenities. In disaster-prone areas such as the Philippines, schools and community centres should not be designated as evacuation centres unless they are equipped with adequate sanitation services.

  1. Validation of a model to investigate the effects of modifying cardiovascular disease (CVD) risk factors on the burden of CVD: the rotterdam ischemic heart disease and stroke computer simulation (RISC) model.

    Science.gov (United States)

    van Kempen, Bob J H; Ferket, Bart S; Hofman, Albert; Steyerberg, Ewout W; Colkesen, Ersen B; Boekholdt, S Matthijs; Wareham, Nicholas J; Khaw, Kay-Tee; Hunink, M G Myriam

    2012-12-06

    We developed a Monte Carlo Markov model designed to investigate the effects of modifying cardiovascular disease (CVD) risk factors on the burden of CVD. Internal, predictive, and external validity of the model have not yet been established. The Rotterdam Ischemic Heart Disease and Stroke Computer Simulation (RISC) model was developed using data covering 5 years of follow-up from the Rotterdam Study. To prove 1) internal and 2) predictive validity, the incidences of coronary heart disease (CHD), stroke, CVD death, and non-CVD death simulated by the model over a 13-year period were compared with those recorded for 3,478 participants in the Rotterdam Study with at least 13 years of follow-up. 3) External validity was verified using 10 years of follow-up data from the European Prospective Investigation of Cancer (EPIC)-Norfolk study of 25,492 participants, for whom CVD and non-CVD mortality was compared. At year 5, the observed incidences (with simulated incidences in brackets) of CHD, stroke, and CVD and non-CVD mortality for the 3,478 Rotterdam Study participants were 5.30% (4.68%), 3.60% (3.23%), 4.70% (4.80%), and 7.50% (7.96%), respectively. At year 13, these percentages were 10.60% (10.91%), 9.90% (9.13%), 14.20% (15.12%), and 24.30% (23.42%). After recalibrating the model for the EPIC-Norfolk population, the 10-year observed (simulated) incidences of CVD and non-CVD mortality were 3.70% (4.95%) and 6.50% (6.29%). All observed incidences fell well within the 95% credibility intervals of the simulated incidences. We have confirmed the internal, predictive, and external validity of the RISC model. These findings provide a basis for analyzing the effects of modifying cardiovascular disease risk factors on the burden of CVD with the RISC model.

  2. Validation of a model to investigate the effects of modifying cardiovascular disease (CVD risk factors on the burden of CVD: the rotterdam ischemic heart disease and stroke computer simulation (RISC model

    Directory of Open Access Journals (Sweden)

    van Kempen Bob JH

    2012-12-01

    Full Text Available Abstract Background We developed a Monte Carlo Markov model designed to investigate the effects of modifying cardiovascular disease (CVD risk factors on the burden of CVD. Internal, predictive, and external validity of the model have not yet been established. Methods The Rotterdam Ischemic Heart Disease and Stroke Computer Simulation (RISC model was developed using data covering 5 years of follow-up from the Rotterdam Study. To prove 1 internal and 2 predictive validity, the incidences of coronary heart disease (CHD, stroke, CVD death, and non-CVD death simulated by the model over a 13-year period were compared with those recorded for 3,478 participants in the Rotterdam Study with at least 13 years of follow-up. 3 External validity was verified using 10 years of follow-up data from the European Prospective Investigation of Cancer (EPIC-Norfolk study of 25,492 participants, for whom CVD and non-CVD mortality was compared. Results At year 5, the observed incidences (with simulated incidences in brackets of CHD, stroke, and CVD and non-CVD mortality for the 3,478 Rotterdam Study participants were 5.30% (4.68%, 3.60% (3.23%, 4.70% (4.80%, and 7.50% (7.96%, respectively. At year 13, these percentages were 10.60% (10.91%, 9.90% (9.13%, 14.20% (15.12%, and 24.30% (23.42%. After recalibrating the model for the EPIC-Norfolk population, the 10-year observed (simulated incidences of CVD and non-CVD mortality were 3.70% (4.95% and 6.50% (6.29%. All observed incidences fell well within the 95% credibility intervals of the simulated incidences. Conclusions We have confirmed the internal, predictive, and external validity of the RISC model. These findings provide a basis for analyzing the effects of modifying cardiovascular disease risk factors on the burden of CVD with the RISC model.

  3. Addiction research centres and the nurturing of creativity: National Drug Dependence Treatment Centre, India--a profile.

    Science.gov (United States)

    Ray, Rajat; Dhawan, Anju; Chopra, Anita

    2013-10-01

    The National Drug Dependence Treatment Centre (NDDTC) is a part of the All India Institute of Medical Sciences, a premier autonomous medical university in India. This article provides an account of its origin and its contribution to the field of substance use disorder at the national and international levels. Since its establishment, the NDDTC has played a major role in the development of various replicable models of care, the training of post-graduate students of psychiatry, research, policy development and planning. An assessment of the magnitude of drug abuse in India began in the early 1990s and this was followed by a National Survey on Extent, Patterns and Trends of Drug Abuse in 2004. Several models of clinical care have been developed for population subgroups in diverse settings. The centre played an important role in producing data and resource material which helped to scale up opioid substitution treatment in India. A nationwide database on the profile of patients seeking treatment (Drug Abuse Monitoring System) at government drug treatment centres has also been created. The centre has provided valuable inputs for the Government of India's programme planning. Besides clinical studies, research has also focused on pre-clinical studies. Capacity-building is an important priority, with training curricula and resource material being developed for doctors and paramedical staff. Many of these training programmes are conducted in collaboration with other institutions in the country. The NDDTC has received funding from several national and international organizations for research and scientific meetings, and, most recently (2012), it has been designated as a World Health Organization Collaborating Centre on Substance Abuse. © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.

  4. MAAGs (Medical Audit Advisory Groups): the Eli Lilly National Clinical Audit Centre.

    Science.gov (United States)

    Baker, R; Fraser, R

    1993-01-01

    Outlines the framework for promoting audit in general practice, created as one part of the health service reforms. Medical Audit Advisory Groups (MAAGs) were set up in each district with the aim of participation in audit of all general practitioners by April 1992. The activities undertaken have included those recommended by the Department of Health; the most significant of these being the appointment of lay facilitators who are able to assist general practitioners and primary care teams co-operate over efforts to improve the quality of care, and may offer one means of introducing some of the methods of total quality management into general practice. Discusses the problems which remain: audit is not yet sufficiently systematic, interface audit with secondary care is at a very early stage, the ways to involve managers and patients in audit remain to be clarified, and there is little evidence of the consequences of audit in terms of improved care. The Eli Lilly National Clinical Audit Centre has been set up within the Department of General Practice, University of Leicester, in order to address these issues.

  5. The Ottawa ankle rules for the use of diagnostic X-ray in after hours medical centres in New Zealand.

    Science.gov (United States)

    Wynn-Thomas, Simon; Love, Tom; McLeod, Deborah; Vernall, Sue; Kljakovic, Marjan; Dowell, Antony; Durham, John

    2002-09-27

    The aims of this study were to measure baseline use of Ottawa ankle rules (OAR), validate the OAR and, if appropriate, explore the impact of implementing the Rules on X-ray rates in a primary care, after hours medical centre setting. General practitioners (GPs) were surveyed to find their awareness of ankle injury guidelines. Data concerning diagnosis and X-ray utilisation were collected prospectively for patients presenting with ankle injuries to two after hours medical centres. The OAR were applied retrospectively, and the sensitivity and specificity of the OAR were compared with GPs clinical judgement in ordering X-rays. The outcome measures were X-ray utilisation and diagnosis of fracture. Awareness of the OAR was low. The sensitivity of the OAR for diagnosis of fractures was 100% (95% CI: 75.3 - 100) and the specificity was 47% (95% CI: 40.5 - 54.5). The sensitivity of GPs clinical judgement was 100% (95% CI: 75.3 - 100) and the specificity was 37% (95% CI: 30.2 - 44.2). Implementing the OAR would reduce X-ray utilisation by 16% (95% CI: approx 10.8 - 21.3). The OAR are valid in a New Zealand primary care setting. Further implementation of the rules would result in some reduction of X-rays ordered for ankle injuries, but less than the reduction found in previous studies.

  6. Clinical importance of re-interpretation of PET/CT scanning in patients referred to a tertiary care medical centre

    DEFF Research Database (Denmark)

    Löfgren, Johan; Loft, Annika; Barbosa de Lima, Vinicius Araújo

    2017-01-01

    had an external F-18-FDG PET/CT scan were included. Only information that had been available at the time of the initial reading at the external hospital was available at re-interpretation. Teams with one radiologist and one nuclear medicine physician working side by side performed the re......PURPOSE: To evaluate, in a controlled prospective manner with double-blind read, whether there are differences in interpretations of PET/CT scans at our tertiary medical centre, Rigshospitalet, compared to the external hospitals. METHODS: Ninety consecutive patients referred to our department who...

  7. The flow of goods model of the Rotterdam Port Authority; Het goederenstromenmodel voor de Rotterdamse haven. De verhouding tussen fysieke stromen en economische grootheden

    Energy Technology Data Exchange (ETDEWEB)

    Saitua, R. [Haveninnovatie van het Gemeentelijk Havenbedrijf, Rotterdam (Netherlands)

    1995-12-01

    Long term forecasts of the flow of goods through the Port of Rotterdam are essential for port development aims and to quantify the environmental effects of the generated traffic. Experience of the Rotterdam Port Authority shows that the differences between forecasts and realization can be explained by radical changes in the trends as a consequence of technological and social developments. In the `Flow of goods model number 6` scenario, techniques have been used to asses the fundamental uncertainty of the future, as well as a combination of quantitative and qualitative methods (for example expert judgements). Much attention has been given to the so called `dematerialization` trend, which means less use of primary commodities by production unit. Problems that have to be tackled within a more appropriate way are: (1) expected less growth of the trade measured in weight than the trade measured in monetary units; and (2) the influence of geographical patterns of production (lean production with global sourcing versus more local diffused production) on trade and transport flows. 2 tabs., 9 refs.

  8. Changing trend of viral hepatitis -- 'A twenty one year report from Pakistan medical research council research centre, Jinnah Postgraduate Medical Centre, Karachi'

    International Nuclear Information System (INIS)

    Ahmed, W.; Qureshi, H.; Arif, A.; Alam, S.E.

    2010-01-01

    To determine the frequency and pattern of Hepatitis B and C over the past twenty one years, in a liver research unit of Karachi. Retrospective analysis of the records of PMRC, Research Centre, Jinnah Postgraduate Medical Centre, Karachi, from 1987 to 2007 were reviewed. A special flow sheet was made where information of all patients with viral liver disease was entered. Patients having complete information of viral markers were included in the analysis. Cases with HBsAg, Anti HBc IgM positive and raised ALT were considered as acute Hepatitis B. HBs Ag/ Anti HBc IgG positive were considered as chronic Hepatitis B. Delta antibody positive with or without HBsAg were considered as Delta Hepatitis. Anti HCV positive and raised ALT more than ten times for less than 6 months were considered as acute Hepatitis C, whereas Anti HCV and HCV-RNA positive with or without raised ALT for more than six months were considered as chronic Hepatitis C. Anti HEV IgM and Anti HAV IgM positive were considered as acute Hepatitis E and A respectively. A total of 5193 cases fulfilling all criteria of viral hepatitis were seen in the past 21 years. Of the total 3247 (62.5 %) were males and 1946 (37.5 %) females giving a male to female ratio of 1.7:1 Hepatitis C was the most common infection seen in 2896 cases (55.8 %), followed by Hepatitis B in 1691 cases (32.6 %). Seventy five percent cases of Hepatitis B were males and 25 % females while 55% Hepatitis C cases were males and 45 % females. Hepatitis B was seen a decade earlier in different age groups than hepatitis C. Overall, out of the total 5193 cases, 2294 (44.2%) were of chronic hepatitis, 1430 (27.5%) cirrhosis, 1083 (20.8%) carriers and 346 (6.7%) had acute hepatitis (hepatitis B; 214 (61.8%), hepatitis C; 21 (6.0%). While hepatitis B and hepatitis C both were present in 3 (1.3%). Hepatitis E was 70 (20.2%) hepatitis A 12 (3.5%) and all markers were negative in 26 (7.5%) cases). Forty cases (0.8%) were of Hepatocellular carcinoma

  9. EXPLORING SERVICE QUALITY IMPACTS ON CUSTOMER SATISFACTION IN MILITARY MEDICAL CENTRES: MODERATING ROLE OF PERCEIVED VALUE

    Directory of Open Access Journals (Sweden)

    Azman Ismail

    2016-12-01

    Full Text Available Much has been written about service quality impacts on customer satisfaction. However, little research on this perspective has been carried out in military settings. The aim of this study is to examine the relationship between service quality and customer satisfaction, and moderating effects of perceived value in military medical centre. A survey method was employed and data was collected from customers at medical centers under the administration of Malaysian army organization. Analysis was performed using SmartPLS path model analysis. The results show two important findings: first, the interaction between four service quality components (i.e., tangible, reliability, responsiveness and assurance and customers’ perceived value were significantly correlated with customer satisfaction. Second, the interaction between one service quality component (i.e., tangible were not significantly correlated with customer satisfaction. In overall, this result confirms that effect of tangible, reliability, responsiveness and assurance on customer satisfaction has been moderated by customers’ perceived value. Conversely, effect empathy on customer satisfaction has not been moderated by customers’ perceived value. Further, this study offers discussion, implications and conclusion.

  10. Improved diagnosis of Trichomonas vaginalis infection by PCR using vaginal swabs and urine specimens compared to diagnosis by wet mount microscopy, culture, and fluorescent staining

    NARCIS (Netherlands)

    C. van der Schee (Cindy); A.F. van Belkum (Alex); L. Zwijgers (Lisette); E. van der Brugge; E.L. O'Neill; A. Luijendijk (Ad); T. van Rijsoort-Vos; W.I. van der Meijden (Willem); J.F. Sluiters (Hans); H.A. Verbrugh (Henri)

    1999-01-01

    textabstractFour vaginal cotton swab specimens were obtained from each of 804 women visiting the outpatient sexually transmitted disease clinic of the Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands, for validation of various forms of Trichomonas

  11. Singapore's proposed graduate medical school--an expensive medical tutorial college or an opportunity for transforming Singapore medicine?

    Science.gov (United States)

    Soo, K C

    2005-07-01

    The proposed Graduate Medical School at the Outram Campus will open in 2007. The main value of this medical school is the transformation of the medical institutions in the campus and SingHealth into Academic Medical Centres. Such centres will train and host quality physicians and physician-scientists. It will help push the development of translational research, complementing the country's investment in Biopolis. It will also underpin Singapore's push into regional medical tourism and its development as an educational hub in the biomedical sciences.

  12. Unintentional Pharmaceutical-Related Medication Errors Caused by Laypersons Reported to the Toxicological Information Centre in the Czech Republic.

    Science.gov (United States)

    Urban, Michal; Leššo, Roman; Pelclová, Daniela

    2016-07-01

    The purpose of the article was to study unintentional pharmaceutical-related poisonings committed by laypersons that were reported to the Toxicological Information Centre in the Czech Republic. Identifying frequency, sources, reasons and consequences of the medication errors in laypersons could help to reduce the overall rate of medication errors. Records of medication error enquiries from 2013 to 2014 were extracted from the electronic database, and the following variables were reviewed: drug class, dosage form, dose, age of the subject, cause of the error, time interval from ingestion to the call, symptoms, prognosis at the time of the call and first aid recommended. Of the calls, 1354 met the inclusion criteria. Among them, central nervous system-affecting drugs (23.6%), respiratory drugs (18.5%) and alimentary drugs (16.2%) were the most common drug classes involved in the medication errors. The highest proportion of the patients was in the youngest age subgroup 0-5 year-old (46%). The reasons for the medication errors involved the leaflet misinterpretation and mistaken dose (53.6%), mixing up medications (19.2%), attempting to reduce pain with repeated doses (6.4%), erroneous routes of administration (2.2%), psychiatric/elderly patients (2.7%), others (9.0%) or unknown (6.9%). A high proportion of children among the patients may be due to the fact that children's dosages for many drugs vary by their weight, and more medications come in a variety of concentrations. Most overdoses could be prevented by safer labelling, proper cap closure systems for liquid products and medication reconciliation by both physicians and pharmacists. © 2016 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).

  13. From the coliseum to the convention centre: a reflection on the current state of medical education conferences and conference-goers.

    Science.gov (United States)

    Blanchard, Rebecca D; Engle, Deborah L; Howley, Lisa D; Whicker, Shari A; Nagler, Alisa

    2016-12-01

    The advancement of knowledge and development of policy in the field of medical education require critical academic discourse among the most intelligent medical educators; and critical academic discourse requires coffee. In this essay, we reflect on the state of professional development conferences in the field of medical education and the rituals that surround their success. Having begun in ancient Greece, symposia were ripe with debauchery. Today, sedated by the light brown walls of hotel conference centres, symposia are more serious endeavours, engaging men and women in the sometimes turbulent waters of epistemological debate. The abstract submission process (summed up by: 'Yay! It was accepted for presentation' [Deep breath] 'Oh no…it was accepted for presentation'), the 'juggling act' of parent attendees, the acting prowess of abstract presenters and the unapologetic approach to buffet eating are all by-products of the collision of true intellects among medical education scholars. We hold these rituals in high regard and argue that they are required to advance the field of medical education. These rituals bind the walls supporting true progressive thought and innovative research, all fuelled by the glass of wine purchased with that one coveted drink ticket. © 2016 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

  14. Assessing patient-centred communication in teaching: a systematic review of instruments

    NARCIS (Netherlands)

    Brouwers, M.H.; Rasenberg, E.M.C.; Weel, C. van; Laan, R.F.; Weel-Baumgarten, E.M. van

    2017-01-01

    CONTEXT: Patient-centred communication is a key component of patient centredness in medical care. Therefore, adequate education in and assessment of patient-centred communication skills are necessary. In general, feedback on communication skills is most effective when it is provided directly and is

  15. A person-centred approach in medicine to reduce the psychosocial and existential burden of chronic and life-threatening medical illness.

    Science.gov (United States)

    Grassi, Luigi; Mezzich, Juan E; Nanni, Maria Giulia; Riba, Michelle B; Sabato, Silvana; Caruso, Rosangela

    2017-10-01

    The psychiatric, psychosocial, and existential/spiritual pain determined by chronic medical disorders, especially if in advanced stages, have been repeatedly underlined. The right to approach patients as persons, rather than symptoms of organs to be repaired, has also been reported, from Paul Tournier to Karl Jaspers, in opposition and contrast with the technically-enhanced evidence-based domain of sciences that have reduced the patients to 'objects' and weakened the physician's identity deprived of its ethical value of meeting, listening, and treating subjects. The paper will discuss the main psychosocial and existential burden related to chronic and advanced medical illnesses, and the diagnostic and therapeutic implications for a dignity preserving care within a person-centred approach in medicine, examined in terms of care of the person (of the person's whole health), for the person (for the fulfilment of the person's health aspirations), by the person (with physicians extending themselves as total human beings), and with the person (working respectfully with the medically ill person).

  16. Information Centre Radioactivity Switzerland; Beratungsstelle Radioaktivitaet Schweiz

    Energy Technology Data Exchange (ETDEWEB)

    Mosimann, N.; Balsiger, B.; Burger, M. [Bundesamt fuer Bevoelkerungsschutz (Switzerland). LABOR SPIEZ

    2016-07-01

    The Information Centre Radioactivity Switzerland is meant to assess the radiological condition and serves for psychological-medical care of affected members of the Swiss public following an event of increased radioactivity in the environment. The Centre is structured in a modular way consisting of the following modules: ''Entry Measurement'': The visitors are registered and measured for contamination, ''Decontamination'': Contaminated visitors are decontaminated, ''Additional Measurements'': If required, thyroid and whole body measurements are performed, ''Information'': The visitors are informed about radioactivity, radiation protection, the current situation and their individual next steps, ''Exit'': Administrative release from the Information Centre.

  17. Reach and effectiveness of a community program to reduce smoking among ethnic Turkish residents in Rotterdam, the Netherlands: a quasi-experimental design.

    Science.gov (United States)

    Nierkens, Vera; Kunst, Anton E; De Vries, Hein; Voorham, Toon A J; Stronks, Karien

    2013-01-01

    Community interventions have been considered promising strategies to reduce smoking prevalence among ethnic minority populations. We assessed the reach and effectiveness of a community program targeted at the Turkish population in Rotterdam, the Netherlands. The study had a quasi-experimental design, with 1 pretest and 1 posttest among 18- to 60-year-old Turkish residents in a district in Rotterdam (n = 388 at pretest) and in a comparison area in the city of Utrecht (n = 389 at pretest). The surveys included measures of reach and measures of effectiveness. Logistic regression analysis assessed changes in the outcome measures over time, adjusting for sex, age, and educational level. At posttest, more smokers (62.5%) perceived pros of quitting, and 8.2% had quit. Compared with the comparison group, in the intervention group the changes tended to be greater, but differences were not statistically significant. Of all respondents, 61.2% recognized at least 1 program component, and 23.1% participated in at least 1. Based on the greater changes in the intervention group (particularly regarding quit rates and pros of smoking), this community intervention can become a promising strategy. To increase potential effectiveness, participation rates need to increase and interventions should last longer and include smoking-cessation support.

  18. Teachers' conceptions of learning and teaching in student-centred medical curricula: the impact of context and personal characteristics.

    Science.gov (United States)

    Jacobs, Johanna C G; van Luijk, Scheltus J; van der Vleuten, Cees P M; Kusurkar, Rashmi A; Croiset, Gerda; Scheele, Fedde

    2016-09-21

    Gibbs and Coffey (2004) have reported that teaching practices are influenced by teachers' conceptions of learning and teaching. In our previous research we found significant differences between teachers' conceptions in two medical schools with student-centred education. Medical school was the most important predictor, next to discipline, gender and teaching experience. Our research questions for the current study are (1) which specific elements of medical school explain the effect of medical school on teachers' conceptions of learning and teaching? How? and (2) which contextual and personal characteristics are related to conceptions of learning and teaching? How? Individual interviews were conducted with 13 teachers of the undergraduate curricula in two medical schools. Previously their conceptions of learning and teaching were assessed with the COLT questionnaire. We investigated the meanings they attached to context and personal characteristics, in relation to their conceptions of learning and teaching. We used a template analysis. Large individual differences existed between teachers. Characteristics mentioned at the medical school and curriculum level were 'curriculum tradition', 'support by educational department' and 'management and finances'. Other contextual characteristics were 'leadership style' at all levels but especially of department chairs, 'affordances and support', 'support and relatedness', and 'students' characteristics'. Personal characteristics were 'agency', 'experience with PBL (as a student or a teacher)','personal development', 'motivation and work engagement'and 'high content expertise'. Several context and personal characteristics associated with teachers' conceptions were identified, enabling a broader view on faculty development with attention for these characteristics, next to teaching skills.

  19. Student-centred learning in Community Medicine: An experience from Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry.

    Science.gov (United States)

    Kar, S S; Premarajan, K C; L, Subitha; Archana, R; Iswarya, S; A, Sujiv

    2014-01-01

    Student-centred learning (SCL) places the student at the centre of policies, practices and decision-making in the teaching-learning process. SCL methodology also advocates active involvement of students in the curriculum planning, selection of teaching-learning methods and assessment process. We planned an education innovation project to assess the perception of fifth semester undergraduate medical students towards implementation of an SCL methodology. The study was done among 87 fifth semester undergraduate medical students (batch of 2010-11) in the noncommunicable disease epidemiology section of Community Medicine at the Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry. The students divided themselves into seven groups and developed the learning objectives, selected teaching-learning methods and assessment process for each session. The facilitators had 3-5 rounds of interaction with each group before the session. Qualitative analysis of feedback collected from students and external faculty after each session was done. The effect of implementing the SCL methodology was assessed by the reaction level of Kirkpatrick's training evaluation model by using a rating scale Results. Of the 87 eligible students, 73 (83.9%) returned the forms for evaluation. All seven groups were able to formulate the learning objectives. Most of the groups had used PowerPoint slides and videos as a teaching-learning tool. Innovative assessment methods such as crosswords and 'chocopati' were used by some groups. In general, the perception of students was favourable towards SCL compared to conventional methods and they felt that this methodology should be adopted more often. Time management and organization of sessions were the main problems encountered by the students. The mean (SD) score for the items 'sessions were useful', 'sessions were enjoyable' and 'sessions improved my knowledge' were 6.2 (1.8), 7.1 (1.8) and 6.3 (1.9), respectively. The

  20. The Australian centre for RF bioeffects research (ACRBR) - an NHMRC centre of research excellence

    International Nuclear Information System (INIS)

    Wood, A.; Croft, R.; Abramson, M.; Anderson, V.; Cosic, I.; Finnie, J.; McKenzie, R.

    2004-01-01

    Full text: The Australian Centre for Radiofrequency Bioeffects Research (ACRBR) is a newly established multi-institutional research centre which seeks to research questions pertaining to possible health effects of exposure to radiofrequency devices, such as mobile phones and which is funded under the Australian National Health and Medical Research Council (NHMRC) Centres of Research Excellence funding program. The Centre of Research Excellence in Electromagnetic Energy is combining the efforts of engineers, epidemiologists, physicists, psychophysiologists and veterinary pathologists from RMIT University, the Institute of Medical and Veterinary Science in South Australia (IMVS), Monash University, Swinburne University of Technology and Telstra Research Laboratories (TRL). The centre is funded at $2.5 M over five years and will undertake a program of research to address the issue of exposure to radiofrequency (RF) devices and health. It will also train new scientists, keep the community informed of ongoing developments and help the development of government policies in this area of considerable public concern. The 5-year program has the following components: Neurobiology: One important area where there is a perceived research gap is in the area of potential neurological effects, which will hence be a major focus of this Centre. The proposed studies range from in vitro and in vivo research studies of RF effects on neuron and neural system functioning in rodents, to that of RF effects on simple neural function, cognition and subjective report in humans. The latter series of studies have been developed to account for the consensus view that more emphasis needs to be placed on possible differences in RF population sensitivity (e.g. youth versus aged, and ' electromagnetic hypersensitives'). Epidemiological studies are an important tool in studying the impact on public health from exposure of whole populations to modern radio technologies. Cancer outcomes in this area of

  1. [Interdisciplinary healthcare centres--a way of organising healthcare in the future from a health insurer's perspective].

    Science.gov (United States)

    Hecke, Torsten L; Hoyer, Jens Martin

    2009-01-01

    The German healthcare system modernization act enables healthcare providers to fund interdisciplinary healthcare centres. The Techniker Krankenkasse (TK) is a statutory health sickness fund that has contracted with some of the interdisciplinary healthcare centres named ATRIO-MED to achieve high-quality medical care and healthcare management. A range of patient-centred services is described in the cooperation agreement; in addition to central medical patient records one of the core competencies includes integrated pathways for defined diagnosis. The concept of the interdisciplinary healthcare centre is highly accepted among patients. It will serve as a platform for future TK healthcare policies.

  2. Descriptive epidemiology of colorectal cancer in University Malaya Medical Centre, 2001 to 2010.

    Science.gov (United States)

    Magaji, Bello Arkilla; Moy, Foong Ming; Roslani, April Camilla; Law, Chee Wei

    2014-01-01

    Colorectal cancer is the second most frequent cancer in Malaysia. Nevertheless, there is little information on treatment and outcomes nationally. We aimed to determine the demographic, clinical and treatment characteristics of colorectal cancer patients treated at the University Malaya Medical Centre (UMMC) as part of a larger project on survival and quality of life outcomes. Medical records of 1,212 patients undergoing treatment in UMMC between January 2001 and December 2010 were reviewed. A retrospective-prospective cohort study design was used. Research tools included the National Cancer Patient Registration form. Statistical analysis included means, standard deviations (SD), proportions, chi square, t-test/ ANOVA. P-value significance was set at 0.05. The male: female ratio was 1.2:1. The mean age was 62.1 (SD12.4) years. Patients were predominantly Chinese (67%), then Malays (18%), Indians (13%) and others (2%). Malays were younger than Chinese and Indians (mean age 57 versus 62 versus 62 years, p<0.001). More females (56%) had colon cancers compared to males (44%) (p=0.022). Malays (57%) had more rectal cancer compared to Chinese (45%) and Indians (49%) (p=0.004). Dukes' stage data weres available in 67%, with Dukes' C and D accounting for 64%. Stage was not affected by age, gender, ethnicity or tumor site. Treatment modalities included surgery alone (40%), surgery and chemo/radiotherapy 32%, chemo and radiotherapy (8%) and others (20%). Significant ethnic differences in age and site distribution, if verified in population-based settings, would support implementation of preventive measures targeting those with the greatest need, at the right age.

  3. Knowledge and attitudes of nurses in community health centres about electronic medical records

    Directory of Open Access Journals (Sweden)

    Don O’Mahony

    2014-03-01

    Full Text Available Background: Nurses in primary healthcare record data for the monitoring and evaluation of diseases and services. Information and communications technology (ICT can improve quality in healthcare by providing quality medical records. However, worldwide, the majority of health ICT projects have failed. Individual user acceptance is a crucial factor in successful ICT implementation. Objectives: The aim of this study is to explore nurses’ knowledge, attitudes and perceptions regarding ICT so as to inform the future implementation of electronic medical record (EMR systems. Methods: A qualitative design was used. Semi-structured interviews were undertaken with nurses at three community health centres (CHCs in the King Sabata Dalyindyebo Local Municipality. The interview guide was informed by the literature on user acceptance of ICT. Interviews were recorded and analysed using content analysis. Results: Many nurses knew about health ICT and articulated clearly the potential benefits of an EMR such as fewer errors, more complete records, easier reporting and access to information. They thought that an EMR system would solve the challenges they identified with the current paper-based record system, including duplication of data, misfiling, lack of a chronological patient record, excessive time in recording and reduced time for patient care. For personal ICT needs, approximately half used cellphone Internet-based services and computers. Conclusions: In this study, nurses identified many challenges with the current recording methods. They thought that an EMR should be installed at CHCs. Their knowledge about EMR, positive attitudes to ICT and personal use of ICT devices increase the likelihood of successful EMR implementation at CHCs.

  4. Can IMRT or Brachytherapy Reduce Dysphagia Associated With Chemoradiotherapy of Head and Neck Cancer? The Michigan and Rotterdam Experiences

    International Nuclear Information System (INIS)

    Eisbruch, Avraham; Levendag, Peter C.; Feng, Felix Y.; Teguh, David; Lyden, Teresa M.A.; Schmitz, Paul I.M.; Haxer, Marc; Noever, Inge; Chepeha, Douglas B.; Heijmen, Ben J.

    2007-01-01

    Purpose: Dysphagia is a major late complication of intensive chemoradiotherapy of head and neck cancer. The initial clinical results of intensity-modulated radiotherapy (IMRT), or brachytherapy, planned specifically to reduce dysphagia are presented. Patients and Methods: Previous research at Michigan University has suggested that the pharyngeal constrictors and glottic and supraglottic larynx are likely structures whose damage by chemo-RT causes dysphagia and aspiration. In a prospective Michigan trial, 36 patients with oropharyngeal (n = 31) or nasopharyngeal (n = 5) cancer underwent chemo-IMRT. IMRT cost functions included sparing noninvolved pharyngeal constrictors and the glottic and supraglottic larynx. After a review of published studies, the retropharyngeal nodes at risk were defined as the lateral, but not the medial, retropharyngeal nodes, which facilitated sparing of the swallowing structures. In Rotterdam, 77 patients with oropharyngeal cancer were treated with IMRT, three dimensional RT, or conventional RT; also one-half received brachytherapy. The dysphagia endpoints included videofluoroscopy and observer-assessed scores at Michigan and patient-reported quality-of-life instruments in both studies. Results: In both studies, the doses to the upper and middle constrictors correlated highly with the dysphagia endpoints. In addition, doses to the glottic and supraglottic larynx were significant in the Michigan series. In the Rotterdam series, brachytherapy (which reduced the doses to the swallowing structures) was the only significant factor on multivariate analysis. Conclusion: The dose-response relationships for the swallowing structures found in these studies suggest that reducing their doses, using either IMRT aimed at their sparing, or brachytherapy, might achieve clinical gains in dysphagia

  5. Creating opportunities for interdisciplinary collaboration and patient-centred care: how nurses, doctors, pharmacists and patients use communication strategies when managing medications in an acute hospital setting.

    Science.gov (United States)

    Liu, Wei; Gerdtz, Marie; Manias, Elizabeth

    2016-10-01

    This paper examines the communication strategies that nurses, doctors, pharmacists and patients use when managing medications. Patient-centred medication management is best accomplished through interdisciplinary practice. Effective communication about managing medications between clinicians and patients has a direct influence on patient outcomes. There is a lack of research that adopts a multidisciplinary approach and involves critical in-depth analysis of medication interactions among nurses, doctors, pharmacists and patients. A critical ethnographic approach with video reflexivity was adopted to capture communication strategies during medication activities in two general medical wards of an acute care hospital in Melbourne, Australia. A mixed ethnographic approach combining participant observations, field interviews, video recordings and video reflexive focus groups and interviews was employed. Seventy-six nurses, 31 doctors, 1 pharmacist and 27 patients gave written consent to participate in the study. Data analysis was informed by Fairclough's critical discourse analytic framework. Clinicians' use of communication strategies was demonstrated in their interpersonal, authoritative and instructive talk with patients. Doctors adopted the language discourse of normalisation to standardise patients' illness experiences. Nurses and pharmacists employed the language discourses of preparedness and scrutiny to ensure that patient safety was maintained. Patients took up the discourse of politeness to raise medication concerns and question treatment decisions made by doctors, in their attempts to challenge decision-making about their health care treatment. In addition, the video method revealed clinicians' extensive use of body language in communication processes for medication management. The use of communication strategies by nurses, doctors, pharmacists and patients created opportunities for improved interdisciplinary collaboration and patient-centred medication

  6. A South African outpatient drug treatment centre | Karassellos ...

    African Journals Online (AJOL)

    The Cape Town Drug Counselling Centre is an outpatient drug treatment ... Management of clients, which includes psychotherapy with an emphasis on ... medical intervention, is described, and proposed areas for further research are outlined.

  7. Palliative care and the arts: vehicles to introduce medical students to patient-centred decision-making and the art of caring.

    Science.gov (United States)

    Centeno, Carlos; Robinson, Carole; Noguera-Tejedor, Antonio; Arantzamendi, María; Echarri, Fernando; Pereira, José

    2017-12-16

    Medical Schools are challenged to improve palliative care education and to find ways to introduce and nurture attitudes and behaviours such as empathy, patient-centred care and wholistic care. This paper describes the curriculum and evaluation results of a unique course centred on palliative care decision-making but aimed at introducing these other important competencies as well. The 20 h-long optional course, presented in an art museum, combined different learning methods, including reflections on art, case studies, didactic sessions, personal experiences of faculty, reflective trigger videos and group discussions. A mixed methods approach was used to evaluate the course, including a) a post-course reflective exercise; b) a standardized evaluation form used by the University for all courses; and c) a focus group. Twenty students (2nd to 6th years) participated. The course was rated highly by the students. Their understanding of palliative care changed and misconceptions were dispelled. They came to appreciate the multifaceted nature of decision-making in the palliative care setting and the need to individualize care plans. Moreover, the course resulted in a re-conceptualization of relationships with patients and families, as well as their role as future physicians. Palliative care decision-making therefore, augmented by the visual arts, can serve as a vehicle to address several competencies, including the introduction of competencies related to being patient-centred and empathic.

  8. Improved health-related quality of life, participation, and autonomy in patients with treatment-resistant chronic pain after an intensive social cognitive intervention with the participation of support partners

    Directory of Open Access Journals (Sweden)

    Jongen PJ

    2017-12-01

    Full Text Available Peter Joseph Jongen,1,2 Rob P Ruimschotel,3 YM Museler-Kreijns,4 TMC Dragstra,4 L Duyverman,3 J Valkenburg-Vissers,5 J Cornelissen,6 R Lagrand,7 Rogier Donders,8 A Hartog1Department of Community and Occupational Medicine, University Medical Centre Groningen, Groningen, 2MS4 Research Institute, Nijmegen, 3Medical Psychiatric Centre PsyToBe, 4DC Klinieken Rotterdam, Rotterdam, 5Fysiotherapie Maaspoort, ‘s Hertogenbosch, 6Dansjobs, Landsmeer, 7Fysio- en Manuele Therapie R. & Y.M. Lagrand, Rotterdam, 8Department for Health Evidence, Radboud University Medical Centre, Nijmegen, The NetherlandsAbstract: Despite the availability of various specific treatments, most patients with chronic pain (CP consider their pain problem as undertreated. Recently, multiple sclerosis (MS patients who were given an intensive 3-day social cognitive treatment with the participation of support partners experienced lasting improvements in health-related quality of life (HRQoL and self-efficacy. In this study, a similar intervention was given to treatment-resistant CP patients with stressors, relational problems with support partner, and distress, anxiety or depression. Before and 1, 3, and 6 months after the intervention, patients completed the Euro-Qol 5 Dimensions 5 Levels (EQ-5D-5L and Impact on Participation and Autonomy (IPA questionnaires (primary outcomes, and the Survey Of Pain Attitudes (SOPA, the Four-Dimensional Symptom Questionnaire (4DSQ (distress, depression, anxiety, and somatization, and Visual Analog Scale for pain intensity, whereas the support partners completed the Caregiver Strain Index (CSI questionnaire. Differences between baseline and post-treatment were tested via paired t-tests (significance level 0.05. Of the 39 patients who were included, 34 (87.2% completed the 3-day treatment. At 1, 3, and 6 months, improvements were seen in EQ-5D-5L-Index (+40.6%; +22.4%; +31.7%, Health Today (+61.8%; +36.3%; +46.8%, Control attitude (+45.8%; not

  9. Arco to enter European PGE production with new Rotterdam plant

    International Nuclear Information System (INIS)

    Young, I.

    1993-01-01

    Arco Chemical (Newtown Square, PA) will enter production of propylene glycol ethers (PGEs) in Europe by building a 70,000-m.t./year plant at its Rotterdam site. Arco's board has approved the project, with construction to begin this year and completion expected in mid-1995. 'This new plant supports the company's long-standing strategy to increase its downstream integration in value-added derivatives of propylene oxide,' says Jack Oppasser, president of Arco Chemical Europe (Maidenhead, U.K.). 'It allows the company to sustain its strong position in the growing European glycol ether market.' Arco's move represents a challenge to Dow Europe (Horgen, Switzerland), which dominates the European PGE market. Dow is Europe's biggest producer of PGEs, with its Dowanol brands commanding a share greater than 50% of the estimated 90,000-m.t./year methyl-based PGE market. This was recently boosted by completion of the expansion of its plant at Stade, Germany, from 60,000 m.t./year to 110,000 m.t./year. While Arco does not currently make PGEs in Europe, it is the second-largest supplier, with about 15,000 m.t.-20,000 m.t./year, via 'third-party manufacturing arrangements' with European producers, including BP Chemicals, and imports from its 90-million lbs/year plant at Bayport, TX. However, Arco refuses to comment on this because of 'antitrust aspects.'

  10. Gender and psychiatric diagnosis: a 5-year retrospective study in a Nigerian Federal Medical Centre.

    Science.gov (United States)

    Agbir, T M; Oyigeya, M; Audu, M; Dapap, D D; Goar, S G

    2010-01-01

    The role of gender in psychiatry disorders is becoming increasingly important. This study is therefore, aimed at identifying gender pattern of admissions to a public mental health centre with regards to demographic characteristic, psychiatry diagnosis and length of stay on admission. In this retrospective study Hospital records of 388 patients admitted at the psychiatric section of the Federal Medical Centre (FMC) Makurdi, between January, 2004 and December, 2008 were studied for gender differences regarding demographic attributes, length of stay and psychiatry diagnoses. Findings revealed that more men than women were admitted overall. Most men (56%) were less than 30 years old whereas 60.6% of women were within 30-59 years aged bracket. For men the main diagnosis was schizophrenia (30.5%), followed by substance related disorders (16.5%) then depression (14.0%); for women the main diagnosis was also schizophrenia (30.3%), this was followed by depression (24.5%), only one woman was diagnosed with substance related disorder. A statistically significant association was also found between having a personality disorder and being a male (p = 0.009). Most female were single and belong to the lowest occupational group. There was no significant difference in the gender distribution of patients with respect to length of stay on admission (p = 0.161). The results revealed how psychiatry diagnosis is significantly influence by gender issues. We therefore recommend that; for a more effective psychiatry formulation, it is imperative to pay attention to gender issues that may affect the development of psychopathology.

  11. Perceptions of point-of-care infectious disease testing among European medical personnel, point-of-care test kit manufacturers, and the general public

    Directory of Open Access Journals (Sweden)

    Kaman WE

    2013-06-01

    Full Text Available Wendy E Kaman,1 Eleni-Rosalina Andrinopoulou,2 John P Hays11Department of Medical Microbiology and Infectious Diseases, Erasmus Medical Center, Rotterdam, The Netherlands; 2Department of Biostatistics, Erasmus Medical Center, Rotterdam, The NetherlandsBackground: The proper development and implementation of point-of-care (POC diagnostics requires knowledge of the perceived requirements and barriers to their implementation. To determine the current requirements and perceived barriers to the introduction of POC diagnostics in the field of medical microbiology (MM-POC a prospective online survey (TEMPOtest-QC was established.Methods and results: The TEMPOtest-QC survey was online between February 2011 and July 2012 and targeted the medical community, POC test diagnostic manufacturers, general practitioners, and the general public. In total, 293 individuals responded to the survey, including 91 (31% medical microbiologists, 39 (13% nonmedical microbiologists, 25 (9% employees of POC test manufacturers, and 138 (47% members of the general public. Responses were received from 18 different European countries, with the largest percentage of these living in The Netherlands (52%. The majority (>50% of medical specialists regarded the development of MM-POC for blood culture and hospital acquired infections as “absolutely necessary”, but were much less favorable towards their use in the home environment. Significant differences in perceptions between medical specialists and the general public included the: (1 Effect on quality of patient care; (2 Ability to better monitor patients; (3 Home testing and the doctor-patient relationship; and (4 MM-POC interpretation. Only 34.7% of the general public is willing to pay more than €10 ($13 for a single MM-POC test, with 85.5% preferring to purchase their MM-POC test from a pharmacy.Conclusion: The requirements for the proper implementation of MM-POC were found to be generally similar between medical

  12. Coffee and herbal tea consumption is associated with lower liver stiffness in the general population: The Rotterdam study.

    Science.gov (United States)

    Alferink, Louise J M; Fittipaldi, Juliana; Kiefte-de Jong, Jessica C; Taimr, Pavel; Hansen, Bettina E; Metselaar, Herold J; Schoufour, Josje D; Ikram, M Arfan; Janssen, Harry L A; Franco, Oscar H; Darwish Murad, Sarwa

    2017-08-01

    Coffee and tea have been proposed to limit the progression of liver fibrosis in established liver disease, but it is unknown if this is also true for subclinical fibrosis. We therefore aimed to evaluate whether coffee and tea consumption are associated with liver stiffness in the general population. The Rotterdam Study is an ongoing prospective population-based cohort. We included participants who underwent transient elastography, ultrasound and completed a food frequency questionnaire. Coffee and tea consumption were categorized into no, moderate (>0-3), or frequent (⩾3) intake (cups/day), and tea further into green, black and herbal tea (no/any). Significant fibrosis was defined as liver stiffness measurements (LSM) ⩾8.0kPa. We performed regression analyses relating coffee and tea intake with fibrosis, steatosis and log-transformed LSM and adjusted for energy, sugar and creamer intake, age, gender, BMI, steatosis/LSM, HOMA-IR, ALT, alcohol, smoking, soda, healthy diet index and physical activity. We included 2,424 participants (age 66.5±7.4; 43% male) of whom 5.2% had LSM ⩾8.0kPa and 34.6% steatosis. Proportion of LSM ⩾8.0kPa decreased with higher coffee consumption (7.8%, 6.9% and 4.1% for no, moderate and frequent respectively; P trend =0.006). This inverse association was confirmed in multivariable regression (OR mod 0.75, 95% CI 0.33-1.67; OR freq 0.39, 95% CI 0.18-0.86; p=0.005). Amongst tea consumers, only herbal tea consumers (36.3%) had lower log-transformed LSM after adjustment (Beta-0.05, 95% CI-0.08;-0.02, p=0.001). Subtypes of tea were associated with steatosis in univariate but not multivariable analysis. In the general population, frequent coffee and herbal tea consumption were inversely related with liver stiffness but not steatosis. Longitudinal analyses, as well as studies validating and unravelling underlying mechanisms are needed. The Rotterdam Study is a large ongoing population study of suburban inhabitants of Rotterdam in whom data

  13. Knowledge and attitudes of nurses in community health centres about electronic medical records

    Directory of Open Access Journals (Sweden)

    Don O'Mahony

    2014-02-01

    Full Text Available Background: Nurses in primary healthcare record data for the monitoring and evaluation of diseases and services. Information and communications technology (ICT can improve quality in healthcare by providing quality medical records. However, worldwide, the majority of health ICT projects have failed. Individual user acceptance is a crucial factor in successful ICT implementation. Objectives: The aim of this study is to explore nurses’ knowledge, attitudes and perceptions regarding ICT so as to inform the future implementation of electronic medical record (EMR systems. Methods: A qualitative design was used. Semi-structured interviews were undertaken with nurses at three community health centres (CHCs in the King Sabata Dalyindyebo Local Municipality. The interview guide was informed by the literature on user acceptance of ICT. Interviews were recorded and analysed using content analysis. Results: Many nurses knew about health ICT and articulated clearly the potential benefits of an EMR such as fewer errors, more complete records, easier reporting and access to information. They thought that an EMR system would solve the challenges they identified with the current paper-based record system, including duplication of data, misfiling, lack of a chronological patient record, excessive time in recording and reduced time for patient care. For personal ICT needs, approximately half used cellphone Internet-based services and computers. Conclusions: In this study, nurses identified many challenges with the current recording methods. They thought that an EMR should be installed at CHCs. Their knowledge about EMR, positive attitudes to ICT and personal use of ICT devices increase the likelihood of successful EMR implementation at CHCs.

  14. Annual City Festivals as Tools for Sustainable Competitiveness: The World Port Days Rotterdam

    Directory of Open Access Journals (Sweden)

    Erwin van Tuijl

    2016-05-01

    Full Text Available Many cities organize annual local festivals for the positive effects on urban development, although success is far from straightforward. This article reviews a case study of the World Port Days in Rotterdam in order to demonstrate how annual city festivals can contribute to sustainable competitiveness, despite limitations as well. We show how this maritime event—that is jointly organized by the business community, the Port Authority and the City Government—offers benefits for citizens as well as for firms. Our empirical results unveil that the business value of the event includes generation of societal support, image improvement, labor market development and networking, while the value for society refers to education, leisure and to a certain degree to social inclusion. The direct value of the event for business in terms of sales and recruitment is limited, while the long-term effects of educational function deserve further attention. Finally, we provide policy lessons that, when properly contextualized, other cities may help to use annual local festivals as tools for sustainable competitiveness.

  15. Validation of a model to investigate the effects of modifying cardiovascular disease (CVD) risk factors on the burden of CVD: The rotterdam ischemic heart disease and stroke computer simulation (RISC) model

    NARCIS (Netherlands)

    B.J.H. van Kempen (Bob); B.S. Ferket (Bart); A. Hofman (Albert); E.W. Steyerberg (Ewout); E.B. Colkesen (Ersen); S.M. Boekholdt (Matthijs); N.J. Wareham (Nick); K-T. Khaw (Kay-Tee); M.G.M. Hunink (Myriam)

    2012-01-01

    textabstractBackground: We developed a Monte Carlo Markov model designed to investigate the effects of modifying cardiovascular disease (CVD) risk factors on the burden of CVD. Internal, predictive, and external validity of the model have not yet been established.Methods: The Rotterdam Ischemic

  16. Allergic rhinitis and its associated co-morbidities at Bugando Medical Centre in Northwestern Tanzania; A prospective review of 190 cases

    Directory of Open Access Journals (Sweden)

    Said Said A

    2012-11-01

    Full Text Available Abstract Background Allergic rhinitis is one of the commonest atopic diseases which contribute to significant morbidity world wide while its epidemiology in Tanzania remains sparse. There was paucity of information regarding allergic rhinitis in our setting; therefore it was important to conduct this study to describe our experience on allergic rhinitis, associated co-morbidities and treatment outcome in patients attending Bugando Medical Centre. Methods This was descriptive cross-sectional study involving all patients with a clinical diagnosis of allergic rhinitis at Bugando Medical Centre over a three-month period between June 2011 and August 2011. Data was collected using a pre-tested coded questionnaire and analyzed using SPSS statistical computer software version 17.0. Results A total of 190 patients were studied giving the prevalence of allergic rhinitis 14.7%. The median age of the patients was 8.5 years. The male to female ratio was 1:1. Adenoid hypertrophy, tonsillitis, hypertrophy of inferior turbinate, nasal polyps, otitis media and sinusitis were the most common co-morbidities affecting 92.6% of cases and were the major reason for attending hospital services. Sleep disturbance was common in children with adenoids hypertrophy (χ2 = 28.691, P = 0.000. Allergic conjunctivitis was found in 51.9%. The most common identified triggers were dust, strong perfume odors and cold weather (P χ2 = 4.583, P = 0.032. In this study family history of allergic rhinitis was not a significant risk factor (P =0.423. The majority of patients (68.8% were treated surgically for allergic rhinitis co morbidities. Post operative complication and mortality rates were 2.9% and 1.6% respectively. The overall median duration of hospital stay of in-patients was 3 days (2 – 28 days. Most patients (98.4% had satisfactory results at discharge. Conclusion The study shows that allergic rhinitis is common in our settings representing 14.7% of all

  17. Care for a break? An investigation of informal caregivers' attitudes toward respite care using Q-methodology

    NARCIS (Netherlands)

    Exel, J.; de Graaf, G.; Brouwer, W.

    2007-01-01

    Objective: To investigate informal caregivers' attitudes toward respite care. Method: Interviews with informal caregivers during open-house support groups (three) for informal caregivers, conducted late 2004 at Informal Care Support Centres in the city of Rotterdam, The Netherlands. A

  18. Barriers and opportunities in assessing calls to emergency medical communication centre--a qualitative study.

    Science.gov (United States)

    Lindström, Veronica; Heikkilä, Kristiina; Bohm, Katarina; Castrèn, Maaret; Falk, Ann-Charlotte

    2014-11-11

    Previous studies have described the difficulties and the complexity of assessing an emergency call, and assessment protocols intended to support the emergency medical dispatcher's (EMD) assessment have been developed and evaluated in recent years. At present, the EMD identifies about 50-70 % of patients suffering from cardiac arrest, acute myocardial infarction or stroke. The previous research has primarily been focused on specific conditions, and it is still unclear whether there are any overall factors that may influence the assessment of the call to the emergency medical communication centre (EMCC). The aim of the study was to identify overall factors influencing the registered nurses' (RNs) assessment of calls to the EMCC. A qualitative study design was used; a purposeful selection of calls to the EMCC was analysed by content analysis. One hundred calls to the EMCC were analysed. Barriers and opportunities related to the RN or the caller were identified as the main factors influencing the RN's assessment of calls to the EMCC. The opportunities appeared in the callers' symptom description and the communication strategies used by the RN. The barriers appeared in callers' descriptions of unclear symptoms, paradoxes and the RN's lack of communication strategies during the call. Barriers in assessing the call to the EMCC were associated with contradictory information, the absence of a primary problem, or the structure of the call. Opportunities were associated with a clear symptom description that was also repeated, and the RN's use of different communication strategies such as closed loop communication.

  19. Validation of a model to investigate the effects of modifying cardiovascular disease (CVD) risk factors on the burden of CVD: the rotterdam ischemic heart disease and stroke computer simulation (RISC) model

    NARCIS (Netherlands)

    van Kempen, Bob J. H.; Ferket, Bart S.; Hofman, Albert; Steyerberg, Ewout W.; Colkesen, Ersen B.; Boekholdt, S. Matthijs; Wareham, Nicholas J.; Khaw, Kay-Tee; Hunink, M. G. Myriam

    2012-01-01

    Background: We developed a Monte Carlo Markov model designed to investigate the effects of modifying cardiovascular disease (CVD) risk factors on the burden of CVD. Internal, predictive, and external validity of the model have not yet been established. Methods: The Rotterdam Ischemic Heart Disease

  20. Authorship issues in multi-centre clinical trials

    DEFF Research Database (Denmark)

    Rosenberg, Jacob; Burcharth, Jakob; Pommergaard, Hans-Christian

    2015-01-01

    to qualify for authorship as defined by the International Committee of Medical Journal Editors. Therefore, rules for authorship in multi-centre trials are strongly recommended. We propose two contracts to prevent conflicts regarding authorship; both are freely available for use without pay but with reference...... to the original source....

  1. PRIME Partnerships in International Medical Education - Restoring a Christian ethos to medical education worldwide

    Directory of Open Access Journals (Sweden)

    Huw Morgan

    2016-01-01

    Full Text Available Modern medicine has developed from an essentially Christian world-view and in Western countries has been greatly influenced by the Christian tradition of hospitality and caring for the sick. However, during the 20th century, medical education became increasingly secularised and focussed on the bio-physical model of disease, losing sight of a holistic view of the person that includes awareness of a spiritual dimension. Former Communist countries in particular have little recent tradition of caring, and medical education there tends to be characterised by poor role-models and out-dated didactic teaching. In the resource poor countries of the global South there are many Christian hospitals and clinics but often a lack of experienced medical teachers. Partnerships in International Medical Education (PRIME’s vision and mission is to support health-care education worldwide to restore a Christian-based holistic approach to patients, and act as a resource where needed, tailoring medical educational programmes to meet the needs of overseas partners (or colleagues in the NHS. Using interactive leaner-centred and problem-based educational methods, PRIME tutors (all experienced and qualified Christian medical educators seek to model patient-centred care by using learner-centred teaching, valuing each person as a bearer of the image of God. Most of PRIME’s teaching involves the doctor-patient relationship, communication skills, compassion, ethics and professionalism, often based around particular clinical scenarios to suit the learners. Small teams of voluntary tutors visiting partner institutions and colleagues for a few weeks a year can have a surprisingly large impact, as those grasping the vision become advocates for positive change in their own situations. Training of trainers and teachers in learner-centred, androgogic methodology to build capacity and sustainability is also a major part of the work.

  2. Self-medication among pregnant women attending antenatal clinic at Makongoro health centre in Mwanza, Tanzania: a challenge to health systems.

    Science.gov (United States)

    Marwa, Karol J; Njalika, Agnes; Ruganuza, Deodatus; Katabalo, Deogratias; Kamugisha, Erasmus

    2018-01-08

    Self-medication is a universal challenge that requires attention because of the potential threat not only to the pregnant women but also to unborn child. Data on self-medication practice and predictors among pregnant women is lacking in Tanzania. Information on the effects of this practice to the pregnant woman and the foetus globally is also scanty. This was a cross sectional study which was conducted using face to face interview with 372 pregnant women at Makongoro health centre. Semi-structured questionnaires were used. Data were analysed using STATA 13 (Statistical Corporation, College Station, Texas, US). A total of 372 pregnant women participated in the study. The prevalence of self-medication among pregnant women was 172 (46.24%). There was a significant statistical association between self-medication and occupation (P value =0.01), gestation age (P self-medication (P = 0.809, P = 0.243 and P = 0.922) respectively. When bivariate logistic regression was performed, occupation and education were the only determining factors for self-medication. Pregnant women who were unemployed, doing business and house wife were most likely to practice self-medication than employed pregnant women (P = 0.03; OR = 2.33; 95% CI, 1.06-5.31, P = 0.01; OR = 2.31; CI 1.21-4.41, P = self-medication than pregnant women with college or university education (P leading illness/symptoms which led to self-medication among pregnant women attending clinic were malaria 56 (32.56%, morning sickness 44 (25.55%) and headache 33(19.19%). Drugs commonly used in self-medication among pregnant women were ant malarial 42 (24.42%), antiemetics 59 (34.30%) and analgesics 33 (19.19%). Prevalence of self-medication among pregnant women is high in Tanzania. This is a threat to the safety of the developing foetus and the pregnant woman. Therefore there is a need of interventions to minimize the practice among pregnant women.

  3. Characterizing discrete subsets of polycystic ovary syndrome as defined by the Rotterdam criteria: the impact of weight on phenotype and metabolic features.

    Science.gov (United States)

    Welt, C K; Gudmundsson, J A; Arason, G; Adams, J; Palsdottir, H; Gudlaugsdottir, G; Ingadottir, G; Crowley, W F

    2006-12-01

    The Rotterdam criteria for polycystic ovary syndrome (PCOS) defines discrete subgroups whose phenotypes are not yet clear. The phenotypic characteristics of women in the PCOS subgroups defined by the Rotterdam criteria were compared. The study was observational. Subjects were studied in an outpatient setting in Boston and Reykjavik. Four subgroups of subjects with PCOS defined by 1) irregular menses (IM), hyperandrogenism (HA), and polycystic ovary morphology (PCOM, n = 298); 2) IM/HA (n = 7); 3) HA/PCOM (n = 77); and 4) IM/PCOM (n = 36) and a group of controls (n = 64), aged 18-45 yr, were examined. Subjects underwent a physical exam; fasting blood samples for androgens, gonadotropins, and metabolic parameters; and a transvaginal ultrasound. The phenotype was compared between groups. Ninety-seven percent of women with IM/HA had PCOM. Therefore, the groups with and without PCOM were combined. The Ferriman-Gallwey score and androgen levels were highest in the hyperandrogenic groups (IM/HA and HA/PCOM), whereas ovarian volume was higher in all PCOS subgroups compared with controls, as expected based on the definitions of the PCOS subgroups. Body mass index and insulin levels were highest in the IM/HA subgroup. Subjects with PCOS defined by IM/HA are the most severely affected women on the basis of androgen levels, ovarian volumes, and insulin levels. Their higher body mass index partially accounts for the increased insulin levels, suggesting that weight gain exacerbates the symptoms of PCOS.

  4. Helicopter emergency medical services (HEMS) over-triage and the financial implications for major trauma centres in NSW, Australia.

    Science.gov (United States)

    Taylor, Colman B; Curtis, Kate; Jan, Stephen; Newcombe, Mark

    2013-07-01

    In NSW Australia, a formal trauma system including the use of helicopter emergency medical services (HEMS) has existed for over 20 years. Despite providing many advantages in NSW, HEMS patients are frequently over-triaged; leading to financial implications for major trauma centres that receive HEMS patients. The aim of this study was to investigate the financial implications of HEMS over-triage from the perspective of major trauma centres in NSW. The study sample included all trauma patients transported via HEMS to 12 major trauma centres in NSW during the period: 1 July 2008 to 30 June 2009. Clinical data were gathered from individual hospital trauma registries and merged with financial information obtained from casemix units at respective hospitals. HEMS over-triage was estimated based on the local definition of minor to moderate trauma (ISS≤12) and hospital length of stay of less than 24 hrs. The actual treatment costs were determined and compared to state-wide peer group averages to obtain estimates of potential funding discrepancies. A total of 707 patients transported by HEMS were identified, including 72% pre-hospital (PH; n=507) and 28% inter-hospital (IH; n=200) transports. Over-triage was estimated at 51% for PH patients and 29% for IH patients. Compared to PH patients, IH patients were more costly to treat on average (IH: $42,604; PH: $25,162), however PH patients were more costly overall ($12,329,618 [PH]; $8,265,152 [IH]). When comparing actual treatment costs to peer group averages we found potential funding discrepancies ranging between 4% and 32% across patient groups. Using a sensitivity analysis, the potential funding discrepancy increased with increasing levels of over-triage. HEMS patients are frequently over-triaged in NSW, leading to funding implications for major trauma centres. In general, HEMS patient treatment costs are higher than the peer group average and the potential funding discrepancy varies by injury severity and the type of

  5. The structure and dynamics of health centres in the Netherlands: an institutional analysis.

    NARCIS (Netherlands)

    Batenburg, R.; Eyck, A.

    2011-01-01

    Context: Health centres are seen as a preferred organization of the modernized and integrated primary care. they are expected to facilitate an accessible contact point for medical care as close to people’s homes. Also, health centres are expected to deliver care in an efficient and effective way,

  6. Cardiac patients' perception of patient-centred care: a qualitative study.

    Science.gov (United States)

    Esmaeili, Maryam; Cheraghi, Mohammad A; Salsali, Mahvash

    2016-03-01

    The aim of this study was to explore cardiac patients' perception of patient-centred care. Despite patient's importance in the process of care, less attention has been paid to experiences and expectations of patients in definitions of patient-centred care. As patients are an important element in process of patient-centred care, organizing care programs according to their perceptions and expectations will lead to enhanced quality of care and greater patient satisfaction. This study is a descriptive qualitative study. Content analysis approach was performed for data analysis. Participants were 18 cardiac patients (10 women and 8 men) hospitalized in coronary care units of teaching hospitals affiliated to Tehran University of Medical Sciences. We collected the study data through conducting personal face-to-face semi-structured interviews. The participants' perceptions of patient-centred care fell into three main themes including managing patients uncertainty, providing care with more flexibility and establishing a therapeutic communication. The second theme consisted of two sub-themes: empathizing with patients and having the right to make independent decisions. Receiving patient-centred care is essential for cardiac patients. Attention to priorities and preferences of cardiac patients and making decisions accordingly is among effective strategies for achieving patient-centred care. Cardiac care unit nurses ought to be aware that in spite of technological developments and advances, it is still important to pay attention to patients' needs and expectations in order to achieve patient satisfaction. In planning care programs, they should consider accountability towards patients' needs, flexibility in process of care and establishing medical interactions as an effective strategy for improving quality of care. © 2014 British Association of Critical Care Nurses.

  7. The use of gold markers and electronic portal imaging for radiotherapy verification in prostate cancer patients: Sweden Ghana Medical Centre experience

    Directory of Open Access Journals (Sweden)

    George Felix Acquah

    2014-02-01

    Full Text Available The success of radiotherapy cancer treatment delivery depends on the accuracy of patient setup for each fraction. A significant problem arises from reproducing the same patient position and prostate location during treatment planning for every fraction of the treatment process. To analyze the daily movements of the prostate, gold markers are implanted in the prostate and portal images taken and manually matched with reference images to locate the prostate. Geometrical and fiducial markers are annotated onto a highly quality generated digitally reconstructed radiographs, that are compared with portal images acquired right before treatment dose delivery. A 0 and 270 degree treatment fields are used to calculate prostate shifts for all prostate cancer patients undergoing treatment at the Sweden Ghana Medical Centre, using an iViewGT portal imaging device. After aligning of the marker positions onto the reference images, the set-up deviations corrections are displayed and an on-line correction procedure applied. The measured migrations of the prostate markers are below the threshold of 3 mm for the main plans and 2 mm for the boost plans. With daily electronic portal imaging combined with gold markers, provides an objective method for verifying and correcting the position of the prostate immediately prior to radiation delivery.--------------------------------------------Cite this article as: Acquah GF. The use of gold markers and electronic portal imaging for radiotherapy verification in prostate cancer patients: Sweden Ghana Medical Centre experience. Int J Cancer Ther Oncol 2014; 2(1:020112.DOI: http://dx.doi.org/10.14319/ijcto.0201.12

  8. On the efficiency of the hybrid and the exact second-order sampling formulations of the EnKF: a reality-inspired 3-D test case for estimating biodegradation rates of chlorinated hydrocarbons at the port of Rotterdam

    KAUST Repository

    El Gharamti, Mohamad; Valstar, Johan; Janssen, Gijs; Marsman, Annemieke; Hoteit, Ibrahim

    2016-01-01

    This study considers the assimilation problem of subsurface contaminants at the port of Rotterdam in the Netherlands. It involves the estimation of solute concentrations and biodegradation rates of four different chlorinated solvents. We focus

  9. Cyclotron-produced radioisotopes and their clinical use at the Austin PET Centre

    International Nuclear Information System (INIS)

    Tochon-Danguy, H.J.

    1997-01-01

    A Centre for Positron Emission Tomography (PET) has been established within the Department of Nuclear Medicine at the Austin and Repatriation Medical Centre in Melbourne. PET is a non-invasive technique based on the use of biologically relevant compounds labelled with short-lived positron-emitting radionuclides such as carbon-11, nitrogen-13, oxygen-15 and fluorine-18. The basic equipment consists of a medical cyclotron (10 MeV proton and 5 MeV deuteron), six lead-shielded hot cells with associated radiochemistry facilities and a whole body PET scanner. During its first five years of operation, the Melbourne PET Centre, has pursued a strong radiolabelling development program, leading to an ambitious clinical program in neurology, oncology and cardiology. This presentation will describe the basic principles of the PET technique and review the cyclotron-produced radioisotopes and radiopharmaceuticals. Radiolabelling development programs and clinical applications are also addressed

  10. Splenic injuries at Bugando Medical Centre in northwestern Tanzania: a tertiary hospital experience

    Directory of Open Access Journals (Sweden)

    Chalya Phillipo L

    2012-01-01

    Full Text Available Abstract Background Splenic injuries constitute a continuing diagnostic and therapeutic challenge to the trauma or general surgeons practicing in developing countries where sophisticated imaging facilities are either not available or exorbitantly expensive. The purpose of this review was to describe our own experience in the management of the splenic injuries outlining the aetiological spectrum, injury characteristics and treatment outcome of splenic injuries in our local environment and to identify predictors of outcome among these patients. Methods A prospective descriptive study of splenic injury patients was carried out at Bugando Medical Centre in Northwestern Tanzania between March 2009 and February 2011. Statistical data analysis was done using SPSS software version 17.0. Results A total of 118 patients were studied. The male to female ratio was 6.4:1. Their ages ranged from 8 to 74 years with a median age of 22 years. The modal age group was 21-30 years. The majority of patients (89.8% had blunt trauma and road traffic accidents (63.6% were the most frequent cause of injuries. Most patients sustained grade III (39.0% and IV (38.1% splenic injuries. Majority of patients (86.4% were treated operatively with splenectomy (97.1% being the most frequently performed procedure. Postoperative complications were recorded in 30.5% of cases. The overall length of hospital stay (LOS ranged from 1 day to 120 days with a median of 18 days. Mortality rate was 19.5%. Patients who had severe trauma (Kampala Trauma Score II ≤ 6 and those with associated injuries stayed longer in the hospital (P 2000 mls, HIV infection with CD4 ≤ 200 cells/μl and presence of postoperative complications were significantly associated with mortality (P Conclusion Trauma resulting from road traffic accidents (RTAs remains the most common cause of splenic injuries in our setting. Most of the splenic injuries were Grade III & IV and splenectomy was performed in majority of

  11. IT in legal practice : research in progress

    NARCIS (Netherlands)

    Van der Wees, Leo; Huysman, Marleen

    1994-01-01

    A research project initiated by the Centre for Computers and Law of the Erasmus University Rotterdam will examine the application of information technology (IT) to law firms. The project stresses the specific organizational aspects that need to be taken into account when dealing with the

  12. Length of stay in asylum centres and mental health in asylum seekers: a retrospective study from Denmark.

    Science.gov (United States)

    Hallas, Peter; Hansen, Anne R; Staehr, Mia A; Munk-Andersen, Ebbe; Jorgensen, Henrik L

    2007-10-11

    The length of stay in asylum centres is generally mentioned as a possible health risk to asylum seekers. Medical staff working with asylum seekers has claimed that long lengths of stay in asylum centres might cause or aggravate mental disorders. We used records from a large, multiethnic group of asylum seekers to study if the incidence of mental disorders increased with length of stay. The study population was asylum seekers in Danish asylum centres run by the Danish Red Cross. General medical care was provided by Red Cross staff who could refer selected cases to medical specialists. If an asylum seeker needed more than three specialist consultations for mental illness or five consultations for physical illness the referrals had to be approved by The Danish Immigration Service. Between July 2001 - December 2002 the Red Cross prospectively registered health related data on all new applications (n = 4516) to the Immigration Service regarding referrals to medical specialists. We used these records to analyse the association between length of stay in the asylum centres and overall rate of referral for mental disorders. Data was analysed using weighted linear regression. We found that referrals for mental disorders increased with length of stay in asylum centres in a large, multiethnic population of asylum seekers. The association was found in all the categories of psychiatric illness studied and for a majority of the nationality groups studied. Length of stay in asylum centres was associated with an increase in referrals for mental disorders in a large, multiethnic group of asylum seekers. The present study supports the view that prolonged length of stay in an asylum centre is a risk factor for mental health. The risk of psychiatric illness among asylum seekers should be addressed by political and humanitarian means, giving prevention of illness the highest priority.

  13. Length of stay in asylum centres and mental health in asylum seekers: a retrospective study from Denmark

    Directory of Open Access Journals (Sweden)

    Stæhr Mia A

    2007-10-01

    Full Text Available Abstract Background The length of stay in asylum centres is generally mentioned as a possible health risk to asylum seekers. Medical staff working with asylum seekers has claimed that long lengths of stay in asylum centres might cause or aggravate mental disorders. We used records from a large, multiethnic group of asylum seekers to study if the incidence of mental disorders increased with length of stay. Methods The study population was asylum seekers in Danish asylum centres run by the Danish Red Cross. General medical care was provided by Red Cross staff who could refer selected cases to medical specialists. If an asylum seeker needed more than three specialist consultations for mental illness or five consultations for physical illness the referrals had to be approved by The Danish Immigration Service. Between July 2001 – December 2002 the Red Cross prospectively registered health related data on all new applications (n = 4516 to the Immigration Service regarding referrals to medical specialists. We used these records to analyse the association between length of stay in the asylum centres and overall rate of referral for mental disorders. Data was analysed using weighted linear regression. Results We found that referrals for mental disorders increased with length of stay in asylum centres in a large, multiethnic population of asylum seekers. The association was found in all the categories of psychiatric illness studied and for a majority of the nationality groups studied. Conclusion Length of stay in asylum centres was associated with an increase in referrals for mental disorders in a large, multiethnic group of asylum seekers. The present study supports the view that prolonged length of stay in an asylum centre is a risk factor for mental health. The risk of psychiatric illness among asylum seekers should be addressed by political and humanitarian means, giving prevention of illness the highest priority.

  14. Supporting medical students with learning disabilities in Asian medical schools

    OpenAIRE

    Majumder, Md. Anwarul Azim; Rahman, Sayeeda; D?Souza, Urban JA; Elbeheri, Gad; Abdulrahman, Khalid Bin; Huq, M Muzaherul

    2010-01-01

    Md. Anwarul Azim Majumder1, Sayeeda Rahman2, Urban JA D’Souza3, Gad Elbeheri4, Khalid Bin Abdulrahman5, M Muzaherul Huq61,2Department of Clinical Sciences, School of Life Sciences, University of Bradford, West Yorkshire, Bradford, UK; 3School of Medicine, University Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia; 4Centre for Child Evaluation and Teaching, Kuwait; 5College of Medicine, Al-Imam University, Riyadh, Saudi Arabia; 6Centre for Medical Education (CME), Mohakhali, Dhaka, Ba...

  15. Radioprotection in the medical sector: a new quality approach

    International Nuclear Information System (INIS)

    Prevot, S.

    2008-01-01

    The author describes how quality assurance is organized in the field of radioprotection in the Georges-Francois-Leclerc medical centre in Dijon. She also recalls how this organization has recently evolved because of legal but also technical and technological evolutions. She indicates the main attributions and missions of the radiation protection expert in this medical centre

  16. Use of acupuncture therapy as a supplement to conventional medical treatments for acute ischaemic stroke patients in an academic medical centre in Korea.

    Science.gov (United States)

    Chang, Hyejung; Kwon, Young Dae; Yoon, Sung Sang

    2011-10-01

    Acupuncture has served as a major complementary and alternative therapy that supplements conventional medicine and is the subject of growing public interest. This study was conducted to estimate the usage rate of acupuncture as a supplemental treatment in acute ischaemic stroke patients and to identify factors associated with the choice to use this therapy. Using the registry of stroke patients admitted to an academic medical centre in Korea, the use of acupuncture therapy was recorded and analysed, along with the patients' socio-demographic characteristics, hospital access variables, risk factors for ischaemic stroke and clinical characteristics. The data were analysed using descriptive statistics, chi-square tests and multiple logistic regression analyses. Of 2167 patients, 18% received acupuncture therapy. The choice of acupuncture therapy was significantly associated with stroke severity as well as gender, age, geographical residence and previous history of stroke. After controlling for other significant factors, there was an approximately 3.4-fold greater usage in patients with moderately severe strokes (95% confidence interval (CI)=2.5-4.6) and 4.1-fold greater usage in patients with severe strokes (95% CI=2.7-6.4). The findings provide a better understanding of patients' utilization of acupuncture therapy as a supplement to conventional medical treatments and of factors associated with the utilization of acupuncture in patients with acute ischemic stroke. Strategic implications of acupuncture therapy are suggested for both health-care providers and policy makers. Copyright © 2011 Elsevier Ltd. All rights reserved.

  17. Cyclotron-produced radioisotopes and their clinical use at the Austin PET Centre

    Energy Technology Data Exchange (ETDEWEB)

    Tochon-Danguy, H.J. [Centre for PET, Melbourne, VIC (Australia). Austin and Repatriation Medical Centre

    1997-12-31

    A Centre for Positron Emission Tomography (PET) has been established within the Department of Nuclear Medicine at the Austin and Repatriation Medical Centre in Melbourne. PET is a non-invasive technique based on the use of biologically relevant compounds labelled with short-lived positron-emitting radionuclides such as carbon-11, nitrogen-13, oxygen-15 and fluorine-18. The basic equipment consists of a medical cyclotron (10 MeV proton and 5 MeV deuteron), six lead-shielded hot cells with associated radiochemistry facilities and a whole body PET scanner. During its first five years of operation, the Melbourne PET Centre, has pursued a strong radiolabelling development program, leading to an ambitious clinical program in neurology, oncology and cardiology. This presentation will describe the basic principles of the PET technique and review the cyclotron-produced radioisotopes and radiopharmaceuticals. Radiolabelling development programs and clinical applications are also addressed. 30 refs., 1 tab., 1 fig.

  18. Recurrent major depression, ataxia, and cardiomyopathy: association with a novel POLG mutation?

    Directory of Open Access Journals (Sweden)

    Verhoeven WMA

    2011-05-01

    Full Text Available Willem MA Verhoeven1,2, Jos IM Egger1,3,4, Berry PH Kremer5, Boudewijn JHB de Pont1, Carlo LM Marcelis61Vincent van Gogh Institute for Psychiatry, Centre of Excellence for Neuropsychiatry, Venray, The Netherlands; 2Erasmus University Medical Centre, Department of Psychiatry, Rotterdam, The Netherlands; 3Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands; 4Donders Institute for Brain, Cognition and Behaviour, Centre for Cognition, Radboud University Nijmegen, Nijmegen, The Netherlands; 5Department of Neurology, University Medical Centre Groningen, The Netherlands; 6Department of Human Genetics, Radboud University Nijmegen Medical Centre, Nijmegen, The NetherlandsAbstract: At present, more than 100 disease mutations in mitochondrial DNA polymerase γ (POLG have been indentified that are causally related to an array of neuropsychiatric diseases affecting multiple systems. Both autosomal recessive and autosomal dominant forms can be delineated, the latter being associated with Parkinsonism and depressive or psychotic syndromes. In this report, a middle-aged female patient with recurrent major depression with melancholic features, slowly progressive gait instability, and dilated cardiomyopathy is described. Detailed diagnostic evaluation was performed to elucidate the supposed relationship between ataxia, cardiomyopathy, and major depression with melancholia. After extensive genetic and metabolic investigation, a nucleotide substitution c.2207 A→G in the POLG gene resulting in amino acid change Asn 736Ser in exon 13 was demonstrated. This mutation was considered to be compatible with a mitochondrial disorder and implicated in the pathophysiology of the neuropsychiatric syndrome. It is concluded that this novel POLG mutation forms the most parsimonious etiological explanation for the here-described combination of ataxia, major depression, and cardiomyopathy. Therefore, in patients with a complex neuropsychiatric

  19. Steam inhalation therapy: severe scalds as an adverse side effect

    Science.gov (United States)

    Baartmans, Martin; Kerkhof, Evelien; Vloemans, Jos; Dokter, Jan; Nijman, Susanne; Tibboel, Dick; Nieuwenhuis, Marianne

    2012-01-01

    Background Steam inhalation therapy is often recommended in the treatment of a common cold. However, it has no proven benefit and may in fact have serious adverse side effects in terms of burn injuries. Aim To quantify the human and economic costs of steam inhalation therapy in terms of burn injury. Design and setting A prospective database study of all patients admitted to the burn centres (Beverwijk, Groningen, Rotterdam) and the hospital emergency departments in the Netherlands. Method Number and extent of burn injuries as a result of steam inhalation therapy were analysed, as well as an approximation made of the direct costs for their medical treatment. Results Annually, on average three people are admitted to in one of the Dutch burn centres for burns resulting from steam inhalation therapy. Most victims were children, and they needed skin grafting more often than adults. The total direct medical costs for burn centre and emergency department treatment were €115 500 (£93 000), emotional costs are not reflected. Conclusion As steam inhalation therapy has no proven benefit and the number and extent of complications of this therapy in terms of burn injury are significant, especially in children, steam inhalation therapy should be considered a dangerous procedure and not recommended anymore in professional guidelines and patient brochures. PMID:22781995

  20. Impact of hypoglycemia on daily life of type 2 diabetes patients in Ukraine

    Directory of Open Access Journals (Sweden)

    Mandrik O

    2013-07-01

    Full Text Available Olena Mandrik,1–3 Johan L Severens,1 Olena Doroshenko,4 Vladymir Pan'kiv,5 Nonna Kravchun,6 Maryna Vlasenko,7 Mykola Hulchiy,8 Maryna Baljuk,9 Yuliia Komisarenko,10 Eugene Martsynik,11 Liubov Sokolova,12 Olga Zalis'ka,2 Boris Mankovsky131Erasmus University Rotterdam, Rotterdam, the Netherlands; 2Danylo Halytsky Lviv National Medical University, Lviv, 3MSD Ukraine, 4Ukrainian Institute for Strategic Research, 5Ukrainian Scientific Centre of Endocrine Surgery, 6Institute of Problems of Endocrine Pathology na VY Danylevskogo, Ukrainian Academy of Medical Sciences, Kyiv, 7Vinnitsa National Medical University named after MI Pyrogov, Vinnytsia, 8Kyiv City Teaching Endocrinological Center, Kyiv, 9Danilevsky Institute of Endocrine Pathology Problems, Ukrainian Academy of Medical Sciences, Kharkov, 10OO Bogomolets National Medical University, Kyiv, 11Medical Academy of Dnepropetrovsk, Dnepropetrovsk, 12Institute of Endocrinology and Metabolism after V.P. Komissarenko, National Academy of Medical Sciences of Ukraine, Kyiv, 13PL Shupik National Medical Academy of Postgraduate Education, Kyiv, UkraineAbstract: This study evaluates the impact of hypoglycemia on the lives of Ukrainian patients with type 2 diabetes mellitus. The secondary objective was to explore patient–physician relationships and the attitudes of patients towards various informational resources on diabetes management. Three focus groups with 26 patients were conducted. Qualitative information was evaluated using content analysis. The results show that patients with type 2 diabetes mellitus in Ukraine are adapting to potential attacks of hypoglycemia; however, they still experience periodic manifestations of hypoglycemia that significantly affect their psychological well-being. This result is similar to observations made in other countries. Ukrainian patients >40 years old mainly receive information on disease management from endocrinologists, and rarely use internet resources on diabetes

  1. Patterns in consumption of potentially erosive beverages among adolescent school children in the Netherlands

    NARCIS (Netherlands)

    Gambon, D.L.; Brand, H.S.; Boutkabout, C.; Levie, D.; Veerman, E.C.I.

    2011-01-01

    AIM: To determine the frequency of intake and patterns in consumption of potentially erosive beverages in school children in the Netherlands. METHODS: A cross-sectional, single centre study was performed among 502 school children in Rotterdam, in age varying between 12 and 19 years. Data on

  2. Implementation of an electronic medical record system in previously computer-naïve primary care centres: a pilot study from Cyprus.

    Science.gov (United States)

    Samoutis, George; Soteriades, Elpidoforos S; Kounalakis, Dimitris K; Zachariadou, Theodora; Philalithis, Anastasios; Lionis, Christos

    2007-01-01

    The computer-based electronic medical record (EMR) is an essential new technology in health care, contributing to high-quality patient care and efficient patient management. The majority of southern European countries, however, have not yet implemented universal EMR systems and many efforts are still ongoing. We describe the development of an EMR system and its pilot implementation and evaluation in two previously computer-naïve public primary care centres in Cyprus. One urban and one rural primary care centre along with their personnel (physicians and nurses) were selected to participate. Both qualitative and quantitative evaluation tools were used during the implementation phase. Qualitative data analysis was based on the framework approach, whereas quantitative assessment was based on a nine-item questionnaire and EMR usage parameters. Two public primary care centres participated, and a total often health professionals served as EMR system evaluators. Physicians and nurses rated EMR relatively highly, while patients were the most enthusiastic supporters for the new information system. Major implementation impediments were the physicians' perceptions that EMR usage negatively affected their workflow, physicians' legal concerns, lack of incentives, system breakdowns, software design problems, transition difficulties and lack of familiarity with electronic equipment. The importance of combining qualitative and quantitative evaluation tools is highlighted. More efforts are needed for the universal adoption and routine use of EMR in the primary care system of Cyprus as several barriers to adoption exist; however, none is insurmountable. Computerised systems could improve efficiency and quality of care in Cyprus, benefiting the entire population.

  3. Production, administration and disposal of cyclotron produced shortlived radioactive gases for positron emission tomography studies at the Austin Repatriation Medical Centre, Melbourne

    Energy Technology Data Exchange (ETDEWEB)

    Egan, G.F.; O`Keefe, G. [Austin Hospital, Heidelberg, VIC (Australia); Tochon-Danguy, H.J.; Midgley, S.; Phana, K.S.; Sachinidis, J.; Chan, J.G. [Melbourne Univ., Parkville, VIC (Australia). School of Physics

    1995-01-01

    Positron Emission Tomography (PET) Centre is operational at the Austin Repatriation Medical Centre, Melbourne. The major equipment consists of a 10 MeV cyclotron and a whole body PET scanner. Radioactive gases produced and used directly in clinical studies include [{sup 15}O]O{sub 2}, [{sup 15}O]CO, and [{sup 15}O]CO{sub 2}, whilst [{sup 11}C]CO{sub 2} is also produced for use in radiochemistry syntheses. Radioactivity delivery rates of 3.7, 3.3, and 1.6 GBq/min to the scanner suite have been achieved for [{sup 15}O]O{sub 2}, [{sup 15}O]CO{sub 2}, and [{sup 15}O]CO respectively, and batch productions of 36.3 GBq of [{sup 11}C]CO{sub 2} have been produced. The production. patient administration and disposal of the short-lived radioactive gases has been achieved in compliance with radiation protection principles. Radioactive gas doses of 1.7 GBq are administered to patients with less than 0.02 MBq/m{sup 3} leakage into the scanner suite. Less than 13 MBq of [ {sup 15}O]-labelled gases are released into the environment per patient study at a concentration of 0.018 MBq/m{sup 3}. Annually less than 2 GBq is expected to be released into the environment. The centre design and first four months` experience of radioactive gas production, administration and disposal is presented. 5 refs., 4 tab., 1 fig.

  4. A user-centred approach to requirements elicitation in medical device development: a case study from an industry perspective.

    Science.gov (United States)

    Martin, Jennifer L; Clark, Daniel J; Morgan, Stephen P; Crowe, John A; Murphy, Elizabeth

    2012-01-01

    The healthcare industry is dependent upon the provision of well designed medical devices. To achieve this it is recommended that user-centred design should begin early, and continue throughout device development. This is a challenge, particularly for smaller companies who may lack the necessary expertise and knowledge. The aim of this study was to conduct a rigorous yet focused investigation into the user requirements for a new medical imaging device. Open-ended semi-structured interviews were conducted with potential clinical users of the device to investigate the clinical need for the device and the potential benefits for patients and clinical users. The study identified a number of new and significant clinical needs that suggested that the concept of the device should be fundamentally changed. The clinical and organisational priorities of the clinical users were identified, as well as a number of factors that would act as barriers to the safe and effective adoption of the device. The developers reported that this focused approach to early requirements elicitation would result in an improved product, reduce the time to market, and save the time and cost of producing and evaluating an inappropriate prototype. Copyright © 2011 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  5. [Improving care for cleft lip and palate patients: uniform and patient-orientated outcome measures].

    Science.gov (United States)

    Haj, M; de Gier, H H W; van Veen-van der Hoek, M; Versnel, S L; van Adrichem, L N; Wolvius, E B; Hazelzet, J A; Koudstaal, M J

    2018-02-01

    The quality of care for patients with cleft lip and palate is extremely variable across the world. Treatment protocols differ and methods of data registration are not uniform. Improving this care by means of comparative research is challenging. The best treatment programmes can be identified by uniformly registering patient-orientated outcomes and comparing the outcomes with those of other treatment centres. That knowledge can be used to improve one's own care. An international team consisting of specialists and cleft lip and palate patients has developed a set of outcome measures that are considered by patients to be most important. This team is coordinated by the International Consortium of Health Outcomes Measurement (ICHOM). The cleft lip and palate outcome set can be used by all centres worldwide in following up on cleft lip and palate patients. In the Erasmus Medical Centre in Rotterdam, the 'Zorgmonitor Schisis' (Care Monitor Cleft Lip and Palate) has been built, an application in which these outcome measures are collected at fixed times. Implementing this set of outcome measures in other cleft lip and palate treatment centres and using the outcomes as (inter)national benchmarks will result in transparency and the improvement of the treatment of cleft lip and palate worldwide.

  6. Anthropometric, clinical, and metabolic comparisons of the four Rotterdam PCOS phenotypes: A prospective study of PCOS women.

    Science.gov (United States)

    Kar, Sujata

    2013-07-01

    1. To study the distribution of various Rotterdam classified phenotypes of polycystic ovarian syndrome (PCOS) women, in our population. 2. To compare the four phenotypes with respect to anthropometric, clinical, and metabolic parameters. 3. To report the prevalence of insulin resistance (IR) and metabolic syndrome in these women. Private practice, Prospective cross-sectional comparative study. Women attending gynecology outpatient with the primary complains of irregular menses and/or infertility were evaluated. Each of them underwent detailed clinical examination, transvaginal sonography, and biochemical and hormonal assays. Four hundred and ten women with a clinical diagnosis of PCOS based on Rotterdam criteria were included in the study. The four phenotypes were 1) PCO complete, that is oligo/anovulation (O) + polycystic ovaries (P) + hyperandrogenism (H) 2) P + O, 3) P + H, and 4) O + H. All women were also evaluated for metabolic syndrome (American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI), modified Adult Treatment Panel (ATP) III 2005 guidelines) and IR (homeostatic model assessment-IR (HOMA-IR)). Statistical Package for Social Sciences (SPSS) version 18. Largest group was PCOS complete (65.6%) followed by P + O (22.2%); H + O (11.2%); and P + H (0.9%). Overall prevalence of metabolic syndrome was 35.07%. Hyperandrogenic phenotyptes; H + O (50%) and P + H + O (37.04%), had significantly higher prevalence of metabolic syndrome than normoandrogenic P + O phenotype (10%) (P ≤ 0.001). Body mass index (BMI) ≥ 25 (P = 0.0004; odds ratio (OR) = 3.07 (1.6574-5.7108, 95% CI)), waist circumference (WC) ≥ 80 cm (P = 0.001; OR = 3.68 (1.6807-8.0737, 95% CI)) and family history of diabetes (P = 0.019; OR 1.82 (1.1008-3.0194, 95% CI)), were strongly associated with the presence of metabolic syndrome. The overall prevalence of IR in PCOS women was 30.44% (HOMA-IR cutoff ≥ 3.8) and 34.94% (HOMA-IR cutoff ≥ 3.5). The prevalence of

  7. Proef met ongevalshulp per helicopter : herziene opzet voor een evaluatie-onderzoek met betrekking tot de kosten-effectiviteit.

    NARCIS (Netherlands)

    Mathijssen, M.P.M. Harris, S. & Blokland-Vogelesang, A.W. van

    1995-01-01

    The SWOV Institute for Road Safety Research and the Rotterdam Erasmus University Centre for Health Care Policy and Law (CGR) have formulated a study design. The aim is to assist the evaluation of a trial in terms of cost-effectiveness. During the trial, a helicopter trauma team will render

  8. Splenic injuries at Bugando Medical Centre in northwestern Tanzania: a tertiary hospital experience

    Science.gov (United States)

    2012-01-01

    Background Splenic injuries constitute a continuing diagnostic and therapeutic challenge to the trauma or general surgeons practicing in developing countries where sophisticated imaging facilities are either not available or exorbitantly expensive. The purpose of this review was to describe our own experience in the management of the splenic injuries outlining the aetiological spectrum, injury characteristics and treatment outcome of splenic injuries in our local environment and to identify predictors of outcome among these patients. Methods A prospective descriptive study of splenic injury patients was carried out at Bugando Medical Centre in Northwestern Tanzania between March 2009 and February 2011. Statistical data analysis was done using SPSS software version 17.0. Results A total of 118 patients were studied. The male to female ratio was 6.4:1. Their ages ranged from 8 to 74 years with a median age of 22 years. The modal age group was 21-30 years. The majority of patients (89.8%) had blunt trauma and road traffic accidents (63.6%) were the most frequent cause of injuries. Most patients sustained grade III (39.0%) and IV (38.1%) splenic injuries. Majority of patients (86.4%) were treated operatively with splenectomy (97.1%) being the most frequently performed procedure. Postoperative complications were recorded in 30.5% of cases. The overall length of hospital stay (LOS) ranged from 1 day to 120 days with a median of 18 days. Mortality rate was 19.5%. Patients who had severe trauma (Kampala Trauma Score II ≤ 6) and those with associated injuries stayed longer in the hospital (P trauma scores (KTS II), grade of splenic injuries, admission systolic blood pressure ≤ 90 mmHg, estimated blood loss > 2000 mls, HIV infection with CD4 ≤ 200 cells/μl and presence of postoperative complications were significantly associated with mortality (P Trauma resulting from road traffic accidents (RTAs) remains the most common cause of splenic injuries in our setting. Most

  9. 'Smashed by the National Health'? A Closer Look at the Demise of the Pioneer Health Centre, Peckham.

    Science.gov (United States)

    Conford, Philip

    2016-04-01

    The Pioneer Health Centre, based in South London before and after the Second World War, remains a source of interest for advocates of a positive approach to health promotion in contrast with the treatment of those already ill. Its closure in 1950 for lack of funds has been blamed on the then recently established National Health Service, but this article argues that such an explanation is over-simplified and ignores a number of other factors. The Centre had struggled financially during the 1930s and tried to gain support from the Medical Research Council. The Council appeared interested in the Centre before the war, but was less sympathetic in the 1940s. Around the time of its closure and afterwards, the Centre was also involved in negotiations with London County Council; these failed because the Centre's directors would not accept the changes which the Council would have needed to make. Unpublished documents reveal that the Centre's directors were uncompromising and that their approach to the situation antagonised their colleagues. Changes in medical science also worked against the Centre. The success of sulphonamide drugs appeared to render preventive medicine less significant, while the development of statistical techniques cast doubt on the Centre's experimental methods. The Centre was at the heart of the nascent organic farming movement, which opposed the rapid growth of chemical cultivation. But what might be termed 'chemical triumphalism' was on the march in both medicine and agriculture, and the Centre was out of tune with the mood of the times.

  10. Using benchmarking to identify inter-centre differences in persistent ductus arteriosus treatment: can we improve outcome?

    Science.gov (United States)

    Jansen, Esther J S; Dijkman, Koen P; van Lingen, Richard A; de Vries, Willem B; Vijlbrief, Daniel C; de Boode, Willem P; Andriessen, Peter

    2017-10-01

    The aim of this study was to identify inter-centre differences in persistent ductus arteriosus treatment and their related outcomes. Materials and methods We carried out a retrospective, multicentre study including infants between 24+0 and 27+6 weeks of gestation in the period between 2010 and 2011. In all centres, echocardiography was used as the standard procedure to diagnose a patent ductus arteriosus and to document ductal closure. In total, 367 preterm infants were included. All four participating neonatal ICU had a comparable number of preterm infants; however, differences were observed in the incidence of treatment (33-63%), choice and dosing of medication (ibuprofen or indomethacin), number of pharmacological courses (1-4), and the need for surgical ligation after failure of pharmacological treatment (8-52%). Despite the differences in treatment, we found no difference in short-term morbidity between the centres. Adjusted mortality showed independent risk contribution of gestational age, birth weight, ductal ligation, and perinatal centre. Using benchmarking as a tool identified inter-centre differences. In these four perinatal centres, the factors that explained the differences in patent ductus arteriosus treatment are quite complex. Timing, choice of medication, and dosing are probably important determinants for successful patent ductus arteriosus closure.

  11. Children and adolescents admitted to a university-level trauma centre in Denmark 2002-2011

    DEFF Research Database (Denmark)

    Ekström, Danny Stefan; Hviid Larsen, Rasmus; Lauritsen, Jens Martin

    2017-01-01

    INTRODUCTION: The epidemiology of children or adolescents admitted to a Scandinavian trauma centre is largely unknown. The aim of this paper was to describe the epidemiology and severity of potentially severely injured children and adolescents admitted to a university hospital trauma centre....... METHODS: This was a descriptive study of all children and adolescents aged 0-17 admitted to the university level trauma centre at Odense University Hospital, Denmark in the 2002-2011 period. Data were extracted from the Southern Danish Trauma Register and from medical records. RESULTS: A total of 950...

  12. A student-centred electronic health record system for clinical education.

    Science.gov (United States)

    Elliott, Kristine; Judd, Terry; McColl, Geoff

    2011-01-01

    Electronic Health Record (EHR) systems are an increasingly important feature of the national healthcare system [1]. However, little research has investigated the impact this will have on medical students' learning. As part of an innovative technology platform for a new masters level program in medicine, we are developing a student-centred EHR system for clinical education. A prototype was trialed with medical students over several weeks during 2010. This paper reports on the findings of the trial, which had the overall aim of assisting our understanding of how trainee doctors might use an EHR system for learning and communication in a clinical setting. In primary care and hospital settings, EHR systems offer potential benefits to medical students' learning: Longitudinal tracking of clinical progress towards established learning objectives [2]; Capacity to search across a substantial body of records [3]; Integration with online medical databases [3]; Development of expertise in creating, accessing and managing high quality EHRs [4]. While concerns have been raised that EHR systems may alter the interaction between teachers and students [3], and may negatively influence physician-patient communication [6], there is general consensus that the EHR is changing the current practice environment and teaching practice needs to respond. Final year medical students on clinical placement at a large university teaching hospital were recruited for the trial. Following a four-week period of use, semi-structured interviews were conducted with 10 participants. Audio-recorded interviews were transcribed and data analysed for emerging themes. Study participants were also surveyed about the importance of EHR systems in general, their familiarity with them, and general perceptions of sharing patient records. Medical students in this pilot study identified a number of educational, practical and administrative advantages that the student-centred EHR system offered over their existing ad

  13. Phenotypic characterization of an older adult male with late-onset epilepsy and a novel mutation in ASXL3 shows overlap with the associated Bainbridge-Ropers syndrome

    Directory of Open Access Journals (Sweden)

    Verhoeven W

    2018-03-01

    Full Text Available Willem Verhoeven,1,2 Jos Egger,1,3 Emmy Räkers,4 Arjen van Erkelens,5 Rolph Pfundt,5 Marjolein H Willemsen5 1Vincent van Gogh Institute for Psychiatry, Centre of Excellence for Neuropsychiatry, Venray, the Netherlands; 2Department of Psychiatry, Erasmus University Medical Centre, Rotterdam, the Netherlands; 3Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands; 4ASVZ, Centre for People with Intellectual Disabilities, Sliedrecht, the Netherlands; 5Department of Human Genetics, Radboud University Medical Centre, Nijmegen, the Netherlands Abstract: The additional sex combs like 3 gene is considered to be causative for the rare Bainbridge-Ropers syndrome (BRPS, which is characterized by severe intellectual disability, neonatal hypotonia, nearly absent development of speech and language as well as several facial dysmorphisms. Apart from disruptive autistiform behaviors, sleep disturbances and epileptic phenomena may be present. Here, a 47-year-old severely intellectually disabled male is described in whom exome sequencing disclosed a novel heterozygous frameshift mutation in the ASXL3 gene leading to a premature stopcodon in the last part of the last exon. Mutations in this very end 3' of the gene have not been reported before in BRPS. The phenotypical presentation of the patient including partially therapy-resistant epilepsy starting in later adulthood shows overlap with BRPS, and it was therefore concluded that the phenotype is likely explained by the identified mutation in ASXL3. Keywords: Bainbridge-Ropers syndrome, ASLX3, frameshift mutation, epilepsy, intellectual disability, array analysis, whole exome sequencing, autism spectrum disorder

  14. Shaken but prepared: Analysis of disaster response at an academic medical centre following the Boston Marathon bombings.

    Science.gov (United States)

    Osgood, Robert; Scanlon, Courtney; Jotwani, Rohan; Rodkey, Daniel; Arshanskiy, Maria; Salem, Deeb

    Over the last decade, there has been a rise in the number of mass casualty incidences (MCIs) and their subsequent effect on hospital systems. While there has been much discussion over improving procedures to treat victims of MCIs, there has not been a thorough, systems-based analysis concerning the costs incurred by hospitals during such events. Here the authors examine the history of the Hospital Incident Command Center and how its evolution at Tufts Medical Center helped mitigate the damage following the Boston Marathon Bombings. Tufts' unique variations to the Hospital Incident Command Center include strategic communication hierarchies and a 'zero cost centre' financial system which both provided for a quick and adaptive response. Operating in collaboration with the Conference of Boston Teaching Hospitals encouraged coordination and preparation during emergency situations such as mass casualty events. The direct and indirect effects on Tufts Medical Center stemming from the Boston Marathon Bombings were analysed. Tufts MC treated 36 victims immediately following the MCI. The estimated total cost during the week of April 15 to April 19, 2013 was $776,051. The cost was primarily comprised of lost revenue from cancelled outpatient and inpatient hospital services, as well as expenses incurred due to overtime pay, salary expenses, PPE kits and hospitality services. Finally, the authors examine ways to reduce the future costs during emergency situations through increasing communication with employees, understanding the source of all direct expenses, and mitigating excess risk by developing partnerships with other hospital systems.

  15. The Defence Medical Library Service and military medicine.

    Science.gov (United States)

    Walker, S B

    2005-01-01

    The Defence Medical Library Service (DMLS) supports the clinical practice and career development of military health professionals across the world. Clinical governance and the need for medical knowledge to be evidence-based means the DMLS has a central role to play in support of defence medicine. The DMLS is important for enabling health professionals to make sense of the evidence-based pyramid and the hierarchy of medical knowledge. The Royal Centre for Defence Medicine (RCDM) in Birmingham is recognised as an international centre of excellence. The information, knowledge and research requirements of the RCDM will provide opportunities for the DMLS to support and engage with the academic community.

  16. [Medical Rehabilitation as an Attractive Field of Work for Medical Doctors? - A Qualitative Survey].

    Science.gov (United States)

    Lederle, Mareike; Kotzjan, Priscilla Simone; Niehues, Christiane; Brüggemann, Silke; Bitzer, Eva-Maria

    2017-10-01

    In the German Health system there is an increasing competition in the recruitment of specialised staff, especially for rehabilitation centres, which are deemed less attractive. Therefore, this study examines the attractiveness of the field of medical rehabilitation from the point of view of medical professionals. We conducted 16 semi-structured interviews with doctors from 7 rehabilitation centres with different medical specialisations. The interviews were digitized and transcribed. A structured content analysis was carried out using the software MAXQDA 11. 745 codes were identified and assigned to the categories "attractiveness", "unfavourable aspects" and "special features" of rehabilitation. Regarding medical rehabilitation, the interviewees appreciated especially the predictable, flexible working environment with little time pressure. Other than working with rehabilitative patients working as part of an interdisciplinary team was of high importance for the interviewees. Among the special features of rehabilitation in comparison with acute care were the higher relevance of the bio-psycho-social model of health and illness as well as the higher proportion of communication and organisation. Medical rehabilitation in Germany is an attractive field of work for medical doctors. This fact should be considered more with regards to rehabilitation's public image. © Georg Thieme Verlag KG Stuttgart · New York.

  17. Experiences with the implementation of a national teaching qualification in university medical centres and veterinary medicine in the Netherlands.

    Science.gov (United States)

    Molenaar, Willemina M Ineke; Zanting, Anneke

    2015-02-01

    In 2008, a compulsory national basic teaching qualification was introduced for all university teachers in the Netherlands. At that time all eight University Medical Centres (UMCs) and the only Faculty of Veterinary Medicine had adopted or were setting up teacher development programmes. This study explores how these programmes relate to each other and to the basic teaching qualification. To gather information on teacher development programmes in the UMCs and the Veterinary Medicine Faculty an online survey was filled out by teacher development representatives from each of them. The programmes had main features in common (e.g. competency based and portfolio assessment), but differed somewhat in contents according to the local situation. Importantly, they had all been formally accepted as equivalent to the basic teaching qualification. We consider the freedom to tailor the qualifications to the medical context as well as to the local situation of the UMCs and the Veterinary Medicine Faculty one of the major success factors and the well-established collaboration between teacher development representatives of the UMCs and the Faculty of Veterinary Medicine as another. Challenges for the future include embedding the teacher development programmes in the institutional organizations and maintaining and further developing the programmes and the competencies of the qualified teachers, e.g. in a senior qualification.

  18. Phase II trial of Uracil/Tegafur plus leucovorin and celecoxib combined with radiotherapy in locally advanced pancreatic cancer

    International Nuclear Information System (INIS)

    Morak, Marjolein J.M.; Richel, Dick J.; Eijck, Casper H.J. van; Nuyttens, Joost J.M.E.; Gaast, Ate van der; Vervenne, Walter L.; Padmos, Esther E.; Schaake, Eva E.; Busch, Olivier R.C.; Tienhoven, Geertjan van

    2011-01-01

    Background and purpose: To investigate the efficacy and toxicity of a short intensive Uracil/Tegafur (UFT) based chemoradiotherapy scheme combined with celecoxib in locally advanced pancreatic cancer. Material and methods: The Academic Medical Centre, Amsterdam and the Erasmus Medical Centre, Rotterdam enrolled 83 eligible patients with unresectable pancreatic cancer in a prospective multicentre phase II study. Median age was 62 years, median tumour size 40 mm and the majority of the patients (85%) had pancreatic head cancers. Treatment consisted of 20 x 2.5 Gy radiotherapy combined with UFT 300 mg/m 2 per day, leucovorin (folinic acid) 30 mg and celecoxib 800 mg for 28 days concomitant with radiotherapy. Four patients were lost to follow-up. Results: Full treatment compliance was achieved in 55% of patients, 80% received at least 3 weeks of treatment. No partial or complete response was observed. Median survival was 10.6 months and median time to progression 6.9 months. Toxicity was substantial with 28% grades III and IV gastro-intestinal toxicity and two early toxic deaths. Conclusions: Based on the lack of response, the substantial toxicity of mainly gastro-intestinal origin and the reported mediocre overall and progression free survival, we cannot advise our short intensive chemoradiotherapy schedule combined with celecoxib as the standard treatment.

  19. Trauma treatment in a role 1 medical facility in Afghanistan

    DEFF Research Database (Denmark)

    Vedel, Pernille Nygaard; Helsø, I; Jørgensen, H L

    2013-01-01

    Most of the emergency care delivered in Afghanistan is currently provided by the military sector and non-governmental organisations. Main Operating Base (MOB) Price in Helmand Province has a small medical centre and due to its location provides critical care to civilians and military casualties a...... and this article describes the patterns in trauma patient care at the MOB Price medical centre regarding the types of patients and injuries....

  20. Centre of Excellence For Simulation Education and Innovation (CESEI).

    Science.gov (United States)

    Qayumi, A Karim

    2010-01-01

    Simulation is becoming an integral part of medical education. The American College of Surgeons (ACS) was the first organization to recognize the value of simulation-based learning, and to award accreditation for educational institutions that aim to provide simulation as part of the experiential learning opportunity. Centre of Excellence for Simulation Education and Innovation (CESEI) is a multidisciplinary and interprofessional educational facility that is based at the University of British Columbia (UBC) and Vancouver Costal Health Authority (VCH). Centre of Excellence for Simulation Education and Innovation's goal is to provide excellence in education, research, and healthcare delivery by providing a technologically advanced environment and learning opportunity using simulation for various groups of learners including undergraduate, postgraduate, nursing, and allied health professionals. This article is an attempt to describe the infrastructure, services, and uniqueness of the Centre of Excellence for Simulation Education and Innovation. Copyright 2010 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  1. Anthropometric, clinical, and metabolic comparisons of the four Rotterdam PCOS phenotypes: A prospective study of PCOS women

    Directory of Open Access Journals (Sweden)

    Sujata Kar

    2013-01-01

    Full Text Available Aims: 1. To study the distribution of various Rotterdam classified phenotypes of polycystic ovarian syndrome (PCOS women, in our population. 2. To compare the four phenotypes with respect to anthropometric, clinical, and metabolic parameters. 3. To report the prevalence of insulin resistance (IR and metabolic syndrome in these women. Settings and Design: Private practice, Prospective cross-sectional comparative study. Materials and Methods: Women attending gynecology outpatient with the primary complains of irregular menses and/or infertility were evaluated. Each of them underwent detailed clinical examination, transvaginal sonography, and biochemical and hormonal assays. Four hundred and ten women with a clinical diagnosis of PCOS based on Rotterdam criteria were included in the study. The four phenotypes were 1 PCO complete, that is oligo/anovulation (O + polycystic ovaries (P + hyperandrogenism (H 2 P + O, 3 P + H, and 4 O + H. All women were also evaluated for metabolic syndrome (American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI, modified Adult Treatment Panel (ATP III 2005 guidelines and IR (homeostatic model assessment-IR (HOMA-IR. Statistical Analysis: Statistical Package for Social Sciences (SPSS version 18. Results: Largest group was PCOS complete (65.6% followed by P + O (22.2%; H + O (11.2%; and P + H (0.9%. Overall prevalence of metabolic syndrome was 35.07%. Hyperandrogenic phenotyptes; H + O (50% and P + H + O (37.04%, had significantly higher prevalence of metabolic syndrome than normoandrogenic P + O phenotype (10% (P ≤ 0.001. Body mass index (BMI ≥ 25 (P = 0.0004; odds ratio (OR = 3.07 (1.6574-5.7108, 95% CI, waist circumference (WC ≥ 80 cm (P = 0.001; OR = 3.68 (1.6807-8.0737, 95% CI and family history of diabetes (P = 0.019; OR 1.82 (1.1008-3.0194, 95% CI, were strongly associated with the presence of metabolic syndrome. The overall prevalence of IR in PCOS women was 30.44% (HOMA-IR cutoff

  2. A survey of probiotic use practices among patients at a tertiary medical centre.

    Science.gov (United States)

    Draper, K; Ley, C; Parsonnet, J

    2017-05-30

    Probiotic use has skyrocketed in recent years. Little is known, however, about patient knowledge and practices regarding probiotic use, especially in the context of antibiotic use. An invitation to complete a short, anonymous, electronic survey was sent by email to 965 patients at a tertiary medical centre in California who had agreed to be contacted for participation in research studies. Questions were asked about both probiotic and antibiotic use in the prior three months. Of 333 survey respondents, 55% had recently used probiotics, including food products and/or supplements (90 and 60% of probiotic users, respectively). Women were more likely than men to have used probiotics (odds ratio (OR): 1.99; 95% confidence interval (CI): 1.2-3.4). Health care providers (HCP) had prescribed antibiotics to 79 (24%) respondents in the preceding three months. Among antibiotic users, 33% had initiated or changed probiotics at the time of antibiotic use, usually without a recommendation from their prescribing HCP (72%). Only 12% of those who took probiotics with antibiotics had received a specific recommendation from their HCP. Most patients chose to take probiotic mixtures (56%), with few selecting evidence-based strains, such as Lactobacillus rhamnosus GG (11%). Regular probiotic use among patients is common. Typically, these probiotics are not recommended by a HCP, even in conjunction with antibiotic prescriptions. While a growing body of evidence supports specific probiotic strains for the prevention of antibiotic-associated diarrhoea, patients are often not receiving a specific recommendation from their HCP and appear to be taking strains without guidance from supporting evidence.

  3. Staff eye doses in a large medical centre in Saudi Arabia: are they meeting the new ICRP recommendations?

    International Nuclear Information System (INIS)

    Al-Haj, Abdalla N.; Al-Gain, Ibrahim; Lobriguito, Aida M.

    2015-01-01

    A 5-y retrospective analysis of the cardiology staff eye doses was performed on 34 staff from different categories (cardiologists, nurses and technologists) at King Faisal Specialist Hospital and Research Centre (KFSHRC) in Riyadh, Saudi Arabia. KFSHRC is a tertiary medical centre with 800-bed capacity having more than 5000 cardiac catheterisation procedures performed annually. The aim of the study is to derive staff doses to the lens of the eyes using the personal dose equivalent Hp(0.07) values from the annual TLD dose report for the years 2008-2012 and determine the category of staff with high estimated eye doses. The study also aims to investigate the causes for high doses and recommend dose-reduction techniques. The dose to the lens of the eye was estimated by using the ratio Hp(0.07) slab /H lens of 1.1 where Hp(0.07) values are the reported doses read from TLD badge worn at the collar level. The average annual eye dose of each category for the 5-y monitoring period was determined. Cardiologists tend to receive higher doses than the nurses by a factor of 2-4 and can exceed 5 mSv y -1 . No correlation exists between the eye doses of nurses and the cardiologists. There is a need to use a conversion coefficient in terms of eye lens dose per dose-area product for faster estimation of eye lens doses. However, there is a limitation on the use of the conversion coefficient because it will depend on the clinical procedure and the X-ray tube angulation. Further investigation on this limitation is needed. (authors)

  4. Standard procedures for adults in accredited sleep medicine centres in Europe

    DEFF Research Database (Denmark)

    Fischer, Jürgen; Dogas, Zoran; Bassetti, Claudio L

    2012-01-01

    The present paper describes standardized procedures within clinical sleep medicine. As such, it is a continuation of the previously published European guidelines for the accreditation of sleep medicine centres and European guidelines for the certification of professionals in sleep medicine, aimed...... at creating standards of practice in European sleep medicine. It is also part of a broader action plan of the European Sleep Research Society, including the process of accreditation of sleep medicine centres and certification of sleep medicine experts, as well as publishing the Catalogue of Knowledge...... and Skills for sleep medicine experts (physicians, non-medical health care providers, nurses and technologists), which will be a basis for the development of relevant educational curricula. In the current paper, the standard operational procedures sleep medicine centres regarding the diagnostic...

  5. Length of stay in asylum centres and mental health in asylum seekers

    DEFF Research Database (Denmark)

    Hallas, Peter; Hansen, Anne R; Staehr, Mia A

    2007-01-01

    BACKGROUND: The length of stay in asylum centres is generally mentioned as a possible health risk to asylum seekers. Medical staff working with asylum seekers has claimed that long lengths of stay in asylum centres might cause or aggravate mental disorders. We used records from a large, multiethnic...... specialists. If an asylum seeker needed more than three specialist consultations for mental illness or five consultations for physical illness the referrals had to be approved by The Danish Immigration Service. Between July 2001 - December 2002 the Red Cross prospectively registered health related data on all......: Length of stay in asylum centres was associated with an increase in referrals for mental disorders in a large, multiethnic group of asylum seekers. The present study supports the view that prolonged length of stay in an asylum centre is a risk factor for mental health. The risk of psychiatric illness...

  6. Integrating gender into a basic medical curriculum.

    NARCIS (Netherlands)

    Verdonk, P.; Mans, L.J.L.; Lagro-Janssen, A.L.M.

    2005-01-01

    INTRODUCTION: In 1998, gaps were found to exist in the basic medical curriculum of the Radboud University Nijmegen Medical Centre regarding health-related gender differences in terms of biological, psychological and social factors. After screening the curriculum for language, content and context,

  7. MEDICAL SERVICE - URGENT CALLS

    CERN Multimedia

    Service Médical

    2000-01-01

    IN URGENT NEED OF A DOCTOR GENEVA: EMERGENCY SERVICES GENEVA AND VAUD 144 FIRE BRIGADE 118 POLICE 117 CERN FIREMEN 767-44-44 ANTI-POISONS CENTRE Open 24h/24h 01-251-51-51 Patient not fit to be moved, call family doctor, or: GP AT HOME: Open 24h/24h 748-49-50 AMG- Association Of Geneva Doctors: Emergency Doctors at home 07h-23h 322 20 20 Patient fit to be moved: HOPITAL CANTONAL CENTRAL 24 Micheli-du-Crest 372-33-11 ou 382-33-11 EMERGENCIES 382-33-11 ou 372-33-11 CHILDREN'S HOSPITAL 6 rue Willy-Donzé 372-33-11 MATERNITY 32 bvd.de la Cluse 382-68-16 ou 382-33-11 OPHTHALMOLOGY 22 Alcide Jentzer 382-33-11 ou 372-33-11 MEDICAL CENTRE CORNAVIN 1-3 rue du Jura 345 45 50 HOPITAL DE LA TOUR Meyrin 719-61-11 EMERGENCIES 719-61-11 CHILDREN'S EMERGENCIES 719-61-00 LA TOUR MEDICAL CENTRE 719-74-00 European Emergency Call 112   FRANCE: EMERGENCY SERVICES 15 FIRE BRIGADE 18 POLICE 17 CERN FIREMEN AT HOME 00-41-22-767-44-44 ...

  8. New Models explaining regional Evolution in Europe. Contributions to an international conference in honour of Professor J.H.P. Paelinck Tinbergen Institute, Rotterdam, June 16-17, 1995. Introduction

    Directory of Open Access Journals (Sweden)

    Pierre-Henri Derycke

    1998-02-01

    Full Text Available At the end of the academic year 1994-95, Professor J.Paelinck left the chair of spatial theory he occupied at the Erasmus University in Rotterdam for several decades. On this occasion, his disciples – in particular, Hans KUIPER and Riccardo GIRARDI - and numerous colleagues and friends organised on June 16-17 an International Conference held at the Tinbergen Institute. About forty spatial analysts and regional science specialists, belonging to 10 different countries, were present to this even...

  9. Money for nothing? The net costs of medical training.

    Science.gov (United States)

    Barros, Pedro P; Machado, Sara R

    2010-09-01

    One of the stages of medical training is the residency programme. Hosting institutions often claim compensation for the training provided. How much should this compensation be? According to our results, given the benefits arising from having residents among the house staff, no transfer (either tuition fee or subsidy) should be set to compensate the hosting institution for providing medical training. This paper quantifies the net costs of medical training, defined as the training costs over and above the wage paid. We jointly consider two effects. On the one hand, residents take extra time and resources from both the hosting institution and the supervisor. On the other hand, residents can be regarded as a less expensive substitute to nurses and/or graduate physicians, in the production of health care, both in primary care centres and hospitals. The net effect can be either positive or negative. We use the fact that residents, in Portugal, are centrally allocated to National Health Service hospitals to treat them as a fixed exogenous production factor. The data used comes from Portuguese hospitals and primary care centres. Cost function estimates point to a small negative marginal impact of residents on hospitals' (-0.02%) and primary care centres' (-0.9%) costs. Nonetheless, there is a positive relation between size and cost to the very large hospitals and primary care centres. Our approach to estimation of residents' costs controls for other teaching activities hospitals might have (namely undergraduate Medical Schools). Overall, the net costs of medical training appear to be quite small.

  10. Medical physics education and training activities in India

    International Nuclear Information System (INIS)

    Kumar, Munish; Gomathi, K.; Sharma, S.D.; Chourasiya, G.; Mayya, Y.S.; Sahani, G.; Sharma Dash, P.K.; Agarwal, S.P.

    2008-01-01

    Since the discovery of x-rays and radioactivity, ionising radiations are finding extensive applications in human health care programmes worldwide. X-rays are being used in India for various applications since 1898. Further the establishment of Tata Memorial Hospital in 1941, as a centre for the treatment of cancer was the stepping-stone for medical physics in India with Dr. Ramaiah Naidu as the first medical physicist. Since then, the field of medical physics has made a tremendous progress. At cancer treatment centre, medical physicist cum RSO is required not only to ensure and maintain quality of radiation treatment by ensuring quality assurance, treatment planning and resonance with radiation oncologist but also acts as a bridge between the cancer treatment centre and regulatory authority (AERB) and also ensures radiation safety. Currently there are around 399 teletherapy units (280 telecobalt and 119 medical linear accelerator) in our country and the number is further likely to increase in future due to i) More awareness about cancer and prevalence of around 1 million new cancer cases per year and ii) The indigenous production of telecobalt and linear accelerator units has brought down the cost. In fact in India, there is a need of more than 1000 teletherapy units. In view of above, well-trained and qualified medical physicists are required. In this paper, various educational and training activities in India are described. The paper also casts light on growing demands for starting M.Phil and Ph.D. degrees in medical physics in India

  11. Medical procedures in the event of nuclear power plant accidents. Guidelines for: Medical consultants for emergency response commander; physicians in emergency care centres; physicians in outpatient and inpatient care

    International Nuclear Information System (INIS)

    Genkel, Simone

    2008-01-01

    The author of the contribution under consideration reports on medical procedures in the event of nuclear power plant accidents. This contribution consists of the following sections: protective measures, tasks of radiation protection physicians, emergency care centres. It has been pointed out that differentiation of the hospitals is acquired which accept radiation accident patients. However, only a small number of hospitals will be able to professionally treat patients with suspected gastrointestinal or pronounced (muco)cutaneous type of hospitals with haemotological-oncological departments. Thus they should be able to treat patients who have been exposed to radiation doses between 1 and 6 Gy without any difficulties. Even larger is the number of hospitals which can accept patients who were exposed to a radiation dose of less than 1 Gy, but suffer from other complicating diseases (injuries, general diseases)

  12. Early experience with open heart surgery in a pioneer private hospital in West Africa: the Biket medical centre experience.

    Science.gov (United States)

    Onakpoya, Uvie Ufuoma; Adenle, Adebisi David; Adenekan, Anthony Taiwo

    2017-01-01

    More than forty years after the first open heart surgery in Nigeria, all open heart surgeries were carried out in government-owned hospitals before the introduction of such surgeries in 2013 at Biket Medical Centre, a privately owned hospital in Osogbo, South-western Nigeria. The aim of this paper is to review our initial experience with open heart surgery in this private hospital. All patients who underwent open heart surgery between August 2013 and January 2014 were included in this prospective study. The medical records of the patients were examined and data on age, sex, diagnosis, type of surgery, cardiopulmonary bypass details, complications and length of hospital stay were extracted and the data was analysed using SPSS version 16. Eighteen patients comprising of 12 males and 6 females with ages ranging between 8 months and 52 years (mean= of 15.7 +/- 15 years) were studied. Pericardial patch closure of isolated ventricular septal defect was done in 7 patients (38.9%) while total correction of isolated tetralogy of Fallot was carried out in 5 patients (27.8%). Two patients had mitral valve repair for rheumatic mitral regurgitation. Sixty day mortality was 0%. Safe conduct of open heart surgery in the private hospital setting is feasible in Nigeria. It may be our only guarantee of hitch free and sustainable cardiac surgery.

  13. Egyptian Journal of Medical Laboratory Sciences

    African Journals Online (AJOL)

    The main objective of this journal is to cover all aspects of medical laboratory science. Contributions are received from staff members of academic, basic and laboratory science departments of the different medical schools and research centres all over Egypt and it fulfils a real need amongst Egyptian doctors working in the ...

  14. Age associated differences in prevalence of individual rotterdam criteria and metabolic risk factors during reproductive age in 446 caucasian women with polycystic ovary syndrome

    DEFF Research Database (Denmark)

    Glintborg, D; Mumm, H; Ravn, P

    2012-01-01

    , fasting lipids, insulin, glucose), transvaginal ultrasound, oral glucose tolerance tests (OGTT) (n=234), and ACTH tests (n=201). BMI, waist, Ferriman-Gallwey score, blood pressure, and lipid profile were higher in older vs. younger age groups whereas androgen levels were lower. Measures of insulin...... resistance were unchanged between age groups, but glucose levels were significantly higher in older age groups. Rotterdam criteria: The prevalence of PCO and biochemical hyperandrogenism decreased in the oldest age group whereas clinical hyperandrogenism increased. Young patients are characterized by PCO...... and biochemical hyperandrogenism, whereas older patients are more obese with more severe hirsutism and more cardiovascular and metabolic risk factors....

  15. [Approaches to development and implementation of the medical information system for military-medical commission of the multidisciplinary military-medical organisation].

    Science.gov (United States)

    Kuvshinov, K E; Klipak, V M; Chaplyuk, A L; Moskovko, V M; Belyshev, D V; Zherebko, O A

    2015-06-01

    The current task of the implementation of medical information systems in the military and medical organizations is an automation of the military-medical expertise as one of the most important activities. In this regard, noteworthy experience of the 9th Medical Diagnostic Centre (9th MDC), where on the basis of medical information system "Interi PROMIS" for the first time was implemented the automation of the work of military medical commission. The given paper presents an algorithm for constructing of the information system for the military-medical examination; detailed description of its elements is given. According to military servicemen the implementation of the Military Medical Commission (MMC) subsystem of the medical information system implemented into the 9th MDC has reduced the time required for the MMC and paperwork, greatly facilitate the work of physicians and medical specialists on military servicemen examination. This software can be widely applied in ambulatory and hospital practice, especially in case of mass military-medical examinations.

  16. Length of stay in asylum centres and mental health in asylum seekers: a retrospective study from Denmark

    OpenAIRE

    Hallas, Peter; Hansen, Anne R; St?hr, Mia A; Munk-Andersen, Ebbe; Jorgensen, Henrik L

    2007-01-01

    Abstract Background The length of stay in asylum centres is generally mentioned as a possible health risk to asylum seekers. Medical staff working with asylum seekers has claimed that long lengths of stay in asylum centres might cause or aggravate mental disorders. We used records from a large, multiethnic group of asylum seekers to study if the incidence of mental disorders increased with length of stay. Methods The study population was asylum seekers in Danish asylum centres run by the Dani...

  17. A city park on top of shops and a dike

    NARCIS (Netherlands)

    van Veelen, P.C.; Voorendt, M.Z.; van der Zwet, C; Kothuis, Baukje; Kok, Matthijs

    2017-01-01

    The Roof Park ('Dakpark’) is an elevated park on a former railway yard in the Delfshaven quarter in Rotterdam. The park is located on top of the roof of a new shopping centre, which includes a parking garage (hence its name, ‘dak’ means ‘roof’). The park is the

  18. Possibilities for Hospital Treatment of Industrial Accident Victims in Military Medical Academy

    International Nuclear Information System (INIS)

    Todorovic, V.; Jevtic, M.; Jovanovic, D.; Jovic-Stosic, J.

    2007-01-01

    Possibility of mass injuries in traffic, industrial accidents or terrorist attack is every day reality. Management of victims may need complex measures including activities on the site, transportation, and hospital care. Preparedness for hospital treatment of mass trauma or poisoning is among the main duties of Military Medical Academy (MMA). It is medical institution of tertiary level with the capacity of 1214 beds in 13 surgical clinics, 12 internal medicine clinics, 2 neuropsychiatry clinics, poison control centre and organ transplantation centre. National Poison Control Centre is the only specialized institution for treatment of adult's acute poisonings in the country. Centre includes: 1. Clinic of Toxicology and Clinical Pharmacology with Intensive Care Unit and Toxicology Information Department; 2. Institute of Experimental Toxicology and Pharmacology; 3. Mobile Toxicological - Chemical Squad. Being a part of MMA, Centre benefits from all advantages of central type hospital, including possibilities for contemporary diagnostic and therapeutic procedures of different specialities, and other necessary medical and logistic support. Except hospital organization and preparedness for admission of mass injuries victims, one of strategic goals of MMA is functional integration in civilian health care system including more detailed planning for collaboration in case of chemical accidents.(author)

  19. Data analysis in medical education research : a multilevel perspective

    NARCIS (Netherlands)

    Leppink, Jimmie

    A substantial part of medical education research focuses on learning in teams (e.g., departments, problem-based learning groups) or centres (e.g., clinics, institutions) that are followed over time. Individual students or employees sharing the same team or centre tend to be more similar in learning

  20. Headache associated disability in medical students at the Kenyatta ...

    African Journals Online (AJOL)

    Objective: To study headache associated disability in a group of medical students at the Kenyatta National Hospital. Study design: Cross sectional survey. Results: Between October 1994 and January 1995 we conducted a survey on headache characteristics on medical students at both the Kenya Medical Training Centre ...

  1. The prevalence of polycystic ovary syndrome in a normal population according to the Rotterdam criteria versus revised criteria including anti-Müllerian hormone

    DEFF Research Database (Denmark)

    Lauritsen, M P; Bentzen, J G; Pinborg, A

    2014-01-01

    -anovulation, clinical and/or biochemical hyperandrogenism and polycystic ovaries (AFC ≥ 12 and/or ovarian volume >10 ml). However, with the advances in sonography, the relevance of the AFC threshold in the definition of polycystic ovaries has been challenged, and AMH has been proposed as a marker of polycystic ovaries...... ovaries with a significant age-related decrease from 69.0% in women reliable marker of polycystic ovaries in women with PCOS according to the Rotterdam criteria [area....... However, future studies are needed to validate AMH threshold levels, and AMH Z-score may be appropriate to adjust for the age-related decline in the AFC. STUDY FUNDING/COMPETING INTEREST(S): None. TRIAL REGISTRATION NUMBER: Not applicable....

  2. Evaluation of telemedicine centres in Madhya Pradesh, Central India.

    Science.gov (United States)

    Bali, Surya; Gupta, Arti; Khan, Asif; Pakhare, Abhijit

    2016-04-01

    In a developing country such as India, there is substantial inequality in health care distribution. Telemedicine facilities were established in Madhya Pradesh in 2007-2008. The purpose of this study was to evaluate the infrastructure, equipment, manpower, and functional status of Indian Space and Research Organisation (ISRO) telemedicine nodes in Madhya Pradesh. All district hospitals and medical colleges with nodes were visited by a team of three members. The study was conducted from December 2013-January 2014. The team recorded the structural facility situation and physical conditions on a predesigned pro forma. The team also conducted interviews with the nodal officers, data entry operator and other relevant people at these centres. Of the six specialist nodes, four were functional and two were non-functional. Of 10 patient nodes, two nodes were functional, four were semi-functional and four were non-functional. Most of the centres were not working due to a problem with their satellite modem. The overall condition of ISRO run telemedicine centres in Madhya Pradesh was found to be poor. Most of these centres failed to provide telemedicine consultations. We recommend replacing this system with another cost effective system available in the state wide area network (SWAN). We suggest the concept of the virtual out-patient department. © The Author(s) 2015.

  3. East African Medical Journal - Vol 78, No 3 (2001)

    African Journals Online (AJOL)

    HIV infection in elderly medical patients · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT ... Dental caries and periodontal conditions among primary school children in ... Epidemiology of injury patients at Bugando Medical centre, Tanzania ...

  4. Evaluation of risk factors in acute myocardial infarction patients admitted to the coronary care unit, Tripoli Medical Centre, Libya.

    Science.gov (United States)

    Abduelkarem, A R; El-Shareif, H J; Sharif, S I

    2012-04-01

    The aim of this study was to provide an overview of the risk factors for acute myocardial infarction in patients attending Tripoli Medical Centre, Libya. Records were reviewed for 622 patients with a mean age of 58.3 (SD 12.9) years. Diabetes mellitus (48.2%), hypertension (35.7%) and smoking (50.6%) were among the risk factors reported. There were 110 patients (17.7%) who died during hospitalization, mainly suffering cardiogenic shock (48.0%). The rate of use of thrombolytic therapy was low in patients who were female (40.4% versus 58.4% for males), older age (31.6% for those > 85 years versus 63.3% for patients < 55 years), diabetics (45.3% versus 62.0% for non-diabetic patients) and hypertensives (47.3% versus 57.8% for non-hypertensive patients). Prevention strategies should be implemented in order to improve the long-term prognosis and decrease overall morbidity and mortality from coronary artery disease in Libyan patients.

  5. Learning patient-centred communication: The journey and the territory.

    Science.gov (United States)

    Cushing, Annie M

    2015-10-01

    The student entering medical school is about to undergo a socialisation process that profoundly shapes their development as a professional. A central feature is the formal and informal curriculum on the doctor-patient relationship and patient-centred communication. In this paper I will chart some of the features of the student journey which might impact on learning and practice. The medical undergraduate's role is largely that of observer and learner, rather than a provider of care, so much of the formal teaching on patient-centred communication is within simulated practice. Clinical practice environments are the most powerful influences on learning about professional behaviour. Challenges for educational practitioners include how to support authenticity in learners, respond to their agendas, and foster insight to enable flexibility about communication in different contexts. Parallels between the doctor-patient relationship and the student-tutor relationship are explored for their relevance. A number of educational theories can inform curriculum design and educational practice, notably Vygotsky's Zone of Proximal Development. Application of this and other social learning theories, together with students' reflections can enrich our planning of educational interventions and understanding of their impact. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  6. [Health risk railroad noise - prognosis of potential health risks subsequent to night-time exposure to railroad noise in the German part of the Transversal Rotterdam Genova].

    Science.gov (United States)

    Greiser, E

    2014-12-01

    Based on risk coefficients for cardiovascular and psychiatric disease derived from a case-control study in the vicinity of a major German airport, statistics on persons exposed to night-time railroad noise in the vicinity of the Rotterdam-Genova Transversal, and on health expenditure calculations by the Federal Statistical Office of Germany a prognosis on effects of railroad noise was performed. It resulted for 1 10-year period in nearly 75 000 excess cases of diseases, nearly 30 000 excess deaths and health expenditures of 3.8 billion euros. © Georg Thieme Verlag KG Stuttgart · New York.

  7. Risk factors for prostate cancer in Universiti Kebangsaan Malaysia Medical Centre: a case-control study.

    Science.gov (United States)

    Subahir, Mohd Nizam; Shah, Shamsul Azhar; Zainuddin, Zulkifli Md

    2009-01-01

    In Malaysia, prostate cancer is ranked 6th among male cancer and expected to increase in the future. Several factors have shown to be related to prostate cancer such as sociodemographic, lifestyle, diet, occupational exposure, medical and health status. This is the first time a similar study was conducted in Malaysia to recognize the risk factors for prostate cancer patients who came for treatment at University Kebangsaan Malaysia Medical Centre (UKMMC). Prostate cancer cases diagnosed between 2003 and 2008 which met with the inclusion criteria were included in the study. One hundred and twelfth (112) pairs of cases and controls matched by age and ethnicity were analysed. McNemar Odds Ratios (OR(M)) were calculated using McNemar Calculator software for univariate analysis while conditional logistic regression was used for multivariate analysis, both using SPSS version 12.0. Most of the prostate cancer patients (68.8%) that came for treatment in UKMMC were above 70 years old. The majority were Chinese (50.0%) followed by Malay (46.4%) and Indian (3.6%). Multivariate analysis showed cases were more likely to have a first-degree relative with a history of cancer (OR= 3.77, 95% CI= 1.19-11.85), to have been exposed to pesticides (OR= 5.57, 95% CI= 1.75-17.78) and consumed more meat (OR= 12.23, 95% CI= 3.89-39.01). Significantly reduced risks of prostate cancer were noted among those consuming more vegetables (OR= 0.12, 95% CI= 0.02-0.84), more tomatoes (OR= 0.35, 95% CI= 0.13-0.93) and those who had frequent sexual intercourse (OR= 0.44, 95% CI= 0.19-0.96). Some lifestyle and occupation factors are strong predictors of the occurrence of prostate cancer among patients in UKMMC. More importantly, with the identification of the potentially modifiable risk factors, proper public health intervention can be improved.

  8. Establishment of a South African nuclear science exhibition centre

    Energy Technology Data Exchange (ETDEWEB)

    Lekwe, K.G.; Stander, G.; Faanhof, A. [South African Nuclear Energy Cooperation, P O Box 582, Pretoria (South Africa)

    2008-07-01

    After an initial survey undertaken by the South African Nuclear Energy Corporation (Necsa), one of the findings was that nuclear knowledge is virtually non-existent amongst the general public, including school children, throughout the country. The Department of Education (DoE) is currently in the process of introducing Nuclear as part of the school curriculum, which would require a collective effort between the schools and all the Nuclear Institutions in the country. Necsa as well as other nuclear industries have the responsibility to promote public awareness, appreciation and understanding of science and nuclear science in particular. Necsa is leading the national initiative to establish the nuclear science centre which would amongst others guide a person from the very basics of nuclear science to present and future applications thereof. The nuclear science centre will include information on the SAFARI-1 reactor, the Koeberg power reactor, the Pebble Bed Modular Reactor (PBMR), particle accelerators, food preservation, medical applications, etc. This paper will give the overview of the centre as well as its objectives thereof. (authors)

  9. Establishment of a South African nuclear science exhibition centre

    International Nuclear Information System (INIS)

    Lekwe, K.G.; Stander, G.; Faanhof, A.

    2008-01-01

    After an initial survey undertaken by the South African Nuclear Energy Corporation (Necsa), one of the findings was that nuclear knowledge is virtually non-existent amongst the general public, including school children, throughout the country. The Department of Education (DoE) is currently in the process of introducing Nuclear as part of the school curriculum, which would require a collective effort between the schools and all the Nuclear Institutions in the country. Necsa as well as other nuclear industries have the responsibility to promote public awareness, appreciation and understanding of science and nuclear science in particular. Necsa is leading the national initiative to establish the nuclear science centre which would amongst others guide a person from the very basics of nuclear science to present and future applications thereof. The nuclear science centre will include information on the SAFARI-1 reactor, the Koeberg power reactor, the Pebble Bed Modular Reactor (PBMR), particle accelerators, food preservation, medical applications, etc. This paper will give the overview of the centre as well as its objectives thereof. (authors)

  10. The epidemology of burn injuries of children and the importance of modern burn centre

    Directory of Open Access Journals (Sweden)

    Janez Mohar

    2007-01-01

    Full Text Available Background: Burns represent the major percentage of injuries to children. Their incidence level, injury mechanisms and treatment often differ from the burn injuries of adults.Methods: From the medical records of the Department for Plastic and Reconstructive Surgery of the Ljubljana Medical Centre we gathered, analyzed and compared the burn injuries of children up to the age of 15 who were admitted to hospital in the year 2003 to those who were treated as outpatients. Moreover, we compared the burn injuries of hospitalized children at the same department in the years 2003, 1993 and 1983 respectively. We compared their gender, age, the total body surface area of burns, the depth of burns, frequency of the mechanisms of injury, the affected parts of the body and the length and mode of treatment. Finally, we compared our results with the results of similar studies from other burn centres.Results: The number of children treated for burns at the department has declined. In all the years studied, the injured children were younger than 5 and the majority of them were boys. The number of children admitted with substantial total body surface areas of burns was also declining. However, there was an increase in the number of children admitted with burns less than 10 % of their total body surface area. The number of burns treated by surgery slightly increased over the years studied. There was a similar sex and age distribution among the hospitalized children and those treated as outpatients.Conclusions: The number of children hospitalized with burns is in decline. In the years 1983, 1993 and 2003, there was no significant difference in the percentage of children who were treated surgically and those who were treated conservatively (P = 0.247. The Burn Centre at the Department for Plastic and Reconstructive Surgery of the Ljubljana Medical Centre which together with the Burn Department of the Maribor General Hospital covers the population of two million

  11. Key factors in work engagement and job motivation of teaching faculty at a university medical centre.

    Science.gov (United States)

    van den Berg, B A M; Bakker, Arnold B; Ten Cate, Th J

    2013-11-01

    This study reports about teacher motivation and work engagement in a Dutch University Medical Centre (UMC). We examined factors affecting the motivation for teaching in a UMC, the engagement of UMC Utrecht teaching faculty in their work, and their engagement in teaching compared with engagement in patient care and research. Based on a pilot study within various departments at the UMCU, a survey on teaching motivation and work engagement was developed and sent to over 600 UMCU teachers. About 50 % responded. Work engagement was measured by the Utrecht Work Engagement Scale, included in this survey. From a list of 22 pre-defined items, 5 were marked as most motivating: teaching about my own speciality, noticeable appreciation for teaching by my direct superior, teaching small groups, feedback on my teaching performance, and freedom to determine what I teach. Feedback on my teaching performance showed the strongest predictive value for teaching engagement. Engagement scores were relatively favourable, but engagement with patient care was higher than with research and teaching. Task combinations appear to decrease teaching engagement. Our results match with self-determination theory and the job demands-resources model, and challenge the policy to combine teaching with research and patient care.

  12. Inclusion of persons with mental illness in patient-centred medical homes: cross-sectional findings from Ontario, Canada.

    Science.gov (United States)

    Steele, Leah S; Durbin, Anna; Sibley, Lyn M; Glazier, Richard

    2013-01-01

    In Ontario, Canada, the patient-centred medical home is a model of primary care delivery that includes 3 model types of interest for this study: enhanced fee-for-service, blended capitation, and team-based blended capitation. All 3 models involve rostering of patients and have similar practice requirements but differ in method of physician reimbursement, with the blended capitation models incorporating adjustments for age and sex, but not case mix, of rostered patients. We evaluated the extent to which persons with mental illness were included in physicians' total practices (as rostered and non-rostered patients) and were included on physicians' rosters across types of medical homes in Ontario. Using population-based administrative data, we considered 3 groups of patients: those with psychotic or bipolar diagnoses, those with other mental health diagnoses, and those with no mental health diagnoses. We modelled the prevalence of mental health diagnoses and the proportion of patients with such diagnoses who were rostered across the 3 medical home model types, controlling for demographic characteristics and case mix. Compared with enhanced fee-for-service practices, and relative to patients without mental illness, the proportions of patients with psychosis or bipolar disorders were not different in blended capitation and team-based blended capitation practices (rate ratio [RR] 0.91, 95% confidence interval [CI] 0.82-1.01; RR 1.06, 95% CI 0.96-1.17, respectively). However, there were fewer patients with other mental illnesses (RR 0.94, 95% CI 0.90-0.99; RR 0.89, 95% CI 0.85-0.94, respectively). Compared with expected proportions, practices based on both capitation models were significantly less likely than enhanced fee-for-service practices to roster patients with psychosis or bipolar disorders (for blended capitation, RR 0.92, 95% CI 0.90-0.93; for team-based capitation, RR 0.92, 95% CI 0.88-0.93) and also patients with other mental illnesses (for blended capitation

  13. Manche centre

    International Nuclear Information System (INIS)

    1997-05-01

    After a general presentation of radioactivity and radioactive wastes and of the French national agency for the management of radioactive wastes (ANDRA), this brochure gives a general overview of the Manche low- and medium-level radioactive waste disposal centre: principles of storage safety, waste containers (first confinement barrier), storage facility and cover (second confinement barrier), the underground (third confinement barrier), the impact of the centre on its environment, and the control of radioactivity in the vicinity of the centre. (J.S.)

  14. A profile of traumatic spinal cord injury and medical complications in Latvia

    OpenAIRE

    Nulle, Anda; Tjurina, Uljana; Erts, Renars; Vetra, Anita

    2017-01-01

    Study design A single centre retrospective study. Objectives To collect data and analyse the epidemiological profile of traumatic spinal cord injury and its medical complications during the subacute rehabilitation period. Setting Spinal Cord Injury Rehabilitation Programme of the National Rehabilitation Centre, ‘Vaivari’, Jurmala, Latvia. Methods Information was collected in 2015 from the medical records of 134 patients with a traumatic spinal cord injury admitted for primary rehabilitation b...

  15. Supporting medical students with learning disabilities in Asian medical schools

    Directory of Open Access Journals (Sweden)

    Md. Anwarul Azim Majumder

    2010-10-01

    Full Text Available Md. Anwarul Azim Majumder1, Sayeeda Rahman2, Urban JA D’Souza3, Gad Elbeheri4, Khalid Bin Abdulrahman5, M Muzaherul Huq61,2Department of Clinical Sciences, School of Life Sciences, University of Bradford, West Yorkshire, Bradford, UK; 3School of Medicine, University Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia; 4Centre for Child Evaluation and Teaching, Kuwait; 5College of Medicine, Al-Imam University, Riyadh, Saudi Arabia; 6Centre for Medical Education (CME, Mohakhali, Dhaka, BangladeshAbstract: Learning disabilities (LDs represent the largest group of disabilities in higher education (HE institutes, including medical schools, and the numbers are continuing to rise. The worrying concern is that two-thirds to half of these students with LDs remain undiagnosed when they start their undergraduate education and may even graduate without having their disabilities diagnosed. These students struggle with their academic abilities, receive poor grades and, as a result, develop lower perceptions of their intellectual abilities than do those students without LDs. All these ultimately hamper their professional practice, employment, and career progression. Appropriate and adequate educational policies, provisions, and practices help students to progress satisfactorily. In Asian countries, public and professional awareness about LDs is low, supportive provisions are limited, legislations are inadequate, data are scarce, and equal-opportunity/widening-participation policies are not implemented effectively in the HE sector. This article discusses the issues related to LDs in medical education and draws policy, provision, and practice implications to identify, assess, and support students with LDs in medical schools, particularly in an Asian context.Keywords: medical education, learning disabilities, dyslexia, Asia

  16. Implementation of the ALERT algorithm, a new dispatcher-assisted telephone cardiopulmonary resuscitation protocol, in non-Advanced Medical Priority Dispatch System (AMPDS) Emergency Medical Services centres.

    Science.gov (United States)

    Stipulante, Samuel; Tubes, Rebecca; El Fassi, Mehdi; Donneau, Anne-Francoise; Van Troyen, Barbara; Hartstein, Gary; D'Orio, Vincent; Ghuysen, Alexandre

    2014-02-01

    Early bystander cardiopulmonary resuscitation (CPR) is a key factor in improving survival from out-of-hospital cardiac arrest (OHCA). The ALERT (Algorithme Liégeois d'Encadrement à la Réanimation par Téléphone) algorithm has the potential to help bystanders initiate CPR. This study evaluates the effectiveness of the implementation of this protocol in a non-Advanced Medical Priority Dispatch System area. We designed a before and after study based on a 3-month retrospective assessment of victims of OHCA in 2009, before the implementation of the ALERT protocol in Liege emergency medical communication centre (EMCC), and the prospective evaluation of the same 3 months in 2011, immediately after the implementation. At the moment of the call, dispatchers were able to identify 233 OHCA in the first period and 235 in the second. Victims were predominantly male (59%, both periods), with mean ages of 64.1 and 63.9 years, respectively. In 2009, only 9.9% victims benefited from bystander CPR, this increased to 22.5% in 2011 (p<0.0002). The main reasons for protocol under-utilisation were: assistance not offered by the dispatcher (42.3%), caller physically remote from the victim (20.6%). Median time from call to first compression, defined here as no flow time, was 253s in 2009 and 168s in 2011 (NS). Ten victims were admitted to hospital after ROSC in 2009 and 13 in 2011 (p=0.09). From the beginning and despite its under-utilisation, the ALERT protocol significantly improved the number of patients in whom bystander CPR was attempted. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  17. Evaluation of current care effectiveness: a survey of hypertension guideline implementation in Finnish health centres

    DEFF Research Database (Denmark)

    Alanen, Seija I; Johannala-Kemppainen, Riitta; Ijäs, Jarja J

    2007-01-01

    OBJECTIVE: To assess the extent and style of implementation of the Hypertension Guideline (HT Guideline) in Finnish primary health centres, and to identify a scale of contrasting implementation styles in the health centres (with the two ends of the scale being referred to as information...... implementers or disseminators respectively). DESIGN: A cross-sectional study. Development of a questionnaire and criteria for assessing the extent and style of implementation of the HT Guideline. SETTING: Primary healthcare. SUBJECTS: All head physicians and senior nursing officers in Finnish health centres (n...... =290). MAIN OUTCOME MEASURES: The extent of adoption of the HT Guideline in health centres and the characteristics associated with the implementation style. RESULTS: Responses were received from 410 senior medical staff (246 senior nursing officers and 164 head physicians) representing altogether 264...

  18. Does non-medical prescribing make a difference to patients?

    Science.gov (United States)

    Carey, Nicola; Stenner, Karen

    This article examines the literature on non-medical prescribing to establish its impact on UK healthcare. It discusses how better access to medication through non-medical prescribing can improve patient safety and patient-centred care, and how nurse prescribing can help ensure quality of care in the NHS during the current financial crisis.

  19. [The use of medical journals by medical students. Which medical journals are read?].

    Science.gov (United States)

    Algra, Annemijn M; Dekker, Friedo W

    2015-01-01

    To investigate the role of scientific medical journals in Dutch medical curricula. Descriptive questionnaire study. In 2013, medical students (from year 3 onwards) at the Leiden University Medical Centre (LUMC), were invited to respond to an online questionnaire. They were presented with 28 multiple-choice questions and 11 statements about the use of scientific medical journals in the medical curriculum. We calculated the frequencies of the answers per question and analysed differences between medical students using two-by-two tables. The questionnaire was completed by 680 (53.0%) of 1277 invited medical students enrolled at the LUMC. Most of the respondents were those doing clinical rotations (56.6%) and 60.1% had research experience. More than half of the students read at least one scientific journal a few times per month; this percentage was 38.8% among third-year students, 49.3% among fourth-year students, 60.0% among those on clinical rotation, and was higher among students with research experience (63.3%) than among those without research experience (44.1%). Nearly 90% of students agreed with the statement that the development of academic and scientific education should take place in the bachelor's phase of medical school. Medical students start to read scientific medical journals at an early phase in the medical curriculum and this increases further when students start to undertake research projects or go on clinical rotation. Medical curricula should be constructed in such a way that medical students learn to select and interpret research findings adequately for themselves before they turn to articles from scientific medical journals.

  20. Association Between Mind-Body Practice and Cardiometabolic Risk Factors: The Rotterdam Study.

    Science.gov (United States)

    Younge, John O; Leening, Maarten J G; Tiemeier, Henning; Franco, Oscar H; Kiefte-de Jong, Jessica; Hofman, Albert; Roos-Hesselink, Jolien W; Hunink, M G Myriam

    2015-09-01

    The increased popularity of mind-body practices highlights the need to explore their potential effects. We determined the cross-sectional association between mind-body practices and cardiometabolic risk factors. We used data from 2579 participants free of cardiovascular disease from the Rotterdam Study (2009-2013). A structured home-based interview was used to evaluate engagement in mind-body practices including meditation, yoga, self-prayer, breathing exercises, or other forms of mind-body practice. We regressed engagement in mind-body practices on cardiometabolic risk factors (body mass index, blood pressure, and fasting blood levels of cholesterol, triglycerides, and glucose) and presence of metabolic syndrome. All analyses were adjusted for age, sex, educational level, smoking, alcohol consumption, (in)activities in daily living, grief, and depressive symptoms. Fifteen percent of the participants engaged in a form of mind-body practice. Those who did mind-body practices had significantly lower body mass index (β = -0.84 kg/m, 95% confidence interval [CI] = -1.30 to -0.38, p triglyceride levels (β = -0.02, 95% CI = -0.04 to -0.001, p = .037), and log-transformed fasting glucose levels (β = -0.01, 95% CI = -0.02 to -0.004, p = .004). Metabolic syndrome was less common among individuals who engaged in mind-body practices (odds ratio = 0.71, 95% CI = 0.54-0.95, p = .019). Individuals who do mind-body practices have a favorable cardiometabolic risk profile compared with those who do not. However, the cross-sectional design of this study does not allow for causal inference and prospective, and intervention studies are needed to elucidate the association between mind-body practices and cardiometabolic processes.

  1. The ideal Atomic Centre; Le Centre Atomique ideal

    Energy Technology Data Exchange (ETDEWEB)

    Mas, R [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

    1965-07-01

    The author presents considerations which should prove to be of interest to all those who have to design, to construct and to operate a nuclear research centre. A large number of the ideas presented can also be applied to non-nuclear scientific research centres. In his report the author reviews: various problems with which the constructor is faced: ground-plan, infrastructure, buildings and the large units of scientific equipment in the centre, and those problems facing the director: maintenance, production, supplies, security. The author stresses the relationship which ought to exist between the research workers and the management. With this aim in view he proposes the creation of National School for Administration in Research which would train administrative executives for public or private organisations; they would be specialised in the fields of fundamental or applied research. (author) [French] L'auteur propose une base de reflexions a tous ceux qui doivent concevoir, realiser et faire vivre un Centre d'Etudes Nucleaires. Un grand nombre des idees exprimees peut d'ailleurs s'appliquer a un Centre d'Etudes Scientifiques non nucleaires. Dans son ouvrage, l'auteur passe en revue les differents problemes qui se posent au constructeur: plan, masse, infrastructure, batiments et grands appareils du Centre, et ceux qu'a a resoudre le directeur: entretien, fabrication, approvisionnements, securite. L'auteur insiste sur l'aspect des rapports qui doivent exister entre les chercheurs et ceux qui les administrent. Il propose a cette fin la creation d'une Ecole Nationale d'Administration de la Recherche qui formerait des cadres administratifs pour les organismes publics ou prives, specialises dans la Recherche fondamentale ou appliquee. (auteur)

  2. ‘Smashed by the National Health’? A Closer Look at the Demise of the Pioneer Health Centre, Peckham

    Science.gov (United States)

    Conford, Philip

    2016-01-01

    The Pioneer Health Centre, based in South London before and after the Second World War, remains a source of interest for advocates of a positive approach to health promotion in contrast with the treatment of those already ill. Its closure in 1950 for lack of funds has been blamed on the then recently established National Health Service, but this article argues that such an explanation is over-simplified and ignores a number of other factors. The Centre had struggled financially during the 1930s and tried to gain support from the Medical Research Council. The Council appeared interested in the Centre before the war, but was less sympathetic in the 1940s. Around the time of its closure and afterwards, the Centre was also involved in negotiations with London County Council; these failed because the Centre’s directors would not accept the changes which the Council would have needed to make. Unpublished documents reveal that the Centre’s directors were uncompromising and that their approach to the situation antagonised their colleagues. Changes in medical science also worked against the Centre. The success of sulphonamide drugs appeared to render preventive medicine less significant, while the development of statistical techniques cast doubt on the Centre’s experimental methods. The Centre was at the heart of the nascent organic farming movement, which opposed the rapid growth of chemical cultivation. But what might be termed ‘chemical triumphalism’ was on the march in both medicine and agriculture, and the Centre was out of tune with the mood of the times. PMID:26971599

  3. Dosimetry practices at the Radiation Technology Centre (Ghana)

    International Nuclear Information System (INIS)

    Emi-Reynolds, G.; Banini, G.K.; Ennison, I.

    1997-01-01

    Dosimetry practices undertaken to support research and pilot scale gamma irradiation activities at the Radiation Technology Centre of the Ghana Atomic Energy Commission are presented. The Fricke dosemeter was used for calibrating the gamma field of the gammacell-220. The Fricke system and the gammacell-220 were then used to calibrate the ethanol chlorobenzene (ECB) dosemeter. The Fricke and ECB dosemeter systems have become routine dosemeters at the centre. Dosimetry work has covered a wide range of research specimens and pilot scale products to establish the relevant irradiation protocol and parameters for routine treatment. These include yams, pineapple explants, blood for feeding tsetseflies, cocoa bud wood and cassava sticks. Pilot scale dosimetry studies on maize, medical devices like intravenous infusion sets and surgical gauze have also been completed. The results and observations made on some of these products are reported. (author). 4 refs., 5 figs

  4. Canadian Irradiation Centre

    International Nuclear Information System (INIS)

    1987-05-01

    The Canadian Irradiation Centre is a non-profit cooperative project between Atomic Energy of Canada Limited, Radiochemical Company and Universite du Quebec, Institut Armand-Frappier, Centre for Applied Research in Food Science. The Centre's objectives are to develop, demonstrate and promote Canada's radiation processing technology and its applications by conducting applied research; training technical, professional and scientific personnel; educating industry and government; demonstrating operational and scientific procedures; developing processing procedures and standards, and performing product and market acceptance trials. This pamphlet outlines the history of radoation technology and the services offered by the Canadian Irradiation Centre

  5. Trends and Weekly Cycles in a Large Swiss Emergency Centre: A 10 Year Period at the University Hospital of Bern

    Directory of Open Access Journals (Sweden)

    Christian T. Braun

    2017-10-01

    Full Text Available Popular demand for high quality care has increased in recent years. This is also the case for medical services and support at all times of the day and night is nowadays required. During the last ten years, there has been a marked increase in the demands on hospital emergency hospitals, particularly in the Western industrialized countries. The present retrospective study investigates how the demands on a large Swiss university centre have changed over a period of 10 years. Patient numbers are differentiated by age, gender, nationality, weekday and mode of referral. A retrospective analysis was performed of the data of the patients admitted to the Emergency Centre of Bern University Medical Hospital (Inselspital during the ten-year period from 2004 up to and including 2013 and who were treated as emergencies. A total of 264,272 patients were included in the study. It was shown that there was an uninterrupted annual increase from 23,555 patients in 2004 to 34,918 patients in 2013 (+48%. Most patients came to the Emergency Centre on Mondays, followed by Fridays. Because of the marked increase in life expectancy and the resulting demographic changes, there has been a marked increase in the number of older patients coming to the Emergency Centre for acute medical care. It was found that there were disproportionately high numbers of patients aged 20 to 49 years who were not Swiss citizens. In contrast, most patients over 60 were Swiss. In the coming years, emergency centres will have to adapt to the continued increase in patient numbers. This trend will continue, so that it is essential to consider the sociodemographic structure of a region when planning the availability of emergency medical care.

  6. Effects of combined healthy lifestyle factors on functional vascular aging: the Rotterdam Study.

    Science.gov (United States)

    Karimi, Leila; Mattace-Raso, Francesco U S; van Rosmalen, Joost; van Rooij, Frank; Hofman, Albert; Franco, Oscar H

    2016-05-01

    To evaluate whether components of a healthy lifestyle, combined and individually, are associated with arterial stiffness as a marker of functional vascular aging. We included 3235 participants aged 61-96 years from the Rotterdam Study. Measures of arterial stiffness included: aortic pulse wave velocity and carotid distensibility coefficient. Participants were scored one point for each of healthy lifestyle factors: consumption of five or more of fruits and/or vegetables per day, 75 min or more vigorous physical activity per week, 18.5 ≤ BMI ≤ 24. 9, never smoked and light-to-moderate alcohol intake (maximum seven glasses for women and 14 glasses for men) per week. Also a combined score (0-5) was computed by adding the five factors. Linear regression analysis was used to evaluate the association of healthy lifestyle and measures of arterial stiffness adjusting for confounders. Participants had -0.113 [95% confidence interval (CI): -0.196, -0.029] difference in mean aortic pulse wave velocity m/s per unit increment of the lifestyle factors score, independent of cardiovascular risk factors. Higher fruit and vegetable consumption -0.221 (95% CI: -0.409, -0.034) and physical activity -0.239 (95% CI: -0.433, -0.044) were also significantly associated with reduced aortic pulse wave velocity. The corresponding estimates in carotid distensibility coefficient lacked statistical significance when we adjusted for cardiovascular risk factors. Combining multiple healthy lifestyle factors is associated with reduced aortic stiffness, a measure of functional vascular aging and independent of cardiovascular risk factors.

  7. CMS Centre at CERN

    CERN Multimedia

    2007-01-01

    A new "CMS Centre" is being established on the CERN Meyrin site by the CMS collaboration. It will be a focal point for communications, where physicists will work together on data quality monitoring, detector calibration, offline analysis of physics events, and CMS computing operations. Construction of the CMS Centre begins in the historic Proton Synchrotron (PS) control room. The historic Proton Synchrotron (PS) control room, Opened by Niels Bohr in 1960, will be reused by CMS to built its control centre. TThe LHC@FNAL Centre, in operation at Fermilab in the US, will work very closely with the CMS Centre, as well as the CERN Control Centre. (Photo Fermilab)The historic Proton Synchrotron (PS) control room is about to start a new life. Opened by Niels Bohr in 1960, the room will be reused by CMS to built its control centre. When finished, it will resemble the CERN Contro...

  8. Human-centred Governance

    DEFF Research Database (Denmark)

    Bason, Christian

    2017-01-01

    Design approaches are now being applied all over the world as a powerful approach to innovating public policies and services. Christian Bason, author of Leading public design: Discovering human-centred governance, argues that by bringing design methods into play, public managers can lead change...... with citizens at the centre, and discover a new model for steering public organisations: human-centred governance....

  9. Treatment of prolonged convulsive seizures in children; a single centre, retrospective, observational study

    NARCIS (Netherlands)

    Vlaskamp, Danique R. M.; Brouwer, Oebele F.; Callenbach, Petra M. C.

    2014-01-01

    Objectives: To evaluate treatment of children with Prolonged Convulsive Seizures (PCS) at the University Medical Centre Groningen (UMCG). Material and methods: PCS were identified from an UMCG database of children with epilepsy aged = 10 mm and occurred between January 2000 and October 2012 in

  10. Closing the gender leadership gap: a multi-centre cross-country comparison of women in management and leadership in academic health centres in the European Union.

    Science.gov (United States)

    Kuhlmann, Ellen; Ovseiko, Pavel V; Kurmeyer, Christine; Gutiérrez-Lobos, Karin; Steinböck, Sandra; von Knorring, Mia; Buchan, Alastair M; Brommels, Mats

    2017-01-06

    Women's participation in medicine and the need for gender equality in healthcare are increasingly recognised, yet little attention is paid to leadership and management positions in large publicly funded academic health centres. This study illustrates such a need, taking the case of four large European centres: Charité - Universitätsmedizin Berlin (Germany), Karolinska Institutet (Sweden), Medizinische Universität Wien (Austria), and Oxford Academic Health Science Centre (United Kingdom). The percentage of female medical students and doctors in all four countries is now well within the 40-60% gender balance zone. Women are less well represented among specialists and remain significantly under-represented among senior doctors and full professors. All four centres have made progress in closing the gender leadership gap on boards and other top-level decision-making bodies, but a gender leadership gap remains relevant. The level of achieved gender balance varies significantly between the centres and largely mirrors country-specific welfare state models, with more equal gender relations in Sweden than in the other countries. Notably, there are also similar trends across countries and centres: gender inequality is stronger within academic enterprises than within hospital enterprises and stronger in middle management than at the top level. These novel findings reveal fissures in the 'glass ceiling' effects at top-level management, while the barriers for women shift to middle-level management and remain strong in academic positions. The uneven shifts in the leadership gap are highly relevant and have policy implications. Setting gender balance objectives exclusively for top-level decision-making bodies may not effectively promote a wider goal of gender equality. Academic health centres should pay greater attention to gender equality as an issue of organisational performance and good leadership at all levels of management, with particular attention to academic enterprises

  11. Report on Greece. Establishment of an atomic centre

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1959-07-15

    the IAEA to provide them with four experts. One of these experts - a specialist in health physics - will assist the Greek AEC in organizing a health physics department and a central radiation safety service and in preparing a health hazards report for the Greek research reactor. Another expert will be concerned with the medical applications of radioisotopes, particularly in the clinical research field. Routine diagnostic and therapeutic radioisotope services have already been established at the Alexandra Hospital, and the time has come for extending the work to include clinical research on diseases which are common in Greece. The advice of a third expert will be available mainly in connexion with the research programme of the Greek reactor. The fourth expert will advise the Greek AEC on the setting up of the biological laboratory of the Greek Nuclear Centre; he will also assist in developing a work programme and take part in actual research work. The IAEA Board also approved a Greek request for the supply of a small amount of equipment, essential for the work of the experts. Besides, the first medical research contract to be given by IAEA was placed with the Department of Clinical Therapeutics of Athens University for work on the diagnosis of certain diseases with the aid of radioisotopes

  12. Report on Greece. Establishment of an atomic centre

    International Nuclear Information System (INIS)

    1959-01-01

    the IAEA to provide them with four experts. One of these experts - a specialist in health physics - will assist the Greek AEC in organizing a health physics department and a central radiation safety service and in preparing a health hazards report for the Greek research reactor. Another expert will be concerned with the medical applications of radioisotopes, particularly in the clinical research field. Routine diagnostic and therapeutic radioisotope services have already been established at the Alexandra Hospital, and the time has come for extending the work to include clinical research on diseases which are common in Greece. The advice of a third expert will be available mainly in connexion with the research programme of the Greek reactor. The fourth expert will advise the Greek AEC on the setting up of the biological laboratory of the Greek Nuclear Centre; he will also assist in developing a work programme and take part in actual research work. The IAEA Board also approved a Greek request for the supply of a small amount of equipment, essential for the work of the experts. Besides, the first medical research contract to be given by IAEA was placed with the Department of Clinical Therapeutics of Athens University for work on the diagnosis of certain diseases with the aid of radioisotopes

  13. Educating medical students for work in culturally diverse societies.

    Science.gov (United States)

    Loudon, R F; Anderson, P M; Gill, P S; Greenfield, S M

    1999-09-01

    Recent attention has focused on whether government health service institutions, particularly in the United Kingdom, reflect cultural sensitivity and competence and whether medical students receive proper guidance in this area. To systematically identify educational programs for medical students on cultural diversity, in particular, racial and ethnic diversity. The following databases were searched: MEDLINE (1963-August 1998); Bath International Data Service (BIDS) Institute for Scientific Information science and social science citation indexes (1981-August 1998); BIDS International Bibliography for the Social Sciences (1981-August 1998); and the Educational Resources Information Centre (1981-August 1998). In addition, the following online data sets were searched: Kings Fund; Centre for Ethnic Relations, University of Warwick; Health Education Authority; European Research Centre on Migration and Ethnic Relations, University of Utrecht; International Centre for Intercultural Studies, University of London; the Refugee Studies Programme, University of Oxford. Medical education and academic medicine journals (1994-1998) were searched manually and experts in medical education were contacted. Studies included in the analysis were articles published in English before August 1998 that described specific programs for medical students on racial and ethnic diversity. Of 1456 studies identified by the literature search, 17 met the criteria. Two of the authors performed the study selection independently. The following data were extracted: publication year, program setting, student year, whether a program was required or optional, the teaching staff and involvement of minority racial and ethnic communities, program length, content and teaching methods, student assessment, and nature of program evaluation. Of the 17 selected programs, 13 were conducted in North America. Eleven programs were exclusively for students in years 1 or 2. Fewer than half (n = 7) the programs were part of

  14. Physical activity types and life expectancy with and without cardiovascular disease: the Rotterdam Study.

    Science.gov (United States)

    Dhana, Klodian; Koolhaas, Chantal M; Berghout, Mathilde A; Peeters, Anna; Ikram, M Arfan; Tiemeier, Henning; Hofman, Albert; Nusselder, Wilma; Franco, Oscar H

    2017-12-01

    We aimed to determine the contribution of specific physical activity (PA) types (i.e. walking, cycling, domestic work, sports and gardening) on total life expectancy (LE) and LE with and without cardiovascular disease (CVD). We constructed multistate life tables to calculate the effects of total PA and PA types on LE, among individuals older than 55 years from the Rotterdam Study. For the life table calculations, we used sex-specific prevalences, incident rates and hazard ratios for three transitions (healthy-to-CVD, healthy-to-death and CVD-to-death) by levels of PA and adjusted for confounders. High total PA was associated with gains in total and CVD-free LE. High cycling contributed to higher total LE in men (3.7 years) and women (2.1 years) and higher LE without CVD in men (3.1 years) and women (2.4 years). Total and CVD-free LE were increased by high domestic work in women (2.6 and 2.4 years, respectively) and high gardening in men (2.7 and 2.0 years, respectively). Higher PA levels are associated with increased LE and more years lived without CVD. Of the different PA types, cycling provided high effects in both men and women. Cycling could be more strongly encouraged in activity guidelines to maximize the population benefits of PA. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  15. The South African National Accelerator Centre and its research programme

    Energy Technology Data Exchange (ETDEWEB)

    Watanabe, Y. [Kyushu Univ., Fukuoka (Japan)

    1997-03-01

    An overview of the South African National Accelerator Centre and its research activities is given with emphasis on medium energy nuclear physics and nuclear data measurements for medical use. Also presented is a preliminary result of {sup 40}Ca(p,p`x) spectrum measurement for 392 MeV which has been carried out at RCNP, Osaka University, under the South Africa-Japan collaborative programme. (author)

  16. Developments in the instruction of biostatistics at the Kuwait University Health Science Centre in a decade.

    Science.gov (United States)

    Moussa, Mohamed A A

    2002-01-01

    Kuwait has witnessed many changes that influenced, among other things, the structure of medical education including biostatistics. This article describes the developments in biostatistics instruction and curriculum in the Health Science Centre, University of Kuwait, during the past 10 years. Instead of teaching biostatistics as an independent component, the university has developed an integrated course (35 hr of lectures and 12 hr of tutorial sessions) of biostatistics, epidemiology, and demography that is taught to undergraduate medical and dentistry students to ensure interdisciplinary interaction, to remove redundancies, and to standardize terminology across the three disciplines. The core curriculum of the biostatistics course is compatible with the recommendations of the American Statistical Association. Separate biostatistics courses are also offered to pharmacy and allied health students to address their diverse interests. In addition, new biostatistics and computer applications instruction courses were developed and are taught to the students of the Master of Science (MSc), Master of Public Health (MPH), and PhD programs. For continuing medical education, a workshop on biostatistics and computer applications is organized annually for the medical profession as a collaboration between the Health Science Centre and the Kuwait Institute for Medical Specialization. The instructor and curriculum content of the biostatistics courses are confidentially evaluated and independently analyzed by the office of the Vice Dean for Academic Affairs. Overall, students evaluate the biostatistics instructors highly and are pleased with the content of the biostatistics curriculum. During the last decade, biostatistics instruction in the Kuwait Health Science Centre had many new developments. An integrated course on biostatistics, epidemiology, and demography was developed with emphasis on problem solving and small group learning. Another biostatistics course is offered to the

  17. Physician-staffed emergency helicopter reduces transportation time from alarm call to highly specialized centre

    DEFF Research Database (Denmark)

    Fjaeldstad, A.

    2013-01-01

    INTRODUCTION: Since 2007, the number of Danish emergency departments has decreased from 44 to 21. Longer distances to specialized treatment have increased the demand for advanced prehospital treatment. A Danish 24/7 Helicopter Emergency Medical System (HEMS) project in western Denmark was initiated......-to-centre) for patients with ST-elevation myocardial infarction (STEMI) or severe injury (Injury Severity Score > 15). MATERIAL AND METHODS: In this prospective study with a matched historical control group, the time-to-doctor and the time-to-centre for patients with STEMI or severe injury transported by HEMS were...

  18. Authorship issues in multi-centre clinical trials: the importance of making an authorship contract.

    Science.gov (United States)

    Rosenberg, Jacob; Burcharth, Jakob; Pommergaard, Hans-Christian; Vinther, Siri

    2015-02-01

    Discussions about authorship often arise in multi-centre clinical trials. Such trials may involve up to hundreds of contributors of whom some will eventually co-author the final publication. It is, however, often impossible to involve all contributors in the manuscript process sufficiently for them to qualify for authorship as defined by the International Committee of Medical Journal Editors. Therefore, rules for authorship in multi-centre trials are strongly recommended. We propose two contracts to prevent conflicts regarding authorship; both are freely available for use without pay but with reference to the original source.

  19. Medical complications and outcomes at an onsite rehabilitation unit for older people.

    LENUS (Irish Health Repository)

    Mulroy, M

    2013-09-01

    The rehabilitation of older patients in Ireland after an acute medical event occurs at dedicated onsite hospital units or at offsite centres. Information on medical complications and outcomes is inadequate.

  20. Determination of medical education environment in Punjab private and public medical colleges affiliated with University of Health Sciences, Lahore-Pakistan.

    Science.gov (United States)

    Khan, Junaid Sarfraz; Tabasum, Saima; Yousafzai, Usman Khalil

    2009-01-01

    The main purpose of this study was to identify differences, if any, in the Medical Education Climate between the Private and Public Medical Colleges in the Province of Punjab affiliated with the University of Health Sciences, Lahore and to gather recommendations from students on measures that need to be taken to improve the environment. This Mixed Quantitative and Qualitative Prospective Study was conducted in 2008. The population of the study consisted of 1612 MBBS Final Year Medical Students of both Private and Public Medical Colleges. Stratified Random Sampling was done to ensure representation of both Sectors. Dundee Ready Education Environment Measure (DREEM) was used to assimilate Quantitative Data and a Questionnaire consisting of 10 items was used to accumulate Qualitative Data. To analyse Quantitative Data, t-test and Chi-square tests were used. Common themes were identified in the Qualitative Data. All the SIX Research Hypotheses were rejected and Null Hypotheses were upheld. Analysis of Qualitative Data indicated a number of Examination, Curriculum, Teaching Methodology, Teacher and Peer related Stressors without discrimination in students of both Private and Public Sectors. Solutions by students focused on improving co-ordination between Institutions and University of Health Sciences as well as developing and delivering Clinically-Centred, Community-Oriented and Problem-Based Education through development of appropriate Teaching Methodologies. Even though there is no difference in the Medical Education Climate between the Private and Public Medical Education Sectors, the Environment is less than Ideal. However, this can be improved through shifting the onus of Education from Teacher-Centred Didactic Approach to a more Student-Centred Self-Learning Strategy. In this paradigm shift the UHS, Lahore needs to play a pivotal role in order to effectively train the Trainers and standardise this change throughout Punjab.

  1. Assessing communication skills of clinical call handlers working at an out-of-hours centre: development of the RICE rating scale.

    Science.gov (United States)

    Derkx, Hay P; Rethans, Jan-Joost E; Knottnerus, J André; Ram, Paul M

    2007-05-01

    Out-of-hours centres provide telephone support to patients with medical problems. In most of these centres specially-trained nurses handle incoming telephone calls. They assess patients' needs, the degree of urgency, and determine the level of care required. Assessment of the medical problem and the quality of 'care-by-phone' depend on the medical and communication skills of the call handlers. To develop a valid, reliable, and practical rating scale to evaluate the communication skills of call handlers working at an out-of-hours centre and to improve quality of communication. Qualitative study with focus groups followed by validation of the rating scale and measurement of reliability (internal consistency). Out-of-hours centres in the Netherlands. A focus group developed the rating scale. Experts with experience in training and evaluating communication skills of medical students and GPs commented on the scale to ensure content validity. The reliability of the rating scale was tested in a pilot in which ten specially-trained assessors scored six telephone calls each. The scale, known as the RICE rating scale, has 17 items divided over four different phases of the telephone consultation: Reason for calling; Information gathering; Conclusion; and Evaluation (RICE). Content validity of the scale was assessed by two experts. Reliability of the scale tested in the pilot was 0.73 (Cronbach's alpha). Establishing a rating scale to assess the communication skills of call handlers which meets common scientific demands, such as content validity and reliability, proved successful. This instrument can be used to give feedback to call handlers.

  2. Vitamin D status and metabolic syndrome in the elderly: the Rotterdam Study.

    Science.gov (United States)

    Vitezova, A; Zillikens, M C; van Herpt, T T W; Sijbrands, E J G; Hofman, A; Uitterlinden, A G; Franco, O H; Kiefte-de Jong, J C

    2015-03-01

    The effects of vitamin D in the elderly are inconsistent. The aim of this study was to evaluate the association between vitamin D status and the metabolic syndrome (MetS) in the elderly, as well as between vitamin D status and the components of MetS (i.e. serum glucose, triglycerides (TG), HDL cholesterol (HDL-C), waist circumference (WC), and blood pressure (BP)). The study was embedded in the Rotterdam Study, a population-based cohort of middle-aged and elderly adults. We analyzed data from 3240 people (median age 71.2 years) who did not have type 2 diabetes mellitus at baseline. We found higher 25-hydroxyvitamin D (25(OH)D) concentrations associated with lower prevalence of MetS (odds ratio (OR); 95% CI: 0.61; 0.49, 0.77 for adequate levels (≥75  nmol/l) vs deficiency (vitamin D levels were: 0.66 (95% CI 0.53, 0.83) for elevated WC, 0.67 (95% CI 0.52, 0.86) for reduced HDL-C, 0.69 (95% CI 0.54, 0.88) for elevated TG, and 0.80 (95% CI 0.65, 0.99) for elevated fasting glucose. Vitamin D was not associated with elevated blood pressure, and ORs for adequacy vs deficiency were 0.82 (95% CI 0.65, 1.03). Higher 25(OH)D concentrations in the elderly are associated with lower prevalence of MetS and, in particular, with more beneficial HDL-C, TG, WC, and serum glucose. Since the prevalence of vitamin D deficiency is common worldwide and its risk increases with age, if causality is proven, benefits of improving vitamin D status among the elderly may be great. © 2015 European Society of Endocrinology.

  3. Spinal injuries admitted at the Federal Medical Centre, Umuahia ...

    African Journals Online (AJOL)

    The treatment was mostly conservative . The most frequent complication were bowel dysfunction, urinary bladder dysfunction , urinary tract infection and pressure ulcers. Ten (20.4%) walked without support, 9(18.4%) discharged against medical advice and 4(8.2%) were discharged on wheel chair. Twenty-two (44.9%) were ...

  4. Validation of core medical knowledge by postgraduates and specialists.

    NARCIS (Netherlands)

    Koens, F.; Rademakers, J.J.; Cate, O.T.J. ten

    2005-01-01

    BACKGROUND: Curriculum constructors and teachers must decide on the content and level of objectives and materials included in the medical curriculum. At University Medical Centre Utrecht it was decided to test relatively detailed knowledge at a regular level in study blocks and to design a progress

  5. A Study on the Socio demographic Profile of the Attendees at the Integrated Counseling and Testing Centre of Institute of Medical Sciences BHU, Varanasi, Uttar Pradesh

    Directory of Open Access Journals (Sweden)

    Rashmi Kumari

    2016-03-01

    Full Text Available Introduction: Human Immunodeficiency Virus (HIV counseling and testing services are a key entry point to the prevention of HIV infection and to the treatment and care of the people who are infected with HIV. The Integrated Counseling and Testing Centre (ICTC services are a cost effective intervention in the prevention of HIV/AIDS.Aims: To study the socio demographic characteristics of the attendees at the ICTC centre.Material and Methods: Setting – ICTC of Institutes of Medical Sciences BHU, Varanasi, Study Design: A cross-sectional, record based study, Study duration: The study population included 41159 clients who attended the ICTC centres from January 2009 to December 2011.Results: An overall 12.85% of the ICTC attendees were HIV Seropositive subjects. During 2009 to 2011. i.e. during past 3 years total males tested for HIV at the ICTC were 23326, out of which 3202 were HIV+ve showing positivity rate of 13.7%, while total females tested were 16671 out of which 2063 were HIV+ve showing positivity rate of about 12.4%. Consecutively in the last three years maximum load of patients was from the age groups 35-49 years (19.13% followed by 25-34 years (15.4%.Conclusion: People’s attitudes towards HIV are changing after the introduction of the ICTC, which plays a major role in the primary and secondary prevention of HIV. There is a more urgent need for the introduction of interventional measures like sex education and preventive education among the general population

  6. Experience with a bone bank operation and allograft bone infection in recipients at a medical centre in southern Taiwan.

    Science.gov (United States)

    Liu, J W; Chao, L H; Su, L H; Wang, J W; Wang, C J

    2002-04-01

    To assess the contamination rate of allograft bones at retrieval and the infection rate of the implanted allograft bone, we audited a bone bank retrospectively and reviewed the medical charts of allograft bone recipients between June 1999 and June 2000 at a medical centre in southern Taiwan. The bone bank did its utmost to minimize allograft contamination with hospital-acquired pathogens by adopting purposefully designed criteria for selection of donors. This protocol included sterilization with soaking of the retrieved allograft in a solution of a first-generation cephalosporin before storage and prophylaxis in recipients with first-generation cephalosporin. The contamination rates at allograft retrieval from living and cadaveric donors were 2.7% and 12.4%, respectively (P<0.001). Culture of 262 specimens taken at allograft implant revealed 12 (4.6%) positive for culture. Of the 12 patients implanted with allograft bones positive for culture, nine (75.0%) had allograft bone infection, while three (25.0%) did not. Among the 250 recipients with sterile allograft bones, four (1.6%) were found to have allograft infection. None of the cases of infection required removal of the allograft bones, and all cases were successfully treated with tailored antimicrobial therapy based on susceptibility tests on isolated bacteria. The overall infection rate was 5.0%, which compared favourably with those in other series. A prospective cohort study is needed to determine which of the varied sterilization methodologies gives the best and/or most cost-effective outcome. Copyright 2002 The Hospital Infection Society.

  7. Identifying potentially cost effective chronic care programs for people with COPD

    Directory of Open Access Journals (Sweden)

    L M G Steuten

    2008-12-01

    Full Text Available L M G Steuten1, K M M Lemmens2, A P Nieboer2, H JM Vrijhoef31Maastricht University Medical Centre, School for Care and Public Health Research, Department of Health, Organisation, Policy and Economics, Maastricht, The Netherlands; 2Erasmus University Medical Centre, Institute of Health Policy and Management, Rotterdam, The Netherlands; 3Maastricht University Medical Centre, School for Care and Public Health Research, Department of Integrated Care, Maastricht, The NetherlandsObjective: To review published evidence regarding the cost effectiveness of multi-component COPD programs and to illustrate how potentially cost effective programs can be identified.Methods: Systematic search of Medline and Cochrane databases for evaluations of multi-component disease management or chronic care programs for adults with COPD, describing process, intermediate, and end results of care. Data were independently extracted by two reviewers and descriptively summarized.Results: Twenty articles describing 17 unique COPD programs were included. There is little evidence for significant improvements in process and intermediate outcomes, except for increased provision of patient self-management education and improved disease-specific knowledge. Overall, the COPD programs generate end results equivalent to usual care, but programs containing ≥3 components show lower relative risks for hospitalization. There is limited scope for programs to break-even or save money.Conclusion: Identifying cost effective multi-component COPD programs remains a challenge due to scarce methodologically sound studies that demonstrate significant improvements on process, intermediate and end results of care. Estimations of potential cost effectiveness of specific programs illustrated in this paper can, in the absence of ‘perfect data’, support timely decision-making regarding these programs. Nevertheless, well-designed health economic studies are needed to decrease the current decision

  8. Classification of Cortical Brain Malformations

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2008-03-01

    Full Text Available Clinical, radiological, and genetic classifications of 113 cases of malformations of cortical development (MCD were evaluated at the Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, the Netherlands.

  9. RTEMS Centre - Support and Maintenance Centre to RTEMS Operating System

    Science.gov (United States)

    Silva, H.; Constantino, A.; Freitas, D.; Coutinho, M.; Faustino, S.; Mota, M.; Colaço, P.; Sousa, J.; Dias, L.; Damjanovic, B.; Zulianello, M.; Rufino, J.

    2009-05-01

    RTEMS CENTRE - Support and Maintenance Centre to RTEMS Operating System is a joint ESA/Portuguese Task Force initiative to develop a support and maintenance centre to the Real-Time Executive for Multiprocessor Systems (RTEMS). This paper gives a high level visibility of the progress, the results obtained and the future work in the RTEMS CENTRE [6] and in the RTEMS Improvement [7] projects. RTEMS CENTRE started officially in November 2006, with the RTEMS 4.6.99.2 version. A full analysis of RTEMS operating system was produced. The architecture was analysed in terms of conceptual, organizational and operational concepts. The original objectives [1] of the centre were primarily to create and maintain technical expertise and competences in this RTOS, to develop a website to provide the European Space Community an entry point for obtaining support (http://rtemscentre.edisoft.pt), to design, develop, maintain and integrate some RTEMS support tools (Timeline Tool, Configuration and Management Tools), to maintain flight libraries and Board Support Packages, to develop a strong relationship with the World RTEMS Community and finally to produce some considerations in ARINC-653, DO-178B and ECSS E-40 standards. RTEMS Improvement is the continuation of the RTEMS CENTRE. Currently the RTEMS, version 4.8.0, is being facilitated for a future qualification. In this work, the validation material is being produced following the Galileo Software Standards Development Assurance Level B [5]. RTEMS is being completely tested, errors analysed, dead and deactivated code removed and tests produced to achieve 100% statement and decision coverage of source code [2]. The SW to exploit the LEON Memory Management Unit (MMU) hardware will be also added. A brief description of the expected implementations will be given.

  10. Medical, psychological and social features in a large cohort of adults with Prader-Willi syndrome: experience from a dedicated centre in France.

    Science.gov (United States)

    Laurier, V; Lapeyrade, A; Copet, P; Demeer, G; Silvie, M; Bieth, E; Coupaye, M; Poitou, C; Lorenzini, F; Labrousse, F; Molinas, C; Tauber, M; Thuilleaux, D; Jauregi, J

    2015-05-01

    Prader-Willi syndrome (PWS) is a developmental genetic disorder characterised by a variable expression of medical, cognitive and behavioural symptoms. In adulthood, the prevalence and severity of these symptoms determine the quality of life of the affected persons. Because of their rare disease condition, data on health and social problems in adults with PWS are scarce. In this research, we present medical, psychological and social features of a large cohort of adults admitted to a specialised PWS centre in France and analyse the differences according to genotype, gender and age. Data from 154 patients (68 men/86 women), with a median age of 27 years (range 16-54), were collected during their stay in our centre. Clinical histories were completed using information from parents or main caregivers, and the same medical team performed the diagnosis of different clinical conditions. Statistical analyses were performed to determine the influence of factors such as genotype, age or gender. Paternal deletion genotype was the most frequent (65%) at all ages. Most patients had mild or moderate intellectual disability (87%). Only 30% had studied beyond primary school and 70% were in some special educational or working programme. Most of them lived in the family home (57%). The most prevalent somatic comorbidities were scoliosis (78%), respiratory problems (75%), dermatological lesions (50%), hyperlipidaemia (35%), hypothyroidism (26%), Type 2 diabetes mellitus (25%) and lymph oedema (22%). Some form of psychotropic treatment was prescribed in 58% of subjects, and sex hormones in 43%. Patients with deletion had a higher body mass index (44 vs. 38.9 kg/m(2)) and displayed higher frequency of sleep apnoeas. Non-deletion patients received insulin treatment (19% vs. 4%) and antipsychotic treatment (54.8% vs. 32.7%) more frequently. No difference was observed in the prevalence of Type 2 diabetes between the two genotype groups. Patients >27 years of age had a higher rate of

  11. Medical radiation physics in Bulgaria

    International Nuclear Information System (INIS)

    Todorov, V.; Vasileva, G.

    1999-01-01

    In Bulgaria medical radiation physics in not yet on a world level. The number of medical physicists working in diagnostic and therapeutic centres is low. Comparatively good is the situation of medical physics in the areas of therapy and radiation protection. But the role of physics in medicine is underestimated as a whole, because of subjective reasons. At the other hand the education in this area is good and very professional. Since 1992 there has been established a specialty 'medical physics' in University of Shoumen and since 1997 the same specialty exists in Sofia University. The situation is expected to be approved with reorganization of the Health System in Bulgaria with compliance with the European standards

  12. Sudan Journal of Medical Sciences

    African Journals Online (AJOL)

    Sudan JMS is a joint project of continuous medical education program at Faculty of Medicine - Omdurman Islamic University, The National Centre for Gastroenterology and Liver Diseases, Ibn Sina Hospital and Omdurman teaching Hospital (Sudan). Sudan JMS is published every three months. High-quality papers written ...

  13. Nuclear research centres in the 21st century: An AECL perspective

    International Nuclear Information System (INIS)

    Fehrenbach, P.J.

    2001-01-01

    The nuclear energy programme of Canada started at Chalk River Laboratories with the setting up of Zero Energy Experimental Site in 1945. One of the early research reactors of Canada, the National Research Universal (NRU) continues to provide 70% of the world requirement of isotopes for medical and industrial applications. A CANDU prototype (208 MW(e)) came on line in 1967 and based on this concept, Canada has a large nuclear power programme. The role of nuclear research centres has evolved with time starting with strategic research in the initial phases through to implementation of technology, building and supporting industry, and carrying out advanced technology development. Most of these centres have important assets in terms of licensed sites, trained personnel, research reactors, shielded facilities and expertise for handling large quantities of radioactivity and high tech laboratories for advanced R and D. These centres would, therefore, continue to play an important role in emission free and economic energy generation, nuclear medicine, food irradiation and industrial applications. Nuclear research centres in different countries are at various stages of development and have many unique features. However, there are generic issues and much will be gained by developing a shared vision for the future and implementing programmes in a collaborative manner. (author)

  14. Perceptions of patient-centred care at public hospitals in Nelson Mandela Bay

    Directory of Open Access Journals (Sweden)

    Sihaam Jardien-Baboo

    2016-10-01

    Full Text Available In South Africa, the quality of health care is directly related to the concept of patient-centred care and the enactment of the Batho Pele Principles and the Patients' Rights Charter. Reports in the media indicate that public hospitals in the Eastern Cape Province are on the brink of collapse, with many patients being treated in condemned hospitals which lacked piped water, electricity and essential medical equipment. Receiving quality care, and principally patient-centred care, in the face of such challenges is unlikely and consequently leads to the following question: “Are patients receiving patient-centred care in public hospitals?” A qualitative, explorative, descriptive and contextual study was conducted to explore and describe the perceptions of professional nurses regarding patient-centred care in public hospitals in Nelson Mandela Bay. Semi-structured interviews were conducted with a total of 40 purposively selected professional nurses working in public hospitals in Nelson Mandela Bay, Eastern Cape Province. Interviews were analysed according to the method described by Tesch in Creswell (2009:192. Professional nurses perceive patient-centred care as an awareness of the importance of the patient's culture, involving the patient's family, incorporating values of love and respect, optimal communication in all facets of patient care and accountability to the patient. Factors which enable patient-centred care were a positive work environment for staff, nursing manager's demonstrating exemplary professional leadership, continuous in service education for staff and collaborative teamwork within the interdisciplinary team. Barriers to patient-centred care were a lack of adequate resources, increased administrative work due to fear of litigation and unprofessional behaviour of nursing staff.

  15. Medical management and planning for radiation emergencies

    International Nuclear Information System (INIS)

    Bongirwar, P.R.

    2001-01-01

    Radiation Emergencies which result as a consequence of nuclear or radiological accidents can produce a spectrum of different types of radiation injuries which could include cases of whole body irradiation causing Acute Radiation Syndrome, partial body irradiation, radiation burns (localized irradiation), radioactive contamination and combined injuries having component of conventional injuries. General principles of managing these cases entail doing triage, offering immediate emergency care and instituting definitive treatment. Infra-structural facilities which are required to facilitate their management include first aid post at plant site, personnel decontamination centre, site clinic and specialized hospital which can offer comprehensive investigational and treatment modalities. Training of medical and paramedical personnel is crucial as part of emergency preparedness programme and if needed, help can be sought from WHO's Radiation Emergency Medical Preparedness and Assistance Network Centres. (author)

  16. The Search for Centre

    Science.gov (United States)

    Nunes, April

    2006-01-01

    This paper acknowledges the importance of a dancer's centre but likewise highlights the problematic nature of the communication of this concept from dance teacher to student. After a brief introduction of orthodox approaches in finding centre, this paper suggests a method of locating centre through the ancient somatic technique.

  17. Patient monitoring in Polish assisted reproductive technology centres

    Directory of Open Access Journals (Sweden)

    Anna Krawczak

    2016-12-01

    Full Text Available In 2014, the Polish non-governmental patient association ‘Our Stork’ (Nasz Bocian introduced the ‘Patient monitoring in ART centres’ research project to gather previously unrecorded information on the situation of infertile people and the provision of assisted reproductive treatment in Poland. When the research project began, assisted reproductive treatment centres were unregulated by the state, a situation that had existed for more than 28 years following the birth of the first Polish test-tube baby in 1987. Patients signed civil contracts, remaining unprotected in terms of safety of treatment and recognition of their rights, and their presumed social position was described by doctors as ‘disciplined patients’ – a reflection of what Michele Foucault described as biopolitics. The research project comprised patient questionnaires (responses from 722 patients provided the basis for the document ‘Patient Recommendations in Infertility Treatment’, analysis of civil contracts and their accuracy in the context of patients’ legal rights in Poland, and in-depth interviews with assisted reproductive treatment centres’ owners, doctors, midwives, and patients to explore patient care. The data reveal that there is a lack of patient-centred care among doctors and medical staff in Poland and that following the passing into law of the 2015 Infertility Act, which introduced state regulation of assisted reproductive treatment centres, the situation for patients worsened.

  18. Psychotropic Medication Refusal: Reasons and Patients′ Perception at a Secure Forensic Psychiatric Treatment Centre

    Directory of Open Access Journals (Sweden)

    Olajide O Adelugba

    2016-01-01

    Full Text Available Poor adherence to prescribed medication regimens can undermine the effectiveness of medications. This study was conducted to determine the demographic profile of forensic psychiatric inpatients refusing medications and to identify the reasons for refusal. Data were collected through interviews using a questionnaire including Drug Attitude Inventory-10. Medication refusal was more common among Aboriginals (68%, n = 34 than Caucasians (32%, n = 16 and was highest among the patients 21-30 years of age (44%, n = 22. Antisocial personality disorder and substance use disorder featured prominently among patients refusing medications. The main reasons for medication refusal were inconvenience (34%, n = 17 followed by side effects (22%, n = 11, ineffective medication (20%, n = 10, illness-related (16%, n = 8, and no reasons (8%, n = 6. Antipsychotic medications topped the list of the major classes of medications refused followed by Antidepressants and Mood Stabilizers.

  19. A comparative study of medication use after stroke in four countries.

    Science.gov (United States)

    Desmaele, Sara; Putman, Koen; De Wit, Liesbet; Dejaeger, Eddy; Gantenbein, Andreas R; Schupp, Wilfried; Steurbaut, Stephane; Dupont, Alain G; De Paepe, Kristien

    2016-09-01

    The use of medication plays an important role in secondary stroke prevention and treatment of post-stroke comorbidities. The Collaborative Evaluation of Rehabilitation in Stroke across Europe (CERISE) was set up to investigate the inpatient stroke rehabilitation process in four centres, each in a different European country: Belgium, Germany, United Kingdom and Switzerland. Patients' medication use 5 years post-stroke was compared between countries. Focus was put on cerebrovascular secondary prevention, including (a) adequate antithrombotic treatment, (b) treatment of cardiovascular comorbidities and diabetes, and (c) the use of lipid-lowering drugs; as well as on the treatment of stroke-related disorders such as depression, anxiety and pain. Medication data were available for 247 patients. Data about depression and anxiety were available for 233. There were no significant differences between the four centres in antithrombotic treatment and in the treatment of cardiovascular comorbidities and diabetes. However, significantly more patients from the UK were treated with lipid-lowering drugs compared to Belgian patients. Significant differences were also observed between the centres in the prevalence and treatment of depression. More Belgian patients suffered from depression compared to German patients and significantly more Belgian patients took antidepressants than patients in Germany. This was in contrast to the prevalence and treatment of anxiety and pain, for which no significant differences between the centres were seen. Related to pain treatment, it was observed that almost 40% of all patients suffering from pain, used no specific medication. Copyright © 2016 Elsevier B.V. All rights reserved.

  20. Effects of assessing the productivity of faculty in academic medical centres: a systematic review

    Science.gov (United States)

    Akl, Elie A.; Meerpohl, Joerg J.; Raad, Dany; Piaggio, Giulia; Mattioni, Manlio; Paggi, Marco G.; Gurtner, Aymone; Mattarocci, Stefano; Tahir, Rizwan; Muti, Paola; Schünemann, Holger J.

    2012-01-01

    Background: Many academic medical centres have introduced strategies to assess the productivity of faculty as part of compensation schemes. We conducted a systematic review of the effects of such strategies on faculty productivity. Methods: We searched the MEDLINE, Healthstar, Embase and PsycInfo databases from their date of inception up to October 2011. We included studies that assessed academic productivity in clinical, research, teaching and administrative activities, as well as compensation, promotion processes and satisfaction. Results: Of 531 full-text articles assessed for eligibility, we included 9 articles reporting on eight studies. The introduction of strategies for assessing academic productivity as part of compensation schemes resulted in increases in clinical productivity (in six of six studies) in terms of clinical revenue, the work component of relative-value units (these units are nonmonetary standard units of measure used to indicate the value of services provided), patient satisfaction and other departmentally used standards. Increases in research productivity were noted (in five of six studies) in terms of funding and publications. There was no change in teaching productivity (in two of five studies) in terms of educational output. Such strategies also resulted in increases in compensation at both individual and group levels (in three studies), with two studies reporting a change in distribution of compensation in favour of junior faculty. None of the studies assessed effects on administrative productivity or promotion processes. The overall quality of evidence was low. Interpretation: Strategies introduced to assess productivity as part of a compensation scheme appeared to improve productivity in research activities and possibly improved clinical productivity, but they had no effect in the area of teaching. Compensation increased at both group and individual levels, particularly among junior faculty. Higher quality evidence about the benefits

  1. Effects of assessing the productivity of faculty in academic medical centres: a systematic review.

    Science.gov (United States)

    Akl, Elie A; Meerpohl, Joerg J; Raad, Dany; Piaggio, Giulia; Mattioni, Manlio; Paggi, Marco G; Gurtner, Aymone; Mattarocci, Stefano; Tahir, Rizwan; Muti, Paola; Schünemann, Holger J

    2012-08-07

    Many academic medical centres have introduced strategies to assess the productivity of faculty as part of compensation schemes. We conducted a systematic review of the effects of such strategies on faculty productivity. We searched the MEDLINE, Healthstar, Embase and PsycInfo databases from their date of inception up to October 2011. We included studies that assessed academic productivity in clinical, research, teaching and administrative activities, as well as compensation, promotion processes and satisfaction. Of 531 full-text articles assessed for eligibility, we included 9 articles reporting on eight studies. The introduction of strategies for assessing academic productivity as part of compensation schemes resulted in increases in clinical productivity (in six of six studies) in terms of clinical revenue, the work component of relative-value units (these units are nonmonetary standard units of measure used to indicate the value of services provided), patient satisfaction and other departmentally used standards. Increases in research productivity were noted (in five of six studies) in terms of funding and publications. There was no change in teaching productivity (in two of five studies) in terms of educational output. Such strategies also resulted in increases in compensation at both individual and group levels (in three studies), with two studies reporting a change in distribution of compensation in favour of junior faculty. None of the studies assessed effects on administrative productivity or promotion processes. The overall quality of evidence was low. Strategies introduced to assess productivity as part of a compensation scheme appeared to improve productivity in research activities and possibly improved clinical productivity, but they had no effect in the area of teaching. Compensation increased at both group and individual levels, particularly among junior faculty. Higher quality evidence about the benefits and harms of such assessment strategies is

  2. Headache service quality: evaluation of quality indicators in 14 specialist-care centres.

    Science.gov (United States)

    Schramm, Sara; Uluduz, Derya; Gouveia, Raquel Gil; Jensen, Rigmor; Siva, Aksel; Uygunoglu, Ugur; Gvantsa, Giorgadze; Mania, Maka; Braschinsky, Mark; Filatova, Elena; Latysheva, Nina; Osipova, Vera; Skorobogatykh, Kirill; Azimova, Julia; Straube, Andreas; Eren, Ozan Emre; Martelletti, Paolo; De Angelis, Valerio; Negro, Andrea; Linde, Mattias; Hagen, Knut; Radojicic, Aleksandra; Zidverc-Trajkovic, Jasna; Podgorac, Ana; Paemeleire, Koen; De Pue, Annelien; Lampl, Christian; Steiner, Timothy J; Katsarava, Zaza

    2016-12-01

    The study was a collaboration between Lifting The Burden (LTB) and the European Headache Federation (EHF). Its aim was to evaluate the implementation of quality indicators for headache care Europe-wide in specialist headache centres (level-3 according to the EHF/LTB standard). Employing previously-developed instruments in 14 such centres, we made enquiries, in each, of health-care providers (doctors, nurses, psychologists, physiotherapists) and 50 patients, and analysed the medical records of 50 other patients. Enquiries were in 9 domains: diagnostic accuracy, individualized management, referral pathways, patient's education and reassurance, convenience and comfort, patient's satisfaction, equity and efficiency of the headache care, outcome assessment and safety. Our study showed that highly experienced headache centres treated their patients in general very well. The centres were content with their work and their patients were content with their treatment. Including disability and quality-of-life evaluations in clinical assessments, and protocols regarding safety, proved problematic: better standards for these are needed. Some centres had problems with follow-up: many specialised centres operated in one-touch systems, without possibility of controlling long-term management or the success of treatments dependent on this. This first Europe-wide quality study showed that the quality indicators were workable in specialist care. They demonstrated common trends, producing evidence of what is majority practice. They also uncovered deficits that might be remedied in order to improve quality. They offer the means of setting benchmarks against which service quality may be judged. The next step is to take the evaluation process into non-specialist care (EHF/LTB levels 1 and 2).

  3. Language proficiency among immigrants and the establishment of interethnic relations: a comparative analysis of Bilbao, Lisbon and Rotterdam

    Directory of Open Access Journals (Sweden)

    Alina Esteves

    2014-03-01

    Full Text Available Despite the increasing interest in exploring language proficiency among immigrants as a quintessential element for their economic integration in the host country, less attention has been devoted to the social impacts that destination-language proficiency may have on enhancing interethnic contacts between immigrants and the native population. This research aims to shed light on this latter topic, discussing if being a native-speaker immigrant in the host country or, for those immigrants who are non-native speakers, having a stronger command of the destination-language may increase their likelihood of interacting with the native population. Moreover, we question if there are significant differences in the interaction patterns between these two groups and the natives, presenting the cities of Bilbao, Lisbon and Rotterdam as a territorial frame. The analysis is based on data gathered through the GEITONIES survey. The results obtained indicate that native-speaker immigrants generally tend to show more interaction with the natives. Nevertheless, for immigrants not sharing such cultural similarity, those with a higher level of second-language proficiency clearly show stronger bonds with the native population; in both cases this can also be related to individual, group or place related variables.

  4. Validity of the Framingham point scores in the elderly: results from the Rotterdam study.

    Science.gov (United States)

    Koller, Michael T; Steyerberg, Ewout W; Wolbers, Marcel; Stijnen, Theo; Bucher, Heiner C; Hunink, M G Myriam; Witteman, Jacqueline C M

    2007-07-01

    The National Cholesterol Education Program recommends assessing 10-year risk of coronary heart disease (CHD) in individuals free of established CHD with the Framingham Point Scores (FPS). Individuals with a risk >20% are classified as high risk and are candidates for preventive intervention. We aimed to validate the FPS in a European population of elderly subjects. Subjects free of established CHD at baseline were selected from the Rotterdam study, a population-based cohort of subjects 55 years or older in The Netherlands. We studied calibration, discrimination (c-index), and the accuracy of high-risk classifications. Events consisted of fatal CHD and nonfatal myocardial infarction. Among 6795 subjects, 463 died because of CHD and 336 had nonfatal myocardial infarction. Predicted 10-year risk of CHD was on average well calibrated for women (9.9% observed vs 10.1% predicted) but showed substantial overestimation in men (14.3% observed vs 19.8% predicted), particularly with increasing age. This resulted in substantial number of false-positive classifications (specificity 70%) in men. In women, discrimination of the FPS was better than that in men (c-index 0.73 vs 0.63, respectively). However, because of the low baseline risk of CHD and limited discriminatory power, only 33% of all CHD events occurred in women classified as high risk. The FPS need recalibration for elderly men with better incorporation of the effect of age. In elderly women, FPS perform reasonably well. However, maintaining the rational of the high-risk threshold requires better performing models for a population with low incidence of CHD.

  5. Pattern and outcome of chest injuries at Bugando Medical Centre in Northwestern Tanzania

    Science.gov (United States)

    2011-01-01

    Background Chest injuries constitute a continuing challenge to the trauma or general surgeon practicing in developing countries. This study was conducted to outline the etiological spectrum, injury patterns and short term outcome of these injuries in our setting. Patients and methods This was a prospective study involving chest injury patients admitted to Bugando Medical Centre over a six-month period from November 2009 to April 2010 inclusive. Results A total of 150 chest injury patients were studied. Males outnumbered females by a ratio of 3.8:1. Their ages ranged from 1 to 80 years (mean = 32.17 years). The majority of patients (72.7%) sustained blunt injuries. Road traffic crush was the most common cause of injuries affecting 50.7% of patients. Chest wall wounds, hemothorax and rib fractures were the most common type of injuries accounting for 30.0%, 21.3% and 20.7% respectively. Associated injuries were noted in 56.0% of patients and head/neck (33.3%) and musculoskeletal regions (26.7%) were commonly affected. The majority of patients (55.3%) were treated successfully with non-operative approach. Underwater seal drainage was performed in 39 patients (19.3%). One patient (0.7%) underwent thoracotomy due to hemopericardium. Thirty nine patients (26.0%) had complications of which wound sepsis (14.7%) and complications of long bone fractures (12.0%) were the most common complications. The mean LOS was 13.17 days and mortality rate was 3.3%. Using multivariate logistic regression analysis, associated injuries, the type of injury, trauma scores (ISS, RTS and PTS) were found to be significant predictors of the LOS (P trauma scores (ISS, RTS and PTS), the need for ICU admission and the presence of complications (P Chest injuries resulting from RTCs remain a major public health problem in this part of Tanzania. Urgent preventive measures targeting at reducing the occurrence of RTCs is necessary to reduce the incidence of chest injuries in this region. PMID:21244706

  6. How does a shortage of physicians impact on the job satisfaction of health centre staff?

    Science.gov (United States)

    Saxén, Ulla; Jaatinen, Pekka T; Kivelä, Sirkka-Liisa

    2008-01-01

    The aim was to determine how a shortage of physicians at Finnish health centres has affected the job satisfaction of the entire staff. A questionnaire was posted to 2848 employees working with patients at health centres in the Finnish provinces of Satakunta and Varsinais-Suomi. The information concerning the shortage of physicians at health centres was taken from research undertaken by the Finnish Medical Association in October 2003. The health centres were divided into four groups according to the severity of the shortage. The questionnaire was returned by 1447 employees. The staff at health centres with the most severe shortage of physicians were less satisfied with the management of the organization. Employees at health centres with a minor shortage of physicians were more satisfied with the quality of services in their operational unit. The shortage of physicians had no impact on staff satisfaction regarding the operation of their work unit, the strain of dealing with issues within their work environment, feelings of stress, the strain of working under pressure that they experienced, or interest in finding a new job. The majority of healthcare employees are satisfied and motivated in their work. The shortage of physicians has only a slightly negative impact on their satisfaction.

  7. Growth trajectories of the human embryonic head and periconceptional maternal conditions.

    Science.gov (United States)

    Koning, I V; Baken, L; Groenenberg, I A L; Husen, S C; Dudink, J; Willemsen, S P; Gijtenbeek, M; Koning, A H J; Reiss, I K M; Steegers, E A P; Steegers-Theunissen, R P M

    2016-05-01

    Can growth trajectories of the human embryonic head be created using 3D ultrasound (3D-US) and virtual reality (VR) technology, and be associated with second trimester fetal head size and periconceptional maternal conditions? Serial first trimester head circumference (HC) and head volume (HV) measurements were used to create reliable growth trajectories of the embryonic head, which were significantly associated with fetal head size and periconceptional maternal smoking, age and ITALIC! in vitro fertilization (IVF)/intra-cytoplasmic sperm injection (ICSI) treatment. Fetal growth is influenced by periconceptional maternal conditions. We selected 149 singleton pregnancies with a live born non-malformed fetus from the Rotterdam periconception cohort. Bi-parietal diameter and occipital frontal diameter to calculate HC, HV and crown-rump length (CRL) were measured weekly between 9 + 0 and 12 + 6 weeks gestational age (GA) using 3D-US and VR. Fetal HC was obtained from second trimester structural anomaly scans. Growth trajectories of the embryonic head were created with general additive models and linear mixed models were used to estimate associations with maternal periconceptional conditions as a function of GA and CRL, respectively. A total of 303 3D-US images of 149 pregnancies were eligible for embryonic head measurements (intra-class correlation coefficients >0.99). Associations were found between embryonic HC and fetal HC ( ITALIC! ρ = 0.617, ITALIC! P head measured by HC and HV (All ITALIC! P head may be of benefit in future early antenatal care. This study was funded by the Department of Obstetrics and Gynaecology, Erasmus MC University Medical Centre and Sophia Foundation for Medical Research, Rotterdam, The Netherlands (SSWO grant number 644). No competing interests are declared. © The Author 2016. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email

  8. Epidemiology of hemoglobinopathies and thalassemias in individuals referred to the haematology research centre, Shiraz University of Medical Sciences, Shiraz, Iran from 2006 to 2011.

    Science.gov (United States)

    Haghpanah, Sezaneh; Ramzi, Mani; Zakerinia, Maryam; Nourani Khojasteh, Habib; Haghshenas, Mansour; Rezaei, Narges; Moayed, Vida; Rezaei, Alireza; Karimi, Mehran

    2014-01-01

    Hemoglobinopathies and thalassemias are the most frequent genetic hereditary disorders with an increasing global health burden, especially in low- and middle-income countries. We aimed to determine the epidemiologic pattern of hemoglobinopathies and thalassemias in individuals referred to the Haematology Research Centre, Shiraz University of Medical Sciences, Shiraz, Iran, which is the most important referral center in Southern Iran during 2006 to 2011. The most frequent abnormality was β-thalassemia (β-thal) minor (24.0%), followed by α-thalassemia (α-thal) trait (10.0%), hemoglobin (Hb) S trait (4.0%) and Hb D-Punjab trait (4.0%). Because this center is a referral center, we detected a higher prevalence compared to the normal population; however, these data could help policymakers and health service providers to better programming for prevention of births affected with Hb disorders.

  9. South Sudan Medical Journal: Editorial Policies

    African Journals Online (AJOL)

    Dr David Tibbutt. Past Adviser for Continuing Medical Education in Uganda, Editor of the "Uganda CME Newsletter" and Visiting Physician to Kitovu Hospital, Uganda and Kirambi Health Centre, Rwanda. Based in UK. EDITORIAL ADVISOR. Ann Burgess, BSc Nutrition, MPH. Nutritionist and editor working from Scotland.

  10. The Aube centre; Le Centre de l`Aube

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-07-01

    This educational booklet is devoted to a general presentation of the Aube radioactive wastes storage centre. After a short presentation of the Andra, the French national agency for the management of radioactive wastes, it gives some general information about radioactive wastes (origin, classification), containers (quality assurance and different types), wastes transportation (planning, safety), and about the Aube centre itself: description, treatment and conditioning of drums (compacting and injection), storage facilities, geological situation of the site, and environmental controls. (J.S.)

  11. Patients' Non-Medical Characteristics Contribute to Collective Medical Decision-Making at Multidisciplinary Oncological Team Meetings.

    Science.gov (United States)

    Restivo, Léa; Apostolidis, Thémis; Bouhnik, Anne-Déborah; Garciaz, Sylvain; Aurran, Thérèse; Julian-Reynier, Claire

    2016-01-01

    The contribution of patients' non-medical characteristics to individual physicians' decision-making has attracted considerable attention, but little information is available on this topic in the context of collective decision-making. Medical decision-making at cancer centres is currently carried out using a collective approach, at MultiDisciplinary Team (MDT) meetings. The aim of this study was to determine how patients' non-medical characteristics are presented at MDT meetings and how this information may affect the team's final medical decisions. Observations were conducted at a French Cancer Centre during MDT meetings at which non-standard cases involving some uncertainty were discussed from March to May 2014. Physicians' verbal statements and predefined contextual parameters were collected with a non-participant observational approach. Non numerical data collected in the form of open notes were then coded for quantitative analysis. Univariate and multivariate statistical analyses were performed. In the final sample of patients' records included and discussed (N = 290), non-medical characteristics were mentioned in 32.8% (n = 95) of the cases. These characteristics corresponded to demographics in 22.8% (n = 66) of the cases, psychological data in 11.7% (n = 34), and relational data in 6.2% (n = 18). The patient's age and his/her "likeability" were the most frequently mentioned characteristics. In 17.9% of the cases discussed, the final decision was deferred: this outcome was positively associated with the patients' non-medical characteristics and with uncertainty about the outcome of the therapeutic options available. The design of the study made it difficult to draw definite cause-and-effect conclusions. The Social Representations approach suggests that patients' non-medical characteristics constitute a kind of tacit professional knowledge that may be frequently mobilised in physicians' everyday professional practice. The links observed between patients

  12. Contextualisation of patient-centred care

    DEFF Research Database (Denmark)

    Dencker, Annemarie; Kristiansen, Maria; Andreassen Rix, Bo

    2018-01-01

    . In this qualitative comparative study, we explore the influence of medical contexts in three Danish hospital wards, haematology, oncological gynaecology and neuro-intensive care, on communication with patients about their children. In exploring the degree to which the inclusion of children in clinical encounters......Patients' family relations play an important part in the provision of patient-centred cancer care, not least when healthcare professionals encounter seriously ill patients with dependent children. Little is known about how children are perceived and dealt with in clinical encounters....... The thematic analysis was based on Bateson's conceptualisation of communication. We found that healthcare professionals' approach to children in clinical encounters and the ways in which children were positioned on each ward were influenced by aspects specific to the ward, including the diagnosis...

  13. Client Centred Desing

    DEFF Research Database (Denmark)

    Ørngreen, Rikke; Nielsen, Janni; Levinsen, Karin

    2008-01-01

    In this paper we argue for the use of Client Centred preparation phases when designing complex systems. Through Client Centred Design human computer interaction can extend the focus on end-users to alse encompass the client's needs, context and resources....

  14. A 6-YEAR EXPERIENCE OF HEART TRANSPLANTATION IN FEDERAL ALMAZOV NORTH-WEST MEDICAL RESEARCH CENTRE

    Directory of Open Access Journals (Sweden)

    E. V. Shlyakhto

    2016-01-01

    Full Text Available Aim. To estimate the results of 6-year experience of heart transplantation (HT in Federal Almazov North-West Medical Research Centre. Methods. From 2010 to 2015 we have performed 65 HT. Mean age was 44.3 ± 14 years old (from 10 to 64 years old. We used biventricular assist device (BIVAD, Berlin Heart Excor support in 7 heart transplant candidates before HT. 19 patients (29% received thymoglobulin, whereas 46 patients (71% had basiliximab to induce immunosuppression.Results. Extracorporeal membrane oxygenation machines were implanted in 5 patients (7.7% after HT due to acute right ventricular failure. Suture annuloplasty (the Batista procedure for tricuspid valve repair was carried out in 3 cases (4.6%. Venovenous hemodiafi ltration was used in 11 patients (16.9%. A total of 598 endomyocardial biopsies (EMB were performed after HT. Evidence of cellular rejection (R1 and R2 was presented in 286 biopsies (48%. The 30-day in-hospital mortality rate was 3.1%. The 6-month survival rate after HT was 92%, 1-year – 91% and overall survival for the 6-year period of observation – 89.2%. Maximum observation period was 71 months.Conclusions. The 6-year experience of HT in our Center has shown a high level of survival. BIVAD Excor support can be effectively used as a «bridge» to HT. Prevention of graft loss due to acute rejection in heart transplant recipients can be achieved only through regular EMB monitoring. The rate of viral infection increased in 2 months after HT.

  15. Evaluation of doctors? performance as facilitators in basic medical science lecture classes in a new Malaysian medical school

    OpenAIRE

    Ismail, Salwani; Salam, Abdus; Alattraqchi, Ahmed G; Annamalai, Lakshmi; Chockalingam, Annamalai; Elena, Wan Putri; Rahman, Nor Iza A; Abubakar, Abdullahi Rabiu; Haque, Mainul

    2015-01-01

    Salwani Ismail,1 Abdus Salam,2 Ahmed G Alattraqchi,1 Lakshmi Annamalai,1 Annamalai Chockalingam,1 Wan Putri Elena,3 Nor Iza A Rahman,1 Abdullahi Rabiu Abubakar,1 Mainul Haque1 1Faculty of Medicine, Universiti Sultan Zainal Abidin, Kuala Terengganu, Terengganu, Malaysia; 2Department of Medical Education, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia; 3School of Health Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia Background: Dida...

  16. Bone mineral density and mortality in elderly men and women: the Rotterdam Study.

    Science.gov (United States)

    Van Der Klift, M; Pols, H A P; Geleijnse, J M; Van Der Kuip, D A M; Hofman, A; De Laet, C E D H

    2002-04-01

    Recent studies have shown that a low bone mineral density (BMD) is associated with a higher risk of mortality. Most studies have investigated this relationship in women only and presented their risk estimates per standard deviation change in BMD. However, when using this approach, a BMD threshold might be missed when relative risks are presented in the traditional manner. Therefore, in this study our aim was to model the relation between BMD and all-cause mortality. In the Rotterdam Study, follow-up was complete for 5819 men and women aged > or =55 years for whom BMD data were available. During an average follow-up of 5.4 years, 399 men and 317 women died. We calculated BMD Z scores using measurements performed at the femoral neck. Cox proportional hazards regression was used to fit the model. An average BMD, reflected by a Z score = 0, was used as the reference. For women, no significant relationship between BMD and overall mortality was observed. For men, however, a cubic model best fitted the relationship under study, also after adjusting for age and body mass index (BMI). The risk of mortality increased when BMD was below average. Similar results were found when separate curves were made for diabetics and nondiabetics, smokers (ever or never), and tertiles of BMI. Excluding subjects who had suffered hip fractures, or adjusting for the number of drugs used and for lower limb disability, essentially did not change results. This suggests that low BMD is not mainly due to morbidity and impaired mobility in our cohort, which makes this a less likely explanation for the observed relation with mortality. The results of our study suggest that, in men, a nonlinear relationship between BMD and mortality exists, which is independent of comorbidity, whereas, in women, no significant relationship was observed.

  17. Emergency medical assistance programs for nuclear power reactors

    International Nuclear Information System (INIS)

    Linnemann, R.E.; Mettler, F.A. Jr.

    1977-01-01

    This paper deals with a simple but practical medical support of geographically distributed nuclear reactors in isolated areas. A staff of experts at a centre devote their full attention to accident prevention and preparedness at reactor sites. They establish and maintain emergency medical programs at reactor sites and nearby support hospitals. The emphasis is on first aid and emergency treatment by medical attendants who are not and cannot be experts in radiation but do know how to treat patients. (author)

  18. SAP Nuclear Competence Centre

    International Nuclear Information System (INIS)

    Andrlova, Z.

    2009-01-01

    In this issue we continue and introduce the SAP Nuclear Competence Centre and its head Mr. Igor Dzama. SAP Nuclear Competence Centrum is one of the fi rst competence centres outside ENEL headquarters. It should operate in Slovakia and should have competencies within the whole Enel group. We are currently dealing with the issues of organisation and funding. We are trying to balance the accountability to the NPP directors and to the management of the competence centres at Enel headquarters; we are looking at the relations between the competence centres within the group and defining the services that we will provide for the NPPs. author)

  19. Large-scale fuel cycle centres

    International Nuclear Information System (INIS)

    Smiley, S.H.; Black, K.M.

    1977-01-01

    The US Nuclear Regulatory Commission (NRC) has considered the nuclear energy centre concept for fuel cycle plants in the Nuclear Energy Centre Site Survey 1975 (NECSS-75) Rep. No. NUREG-0001, an important study mandated by the US Congress in the Energy Reorganization Act of 1974 which created the NRC. For this study, the NRC defined fuel cycle centres as consisting of fuel reprocessing and mixed-oxide fuel fabrication plants, and optional high-level waste and transuranic waste management facilities. A range of fuel cycle centre sizes corresponded to the fuel throughput of power plants with a total capacity of 50,000-300,000MW(e). The types of fuel cycle facilities located at the fuel cycle centre permit the assessment of the role of fuel cycle centres in enhancing the safeguard of strategic special nuclear materials - plutonium and mixed oxides. Siting fuel cycle centres presents a smaller problem than siting reactors. A single reprocessing plant of the scale projected for use in the USA (1500-2000t/a) can reprocess fuel from reactors producing 50,000-65,000MW(e). Only two or three fuel cycle centres of the upper limit size considered in the NECSS-75 would be required in the USA by the year 2000. The NECSS-75 fuel cycle centre evaluation showed that large-scale fuel cycle centres present no real technical siting difficulties from a radiological effluent and safety standpoint. Some construction economies may be achievable with fuel cycle centres, which offer opportunities to improve waste-management systems. Combined centres consisting of reactors and fuel reprocessing and mixed-oxide fuel fabrication plants were also studied in the NECSS. Such centres can eliminate shipment not only of Pu but also mixed-oxide fuel. Increased fuel cycle costs result from implementation of combined centres unless the fuel reprocessing plants are commercial-sized. Development of Pu-burning reactors could reduce any economic penalties of combined centres. The need for effective fissile

  20. Organization of medical aid and treatment of individuals affected in radiation accidents

    International Nuclear Information System (INIS)

    Mikhajlov, M.G.; Andreev, E.A.; Bliznakov, V.

    1979-01-01

    The emergency programme of the medical service for radiation accidents constitutes part of the whole emergency programme of the establishment whose production process is derectly connected with the utilization of ionizing radiation sources. The chief of the establishment health centre also heads the operative radiation accident group. When a radiation accident occurs the medical personnel, according to a previously developed plan, reports at the Health centre. The medical aid is based on the principle of step treatment and evacuation of the affected persons, according to the prescriptions. The first step of the medical evacuation is the health centre; the second - the District hospital, where a team of specialists is formed, all of them previously well trained in the recognition and treatment of radiation sickness. The third step is the specialized clinic for radiation injuries. Persons, who have received irradiation dose of up to 100 rad, or are in a shock state, or have incorporated radioactive substances, are temporarily hospitalized at the health centre. The assistance rended to them consists of: control of shock, asphyxia and bleeding, primary surgical treatment of wounds in cases of complex injuries, deactivation under dosimetric control, attempt for accelerated removal of the radioactive substances, etc. At the District hospital and the specialized clinic the therapeutic measures are conformed to the pathogenetic mechanism and severity of clinical symptoms, and their dynamics. Their aim is first of all to block the earlier radiation effects, to prevent and to treat the haemorrhagic phenomena and infectious complications, to restore the activity of the blood organs, etc. (A.B.)

  1. Clinical profile and factors associated with mortality in hospitalized patients with HIV/AIDS: a retrospective analysis from Tripoli Medical Centre, Libya, 2013.

    Science.gov (United States)

    Shalaka, N S; Garred, N A; Zeglam, H T; Awasi, S A; Abukathir, L A; Altagdi, M E; Rayes, A A

    2015-10-02

    In Libya, little is known about HIV-related hospitalizations and in-hospital mortality. This was a retrospective analysis of HIV-related hospitalizations at Tripoli Medical Centre in 2013. Of 227 cases analysed, 82.4% were males who were significantly older (40.0 versus 36.5 years), reported injection drug use (58.3% versus 0%) and were hepatitis C virus co-infected (65.8% versus 0%) compared with females. Severe immunosuppression was prevalent (median CD4 count = 42 cell/μL). Candidiasis was the most common diagnosis (26.0%); Pneumocystis pneumonia was the most common respiratory disease (8.8%), while cerebral toxoplasmosis was diagnosed in 8.4% of patients. Current HAART use was independently associated with low risk of in-hospital mortality (OR 0.33), while central nervous system symptoms (OR 4.12), sepsis (OR 6.98) and low total lymphocyte counts (OR 3.60) were associated with increased risk. In this study, late presentation with severe immunosuppression was common, and was associated with significant in-hospital mortality.

  2. Effects of unstratified and centre-stratified randomization in multi-centre clinical trials.

    Science.gov (United States)

    Anisimov, Vladimir V

    2011-01-01

    This paper deals with the analysis of randomization effects in multi-centre clinical trials. The two randomization schemes most often used in clinical trials are considered: unstratified and centre-stratified block-permuted randomization. The prediction of the number of patients randomized to different treatment arms in different regions during the recruitment period accounting for the stochastic nature of the recruitment and effects of multiple centres is investigated. A new analytic approach using a Poisson-gamma patient recruitment model (patients arrive at different centres according to Poisson processes with rates sampled from a gamma distributed population) and its further extensions is proposed. Closed-form expressions for corresponding distributions of the predicted number of the patients randomized in different regions are derived. In the case of two treatments, the properties of the total imbalance in the number of patients on treatment arms caused by using centre-stratified randomization are investigated and for a large number of centres a normal approximation of imbalance is proved. The impact of imbalance on the power of the study is considered. It is shown that the loss of statistical power is practically negligible and can be compensated by a minor increase in sample size. The influence of patient dropout is also investigated. The impact of randomization on predicted drug supply overage is discussed. Copyright © 2010 John Wiley & Sons, Ltd.

  3. Interprofessional collaborative patient-centred care: a critical exploration of two related discourses.

    Science.gov (United States)

    Fox, Ann; Reeves, Scott

    2015-03-01

    There has been sustained international interest from health care policy makers, practitioners, and researchers in developing interprofessional approaches to delivering patient-centred care. In this paper, we offer a critical exploration of a selection of professional discourses related to these practice paradigms, including interprofessional collaboration, patient-centred care, and the combination of the two. We argue that for some groups of patients, inequalities between different health and social care professions and between professionals and patients challenge the successful realization of the positive aims associated with these discourses. Specifically, we argue that interprofessional and professional-patient hierarchies raise a number of key questions about the nature of professions, their relationships with one another as well as their relationship with patients. We explore how the focus on interprofessional collaboration and patient-centred care have the potential to reinforce a patient compliance model by shifting responsibility to patients to do the "right thing" and by extending the reach of medical power across other groups of professionals. Our goal is to stimulate debate that leads to enhanced practice opportunities for health professionals and improved care for patients.

  4. A designated centre for people with disabilities operated by St Aidan's Day Care Centre Ltd., Wexford

    LENUS (Irish Health Repository)

    Gibbons, C

    2015-02-01

    Ireland has seen a steady increase in paediatric sickle cell disease (SCD). In 2005, only 25% of children with SCD were referred to the haemoglobinopathy service in their first year. A non-funded screening programme was implemented. This review aimed to assess the impact screening has had. All children referred to the haemoglobinopathy service born in Ireland after 2005 were identified. Data was collected from the medical chart and laboratory system. Information was analysed using Microsoft Excel. 77 children with SCD were identified. The median age at antibiotic commencement in the screened group was 56 days compared with 447 days in the unscreened group, p = < 0.0003. 22 (28%) of infants were born in centre\\'s that do not screen and 17 (81%) were over 6 months old at referral, compared with 14 (21%) in the screened group. 6 (27%) of those in the unscreened group presented in acute crisis compared with 2 (3%) in the screened population. The point prevalence of SCD in Ireland is 0.2% in children under 15 yr of African and Asian descent. We identified delays in referral and treatment, which reflect the lack of government funded support and policy. We suggest all maternity units commence screening for newborns at risk of SCD. It is a cost effective intervention with a number needed to screen of just 4 to prevent a potentially fatal crisis.

  5. The IOC Centres of Excellence bring prevention to sports medicine.

    Science.gov (United States)

    Engebretsen, Lars; Bahr, Roald; Cook, Jill L; Derman, Wayne; Emery, Carolyn A; Finch, Caroline F; Meeuwisse, Willem H; Schwellnus, Martin; Steffen, Kathrin

    2014-09-01

    The protection of an athlete's health and preventing injuries and illnesses in sport are top priorities for the IOC and its Medical Commission. The IOC therefore partners with selected research centres around the world and supports research in the field of sports medicine. This has enabled the IOC to develop an international network of expert scientists and clinicians in sports injury and disease prevention research. The IOC wants to promote injury and disease prevention and the improvement of physical health of the athlete by: (1) establishing long-term research programmes on injury and disease prevention (including studies on basic epidemiology, risk factors, injury mechanisms and intervention), (2) fostering collaborative relationships with individuals, institutions and organisations to improve athletes' health, (3) implementing and collaborating with applied, ongoing and novel research and development within the framework and long-term strategy of the IOC and (4) setting up knowledge translation mechanisms to share scientific research results with the field throughout the Olympic Movement and sports community and converting these results into concrete actions to protect the health of the athletes. In 2009, the IOC also identified four research centres that had an established track record in research, educational and clinical activities to achieve these ambitions: (1) the Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Australia; (2) the Sport Injury Prevention Research Centre (SIPRC), Canada; (3) the Clinical Sport and Exercise Medicine Research (CSEM), South Africa and (4) the Oslo Sports Trauma Research Center (OSTRC), Norway. This paper highlights the work carried out by these four IOC Centres of Excellence over the past 6 years and their contribution to the world of sports medicine. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  6. Defining and describing birth centres in the Netherlands - a component study of the Dutch Birth Centre Study.

    Science.gov (United States)

    Hermus, M A A; Boesveld, I C; Hitzert, M; Franx, A; de Graaf, J P; Steegers, E A P; Wiegers, T A; van der Pal-de Bruin, K M

    2017-07-03

    During the last decade, a rapid increase of birth locations for low-risk births, other than conventional obstetric units, has been seen in the Netherlands. Internationally some of such locations are called birth centres. The varying international definitions for birth centres are not directly applicable for use within the Dutch obstetric system. A standard definition for a birth centre in the Netherlands is lacking. This study aimed to develop a definition of birth centres for use in the Netherlands, to identify these centres and to describe their characteristics. International definitions of birth centres were analysed to find common descriptions. In July 2013 the Dutch Birth Centre Questionnaire was sent to 46 selected Dutch birth locations that might qualify as birth centre. Questions included: location, reason for establishment, women served, philosophies, facilities that support physiological birth, hotel-facilities, management, environment and transfer procedures in case of referral. Birth centres were visited to confirm the findings from the Dutch Birth Centre Questionnaire and to measure distance and time in case of referral to obstetric care. From all 46 birth locations the questionnaires were received. Based on this information a Dutch definition of a birth centre was constructed. This definition reads: "Birth centres are midwifery-managed locations that offer care to low risk women during labour and birth. They have a homelike environment and provide facilities to support physiological birth. Community midwives take primary professional responsibility for care. In case of referral the obstetric caregiver takes over the professional responsibility of care." Of the 46 selected birth locations 23 fulfilled this definition. Three types of birth centres were distinguished based on their location in relation to the nearest obstetric unit: freestanding (n = 3), alongside (n = 14) and on-site (n = 6). Transfer in case of referral was necessary for all

  7. Determinants of locomotor disability in people aged 55 years and over: The Rotterdam study

    International Nuclear Information System (INIS)

    Odding, Else; Valkenburg, Hans A.; Stam, Hendrik J.; Hofman, Albert

    2001-01-01

    Locomotor disability, as defined by difficulties in activities of daily living related to lower limb function, can be the consequence of diseases and impairments of the cardiovascular, pulmonary, nervous, sensory and musculoskeletal system. We estimated the associations between specific diseases and impairments and locomotor disability, and the proportion of disability attributable to each condition, controlling for age and comorbidity. The Rotterdam Study is a prospective follow-up study among people aged 55 years and over in the general population. Locomotor disability in 1219 men and 1856 women was assessed with the Stanford Health Assessment Questionnaire. Diseases and impairments were radiological osteoarthritis, pain of the hips and knees, morning stiffness, fractures, hypertension, vascular disease, ischemic heart disease, stroke, heart failure, chronic obstructive pulmonary disease (COPD), depression, Parkinson's disease, osteoporosis, diabetes mellitus, overweight, and low vision. Adjusted odds ratios, etiologic and attributable fractions were calculated for locomotor disability. The occurrence of locomotor disability can partly be ascribed to joint pain, COPD, morning stiffness, diabetes and heart failure in both men and women. In addition in women osteoarthritis, osteoporosis, low vision, fractures, stroke and Parkinson's disease are significant etiologic fractions. In men with morning stiffness, joint pain, heart failure, diabetes mellitus, and COPD a significant proportion of their disability is attributable to this impairment. In women this was the case for Parkinson's disease, morning stiffness, low vision, heart failure, joint pain, diabetes, radiological osteoarthritis, stroke, COPD, osteoporosis, and fractures of the lower limbs, in that order. We conclude that locomotor complaints, heart failure, COPD and diabetes mellitus contribute considerably to locomotor disability in non-institutionalized elderly people

  8. Challenges in successfully developing three regional radiotherapy centres. The NCCI experience

    International Nuclear Information System (INIS)

    Greenham, Stuart

    2011-01-01

    Full text: This presentation will provide an overview of the processes, experience, challenges and success involved in the establishment of the North Coast Cancer Institute (NCCI). The NCCI is a network of three Integrated Oncology centres in Northern New South Wales offering integrated Medical, Radiation and Haematology outpatient services. NCCI was developed as part of the introduction of radiotherapy into a region previously without access to a local radiotherapy service and as a result with poor radiotherapy utilisation and referral rates. NCCI commenced radiotherapy services in Coffs Harbour in May 2007 followed by Port Macquarie in August of the same year and finally in Lismore in May 20 I O. Radiotherapy services commenced with Intensity Modulated Radiotherapy and Image guided radiotherapy as standard of care for some disease sites with remote access to planning systems and electronic workflow process supporting the treatment process. Forming a small team to simultaneously design, build and establish two new treatment centres to take advantage of the most contemporary treatment modalities while also planning for a third centre was a significant challenge. The challenges and successful outcomes will be discussed as part of this presentation.

  9. Molecular characteristic of alpha thalassaemia among patients diagnosed in UKM Medical Centre.

    Science.gov (United States)

    Azma, Raja Zahratul; Ainoon, Othman; Hafiza, Alauddin; Azlin, Ithnin; Noor Farisah, Abudul Razak; Nor Hidayati, Sardi; Noor Hamidah, Hussin

    2014-04-01

    Alpha (Α) thalassaemia is the most common inherited disorder in Malaysia. The clinical severity is dependant on the number of Α genes involved. Full blood count (FBC) and haemoglobin (Hb) analysis using either gel electrophoresis, high performance liquid chromatography (HPLC) or capillary zone electrophoresis (CE) are unable to detect definitively alpha thalassaemia carriers. Definitive diagnosis of Α-thalassaemias requires molecular analysis and methods of detecting both common deletional and non-deletional molecular abnormailities are easily performed in any laboratory involved in molecular diagnostics. We carried out a retrospective analysis of 1623 cases referred to our laboratory in Universiti Kebangsaan Malaysia Medical Centre (UKMMC) for the diagnosis of Α-thalassaemia during the period October 2001 to December 2012. We examined the frequency of different types of alpha gene abnormalities and their haematologic features. Molecular diagnosis was made using a combination of multiplex polymerase reaction (PCR) and real time PCR to detect deletional and non-deletional alpha genes relevant to southeast Asian population. Genetic analysis confirmed the diagnosis of Α-thalassaemias in 736 cases. Majority of the cases were Chinese (53.1%) followed by Malays (44.2%), and Indians (2.7%). The most common gene abnormality was ΑΑ/--(SEA) (64.0%) followed by ΑΑ/-Α(3.7) (19.8%), -Α(3.7) /--(SEA) (6.9%), ΑΑ/ΑΑCS (3.0%), --(SEA)/--(SEA) (1.2%), -Α(3.7)/-Α(3.7) (1.1%), ΑΑ/-Α(4.2) (0.7%), -Α(4.2)/--(SEA (0.7%), -Α(3.7)/-Α(4.2) (0.5%), ΑΑ(CS)/-- SEA) (0.4%), ΑΑ(CS)/ΑΑ(Cd59) (0.4%), ΑΑ(CS)/ΑΑ(CS) (0.4%), -Α(3.7)/ΑΑ(Cd59) (0.3%), ΑΑ/ΑΑ(Cd59) (0.1%), ΑΑ(Cd59)/ ΑΑ(IVS I-1) (0.1%), -Α(3.7)/ΑΑ(CS) (0.1%) and --(SEA) /ΑΑ(Cd59) (0.1%). This data indicates that the molecular abnormalities of Α-thalassaemia in the Malaysian population is heterogenous. Although Α-gene deletion is the most common cause, non-deletional Α-gene abnormalities

  10. Poster - 26: Electronic Waiting Room Management for a busy Cancer Centre

    Energy Technology Data Exchange (ETDEWEB)

    Kildea, John; Hijal, Tarek [McGill University Health Center (Canada)

    2016-08-15

    We describe an electronic waiting room management system that we have developed and deployed in our cancer centre. Our system connects with our electronic medical records systems, gathers data for a machine learning algorithm to predict future patient waiting times, and is integrated with a mobile phone app. The system has been in operation for over nine months and has led to reduced lines, calmer waiting rooms and overwhelming patient and staff satisfaction.

  11. Poster - 26: Electronic Waiting Room Management for a busy Cancer Centre

    International Nuclear Information System (INIS)

    Kildea, John; Hijal, Tarek

    2016-01-01

    We describe an electronic waiting room management system that we have developed and deployed in our cancer centre. Our system connects with our electronic medical records systems, gathers data for a machine learning algorithm to predict future patient waiting times, and is integrated with a mobile phone app. The system has been in operation for over nine months and has led to reduced lines, calmer waiting rooms and overwhelming patient and staff satisfaction.

  12. Medical records and radiation exposure cards

    International Nuclear Information System (INIS)

    Vigan, C.

    1975-01-01

    Some ideas concerning medical records at the Ispra Centre are exposed. The approved medical practitioner has two main tasks: he must gather enough relevant information to decide on the worker's suitability and also to determine his physical condition, normal or otherwise, and he must record it with enough detail to permit comparison with findings at later examinations. for the purposes of medical records, clinical examinations and complementary investigations, a large proportion of the measurements are of course made on the critical organs. The problems of the container or physical medium receiving the information to be recorded is considered. The possibilities offered by computer techniques are discussed

  13. Perceived need to take medication is associated with medication non-adherence in patients with rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Zwikker HE

    2014-11-01

    Full Text Available Hanneke E Zwikker,1,2 Sandra van Dulmen,3–5 Alfons A den Broeder,1,2 Bart J van den Bemt,1,2,6 Cornelia H van den Ende1,2 1Department of Rheumatology, 2Department of Pharmacy, Sint Maartenskliniek, Nijmegen, the Netherlands; 3Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, the Netherlands; 4NIVEL (Netherlands Institute for Health Services Research, Utrecht, the Netherlands; 5Department of Health Science, Buskerud and Vestfold University College, Drammen, Norway; 6Department of Pharmacy, Radboud University Medical Centre, Nijmegen, the Netherlands Background: This is the first cross-sectional study that aims to examine associations between beliefs about medication and non-adherence in patients with rheumatoid arthritis (RA using disease-modifying antirheumatic drugs, taking potential psychological confounders into account.Methods: Eligible patients (diagnosed with RA for ≥1 year or ≥18 years, using greater than or equal to one disease-modifying antirheumatic drug were included by their rheumatologist during regular outpatient visits between September 2009 and September 2010. Included patients received questionnaires. The Beliefs about Medicines Questionnaire was used to measure the perceived need to take medication (necessity beliefs, the concerns about taking medication (concern beliefs, general medication beliefs, and attitudes toward taking medication. Medication non-adherence (no/yes was measured using the Compliance Questionnaire Rheumatology (CQR. Associations between beliefs and non-adherence, and the influence of demographical, clinical, and psychological factors (symptoms of anxiety/depression, illness cognitions, self-efficacy were assessed using logistic regression.Results: A total of 580 of the 820 eligible patients willing to participate were included in the analyses (68% female, mean age 63 years, 30% non-adherent to their medication. Weaker necessity beliefs (OR [odds ratio]: 0.8, 95% CI

  14. Multidisciplinary family-centred psychosocial care for patients with CHD: consensus recommendations from the AEPC Psychosocial Working Group.

    Science.gov (United States)

    Utens, Elisabeth M W J; Callus, Edward; Levert, Eveline M; Groote, Katya De; Casey, Frank

    2018-02-01

    Because of the enormous advances in the medical treatment of CHD, the long-term survival of patients suffering from this disease has increased significantly. Currently, about 90% of patients reach adulthood, which entails many new challenges both for patients and their families and for healthcare professionals. The main objective of family-centred psychosocial care is to strengthen the emotional resilience of chronically ill patients and their families by adopting a holistic approach. During the biannual meeting of the psychosocial working group in 2012, participants expressed the need for general European guidelines. The present recommendations were written to support medical staff and psychosocial healthcare professionals to provide the best care for children and adolescents with CHD as well as for their families. This article describes in detail how the integrated family-centred psychological care modules work, involving different healthcare specialists, including a paediatric/congenital cardiologist or a general paediatrician. The different clinical implications and specific needs have been taken into account and recommendations have been provided on the following: structured follow-up screening; identification of stressful periods related to cardiac surgery or invasive medical procedures; evidence-based, disease-specific, and family-oriented psychosocial interventions; and interactive media links to medical and psychosocial information.

  15. The role of the emergency medical dispatch centre (EMDC) and prehospital emergency care safety: results from an incident report (IR) system.

    Science.gov (United States)

    Mortaro, Alberto; Pascu, Diana; Zerman, Tamara; Vallaperta, Enrico; Schönsberg, Alberto; Tardivo, Stefano; Pancheri, Serena; Romano, Gabriele; Moretti, Francesca

    2015-07-01

    The role of the emergency medical dispatch centre (EMDC) is essential to ensure coordinated and safe prehospital care. The aim of this study was to implement an incident report (IR) system in prehospital emergency care management with a view to detecting errors occurring in this setting and guiding the implementation of safety improvement initiatives. An ad hoc IR form for the prehospital setting was developed and implemented within the EMDC of Verona. The form included six phases (from the emergency call to hospital admission) with the relevant list of potential error modes (30 items). This descriptive observational study considered the results from 268 consecutive days between February and November 2010. During the study period, 161 error modes were detected. The majority of these errors occurred in the resource allocation and timing phase (34.2%) and in the dispatch phase (31.0%). Most of the errors were due to human factors (77.6%), and almost half of them were classified as either moderate (27.9%) or severe (19.9%). These results guided the implementation of specific corrective actions, such as the adoption of a more efficient Medical Priority Dispatch System and the development of educational initiatives targeted at both EMDC staff and the population. Despite the intrinsic limits of IR methodology, results suggest how the implementation of an IR system dedicated to the emergency prehospital setting can act as a major driver for the development of a "learning organization" and improve both efficacy and safety of first aid care.

  16. International research centre launched

    International Nuclear Information System (INIS)

    1965-01-01

    Full text: The first scientific research and educational institution to be set up on a completely international basis was officially inaugurated in Trieste on 5 October 1964 by the Director General of IAEA, Dr. Sigvard Eklund, when he opened the first seminar of the International Centre for Theoretical Physics. As evidence of the international nature of the institution he noted that the scientists who would work and teach there during the first year represented sixteen different countries. By the end of 1964, the Centre building was nearing completion and three of the five floors were occupied. A successful symposium had been held on the subject of plasma physics, and a score of professors and fellows were at work, from Bulgaria, Czechoslovakia, Greece, India, Japan, Jordan, the Netherlands, Norway, Pakistan, Poland, the United Kingdom, and the United States. A dozen scientific papers had been issued as preprints. The main purpose of the Centre is to foster the advancement of theoretical physics through training and research; at first the chief subject will be high-energy and elementary particle physics. Plasma physics, low energy physics and solid-state physics will also be dealt with. Special attention is paid to the needs of the developing countries. Of the 25 fellows selected for the academic year 1964-65, more than half are from South America, Africa and Asia. In conjunction with the Research Centre, there is an Advanced School for theoretical Physics to provide graduate training for fellows who need such preparation before they embark upon research. The Centre works under the guidance of a Scientific Council comprising the president, Prof. M. Sandoval-Vallarta (Nuclear Energy Commission of Mexico); Prof. A. Abragam (Saclay, France); Prof. R. Oppenheimer (Institute for Advanced Study, Princeton, USA); Dr. V. Soloviev (Dubna, USSR); Prof V.F. Weiskopf (Director General, CERN) ; Prof Abdus Salam (Imperial College, London) ; Prof. P. Budini (University of Trieste

  17. [Structured care in an ISO certified centre for patients with cystic fibrosis and their families].

    Science.gov (United States)

    Ellemunter, H; Eder, J; Steinkamp, G

    2011-10-01

    Cystic fibrosis (CF) is a chronic, life-shortening disease of multiple organ systems. Guidelines recommend that patients should be treated in specialised CF centres with multi-professional teams. We describe the organisation of medical care at the CF centre of Innsbruck University as well as results of treatment. Procedures and delivery of multi-professional care have been elaborated and structured. Since 2006 the Centre has been repeatedly certified according to DIN ISO 9001:2000. The patient database is being used during the doctor's consultation and for the continuous monitoring of treatment results. In 2010, 71 of the 148 patients (48%) were between 18 and 56 years old. The total number of patients has doubled and the proportion of adults tripled since 1995. Nevertheless, median FEV1 remained stable (>80% of predicted) during the last 15 years. Compared with 18 CF centres of the German Benchmarking Group, patients treated in Innsbruck had favourable FEV1 values: 52% of adults had a normal FEV1 (>80% pred.) and only 23% an FEV1 <50% of predicted. A structured programme of multi-professional care was associated with favourable treatment results, both longitudinally and in comparison to other CF centres. © Georg Thieme Verlag KG Stuttgart · New York.

  18. System of regional centres of first aid in cases of radiation accidents in Germany

    International Nuclear Information System (INIS)

    Fehringer, F.; Seitz, G.

    1996-01-01

    When in the seventies the number of occupational radiation exposed persons in the Federal Republic of Germany increased from about 35,000 (1974) to about 160,000 (1978) the Industrial Injuries Insurance Institutes felt prompted to reflect about special measures to prevent radiation accidents and provide health care for this special cases. They did so without any actual occasion: accidents were persons have been exposed by ionizing radiation were in the seventies just as rare as today. But that fact does not allow the Industrial Injuries Insurance Institutes to neglect the existing potential for severe accidents. So the Industrial Injuries Insurance Institute for the Electrical Industry including Precision Mechanics and the Industrial Injuries Insurance Institute for the Chemical Industry created the Institute for Radiation Protection in 1978. The primary task of that Institute is to guarantee an effective first aid in the case of a radiation accident. To realize that task the Institute contracted 11 wellknown institutions like radiological departments of large hospitals or the medical departments of research centres where the i knowledge on diagnostic and therapy of radiation effects is present. They are called 'Regionale Strahlenschutzzentren', Regional Centres for Radiation Protection (RCRP). In the case of radiation accidents these RCRP are the logistical centres for all arising questions of treatment. They have facilities for reconstructing exposure situations and assessing and evaluating doses, including measurements of internal contamination as well as for medical inpatient or out-patient treating like internal or external decontamination. Another important task of the RCRP is to advise employers in ad radiation protection questions which arise with the industrial application of ionizing radiation. Of course the centres give also answer to many question from members of the public, for example the personal effects of the power plant accident at Chernobyl

  19. Trichomonas vaginalis infection in a low-risk women attended in Obstetrics and Gynaecology Clinic, Universiti Kebangsaan Malaysia Medical Centre

    Institute of Scientific and Technical Information of China (English)

    Norhayati Moktar; Nor Liyana Ismail; Phoy Cheng Chun; Mohamad Asyrab Sapie; Nor Farahin Abdul Kahar; Yusof Suboh; Noraina Abdul Rahim; Nor Azlin Mohamed Ismail; Tengku Shahrul Anuar

    2016-01-01

    Objective: To investigate the presence of trichomoniasis among women attending the Obstetrics and Gynaecology Clinic, Universiti Kebangsaan Malaysia Medical Centre.Methods: A total of 139 high vaginal swabs were taken from the subjects and sent to the laboratory in Amies gel transport media. The specimens were examined for the presence of Trichomonas vaginalis using wet mount, Giemsa staining and cultured in Diamond’s medium. Sociodemographic characteristics and gynaecological complaints were obtained in private using structured questionnaire applied by one investigator.Results: The median age was 32 years, with an interquartile interval of 9.96. Most of the subjects were Malays(76.9%) and the remaining were Chinese(15.1%), Indians(2.2%)and other ethnic groups(5.8%). One hundred and thirty eight(99.3%) of the women were married and 98.6% had less than 6 children. More than half(75.5%) of the women’s last child birth was less than 6 years ago. Forty seven percent of them were involved in supporting administrative work and 64.7% of the women gave a history of previous or current vaginal discharge.Conclusions: The present study reported zero incidence rate of trichomoniasis. The low incidence rate was postulated due to all women who participated in this study were categorized into a low-risk group.

  20. Trichomonas vaginalis infection in a low-risk women attended in Obstetrics and Gynaecology Clinic, Universiti Kebangsaan Malaysia Medical Centre

    Institute of Scientific and Technical Information of China (English)

    Norhayati Moktar; Nor Liyana Ismail; Phoy Cheng Chun; Mohamad Asyrab Sapie; Nor Farahin Abdul Kahar; Yusof Suboh; Noraina Abdul Rahim; Nor Azlin Mohamed Ismail; Tengku Shahrul Anuar

    2016-01-01

    Objective: To investigate the presence of trichomoniasis among women attending the Obstetrics and Gynaecology Clinic, Universiti Kebangsaan Malaysia Medical Centre. Methods: A total of 139 high vaginal swabs were taken from the subjects and sent to the laboratory in Amies gel transport media. The specimens were examined for the presence of Trichomonas vaginalis using wet mount, Giemsa staining and cultured in Diamond's medium. Sociodemographic characteristics and gynaecological complaints were obtained in private using structured questionnaire applied by one investigator. Results: The median age was 32 years, with an interquartile interval of 9.96. Most of the subjects were Malays (76.9%) and the remaining were Chinese (15.1%), Indians (2.2%) and other ethnic groups (5.8%). One hundred and thirty eight (99.3%) of the women were married and 98.6%had less than 6 children. More than half (75.5%) of the women's last child birth was less than 6 years ago. Forty seven percent of them were involved in supporting administrative work and 64.7% of the women gave a history of previous or current vaginal discharge. Conclusions: The present study reported zero incidence rate of trichomoniasis. The low incidence rate was postulated due to all women who participated in this study were categorized into a low-risk group.

  1. Curricular trends in Malaysian medical schools: innovations within.

    Science.gov (United States)

    Azila, Nor Mohd Adnan; Rogayah, Jaafar; Zabidi-Hussin, Zabidi Azhar Mohd Hussin

    2006-09-01

    Various curricular innovations were adopted by medical schools worldwide in an attempt to produce medical graduates that could meet future healthcare needs of society locally and globally. This paper presents findings on curricular approaches implemented in Malaysian medical schools, in trying to meet those needs. Information was obtained from published records, responses from various questionnaires, personal communication and involvement with curricular development. Curricular innovations tended to be implemented in new medical schools upon their establishment. Established medical schools seemed to implement these innovations much later. Curricular trends appear to move towards integration, student-centred and problem-based learning as well as community-oriented medical education, with the Student-centred learning, Problem-based learning, Integrated teaching, Community-based education, Electives and Systematic programme (SPICES) model used as a reference. The focus is based on the premise that although the short-term aim of undergraduate medical education in Malaysia is to prepare graduates for the pre-registration house officer year, they must be able to practise and make decisions independently and be sensitive to the needs of the country's multiracial, multi-religious, and often remote communities. In most cases, curricular planning starts with a prescriptive model where planners focus on several intended outcomes. However, as the plan is implemented and evaluated it becomes descriptive as the planners reassess the internal and external factors that affect outcomes. A common trend in community-oriented educational activities is evident, with the introduction of interesting variations, to ensure that the curriculum can be implemented, sustained and the intended outcomes achieved.

  2. Studies on possibility of building radiation centre in Hunan Province

    International Nuclear Information System (INIS)

    Tang Chuandao

    1987-01-01

    Hunan province is rich in agriculture products and their by-products. The processing and preservation of those products after porduction is an urgent problem to solve. However, radiation techniques can solve the problem of the processing and preservation of part of those products which can not be solved by normal ways. Only in Changsha area, the products such as leather and their products, dried and fresh fruit, medical equipments, industrial chemicals and so on, which can be provided to irradiate, weigh over 1 x 10 5 tons a year. In order to advance the research and application of radiation techniques in the province, over 40 units have been investigated in the province and other provinces. Since 1983, six informal discussions or demonstration meetings were held. 15 pieces of various reports and materials have been put forward. The necessity, possibility, size, place, development aim and united research of building a radiation centre have been scientificly demonstrated and a certain basis have been provided for building radiation centre

  3. The role of the counsellor in a medical centre.

    Science.gov (United States)

    Harray, A S

    1975-12-10

    The counsellor is one member of the para-medical team being used more and more frequently by doctors. His role is allied to, but distinct from the doctor. He is not an authority figure who diagnoses and prescribes, but acts so as to help the patient diagnose the nature of his own dysfunction and assist him to draw on his own resources for growth and change. The methods the counsellor uses vary, but his goal harmonises with the doctor--the removal of disease from the psychosomatic unity of the patient.

  4. Les télécentres, centres de communications polyvalents | CRDI ...

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

    12 juil. 2011 ... ... la raison de leur absence et beaucoup répondent qu'ils ont eu une ... fournisseur de service Internet du télécentre, qui se trouve à Maputo ... Le télécentre s'est révélé être un fournisseur de services utile et recherché par les ...

  5. Attitudes of Medical Students, Clinicians and Sports Scientists Towards Exercise Counselling

    OpenAIRE

    Gnanendran, Abbyrhamy; Pyne, David B.; Fallon, Kieran E.; Fricker, Peter A.

    2011-01-01

    We compared the amount of exercise undertaken by medical students, clinicians, and sport scientists with the National Australian Physical Activity (NAPA) Guidelines. A second aim was to compare attitudes to exercise counselling as preventive medicine between university- and clinic-based professionals. The research setting was a university medical school and a sports science sports medicine centre. A 20-item questionnaire was completed by 216 individuals (131 medical students, 43 clinicians an...

  6. HUG sets up an emergency operations centre on the CERN site

    CERN Multimedia

    Antonella Del Rosso

    2015-01-01

    Discussions between CERN and the Hôpitaux universitaires de Genève (HUG), under the aegis of the Swiss authorities, have resulted in the setting-up of an emergency operations centre on the CERN site. This will be the operations base for an emergency doctor, a medical emergency vehicle and a driver. Located on the Swiss part of the Meyrin site, close to Building 57, it will be inaugurated on 20 May.   SMUR team based at CERN. CERN’s medical staff and fire-fighters dispense first aid but in medical emergencies they are obliged to call on outside services to treat and transfer patients to hospital. In the Canton of Geneva, this service is provided by HUG via the 144 emergency line. But HUG is based on the eastern side of Geneva, a long way from CERN, and response times can be substantial. In order to improve the safety of the growing number of people on the site, CERN asked Switzerland, as one of its Host States, to help it reduce the medical emergency response t...

  7. Training centres - organization and management

    International Nuclear Information System (INIS)

    Kovar, P.

    1986-01-01

    In the lecture 'Training centres - organization and management' some principles and requirements which influence the organization, management and activity pattern of nuclear training centres, are briefly introduced. It is demonstrated, step by step, how these general principles are implemented in the development of the Czechoslovak nuclear power programme, it means, how the training of the NPP personnel proceeds in Czechoslovak nuclear training centres. General principles which are selected: a connection between the capacity of the training centre and the scope and needs of the nuclear power programme, a position of the training center within the institutional set-up, a structure and organization of the training system which complies with the system of NPP construction, reflect the pattern and the activity of the nuclear training centre and nuclear power technical level, a research group of workers in the nuclear training centre, main tasks and technical facilities, management of the training process and a transfer of knowledge and research results into the training process. The lecture is supplemented by pictures and slides. (orig.)

  8. Perceived and normative needs, utilization of oral healthcare services, and barriers to utilization of dental care services at peripheral medical centre: Poonjeri, Mamallapuram, India

    Directory of Open Access Journals (Sweden)

    Prabhu Subramani

    2017-01-01

    Full Text Available Introduction: Dental care utilization is limited, and teeth are often left untreated or extracted in India. Several barriers exist for the utilization of dental services. The present study was undertaken to assess the oral healthcare needs, utilization pattern of oral healthcare services, and barriers to utilization of oral healthcare services among the outpatients of Peripheral Medical Centre, Poonjeri, Mamallapuram, India. Materials and Methods: Simple random sampling was conducted among outpatients and their attenders reporting to the health centre; demographic profile of the patients were recorded followed by interviewer-administered questionnaire for recording the self-perceived dental needs and barriers in utilizing dental care services followed by Type II clinical examination to assess normative dental treatment needs. Results: N =282 study participants participated in the present study; majority of the study participants were from upper lower class and lower middle class. Among the study subjects n = 124 (44% have not accessed any dentist, n = 112 (39.7% had visited dentist for toothache. Common reason cited as Self – perceived barriers for dental care are n = 184 (65.2% – 'Unaware of the dental problems' and n = 118 (41.8% 'Fear of dental treatment'. Logistic regression showed that significant difference was seen in gender, socioeconomic status, and barriers to dental care (P < 0.05 in influencing the utilization pattern of dental care. Conclusion: Perceived and normative dental needs were high among the study population due to problem-oriented care, and it is influenced by various barriers such as unawareness of dental problems, fear, cost, accessibility, and time.

  9. Top-down or bottom-up: Contrasting perspectives on psychiatric diagnoses

    Directory of Open Access Journals (Sweden)

    Willem MA Verhoeven

    2008-09-01

    Full Text Available Willem MA Verhoeven1,2, Siegfried Tuinier1, Ineke van der Burgt31Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands; 2Department of Psychiatry, Erasmus University Medical Centre, Rotterdam, The Netherlands; 3Department of Human Genetics, Radboud University Medical Centre, Nijmegen, The NetherlandsAbstract: Clinical psychiatry is confronted with the expanding knowledge of medical genetics. Most of the research into the genetic underpinnings of major mental disorders as described in the categorical taxonomies, however, did reveal linkage with a variety of chromosomes. This heterogeneity of results is most probably due to the assumption that the nosological categories as used in these studies are disease entities with clear boundaries. If the reverse way of looking, the so-called bottom-up approach, is applied, it becomes clear that genetic abnormalities are in most cases not associated with a single psychiatric disorder but with a certain probability to develop a variety of aspecific psychiatric symptoms. The adequacy of the categorical taxonomy, the so-called top-down approach, seems to be inversely related to the amount of empirical etiological data. This is illustrated by four rather prevalent genetic syndromes, fragile X syndrome, Prader-Willi syndrome, 22q11 deletion syndrome, and Noonan syndrome, as well as by some cases with rare chromosomal abnormalities. From these examples, it becomes clear that psychotic symptoms as well as mood, anxiety, and autistic features can be found in a great variety of different genetic syndromes. A psychiatric phenotype exists, but comprises, apart from the chance to present several psychiatric symptoms, all elements from developmental, neurocognitive, and physical characteristics.Keywords: genetic disorders, psychiatric symptoms, phenotype, mental disorders

  10. Nutrition guidelines for undergraduate medical curricula: a six-country comparison

    OpenAIRE

    Crowley, Jennifer; Ball, Lauren; Laur, Celia; Wall, Clare; Arroll, Bruce; Poole, Phillippa; Ray, Sumantra

    2015-01-01

    Jennifer Crowley,1 Lauren Ball,2 Celia Laur,3 Clare Wall,1 Bruce Arroll,4 Phillippa Poole,5 Sumantra Ray3 1Discipline of Nutrition, School of Medical Sciences, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand; 2Centre for Health Practice Innovation, Griffith University, Gold Coast, QLD, Australia; 3Need for Nutrition Education/Innovation Programme, Medical Research Council Human Nutrition Research, Cambridge, UK; 4Department of General Practice and Pri...

  11. Call Centre- Computer Telephone Integration

    Directory of Open Access Journals (Sweden)

    Dražen Kovačević

    2012-10-01

    Full Text Available Call centre largely came into being as a result of consumerneeds converging with enabling technology- and by the companiesrecognising the revenue opportunities generated by meetingthose needs thereby increasing customer satisfaction. Regardlessof the specific application or activity of a Call centre, customersatisfaction with the interaction is critical to the revenuegenerated or protected by the Call centre. Physical(v, Call centreset up is a place that includes computer, telephone and supervisorstation. Call centre can be available 24 hours a day - whenthe customer wants to make a purchase, needs information, orsimply wishes to register a complaint.

  12. Addressing the challenges of patient-centred design

    Directory of Open Access Journals (Sweden)

    Karen LaBat

    2009-11-01

    Full Text Available Patient-centred design is a relatively new term, but a longstanding concept in clinical practice. This discussion looks at patient-centred design and explores the relationships of patient-centred design to universal design, user-centred design and the newer human-centred design. It also explores why interdisciplinary approaches are needed for patient-centred design and how interdisciplinary collaboration works to address the challenges of patient centred design. Successful patient-centred solutions can grow from collaborations which include shared visions, understanding of both the nature and degree of variation in the patient,materials, and the designed solution, clear regular communication among all parties with careful definition of terms, and respect for the inherent cultures of all disciplines involved.

  13. Baseline dietary glutamic acid intake and the risk of colorectal cancer: The Rotterdam study.

    Science.gov (United States)

    Viana Veloso, Gilson G; Franco, Oscar H; Ruiter, Rikje; de Keyser, Catherina E; Hofman, Albert; Stricker, Bruno C; Kiefte-de Jong, Jessica C

    2016-03-15

    Animal studies have shown that glutamine supplementation may decrease colon carcinogenesis, but any relation with glutamine or its precursors has not been studied in humans. The primary aim of this study was to assess whether dietary glutamic acid intake was associated with colorectal cancer (CRC) risk in community-dwelling adults. A secondary aim was to evaluate whether the association could be modified by the body mass index (BMI). This study was embedded in the Rotterdam study, which included a prospective cohort from 1990 onward that consisted of 5362 subjects who were 55 years old or older and were free of CRC at the baseline. Glutamic acid was calculated as a percentage of the total protein intake with a validated food frequency questionnaire at the baseline. Incident cases of CRC were pathology-based. During follow-up, 242 subjects developed CRC. Baseline dietary glutamic acid intake was significantly associated with a lower risk of developing CRC (hazard ratio [HR] per percent increase in glutamic acid of protein, 0.78; 95% confidence interval [CI], 0.62-0.99). After stratification for BMI, the risk reduction for CRC by dietary glutamic acid was 42% for participants with a BMI ≤ 25 kg/m(2) (HR per percent increase in glutamic acid of protein, 0.58; 95% CI, 0.40-0.85), whereas no association was found in participants with a BMI > 25 kg/m(2) (HR per percent increase in glutamic acid of protein, 0.97; 95% CI, 0.73-1.31). Our data suggest that baseline dietary glutamic acid intake is associated with a lower risk of developing CRC, but this association may be mainly present in nonoverweight subjects. © 2015 American Cancer Society.

  14. The ENDORSE study: Research into environmental determinants of obesity related behaviors in Rotterdam schoolchildren

    Directory of Open Access Journals (Sweden)

    Looij-Jansen Petra

    2008-04-01

    Full Text Available Abstract Background Children and adolescents are important target groups for prevention of overweight and obesity as overweight is often developed early in life and tracks into adulthood. Research into behaviors related to overweight (energy balance-related behaviors and the personal and environmental determinants of these behaviors is fundamental to inform prevention interventions. In the Netherlands and in other countries systematic research into environmental determinants of energy balance related behaviors in younger adolescents is largely lacking. This protocol paper describes the design, the components and the methods of the ENDORSE study (Environmental Determinants of Obesity in Rotterdam SchoolchildrEn, that aims to identify important individual and environmental determinants of behaviors related to overweight and obesity and the interactions between these determinants among adolescents. Methods The ENDORSE study is a longitudinal study with a two-year follow-up of a cohort of adolescents aged 12–15 years. Data will be collected at baseline (2005/2006 and at two years follow-up (2007/2008. Outcome measures are body mass index (BMI, waist circumference, time spent in physical activity and sedentary behaviors, and soft drink, snack and breakfast consumption. The ENDORSE study consists of two phases, first employing qualitative research methods to inform the development of a theoretical framework to examine important energy balance related behaviors and their determinants, and to inform questionnaire development. Subsequently, the hypothetical relationships between behavioral determinants, energy balance related behaviors and BMI will be tested in a quantitative study combining school-based surveys and measurements of anthropometrical characteristics at baseline and two-year follow-up. Discussion The ENDORSE project is a comprehensive longitudinal study that enables investigation of specific environmental and individual determinants of

  15. Towards a standardised informed consent procedure for live donor nephrectomy: the PRINCE (Process of Informed Consent Evaluation) project-study protocol for a nationwide prospective cohort study.

    Science.gov (United States)

    Kortram, Kirsten; Spoon, Emerentia Q W; Ismail, Sohal Y; d'Ancona, Frank C H; Christiaans, Maarten H L; van Heurn, L W Ernest; Hofker, H Sijbrand; Hoksbergen, Arjan W J; Homan van der Heide, Jaap J; Idu, Mirza M; Looman, Caspar W N; Nurmohamed, S Azam; Ringers, Jan; Toorop, Raechel J; van de Wetering, Jacqueline; Ijzermans, Jan N M; Dor, Frank J M F

    2016-04-01

    Informed consent is mandatory for all (surgical) procedures, but it is even more important when it comes to living kidney donors undergoing surgery for the benefit of others. Donor education, leading to informed consent, needs to be carried out according to certain standards. Informed consent procedures for live donor nephrectomy vary per centre, and even per individual healthcare professional. The basis for a standardised, uniform surgical informed consent procedure for live donor nephrectomy can be created by assessing what information donors need to hear to prepare them for the operation and convalescence. The PRINCE (Process of Informed Consent Evaluation) project is a prospective, multicentre cohort study, to be carried out in all eight Dutch kidney transplant centres. Donor knowledge of the procedure and postoperative course will be evaluated by means of pop quizzes. A baseline cohort (prior to receiving any information from a member of the transplant team in one of the transplant centres) will be compared with a control group, the members of which receive the pop quiz on the day of admission for donor nephrectomy. Donor satisfaction will be evaluated for all donors who completed the admission pop-quiz. The primary end point is donor knowledge. In addition, those elements that have to be included in the standardised format informed consent procedure will be identified. Secondary end points are donor satisfaction, current informed consent practices in the different centres (eg, how many visits, which personnel, what kind of information is disclosed, in which format, etc) and correlation of donor knowledge with surgeons' estimation thereof. Approval for this study was obtained from the medical ethical committee of the Erasmus MC, University Medical Center, Rotterdam, on 18 February 2015. Secondary approval has been obtained from the local ethics committees in six participating centres. Approval in the last centre has been sought. Outcome will be published in a

  16. Acute renal failure in the medical ICU still predictive of high mortality ...

    African Journals Online (AJOL)

    Background. We aimed to determine the outcome and certain predictors of outcome for acute renal failure (ARF) in the medical intensive care unit (ICU) at Tygerberg Hospital. Method. We conducted a retrospective, single-centre cohort study over 12 months comprising all patients admitted to the medical ICU with all causes ...

  17. Tinnitus and psychiatric comorbidities in liaison psychiatry analysis of three years in an audiophonology centre.

    Science.gov (United States)

    Jacques, Denis; Nozeret, Yves; Zdanowicz, Nicolas; Reynaert, Christine; Garin, Pierre; Gilain, Chantal

    2013-09-01

    Patients who are suffering from tinnitus are rarely directly referred to an audiophonology centre. Often, they have tried several medications and met with several doctors. Sometimes, they are also referred too quickly to a psychiatrist without a complete ENT assessment. Nevertheless, they frequently develop psychiatric comorbidities in regard to the tinnitus. On the basis of structured interviews with the "Mini International Neuropsychiatric Interview" and on a review of records, we assessed the associated psychiatric diagnoses in patients who consulted for tinnitus as their main complaint at the audiophonology centre from the University Hospital Centre of Mont-Godinne-Dinant between 2009 and 2012. Of the 80 patients who consulted for tinnitus, 28% suffered from a major depressive disorder, 27.5% from a somatoform disorder, 23.7% from sleep disorder, 22.5% from an anxiety disorder and 16% from alcoholic dependence. On the basis of these results, we developed clinical considerations concerning the treatment approach and options for patients suffering from tinnitus with psychiatric comorbidities. The interdisciplinary approach (ENT and liaison psychiatry) in an audiophonology centre seems to be a factor for better treatment adherence for patients with severe and chronic tinnitus.

  18. Cost-utility of collaborative care for the treatment of comorbid major depressive disorder in outpatients with chronic physical conditions. A randomized controlled trial in the general hospital setting (CC-DIM

    Directory of Open Access Journals (Sweden)

    Goorden M

    2017-07-01

    Full Text Available Maartje Goorden,1 Christina M van der Feltz-Cornelis,2,3 Kirsten M van Steenbergen-Weijenburg,4 Eva K Horn,5 Aartjan TF Beekman,6,7 Leona Hakkaart-van Roijen1 1Institute of Health Policy and Management (iBMG/Institute for Medical Technology Assessment (iMTA, Erasmus University Rotterdam, Rotterdam, 2Tranzo Department, Tilburg University, 3Clinical Centre of Excellence for Body, Mind and Health, GGzBreburg, Tilburg, 4Trimbos Instituut, Utrecht, 5Viersprong Institute for Studies on Personality Disorders, Halsteren, 6Department of Psychiatry, 7EMGO+ Research Institute VUmc, VU University Medical Centre, Amsterdam, the Netherlands Purpose: Major depressive disorder (MDD is highly prevalent in patients with a chronic physical condition, and this comorbidity has a negative influence on quality of life, health care costs, self-care, morbidity, and mortality. Research has shown that collaborative care (CC may be a cost-effective treatment. However, its cost-effectiveness in this patient group has not yet been established. Therefore, the aim of this study was to evaluate the cost-utility of CC for the treatment of comorbid MDD in chronically ill patients in the outpatient general hospital setting. The study was conducted from a health care and societal perspective.Patients and methods: In this randomized controlled trial, 81 patients with moderate-to-severe MDD were included; 42 were randomly assigned to the CC group and 39 to the care as usual (CAU group. We applied the TiC-P, short-form Health-Related Quality of Life questionnaire, and EuroQol EQ-5D 3 level version, measuring the use of health care, informal care, and household work, respectively, at baseline and at 3, 6, 9, and 12 months follow-up.Results: The mean annual direct medical costs in the CC group were €6,718 (95% confidence interval [CI]: 3,541 to 10,680 compared to €4,582 (95% CI: 2,782 to 6,740 in the CAU group. The average quality-adjusted life years (QALYs gained were 0.07 higher

  19. Neighbourhood Centres – Organisation, Management and Finance

    DEFF Research Database (Denmark)

    Larsen, Jacob Norvig

    to identify different financial models and analyse economic sustainability. As regards organisational and management models data were collected through documentary sources and by means of personal interviews and field visits to ten centres. Even within the analysed limited population of centres economic...... public subsidy. Some of the centres have high number of users on a daily basis, whereas others are only rarely used. It is explored how organisation, management and financial set-up differs among the centres. Quantitative data on financial issues and annual accounts of fifteen centres were analysed...... and institutional sustainability varies significantly. In organisational terms centres range from fully-integrated in the municipal administration to independent voluntary managed centres. In terms of financial, or economic, models variation is less pronounced as all centres to some degree are dependent on current...

  20. A systematic review of the challenges to implementation of the patient-centred medical home: lessons for Australia.

    Science.gov (United States)

    Janamian, Tina; Jackson, Claire L; Glasson, Nicola; Nicholson, Caroline

    2014-08-04

    To review the available literature to identify the major challenges and barriers to implementation and adoption of the patient-centred medical home (PCMH) model, topical in current Australian primary care reforms. Systematic review of peer-reviewed literature. PubMed and Embase databases were searched in December 2012 for studies published in English between January 2007 and December 2012. Studies of any type were included if they defined PCMH using the Patient-Centered Primary Care Collaborative Joint Principles, and reported data on challenges and barriers to implementation and adoption of the PCMH model. One researcher with content knowledge in the area abstracted data relating to the review objective and study design from eligible articles. A second researcher reviewed the abstracted data alongside the original article to check for accuracy and completeness. Thematic synthesis was used to in three stages: free line-by-line coding of data; organisation of "free codes" into related areas to construct "descriptive" themes and develop "analytical" themes. The main barriers identified related to: challenges with the transformation process; difficulties associated with change management; challenges in implementing and using an electronic health record that administers principles of PCMH; challenges with funding and appropriate payment models; insufficient resources and infrastructure within practices; and inadequate measures of performance. This systematic review documents the key challenges and barriers to implementing the PCMH model in United States family practice. It provides valuable evidence for Australian clinicians, policymakers, and organisations approaching adoption of PCMH elements within reform initiatives in this country.

  1. retrospective data analysis in the Fertility Centre from 1995 to 2000

    OpenAIRE

    Nahid, Hiwa

    2016-01-01

    Introduction: It is estimated that worldwide seven to nine percent of couples of reproductive age suffer from infertility and more than 6 million children were already born with the support of in vitro fertilization (IVF). Methodology: In the first part of this study, the medical records of 4136 patients in the Fertility Centre Berlin over a period of time from 1995 to 2000 in terms of duration of infertility were evaluated retrospectively. The age of women, the age difference between the ...

  2. Doctor-patient interaction in Finnish primary health care as perceived by first year medical students

    Directory of Open Access Journals (Sweden)

    Mäntyselkä Pekka

    2005-09-01

    Full Text Available Abstract Background In Finland, public health care is the responsibility of primary health care centres, which render a wide range of community level preventive, curative and rehabilitative medical care. Since 1990's, medical studies have involved early familiarization of medical students with general practice from the beginning of the studies, as this pre-clinical familiarisation helps medical students understand patients as human beings, recognise the importance of the doctor-patient relationship and identify practicing general practitioners (GPs as role models for their professional development. Focused on doctor-patient relationship, we analysed the reports of 2002 first year medical students in the University of Kuopio. The students observed GPs' work during their 2-day visit to primary health care centres. Methods We analysed systematically the texts of 127 written reports of 2002, which represents 95.5% of the 133 first year pre-clinical medical students reports. The reports of 2003 (N = 118 and 2004 (N = 130 were used as reference material. Results Majority of the students reported GPs as positive role models. Some students reported GPs' poor attitudes, which they, however, regarded as a learning opportunity. Students generally observed a great variety of responsibilities in general practice, and expressed admiration for the skills and abilities required. They appreciated the GPs' interest in patients concerns. GPs' communication styles were found to vary considerably. Students reported some factors disturbing the consultation session, such as the GP staring at the computer screen and other team members entering the room. Working with marginalized groups, the chronically and terminally ill, and dying patients was seen as an area for development in the busy Finnish primary health care centres. Conclusion During the analysis, we discovered that medical students' perceptions in this study are in line with the previous findings about the

  3. Preclinical medical students' performance in and reflections on ...

    African Journals Online (AJOL)

    Background. An effective patient-centred consultation requires the seamless integration of procedural (technical) and communication skills. Research has shown that the two sets of skills should not be taught or assessed separately; yet, clinical communication education has become separated from other parts of medical ...

  4. Challenges in interprofessional collaboration: Experiences of care providers and policymakers in a newly set-up Dutch assault centre

    NARCIS (Netherlands)

    Zijlstra, J.E.; Lo Fo Wong, S.H.; Teerling, A.; Hutschemaekers, G.J.M.; Lagro-Janssen, A.

    2018-01-01

    Background: Sexual and family violence are problems that affect many women and men, and the negative health consequences of violence are numerous. As adequate acute interprofessional care can prevent negative health consequences and improve forensic medical examination, a Centre for Sexual and

  5. Energy centre microgrid model

    Energy Technology Data Exchange (ETDEWEB)

    Pasonen, R.

    2011-09-15

    A simulation model of Energy centre microgrid made with PSCAD simulation software version 4.2.1 has been built in SGEM Smart Grids and Energy Markets (SGEM) work package 6.6. Microgrid is an autonomous electric power system which can operate separate from common distribution system. The idea of energy centre microgrid concept was considered in Master of Science thesis 'Community Microgrid - A Building block of Finnish Smart Grid'. The name of energy centre microgrid comes from a fact that production and storage units are concentrated into a single location, an energy centre. This centre feeds the loads which can be households or industrial loads. Power direction flow on the demand side remains same compared to the current distribution system and allows to the use of standard fuse protection in the system. The model consists of photovoltaic solar array, battery unit, variable frequency boost converter, inverter, isolation transformer and demand side (load) model. The model is capable to automatically switch to islanded mode when there is a fault in outside grid and back to parallel operation mode when fault is removed. The modelled system responses well to load changes and total harmonic distortion related to 50Hz base frequency is kept under 1.5% while operating and feeding passive load. (orig.)

  6. Development of an integral assessment approach of health status in patients with obstructive airway diseases: the CORONA study

    Directory of Open Access Journals (Sweden)

    van den Akker EF

    2015-11-01

    Full Text Available Edmée FMM van den Akker,1 Alex J van ‘t Hul,2 Niels H Chavannes,3 Gert-Jan Braunstahl,1 Alie van Bruggen,1 Maureen PMH Rutten-van Mölken,4 Johannes CCM in ‘t Veen1 1Department of Pulmonary Diseases, STZ Center of Excellence for Asthma & COPD, Sint Franciscus Gasthuis, Rotterdam, 2Department of Pulmonary Disease, Radboud University Medical Center, Nijmegen, 3Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, 4Department of Health Care Policy and Management, Institute of Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, the Netherlands Background: Traditional assessment of patients with obstructive lung diseases (asthma and chronic obstructive pulmonary disease; COPD relies on physiological tests. The COPD and Asthma Rotterdam Integrated Care Approach (CORONA study aims to develop a diagnostic pathway with a more comprehensive approach to the assessment of patients with asthma and COPD in secondary care.Methods: An eight-step method was used to develop and implement the pathway for patients with asthma or COPD referred to an outpatient hospital setting.Results: The diagnostic pathway consists of an evidence-based set of measurements prioritized by a Delphi procedure. The pathway incorporates three innovative diagnostics: the metronome-paced hyperventilation test to measure dynamic hyperinflation, an activity monitor to objectively evaluate physical activity in daily life, and the Nijmegen Clinical Screening Instrument as a comprehensive assessment tool to acquire detailed insight into symptoms, functional limitations, and quality of life.Conclusion: An innovative diagnostic pathway was developed and implemented for patients with obstructive lung diseases referred to secondary care. As this pathway aims to provide a comprehensive analysis of health status, it focuses on biomedical aspects and also reviews behavioral aspects that further elucidate the patient’s health status. The

  7. RTEMS CENTRE- Support and Maintenance CENTRE to RTEMS Operating System

    Science.gov (United States)

    Silva, H.; Constantino, A.; Coutunho, M.; Freitas, D.; Faustino, S.; Mota, M.; Colaço, P.; Zulianello, M.

    2008-08-01

    RTEMS stands for Real-Time Operating System for Multiprocessor Systems. It is a full featured Real Time Operating System that supports a variety of open APIs and interface standards. It provides a high performance environment for embedded applications, including a fixed-priority preemptive/non-preemptive scheduler, a comprehensive set of multitasking operations and a large range of supported architectures. Support and maintenance CENTRE to RTEMS operating system (RTEMS CENTRE) is a joint initiative of ESA-Portugal Task force, aiming to build a strong technical competence in the space flight (on- board) software, to offer support, maintenance and improvements to RTEMS. This paper provides a high level description of the current and future activities of the RTEMS CENTRE. It presents a brief description of the RTEMS operating system, a description of the tools developed and distributed to the community [1] and the improvements to be made to the operating system, including facilitation for the qualification of RTEMS (4.8.0) [2] for the space missions.

  8. Femoral neck BMD is a strong predictor of hip fracture susceptibility in elderly men and women because it detects cortical bone instability: the Rotterdam Study.

    Science.gov (United States)

    Rivadeneira, Fernando; Zillikens, M Carola; De Laet, Chris Edh; Hofman, Albert; Uitterlinden, André G; Beck, Thomas J; Pols, Huibert Ap

    2007-11-01

    We studied HSA measurements in relation to hip fracture risk in 4,806 individuals (2,740 women). Hip fractures (n = 147) occurred at the same absolute levels of bone instability in both sexes. Cortical instability (propensity of thinner cortices in wide diameters to buckle) explains why hip fracture risk at different BMD levels is the same across sexes. Despite the sexual dimorphism of bone, hip fracture risk is very similar in men and women at the same absolute BMD. We aimed to elucidate the main structural properties of bone that underlie the measured BMD and that ultimately determines the risk of hip fracture in elderly men and women. This study is part of the Rotterdam Study (a large prospective population-based cohort) and included 147 incident hip fracture cases in 4,806 participants with DXA-derived hip structural analysis (mean follow-up, 8.6 yr). Indices compared in relation to fracture included neck width, cortical thickness, section modulus (an index of bending strength), and buckling ratio (an index of cortical bone instability). We used a mathematical model to calculate the hip fracture distribution by femoral neck BMD, BMC, bone area, and hip structure analysis (HSA) parameters (cortical thickness, section modulus narrow neck width, and buckling ratio) and compared it with prospective data from the Rotterdam Study. In the prospective data, hip fracture cases in both sexes had lower BMD, thinner cortices, greater bone width, lower strength, and higher instability at baseline. In fractured individuals, men had an average BMD that was 0.09 g/cm(2) higher than women (p men and women. No significant differences were observed between the areas under the ROC curves of BMD (0.8146 in women and 0.8048 in men) and the buckling ratio (0.8161 in women and 0.7759 in men). The buckling ratio (an index of bone instability) portrays in both sexes the critical balance between cortical thickness and bone width. Our findings suggest that extreme thinning of cortices in

  9. The Impact on Tan Tock Seng Hospital’s Teaching Culture of Transforming into an Academic Health Centre

    OpenAIRE

    Tham, K. Y.

    2016-01-01

    Tan Tock Seng Hospital (TTSH), Singapore has a commendable “teaching culture” that teaches medical students well. The first research question is to understand how the teaching culture has been built in TTSH. In 2009 the Nanyang Technological University (NTU) invited TTSH to be its partner to start a new medical school, transforming TTSH into an academic health centre (AHC). The second research question is, “What is the impact on TTSH’s teaching culture of transforming into an AHC?” Qualitativ...

  10. Higher Education Is Associated with a Lower Risk of Dementia after a Stroke or TIA. The Rotterdam Study.

    Science.gov (United States)

    Mirza, Saira Saeed; Portegies, Marileen L P; Wolters, Frank J; Hofman, Albert; Koudstaal, Peter J; Tiemeier, Henning; Ikram, M Arfan

    2016-01-01

    Higher education is associated with a lower risk of dementia, possibly because of a higher tolerance to subclinical neurodegenerative pathology. Whether higher education also protects against dementia after clinical stroke or transient ischemic attack (TIA) remains unknown. Within the population-based Rotterdam Study, 12,561 participants free of stroke, TIA and dementia were followed for occurrence of stroke, TIA and dementia. Across the levels of education, associations of incident stroke or TIA with subsequent development of dementia and differences in cognitive decline following stroke or TIA were investigated. During 124,862 person-years, 1,463 persons suffered a stroke or TIA, 1,158 persons developed dementia, of whom 186 developed dementia after stroke or TIA. Risk of dementia after a stroke or TIA, compared to no stroke or TIA, was highest in the low education category (hazards ratio [HR] 1.46, 95% CI 1.18-1.81) followed by intermediate education category (HR 1.36, 95% CI 1.03-1.81). No significant association was observed in the high education category (HR 0.62, 95% CI 0.25-1.54). In gender stratified analyses, decrease in risk of dementia with increasing education was significant only in men. Higher education is associated with a lower risk of dementia after stroke or TIA, particularly in men, which might be explained by a higher cognitive reserve. © 2016 S. Karger AG, Basel.

  11. Assessing patient-centred communication in teaching: a systematic review of instruments.

    Science.gov (United States)

    Brouwers, Marianne; Rasenberg, Ellemieke; van Weel, Chris; Laan, Roland; van Weel-Baumgarten, Evelyn

    2017-11-01

    Patient-centred communication is a key component of patient centredness in medical care. Therefore, adequate education in and assessment of patient-centred communication skills are necessary. In general, feedback on communication skills is most effective when it is provided directly and is systematic. This calls for adequate measurement instruments. The aim of this study was to provide a systematic review of existing instruments that measure patient centredness in doctor-patient communication and can be used to provide direct feedback. A systematic review was conducted using an extensive validated search strategy for measurement instruments in PubMed, EMBASE, PsycINFO and CINAHL. The databases were searched from their inception to 1 July 2016. Articles describing the development or evaluation of the measurement properties of instruments that measure patient centredness (by applying three or more of the six dimensions of a published definition of patient centredness) in doctor-patient communication and that can be used for the provision of direct feedback were included. The methodological quality of measurement properties was evaluated using the COSMIN checklist. Thirteen articles describing 14 instruments measuring patient centredness in doctor-patient communication were identified. These studies cover a wide range of settings and patient populations, and vary in the dimensions of patient centredness applied and in methodological quality on aspects of reliability and validity. This review gives a comprehensive overview of all instruments available for the measurement of patient centredness in doctor-patient communication that can be used for the provision of direct feedback and are described in the literature. Despite the widely felt need for valid and reliable instruments for the measurement of patient-centred communication, most of the instruments currently available have not been thoroughly investigated. Therefore, we recommend further research into and

  12. The politics of patient-centred care.

    Science.gov (United States)

    Kreindler, Sara A

    2015-10-01

    Despite widespread belief in the importance of patient-centred care, it remains difficult to create a system in which all groups work together for the good of the patient. Part of the problem may be that the issue of patient-centred care itself can be used to prosecute intergroup conflict. This qualitative study of texts examined the presence and nature of intergroup language within the discourse on patient-centred care. A systematic SCOPUS and Google search identified 85 peer-reviewed and grey literature reports that engaged with the concept of patient-centred care. Discourse analysis, informed by the social identity approach, examined how writers defined and portrayed various groups. Managers, physicians and nurses all used the discourse of patient-centred care to imply that their own group was patient centred while other group(s) were not. Patient organizations tended to downplay or even deny the role of managers and providers in promoting patient centredness, and some used the concept to advocate for controversial health policies. Intergroup themes were even more obvious in the rhetoric of political groups across the ideological spectrum. In contrast to accounts that juxtaposed in-groups and out-groups, those from reportedly patient-centred organizations defined a 'mosaic' in-group that encompassed managers, providers and patients. The seemingly benign concept of patient-centred care can easily become a weapon on an intergroup battlefield. Understanding this dimension may help organizations resolve the intergroup tensions that prevent collective achievement of a patient-centred system. © 2013 John Wiley & Sons Ltd.

  13. On organization of medical radionuclides production in Ukraine

    International Nuclear Information System (INIS)

    Zelens'kij, V.F.; Pilipenko, M.Yi.; Shulyika, M.G.; Skibyin, V.Yi.; Kostyin, V.Ya.; Vyikman, Ya.E.; Kalmikov, L.Z.; Nesterov, V.G.; Krasnoperova, A.P.

    1994-01-01

    Annual demand for radiopharmaceuticals in Ukraine is about 50.000 GBq and expenses for their purchase are about 1 - 2 mln US dollars per year. It determines expediency of their production in Ukraine. Taking into consideration the fact that one of the aftereffects of the accident at Chernobyl Atomic Power Station is inevitable increase of the number of oncological diseases (including malignant growths of the thyroid gland) the demand for radionuclides will be increasing steadily. Therefore, it is clear that organization of the centre for radiopharmaceuticals production will not solve the problem of providing radiological departments with them. One of the possible ways to solve the problem is creation of a network of regional centres for radioactive isotopes production. Realisation of the suggested program will allow to solve the problem of providing the medical establishments of Ukraine with medical radionuclides. Performed technical and economical evaluation shows that the expenses will be compensated in 2.9 years

  14. Communications strategy for the Chernobyl Centre

    International Nuclear Information System (INIS)

    Kurilchik, Mykola; Green, Len

    2000-01-01

    This Communications Strategy was developed for the International Chernobyl Centre (ICC) as part of a joint UK/Ukraine project, sponsored by the Department of Trade and Industry and NNC Limited. The Plan was developed during four weeks of workshop discussions in the UK between staff from the centre and experienced PR Professionals from NNC Limited. The requirements for a sustained communications activity at the ICC go much further than simply enhancing or promoting the Centre's scientific and technical activities. Raising sufficient awareness of the Centre among potential funding agents and commercial partners is critical to its future development as a major centre for international co-operation and research. It is only through establishing and developing effective communications that the Centre will become well enough known and understood both within the Ukraine, and internationally, to secure its long term future. However, as the workshop programme unfolded, it also became clear that communications was in itself a legitimate and necessary function of the Centre, and part of the foundations of its existence. The Centre has a fundamental role as an 'information exchange', collecting and communicating information from within the Ukraine to the rest of the world, and interpreting world interest and attitudes to the Ukraine Government and nuclear industry. As such compliments the efforts of individual power plant and corporate PR functions within the Ukraine nuclear energy sector

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

    Science.gov (United States)

    Rostovtsev, E A; Sidorchuk, I V

    2014-09-01

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

  16. Complejo deportivo y sala de exposiciones «Ahoy». en Roherdam – Holanda

    Directory of Open Access Journals (Sweden)

    Passchier, G.

    1975-09-01

    Full Text Available This complex occupies an extraordinarily situated plot, in view of its excellent communications, and it is bound to become a centre of great social and economic importance. It is located only 12 minutes away from Rotterdam railway station and equally close to bus and underground transports and will eventually comprise: a shopping centre, garages, office buildings, housings, a hotel, etc. This article especially describes: the sports palace, with 6,000 seats; a central building for restaurants, coffe-shops, offices, the press and installations; exhibition halls, with altogether 12,000 m2 of exhibition space.Este conjunto edificado ocupa un solar de extraordinaria ubicación, en cuanto a comunicaciones se refiere, y está llamado a ser un centro de gran importancia social y económica. A sólo 12 minutos de la estación de ferrocarril de Rotterdam y en conexión con ella y con otros puntos vitales por autobús y metro, comprenderá: un centro comercial, garajes, edificios de oficinas, viviendas, un hotel, etc. En este artículo se describen especialmente: el palacio de deportes, de 6.000 plazas sentadas; un edificio central para restaurantes, cafeterías, oficinas, prensa e instalación; y salas de exposiciones, con un total de 12.000 m2 utilizables.

  17. Effect of obstetric team training on team performance and medical technical skills: a randomised controlled trial

    NARCIS (Netherlands)

    Fransen, A.F.; Ven, van de J.; Merién, A.E.R.; Wit-Zuurendonk, de L.D.; Houterman, S.; Mol, B.W.J.; Oei, S.G.

    2012-01-01

    Objective To determine whether obstetric team training in a medical simulation centre improves the team performance and utilisation of appropriate medical technical skills of healthcare professionals. Design Cluster randomised controlled trial. Setting The Netherlands. Sample The obstetric

  18. Aligning Islamic Spirituality to Medical Imaging.

    Science.gov (United States)

    Zainuddin, Zainul Ibrahim

    2017-10-01

    This paper attempts to conceptualize Islamic spirituality in medical imaging that deals with the humanistic and technical dimensions. It begins with establishing an understanding concerning spirituality, an area that now accepted as part of patient-centred care. This is followed by discussions pertaining to Islamic spirituality, related to the practitioner, patient care and the practice. Possible avenues towards applying Islamic spirituality in medical imaging are proposed. It is hoped that the resultant harmonization between Islamic spirituality and the practice will trigger awareness and interests pertaining to the role of a Muslim practitioner in advocating and enhancing Islamic spirituality.

  19. Discussion on 'Centres of excellence' in Africa

    International Nuclear Information System (INIS)

    Riad, S.

    1999-01-01

    In Africa, Centres of Excellence should be oriented to build up scientific and technological capacity in the four topics of international Monitoring System related technologies, namely, seismic monitoring, hydro acoustic monitoring, infrasound monitoring and radionuclides monitoring. Training programs on these topics should be a major objective. A network of such centres should be established in a number of African countries. Centres should be equipped with means and materials for on-line course dispatch to interested training centres or research institutions. African centres should develop strong relationship among themselves through information and data exchange and sharing, harmonization of training programs. National data centres may be established as a component of the African Centre of Excellence. States Signatories may authorize the establishment of a specific fund to support the activities of the African center

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

    Directory of Open Access Journals (Sweden)

    Mestres Gonzalvo C

    2015-05-01

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

  1. Detecting medication errors in the New Zealand pharmacovigilance database: a retrospective analysis.

    Science.gov (United States)

    Kunac, Desireé L; Tatley, Michael V

    2011-01-01

    Despite the traditional focus being adverse drug reactions (ADRs), pharmacovigilance centres have recently been identified as a potentially rich and important source of medication error data. To identify medication errors in the New Zealand Pharmacovigilance database (Centre for Adverse Reactions Monitoring [CARM]), and to describe the frequency and characteristics of these events. A retrospective analysis of the CARM pharmacovigilance database operated by the New Zealand Pharmacovigilance Centre was undertaken for the year 1 January-31 December 2007. All reports, excluding those relating to vaccines, clinical trials and pharmaceutical company reports, underwent a preventability assessment using predetermined criteria. Those events deemed preventable were subsequently classified to identify the degree of patient harm, type of error, stage of medication use process where the error occurred and origin of the error. A total of 1412 reports met the inclusion criteria and were reviewed, of which 4.3% (61/1412) were deemed preventable. Not all errors resulted in patient harm: 29.5% (18/61) were 'no harm' errors but 65.5% (40/61) of errors were deemed to have been associated with some degree of patient harm (preventable adverse drug events [ADEs]). For 5.0% (3/61) of events, the degree of patient harm was unable to be determined as the patient outcome was unknown. The majority of preventable ADEs (62.5% [25/40]) occurred in adults aged 65 years and older. The medication classes most involved in preventable ADEs were antibacterials for systemic use and anti-inflammatory agents, with gastrointestinal and respiratory system disorders the most common adverse events reported. For both preventable ADEs and 'no harm' events, most errors were incorrect dose and drug therapy monitoring problems consisting of failures in detection of significant drug interactions, past allergies or lack of necessary clinical monitoring. Preventable events were mostly related to the prescribing and

  2. Neuropsychological phenotype of a patient with a de novo 970 kb interstitial deletion in the distal 16p11.2 region

    Directory of Open Access Journals (Sweden)

    Egger JI

    2014-03-01

    Full Text Available Jos I M Egger,1–3 Willem M A Verhoeven,1,4 Wim Verbeeck,5 Nicole de Leeuw61Vincent van Gogh Institute for Psychiatry, Centre of Excellence for Neuropsychiatry, Venray, the Netherlands; 2Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, the Netherlands; 3Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, the Netherlands; 4Erasmus University Medical Centre, Department of Psychiatry, Rotterdam, the Netherlands; 5Vincent van Gogh Institute for Psychiatry, Centre for Autism and ADHD, Venray, the Netherlands; 6Department of Human Genetics, Radboud University Medical Centre, Nijmegen, the NetherlandsAbstract: The 16p11.2 microdeletion syndrome is characterized by a wide range of phenotypic expressions and is frequently associated with developmental delay, symptoms from the autism spectrum, epilepsy, congenital anomalies, and obesity. These phenotypes are often related to a proximal 16p11.2 deletion of approximately 600 kb (BP4–BP5 that includes the SH2B1 gene that is reported to be causative for morbid obesity. This more centromeric deletion is most strongly related to autism spectrum susceptibility and is functionally different from the more distal 16p12.2p11.2 region, which includes the so-called atypical 16p11.2 BP2–BP3 deletion (approximately 220 kb presenting with developmental delay, behavioral problems and mild facial dysmorphisms. Here, an adult male with a long history of maladaptive behaviors is described who was referred for diagnostic assessment of his amotivational features. Extensive neuropsychological examination demonstrated rigid thinking, anxious beliefs, and ideas of reference in the presence of normal intelligence. Microarray analysis demonstrated a de novo 970 kb 16p11.2 BP1–BP4 microdeletion that can be regarded as explanatory for his behavioral profile. It is concluded that microdeletion syndromes are not exclusively related to intellectual disabilities and

  3. The Aube centre

    International Nuclear Information System (INIS)

    1996-07-01

    This educational booklet is devoted to a general presentation of the Aube radioactive wastes storage centre. After a short presentation of the Andra, the French national agency for the management of radioactive wastes, it gives some general information about radioactive wastes (origin, classification), containers (quality assurance and different types), wastes transportation (planning, safety), and about the Aube centre itself: description, treatment and conditioning of drums (compacting and injection), storage facilities, geological situation of the site, and environmental controls. (J.S.)

  4. Clinical spectrum and various forms of thyrotoxcosis in endocrine clinic of Jinnah Postgraduate Medical Centre

    International Nuclear Information System (INIS)

    Ahsan, T.; Banu, Z.; Jabeen, R.; Farooq, M. U.

    2013-01-01

    Objective: To evaluate clinical symptoms, signs and various forms of thyrotoxicosis, and to assess the thyroid function status at the first 6-week follow-up. Methods: The retrospective chart review involved thyrotoxic patients presenting at the Endocrine Clinic of Jinnah Postgraduate Medical Centre, Karachi, between April 2007 and January 2011. All hyperthyroid patients were included with the exception of those with suspected or proven malignancy. The records were maintained on a structured proforma and analysed statistically to work out frequencies and percentages. Results: A total of 507 patients were included. Most common form of thyrotoxicosis was Graves disease, with diffuse toxic goiter affecting 269 (53%) patients; followed by toxic multinodular goiter in 102 (20.1%); solitary toxic nodule in 56 (11%); thyrotoxicosis without goiter in 44 (8.7%); subclinical hyperthyroidism in 22 (4.3.%); thyroiditis in 9 (1.8%); and thyrotoxicosis with solitary cold nodule in 4 (0.9%). The common presenting symptoms and signs were goiter (n=415; 85.7%), with eye signs present in 137 (27.7%) patients and heart failure in 20 (4.8%) patients. Of the 321 patients who attended the first six-week follow-up, 309 (94.4%) had their FT4 levels checked. Out of them, 130(42.1%) had euthyroid levels; 113 (36.6%) had lower but still toxic level; 36 (11.7%) had no change; and 30(9.7%) became hypothyroid. TSH levels at first follow-up remained suppressed in 211 (73%) patients; normal in 47(16.3%); and increased in 31 (10.7%). Conclusions: Graves disease was found to be the most common cause of hyperthyroidism. At first follow-up 10.4% of patients had become hypothyroid. Therefore the starting dose of antithyroid drugs was reduced in the clinic. Thyroid stimulating hormone assay was of little help in adjusting treatment at the 6-week follow-up, as almost all cases of hypothyroidism could have been picked up on FT4 assay alone. (author)

  5. The GLOBE-Consortium: The Erasmus Computing Grid and The Next Generation Genome Viewer

    NARCIS (Netherlands)

    T.A. Knoch (Tobias)

    2005-01-01

    markdownabstractThe Set-Up of the 20 Teraflop Erasmus Computing Grid: To meet the enormous computational needs of live-science research as well as clinical diagnostics and treatment the Hogeschool Rotterdam and the Erasmus Medical Center are currently setting up one of the largest desktop

  6. The GLOBE-Consortium: The Erasmus Computing Grid – Building a Super-Computer at Erasmus MC for FREE

    NARCIS (Netherlands)

    T.A. Knoch (Tobias)

    2005-01-01

    textabstractTo meet the enormous computational needs of live-science research as well as clinical diagnostics and treatment the Hogeschool Rotterdam and the Erasmus Medical Center are currently setting up one of the largest desktop computing grids in the world – The Erasmus Computing Grid.

  7. Quality of life in adolescents with migraine and other headaches

    NARCIS (Netherlands)

    J.H. Langeveld

    1998-01-01

    textabstractIn 1975 Ihe research line "Stress and Migraine" was started at the "Free University", Amsterdam. Later this research program was continued at the Institute for Medical Psychology and Psychotherapy, Erasmus University Rotterdam. A first aim of this research line was to investigate the

  8. [Determination and analysis of cost and production measures in physicians' practices and hospitals for the objective evaluation of medical measures].

    Science.gov (United States)

    Gessner, U; Horisberger, B

    1981-05-01

    The complete data on 7200 practising physicians in Switzerland were analyzed in the first phase of the project. The 2600 GP's and the 4600 specialists (in 18 medical specialties) were categorized as to year of graduation and geographic regions (population centres). The distributions of the practising physician of the different specialties over the population centres (defined by 30-min. catchment area) areas were evaluated. Trends towards specialization in larger settlement areas were analyzed. The results are being used as a basis for formation of samples for further studies. The inventories of medical technical equipment and medical procedures are in the process of systematization.

  9. Field size and centring for conventional X-ray equipment

    International Nuclear Information System (INIS)

    Klimpel, H.; Kreienfeld, H.; Overbeck, R.

    1989-01-01

    Since 1973, all X-ray equipment for medical applications in the Federal Republic of Germany has had to be examined according to the requirements of the German ''Rontgenverordnung'' before it is used on patients and after each essential modification of design or construction. These examinations are carried out by inspectors appointed by the authorities, e.g. TUV. The field size adjustment and the centring of the radiation beam in relation to the image reception area is checked, along with other tests. To increase quality assurance in X-ray diagnosis, since the mid-1980s X-ray equipment has also been subject to in-service inspections to an increasing extent. (author)

  10. To study the existing system of surgical safety for cataract surgery at tertiary care ophthalmic centre to implement WHO surgical safety checklist

    OpenAIRE

    Ruchi Garg; Neeraj Garg; Shakti Kumar Gupta; J. S. Titiyal; R. Mahesh

    2016-01-01

    Background: Dr. Rajendra Prasad Centre for Ophthalmic Sciences, named after the first President of India, was established on the 10th of March, 1967 as a National centre for ophthalmic science, to provide state of the art patient care, expand human resources for medical education and undertake research to find solutions to eye health problems of national importance. Average numbers of cataract surgeries performed per month are 700 to 1000. Methods: Anticipating implementation in 50% cases...

  11. The right to be informed and fear of disclosure: sustainability of a full error disclosure policy at an Italian cancer centre/clinic.

    Science.gov (United States)

    D'Errico, Stefano; Pennelli, Sara; Colasurdo, Antonio Prospero; Frati, Paola; Sicuro, Lorella; Fineschi, Vittorio

    2015-04-01

    The aim of this study was to investigate the behaviour of physicians in cases of medical error as well as the nature of the information that should be given to the patient and to ascertain whether it is possible to institute a full error disclosure policy. Data was collected through the completion of anonymous questionnaires by medical directors of the IRCCS CROB (the Oncology Centre of Basilicata, Italy). An anonymous questionnaire consisting of 15 questions was prepared and administered to all the physicians working at the IRCCS CROB - the Oncology Centre of Basilicata. The main aim of the research was to evaluate the feasibility of adopting a full disclosure policy and the extent to which such a policy could help reduce administration and legal costs. The physicians interviewed unanimously recognize the importance of error disclosure, given that they themselves would want to be informed if they were the patients. However, 50% have never disclosed a medical error to their patients. Fear of losing the patient's trust (33%) and fear of lawsuits (31%) are the main obstacles to error disclosure. The authors found that physicians were in favour of a full policy disclosure at the IRCCS CROB - the Oncology Centre of Basilicata. Many more studies need to be carried out in order to comprehend the economic impact of a full error disclosure policy.

  12. Pediatric сlinic of Odessa National Medical University: the quality of emergency medical care for children

    Directory of Open Access Journals (Sweden)

    E.A. Starets

    2017-04-01

    guidelines of the United States, Great Britain, Canada, Australia; Ukrainian National Formulary; British National Formulary for Children. All medicines included in these local guidelines are presented in the WHO Model List of Essential Medicines (April 2015. In the Pediatric Clinic the medical care is patient-centred, responsive to and respectful of the patient’s values and choices to promote patient satisfaction and fulfillment of human rights. We use the patient-centred technologies: mothers and infants to remain together 24 hours a day; the preference is given to oral rehydration, rather than intravenous fluid administration; the minimization of pain for all manipulations, to refuse any intramuscular injections; to usage of screening test systems for the diagnosis of Beta-hemolytic streptococcus, rotavirus, influenza, bacteriuria; the humidification of air around the patient. The average period of staying in the ICU is 2 days. The culture of patient safety is a priority in the Pediatric Clinic. The culture of patient’s safety includes: the changing of the attitudes of medical staffs towards the safety of medical care; the identification of triggers and risks of medical care; the identification of all medi-cal errors/“no harm events”/“near miss events”; the implementation of safe technologies, simple algorithms; learning of medical staff. There were more than 40 lectures and practices for medical staff of the Pediatric Clinic, including the training courses CODE BLUE. Conclusions. The measures aimed at improving the quality of emergency medical care for children in the Pediatric Clinic of the Odessa National Medical University are: 1 the organization of ICU and equipping it with mo-dern equipment for diagnose and treatment of children; 2 the triage of patients according to the condition severity by the objective criteria; 3 the reducing of terms of hospitalization due to optimization of treatment in ICU; 4 standardization of medical care by developing local

  13. Modeling the economic impact of medication adherence in type 2 diabetes: a theoretical approach

    Directory of Open Access Journals (Sweden)

    David S Cobden

    2010-08-01

    Full Text Available David S Cobden1, Louis W Niessen2, Frans FH Rutten1, W Ken Redekop11Department of Health Policy and Management, Section of Health Economics – Medical Technology Assessment (HE-MTA, Erasmus MC, Erasmus University Rotterdam, The Netherlands; 2Department of International Health, Johns Hopkins University School of Public Health, Johns Hopkins Medical Institutions, Baltimore, MD, USAAims: While strong correlations exist between medication adherence and health economic outcomes in type 2 diabetes, current economic analyses do not adequately consider them. We propose a new approach to incorporate adherence in cost-effectiveness analysis.Methods: We describe a theoretical approach to incorporating the effect of adherence when estimating the long-term costs and effectiveness of an antidiabetic medication. This approach was applied in a Markov model which includes common diabetic health states. We compared two treatments using hypothetical patient cohorts: injectable insulin (IDM and oral (OAD medications. Two analyses were performed, one which ignored adherence (analysis 1 and one which incorporated it (analysis 2. Results from the two analyses were then compared to explore the extent to which adherence may impact incremental cost-effectiveness ratios.Results: In both analyses, IDM was more costly and more effective than OAD. When adherence was ignored, IDM generated an incremental cost-effectiveness of $12,097 per quality-adjusted life-year (QALY gained versus OAD. Incorporation of adherence resulted in a slightly higher ratio ($16,241/QALY. This increase was primarily due to better adherence with OAD than with IDM, and the higher direct medical costs for IDM.Conclusions: Incorporating medication adherence into economic analyses can meaningfully influence the estimated cost-effectiveness of type 2 diabetes treatments, and should therefore be ­considered in health care decision-making. Future work on the impact of adherence on health

  14. IOMP - Challenges for advancing medical physic globally

    International Nuclear Information System (INIS)

    Nusslin, F.

    2010-01-01

    environment. Education, Training, Certification IOMP Policy Statement No. 1: The Medical Physicist: Role and Responsibilities IOMP Policy Statement No. 2: Basic Requirements for Education and Training of Medical Physicists IOMP Guidelines: Professional Certification of the Medical Physicist Science - Interlinkage of Science and Education - Initiating and fostering national projects for Research in Medical Physics. e.g International Council of Science (ICSU), an International Centre for Medical Physics (Proposal). This is to be located in a developing country and to have permanent and visiting scientific staff. Its main roles will be research, development, education and professional advice. The centre is to focus on: – Needs and priorities of third world countries – Techniques for sustainable development – Technology Transfer – Education and Training Courses – Advice to international bodies Specific actions in LMI countries. E.g. - Collaboration with WHO and IAEA - IUPESM: Health Technology Task Group (HTTG) - Equipment Donation Programme - Library Programme - Travel Assistance

  15. Centre for urban ecotechnology in ``Oeksnehallen``

    Energy Technology Data Exchange (ETDEWEB)

    1992-03-01

    The Lord Mayor`s Department of the municipality of Copenhagen, Denmark, has with support from this project made a proposal for the establishment of the Centre for Urban Ecotechnology in ``Oeksnehallen``, located in the Vesterbro area of the city. The centre should contribute to the dissemination of knowledge on ecological techniques (regarding passive solar energy etc.) to the inhabitants of Vesterbro and other citizens of Copenhagen, and also serve as a centre in an European context. The ecological demonstration centre will cover an area of two thousand square meters and will also include a cafe, a room for showing coloured slides, facilities for exhibitions created by the center and interested firms etc. The centre should play an important role as part of the ecological concept of urban renewal in Vesterbro. (author).

  16. Do primary health centres and hospitals contribute equally towards achievement of the transversal clinical competencies of medical students? Performance on the Objective Structured Clinical Examination (OSCE) in competency acquisition.

    Science.gov (United States)

    Soler-González, Jorge; Buti, Miquel; Boada, Jordi; Ayala, Victoria; Peñascal, Eduard; Rodriguez, Toni

    2016-01-01

    The adaptation of the educational programmes of European faculties of medicine to the European Higher Education Area guidelines has focused curricula design on competence acquisition. Competencies are defined as the achievements of a predetermined level of efficacy in real-world scenarios. Our objective was to assess whether performance on a common competence evaluation test, the Objective Structured Clinical Examination (OSCE), resulted in different scores for second-year students after a practical medical training course took place in a primary health centre (PHC) or in a hospital. A descriptive study was conducted during the 2010-2014 academic year of the OSCE test scores obtained by all second-year students. Faculty of Medicine at the University of Lleida (Catalonia, Spain). We performed a correlation analysis between students who completed their practical medical training at the PHC and hospitals utilising Student's t-test for comparison of means. 423 students who completed internships at the PHC and at hospitals obtained OSCE mean scores of 7.32 (SD; IC) (0.82; 7.18-7.47) points and 7.17 (0.83; 6.07-7.26) points, respectively (p=0.07). Second-year medical students acquired similar competency levels in the two analysed training scenarios. The two areas both serve their teaching purpose. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  17. Netherlands Reactor Centre

    International Nuclear Information System (INIS)

    Anon.

    1976-01-01

    Briefly reviews the last year's work of the twenty year old Netherlands Reactor Centre (RCN) in the fields of reactor safety, fissile material, nuclear fission, non-nuclear energy systems and overseas co-operation. The annual report thus summarised is the last one to appear under the name of RCN. The terms of reference of the organisation having been broadened to include research into energy supply in general, it is to be known in future as the Netherlands Energy Research Centre (ECN). (D.J.B.)

  18. Redesign of a health science centre: reflections on co-leadership.

    Science.gov (United States)

    MacTavish, M; Norton, P

    1995-01-01

    Since 1988, the Sunnybrook Health Science Centre has been proactive in re-designing its system toward decentralized management, the purpose being to further enhance patient care. This process has involved numerous changes, among which were the establishment of three large clinical units. These clinical units are not defined following the historic medical model, but group patients with similar service and care needs. Subsequently, each of the clinical units defined Patient Service Units (PSUs). The hospital has chosen a co-leadership model for the lead management at each of the unit levels. This paper describes the model for clinical units.

  19. High ratings of satisfaction with fertility treatment are common: findings from the Copenhagen Multi-centre Psychosocial Infertility (COMPI) Research Programme

    DEFF Research Database (Denmark)

    Schmidt, L; Holstein, B E; Boivin, J

    2003-01-01

    BACKGROUND: The aims were: (i). to identify gender differences in evaluation of medical and patient-centred (psychosocial) care in fertility clinics and (ii). to identify predictors of satisfaction. METHODS: An epidemiological prospective study based on questionnaire responses among all new coupl...

  20. Does foreign aid crowd out government investments? Evidence from rural health centres in Rwanda

    Science.gov (United States)

    Lu, Chunling; Cook, Benjamin; Desmond, Chris

    2017-01-01

    Background Rural healthcare facilities in low-income countries play a major role in providing primary care to rural populations. We examined the link of foreign aid with government investments and medical service provision in rural health centres in Rwanda. Methods Using the District Health System Strengthening Tool, a web-based database built by the Ministry of Health in Rwanda, we constructed two composite indices representing provision of (1) child and maternal care and (2) HIV, tuberculosis (TB) and malaria services in 330 rural health centres between 2009 and 2011. Financing variables in a healthcare centre included received funds from various sources, including foreign donors and government. We used multilevel random-effects model in regression analyses and examined the robustness of results to a range of alternative specification, including scale of dependent variables, estimation methods and timing of aid effects. Findings Both government and foreign donors increased their direct investments in the 330 rural healthcare centres during the period. Foreign aid was positively associated with government investments (0.13, 95% CI 0.06 to 0.19) in rural health centres. Aid in the previous year was positively associated with service provision for child and maternal health (0.008, 95% CI 0.002 to 0.014) and service provision for HIV, TB and malaria (0.014, 95% CI 0.004 to 0.022) in the current year. The results are robust when using fixed-effects models. Conclusions These findings suggest that foreign aid did not crowd out government investments in the rural healthcare centres. Foreign aid programmes, conducted in addition to government investments, could benefit rural residents in low-income countries through increased service provision in rural healthcare facilities. PMID:29082015

  1. Implementation of regional centres for SPECT QC/QA in Brazil

    International Nuclear Information System (INIS)

    Robilotta, C.C.; Dias-Neto, A.L.; Abe, R.; Khoury, H.J.; Silva, D.C. da; Martini, J.C.; Brunetto, S.; Ney, C.

    2002-01-01

    Aims: SPECT technology was introduced in Brazil at the early 80s and, presently, there are more than 230 systems installed in the whole country. In order to establish a quality standard for these systems, a RCP was submitted and received partial support from IAEA for the implementation of regional centres, so that clinics in different regions could be evaluated using the same protocols. Materials and Methods: Six centres were created in 5 public (federal and state) universities and one private philanthropic medical school in: USP-Sao Paulo, UNICAMP-Campinas, CNEN-Rio de Janeiro, UFBA-Salvador, UFPE-Recife and FM/Santa Casa-Porto Alegre. All sites have teaching and technical supports available and there is at least one nuclear medicine physicist in charge. The basic QC/QA set included: 57 Co sheet source, orthogonal hole phantom, quadrant bar phantom, calibrated sources for dose calibrator ( 57 Co, 133 Ba, and 137 Cs) and a DeLuxe SPECT phantom from Data Spectrum Corp. Basic and complete/acceptance protocols were defined as the reference procedures. Measurements and evaluations were performed in 21 (<10%) centres and inter-comparisons were made amongst the groups. Results: Some information about the centres and evaluated systems are presented. A large number of the visited clinics never had any QC tests done except for the manufacturer's installation tests and the daily uniformity test. On the average, most of the cameras needed tuning and one of them had to have the PM tubes re-coupled. The main difficulties encountered by all groups were the lack of physicists in almost all the visited clinics and the inadequate training of many local technologists, especially in the remote areas. In spite of the misunderstanding and scepticism from some of the visited MDs, the majority recognized the importance of proper QC/QA testing. Conclusions: It was shown that regional centres are essential if one aims quality and reliability in the nuclear medicine clinics, especially in a

  2. Fuel cycle centres

    International Nuclear Information System (INIS)

    Hagen, M.

    1977-01-01

    The concept of co-locating and integrating fuel cycle facilities at one site is discussed. This concept offers considerable advantages, especially in minimizing the amount of radioactive material to be transported on public roads. Safeguards and physical protection as relating to such an integrated system of facilities are analysed in detail, also industrial and commercial questions. An overall risk-benefit evaluation turns out to be in favour of fuel cycle centres. These centres seem to be specifically attractive with regard to the back end of the fuel cycle, including on-site disposal of radioactive wastes. The respective German approach is presented as an example. Special emphasis is given to the site selection procedures in this case. Time scale and cost for the implementation of this concept are important factors to be looked at. Since participation of governmental institutions in these centres seems to be indispensable their respective roles as compared to industry must be clearly defined. The idea of adjusting fuel cycle centres to regional rather than national use might be an attractive option, depending on the specific parameters in the region, though results of existing multinational ventures are inconclusive in this respect. Major difficulties might be expected e.g. because of different national safety regulations and standards as well as commercial conditions among partner countries. Public acceptance in the host country seems to be another stumbling block for the realization of this type of multinational facilities

  3. Developing collaborative person-centred practice: a pilot project on a palliative care unit.

    Science.gov (United States)

    Hall, Pippa; Weaver, Lynda; Gravelle, Debbie; Thibault, Hélène

    2007-02-01

    Maximizing interprofessional collaborative patient-centred practice holds promise for improving patient care and creating satisfying work roles. In Canada's evolving health care system, there are demands for increased efficiency, cost-effectiveness, and quality improvement. Interprofessional collaboration warrants re-examination because maximizing interprofessional collaboration, especially nurse-physician collaboration, holds promise for improving patient care and creating satisfying work roles. A palliative care team seized the opportunity to pilot a different approach to patient and family care when faced with a reduction in medical staff. Grounded in a collaborative patient-centred practice approach, the Canadian Hospice Palliative Care Association's National Model to Guide Hospice Palliative Care (2002), and outcomes from program retreats and workgroups, a collaborative person-centred model of care was developed for a 12-bed pilot project. Preliminary findings show that the pilot project team perceived some specific benefits in continuity of care and interprofessional collaboration, while the presence of the physician was reduced to an average of 3.82 hours on the pilot wing, compared with 8 hours on the non-pilot wings. This pilot study suggests that a person-centred model, when focused on the physician-nurse dyad, may offer improved efficiency, job satisfaction and continuity of care on a palliative care unit. Incorporating all team members and developing strategies to successfully expand the model across the whole unit are the next challenges. Further research into the impact of these changes on the health care professionals, management and patients and families is essential.

  4. [The medical French-speaking world].

    Science.gov (United States)

    Gouazé, André

    2002-01-01

    Medicine has always been and remains the most solid base of the French-speaking world which was born in Africa and Indochina with the admirable action of "colonial" military physicians, the implantation of the Pasteur Institutes and the emergence of resulting overseas medical schools. Obviously, we are referring to the French-speaking medical world. Since the first International Conference of the Deans of French-Speaking Medical Schools in Abidjan in 1981, today medical schools from 40 French-speaking countries participate. The conference undertakes co-operative medical school initiatives in a multi-lateral spirit, comprised by concrete, practical actions to assist universities in developing countries strive for excellence. These actions, which are conducted with the help of both institutional (AUF, MAE, WHO, UNESCO) and private partners mainly concentrate on promoting medical education of medicine, the evaluation of medical schools, the development of scientific and technical information and training teachers in the methodology of scientific clinical research and in public health. For the future, the Conference has three important objectives, to assist in training researchers and consequently in the development of research centres in emerging countries, to promote continuing medical education in rural areas far from medical schools by taking advantage of modern computer technology, and finally to open horizons toward other communities which speak other languages, and first of all, towards non French-speaking countries who live in a French-speaking environment.

  5. Preparation of emergency care centre exercises

    International Nuclear Information System (INIS)

    Schnadt, H.; Miska, H.

    2011-01-01

    Setup and operation of emergency care centres (sometimes also addressed as emergency reception centres) are part of emergency response in the environs of nuclear power plants. The preparation of an exercise scenario for such a centre is very demanding on the responsible agency. Therefore, a computer code has been developed which helps to translate the exercise objectives into instructions for figurants which simulate the affected population. These instructions are intended to steer a determined flow of people through the emergency care centre by providing fictitious radiological readings and by injecting the demand for additional actions of response personnel by statements and questions. (orig.)

  6. Women with oligo-/amenorrhoea and polycystic ovaries have identical responses to GnRH stimulation regardless of their androgen status: comparison of the Rotterdam and Androgen Excess Society diagnostic criteria.

    Science.gov (United States)

    Lewandowski, Krzysztof C; Cajdler-Luba, Agata; Bieńkiewicz, Małgorzata; Lewiński, Andrzej

    2011-01-01

    As increased frequency of gonadotrophin-releasing hormone (GnRH) pulses is characteristic for polycystic ovary syndrome (PCOS), we assessed gonadotrophin response to GnRH in women with PCOS with normal and raised androgens and in regularly menstruating controls. The study involved 155 subjects: PCOS, n=121, age (mean±SD) 24.8±5.4 yrs, BMI 24.5±6.0 kg/m2, all with oligo-/amenorrhoea and PCO morphology, and 34 controls. Gonadotrophins were measured in early follicular phase after GnRH stimulation (0, 30 and 60 minutes). Fifty four (41.9%) women with PCOS had androgens (testosterone, androstendione, dihydroepiandrosterone sulphate) within the reference range, and would fulfil the "Rotterdam", but not the Androgen Excess Society PCOS criteria. Baseline and stimulated LH concentrations were higher in PCOS (9.09±5.56 vs 4.83±1.71 IU/l, 35.48±31.4 vs 16.30±6.68 IU/l, 33.86±31.8 vs 13.45±5.2 IU/l, at 0, 30 and 60 min post GnRH, respectively, pPCOS increased further after GnRH stimulation. ROC analysis revealed that LH30min/FSH30min >2.11 or LH60min/FSH60min >1.72 had 78.3% and 87.5% sensitivity and 81.7% and 81.3% specificity for diagnosis of PCOS. Both baseline and GnRH-stimulated LH and FSH concentrations were similar in women with PCOS and raised androgens and with androgens within the reference range (p=0.71 and p=0.20 for LH and FSH, respectively). Regardless of their androgen status, women with PCO morphology and oligo-/amenorrhoea have higher baseline and GnRH-stimulated LH concentrations and higher GnRH-stimulated LH/FSH ratio than controls, suggestive of similar underlying mechanism accounting for menstrual irregularities. These observations support validity of PCOS diagnostic criteria based on the Rotterdam consensus.

  7. The 20 Tera flop Erasmus Computing Grid (ECG).

    NARCIS (Netherlands)

    T.A. Knoch (Tobias); L.V. de Zeeuw (Luc)

    2006-01-01

    textabstractThe Set-Up of the 20 Teraflop Erasmus Computing Grid: To meet the enormous computational needs of live- science research as well as clinical diagnostics and treatment the Hogeschool Rotterdam and the Erasmus Medical Center are currently setting up one of the largest desktop computing

  8. The 20 Tera flop Erasmus Computing Grid (ECG)

    NARCIS (Netherlands)

    T.A. Knoch (Tobias); L.V. de Zeeuw (Luc)

    2009-01-01

    textabstractThe Set-Up of the 20 Teraflop Erasmus Computing Grid: To meet the enormous computational needs of live- science research as well as clinical diagnostics and treatment the Hogeschool Rotterdam and the Erasmus Medical Center are currently setting up one of the largest desktop computing

  9. High androgens in postmenopausal women and the risk for atherosclerosis and cardiovascular disease: the Rotterdam Study.

    Science.gov (United States)

    Meun, Cindy; Franco, Oscar H; Dhana, Klodian; Jaspers, Loes; Muka, Taulant; Louwers, Yvonne; Ikram, M Arfan; Fauser, Bart C J M; Kavousi, Maryam; Laven, Joop S E

    2018-02-01

    Polycystic ovary syndrome (PCOS) is closely linked to hyperandrogenism. In PCOS, hyperandrogenism has been associated with metabolic disturbances which increase the risk for cardiovascular disease (CVD). To assess the association of high serum androgen levels, as a postmenopausal remnant of PCOS, with the prevalence of atherosclerosis and incidence of CVD in postmenopausal women. The Rotterdam Study, a prospective population-based cohort study. Median follow up was 11.36 years. General community. 2578 women aged over 55. Exclusion criteria were missing informed consent or follow-up data, perimenopausal status, menopause by surgical intervention or at an unnatural age (age 62). None. Linear, logistic, and cox regression models assessed the association of top quartiles (P75) of serum testosterone, free androgen index (FAI), dehydroepiandrosterone, and androstenedione and SHBG with coronary artery calcium, carotid intima media thickness (IMT), pulse wave velocity, peripheral artery disease and incidence of coronary heart disease, stroke, and CVD. Mean age (standard deviation) was 70.19 (8.71) years and average time since menopause 19.85 (9.94) years. Highest quartile FAI was associated with higher pulse wave velocity [β (95%CI): 0.009 (0.000;0.018)]. Highest quartile dehydroepiandrosterone [β (95%CI): -0.008 (-0.015;-0.001)] and androstenedione [β (95%CI): -0.010 (-0.017;-0.003)] levels were associated with a lower IMT. We found no association between high androgen levels and incident stroke, coronary heart disease, or cardiovascular disease. Postmenopausal high androgen levels were not associated with an increased risk for CVD. Cardiovascular health in women with PCOS might be better than was anticipated. Copyright © 2018 Endocrine Society

  10. Medical Abortion: The Tunisian Experience | Hajri | African Journal ...

    African Journals Online (AJOL)

    This paper reports the Tunisian experience of medical abortion. The project started in 1998 with a small introductory study at the obstetric and gynaecology department of a university hospital and was later extended step by step to other family planning and public health centres that provided abortion services. The study was ...

  11. Council celebrates CERN Control Centre

    CERN Multimedia

    2006-01-01

    With the unveiling of its new sign, the CERN Control Centre was officially inaugurated on Thursday 16 March. To celebrate its startup, CERN Council members visited the sleek centre, a futuristic-looking room filled with a multitude of monitoring screens.

  12. Glad you brought it up: a patient-centred programme to reduce proton-pump inhibitor prescribing in general medical practice.

    Science.gov (United States)

    Murie, Jill; Allen, Jane; Simmonds, Ray; de Wet, Carl

    2012-01-01

    Many patients unnecessarily receive proton-pump inhibitor (PPI) drugs long term with significant financial and safety implications. Educating, empowering and supporting patients to self-manage their symptoms can lead to significant and sustained reductions in PPI prescribing. We aimed to implement a programme to reduce inappropriate PPI prescribing. Eligible patients in one general medical practice in rural Scotland were invited for participation between November 2008 and February 2010. Patients attended special nurse advisor clinics, completed dyspepsia questionnaires, received information, formulated self-management plans and were offered flexible support. Of the study population, 437/2883 (15%) were prescribed PPIs. Of these, 166 (38%) were judged eligible for participation. After 12 months, 138/157 (83%) had reduced or stopped their PPIs, while 19/157 (11%) had reverted. The estimated annual net saving in the prescribing budget was ?3180.67. Self-reported understanding of symptom self-management increased from 6/20 (30%) to 18/20 (90%) patients after participation in the programme. A patient-centred programme delivered by a specialist nurse significantly reduced PPI prescribing with financial and potential therapeutic benefits. The vast majority of eligible patients were able to 'step down and off' or 'step off' PPI use after 12 months without any complications or deteriorating symptom control. Further research with larger cohorts of practices and patients is needed to develop a feasible, acceptable and effective programme if similar benefits are to be achieved for primary care in general.

  13. Medical aspects of the Chernobyl accident

    International Nuclear Information System (INIS)

    1988-07-01

    From 11 to 13 May 1988, the All-Union Scientific Centre of Radiation Medicine convened a Conference on Medical Aspects of the Chernobyl Accident in Kiev. This was the first conference on this subject with international participation held in the Soviet Union. There were 310 specialists representing Soviet scientific establishments and over 60 experts from 23 other countries and international organizations participated in the Conference. Participants at the Conference discussed medical aspects of accident mitigation, including therapeutic, psychological, demographic, epidemiological and dosimetric problems. These proceedings include 29 reports presented by Soviet scientists during the four sessions as well as summaries of discussions and opening addresses. Refs, figs and tabs

  14. Training centres in Latin America

    International Nuclear Information System (INIS)

    1959-01-01

    Early 1958 the Brazilian representative on the Board of Governors of the International Atomic Energy Agency - supported by the Governors from Argentina and Guatemala -proposed that a study should be made of the possibility of setting up one or more atomic energy training centres in Latin America. On the Board's recommendation, the Director General of the Agency appointed a fact-finding team to make anon-the-spot study. In drafting this report the team was invited to consider the following points: (a) The need for establishing one or more regional training centres; (b) Existing facilities that are being or could be used for training, together with technical data concerning them; (c) The general scientific technological and industrial conditions of the countries visited insofar as they have a bearing on their training needs and capabilities. The authors of the report conclude that 'a training centre in radio-botany should provide vitally needed knowledge and vitally needed specialists to all the agricultural installations in Latin America. A training centre like this might provide an excellent model upon which to base training centres in other areas'. The report recommends that: 1. The Agency should meet the requests of Latin American universities by, for example, supplying equipment and sending experts; 2. At least one specialized training centre should be established as soon as possible. Taking as an example the field of radio-botany, such a centre would provide trained specialists in radio-botany to agricultural institutions throughout Latin America and also provide basic research results vital to agriculture. The cost of new facilities might be of the order of $7 500 000, with an annual budget of approximately $650 000. Staff required: 40 scientists and 175 employees; 3. Whenever it appears feasible to gather necessary staff of high creative ability and established productivity and when funds can be made available for facilities, equipment and operating costs, at

  15. Training centres in Latin America

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1959-04-15

    Early 1958 the Brazilian representative on the Board of Governors of the International Atomic Energy Agency - supported by the Governors from Argentina and Guatemala -proposed that a study should be made of the possibility of setting up one or more atomic energy training centres in Latin America. On the Board's recommendation, the Director General of the Agency appointed a fact-finding team to make anon-the-spot study. In drafting this report the team was invited to consider the following points: (a) The need for establishing one or more regional training centres; (b) Existing facilities that are being or could be used for training, together with technical data concerning them; (c) The general scientific technological and industrial conditions of the countries visited insofar as they have a bearing on their training needs and capabilities. The authors of the report conclude that 'a training centre in radio-botany should provide vitally needed knowledge and vitally needed specialists to all the agricultural installations in Latin America. A training centre like this might provide an excellent model upon which to base training centres in other areas'. The report recommends that: 1. The Agency should meet the requests of Latin American universities by, for example, supplying equipment and sending experts; 2. At least one specialized training centre should be established as soon as possible. Taking as an example the field of radio-botany, such a centre would provide trained specialists in radio-botany to agricultural institutions throughout Latin America and also provide basic research results vital to agriculture. The cost of new facilities might be of the order of $7 500 000, with an annual budget of approximately $650 000. Staff required: 40 scientists and 175 employees; 3. Whenever it appears feasible to gather necessary staff of high creative ability and established productivity and when funds can be made available for facilities, equipment and operating costs, at

  16. Does the inclusion of 'professional development' teaching improve medical students' communication skills?

    Science.gov (United States)

    2011-01-01

    Background This study investigated whether the introduction of professional development teaching in the first two years of a medical course improved students' observed communication skills with simulated patients. Students' observed communication skills were related to patient-centred attitudes, confidence in communicating with patients and performance in later clinical examinations. Methods Eighty-two medical students from two consecutive cohorts at a UK medical school completed two videoed consultations with a simulated patient: one at the beginning of year 1 and one at the end of year 2. Group 1 (n = 35) received a traditional pre-clinical curriculum. Group 2 (n = 47) received a curriculum that included communication skills training integrated into a 'professional development' vertical module. Videoed consultations were rated using the Evans Interview Rating Scale by communication skills tutors. A subset of 27% were double-coded. Inter-rater reliability is reported. Results Students who had received the professional development teaching achieved higher ratings for use of silence, not interrupting the patient, and keeping the discussion relevant compared to students receiving the traditional curriculum. Patient-centred attitudes were not related to observed communication. Students who were less nervous and felt they knew how to listen were rated as better communicators. Students receiving the traditional curriculum and who had been rated as better communicators when they entered medical school performed less well in the final year clinical examination. Conclusions Students receiving the professional development training showed significant improvements in certain communication skills, but students in both cohorts improved over time. The lack of a relationship between observed communication skills and patient-centred attitudes may be a reflection of students' inexperience in working with patients, resulting in 'patient-centredness' being an abstract concept

  17. Does the inclusion of 'professional development' teaching improve medical students' communication skills?

    Directory of Open Access Journals (Sweden)

    Kubacki Angela M

    2011-06-01

    Full Text Available Abstract Background This study investigated whether the introduction of professional development teaching in the first two years of a medical course improved students' observed communication skills with simulated patients. Students' observed communication skills were related to patient-centred attitudes, confidence in communicating with patients and performance in later clinical examinations. Methods Eighty-two medical students from two consecutive cohorts at a UK medical school completed two videoed consultations with a simulated patient: one at the beginning of year 1 and one at the end of year 2. Group 1 (n = 35 received a traditional pre-clinical curriculum. Group 2 (n = 47 received a curriculum that included communication skills training integrated into a 'professional development' vertical module. Videoed consultations were rated using the Evans Interview Rating Scale by communication skills tutors. A subset of 27% were double-coded. Inter-rater reliability is reported. Results Students who had received the professional development teaching achieved higher ratings for use of silence, not interrupting the patient, and keeping the discussion relevant compared to students receiving the traditional curriculum. Patient-centred attitudes were not related to observed communication. Students who were less nervous and felt they knew how to listen were rated as better communicators. Students receiving the traditional curriculum and who had been rated as better communicators when they entered medical school performed less well in the final year clinical examination. Conclusions Students receiving the professional development training showed significant improvements in certain communication skills, but students in both cohorts improved over time. The lack of a relationship between observed communication skills and patient-centred attitudes may be a reflection of students' inexperience in working with patients, resulting in 'patient-centredness' being

  18. [The contribution of the Russian Research Centre of Medical Rehabilitation and Balneotherapeutics to the development of the health resort business in this country].

    Science.gov (United States)

    Povazhnaia, E A; Bobrovnitskiĭ, I P

    2013-01-01

    The definition of the notion of health resort business is proposed in the context of the legislation pertinent to the natural therapeutic resources, health and recreational localities, spa and resort facilities currently in force in this country. The main landmark events in the history of the Russian Research Centre of Rehabilitative Medicine and Balneotherapeutics are highlighted, its role in the development of balneotherapeutic science and health resort business is described. The major achievements of the Centre in the investigations of therapeutic properties of natural physical factors (climate, mineral waters, peloids, etc.), their action on the human organism, the possibilities of their application for the treatment and prevention of various pathological conditions in and outside health resort facilities are presented. The contribution of the specialists of the Centre to the search for and discovery of new resort resources is emphasized. Community needs in balneotheraputic treatment are estimated, scientific basis for its organization, principles and normatives of health resort business are discussed along with the problems of sanitary control and protection. The activities of the Centre as an organizer of the unique system of rehabilitative and balneotherapeutic aid to the population are overviewed. Scientifically substantiated indications and contraindications for the spa and resort-based treatment of various diseases are proposed in conjunction with the methods for the application of physiotherapeutic factors. The tasks currently facing the Centre and prospects for its future research activities in the fields of rehabilitative medicine and balneotherapeutics are discussed.

  19. The Centres for Environment-friendly Energy Research (FME)

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2011-07-01

    High expectations for Norway's Centres for Environment-friendly Energy Research (FME).The FME centres address a broad range of areas, allcentral to developing the energy sector of the future. The activities of the eight centres established in 2009 focus on renewable energy, raising energy efficiency, energy planning, and carbon capture and storage (CCS). In 2011 three new FME centres were established which focus on social science-related energy research. The FME scheme is a direct follow-up of the broad-based political agreement on climate policy achieved in the Storting in January 2008, and of the national RandD Energi21 strategy submitted in February 2008 to the Ministry of Petroleum and Energy. In April 2008 the Research Council of Norway's Executive Board decided to launch a process to establish centres for environment-friendly energy research, and a funding announcement was issued that same year. In 2010 it was decided that additional FME centres would be established in the field of social science-related energy research. After a thorough assessment of each project (based on feasibility, scientific merit, potential to generate value creation and innovation, and composition of the consortium) eight applicants were selected to become FME centres in February 2009. A new call for proposals was issued in 2010, and three more centres were awarded FME status in February 2011. The objective of the FME scheme is to establish time-limited research centres which conduct concentrated, focused and long-term research of high international calibre in order to solve specific challenges in the energy sphere. The selected centres must exhibit higher goals, a longer-term perspective and a more concentrated focus than is required under other funding instruments for the same scientific area. The make-up of the centres is critical to achieving this objective. The centres bring together Norway's leading research institutions and key players in private enterprise, the

  20. Medical physics 1981

    International Nuclear Information System (INIS)

    Bunde, E.

    1982-01-01

    This volume continues the series of congress publications with which the Deutsche Gesellschaft fuer Medizinische Physik has been completely documenting its annual meetings for some years. The meeting was aimed to show the complexity not only of the scientific specialty medical physics but also of the practical activities of medical physicists, or at least give some idea of it. The conference was centred on the following points: Possibilities of optimization and methods for re-examination of techniques used in X-ray diagnostics, nuclear diagnostics and ultrasonographic diagnostics; bases of dosimetry in practical radiotherapy, especially with a view to the plans to make gauging of therapeutical dosemeters compulsory; current state of neutron therapy and dosimetry; safety and constancy of irradiation devices in operation; planning and equipment of modern radiotherapy departments. Furthermore topics from medical optics and nuclearbiological research were dealt with. Reports were given on the clinical use of whole-body counters. Climatology and surgical research were marginally dealt with in two synoptical papers. Short reports on work currently under way completed the subject groups given and allowed insight into further topical fields of work of medical physicists in science and practice. Finally, the question of education received particular interest. (orig./MG) [de

  1. A new model of collaborative research: experiences from one of Australia's NHMRC Partnership Centres for Better Health.

    Science.gov (United States)

    Wutzke, Sonia; Redman, Sally; Bauman, Adrian; Hawe, Penelope; Shiell, Alan; Thackway, Sarah; Wilson, Andrew

    2017-02-15

    There is often a disconnection between the creation of evidence and its use in policy and practice. Cross-sectoral, multidisciplinary partnership research, founded on shared governance and coproduction, is considered to be one of the most effective means of overcoming this research-policy-practice disconnect. Similar to a number of funding bodies internationally, Australia's National Health and Medical Research Council has introduced Partnership Centres for Better Health: a scheme explicitly designed to encourage coproduced partnership research. In this paper, we describe our experiences of The Australian Prevention Partnership Centre, established in June 2013 to explore the systems, strategies and structures that inform decisions about how to prevent lifestyle-related chronic disease. We present our view on how the Partnership Centre model is working in practice. We comment on the unique features of the Partnership Centre funding model, how these features enable ways of working that are different from both investigator-initiated and commissioned research, and how these ways of working can result in unique outcomes that would otherwise not have been possible. Although not without challenges, the Partnership Centre approach addresses a major gap in the Australian research environment, whereby large-scale, research-policy-practice partnerships are established with sufficient time, resources and flexibility to deliver highly innovative, timely and accessible research that is of use to policy and practice.

  2. 'Oral health is not my department'. Perceptions of elderly patients' oral health by general medical practitioners in primary health care centres: a qualitative interview study.

    Science.gov (United States)

    Andersson, Kerstin; Furhoff, Anna-Karin; Nordenram, Gunilla; Wårdh, Inger

    2007-03-01

    The purpose of this study was to explore general medical practitioners' (GPs) perceptions of the oral health of their elderly patients. The design was a qualitative study based on individual in-depth interviews with GPs. The criterion for inclusion in the study was that the GP was a specialist in family medicine working in a primary health care centre (PHCC:s) in the county of Stockholm. The participants took part in the study after informed consent. Eleven GPs were interviewed. The interview started with semi-structured questions about the respondents' clinical presentation of their elderly patients', e.g. medication, medical treatment and socioeconomic status. The interview concluded with questions about the respondents' experiences of and perceptions of the oral health of their patients. This process started with the first interview and proceeded with successive interviews until no new relevant information was forthcoming. The initial semi-structured part of the interview guide was analysed for content with special reference to descriptive answers. The final open questions were analysed by a method inspired by grounded theory (GT) and comprised three stages: open coding, axial coding and selective coding. In the GT influenced analysis process, three categories, health perspective, working conditions and cultural differences, each in turn containing subcategories, were identified and labelled. The most significant category, cultural differences, was identified as the core category, explaining the central meaning of the respondents' perceptions of the oral health of their elderly patients. The GPs in this study showed little or no awareness of the oral health of their elderly patients. The interviews disclosed several contributing factors. Barriers to closer integration of oral and general health in the elderly were identified. There existed a cultural gap between the disciplines of dentistry and medicine, which does not enhance and may be detrimental to the

  3. The centre of mass of a triangular plate

    International Nuclear Information System (INIS)

    Sluesarenko, Viktor; Rojas, Roberto; Fuster, Gonzalo

    2008-01-01

    We present a derivation for the coordinates of the centre of mass-or centre of gravity-of a homogeneous triangular plate by using scaling and symmetry. We scale the triangular plate by a factor of 2 and divide its area into four plates identical to the original. By symmetry, we assert that the centre of mass of two identical masses lies at the midpoint of the line joining their centres of mass. By relating the centres of mass of the original to those of the scaled plates, we find the coordinates of the centre of mass as the solution of an algebraic equation

  4. The Bruce Energy Centre

    International Nuclear Information System (INIS)

    Jones, R.I.

    1982-06-01

    The Bruce Energy Centre Development Corporation is a joint venture of the Ontario Energy Corporation and 6 private companies formed to market surplus steam from the Bruce Nuclear Power Development. The corporation will also sell or lease land near Bruce NPD. The Bruce Energy Centre has an energy output of 900 BTU per day per dollar invested. Potential customers include greenhouse operators, aquaculturalists, food and beverage manufacturers, and traditional manufacturers

  5. Investigation of radiation protection of medical staff performing medical diagnostic examinations by using PET/CT technique

    International Nuclear Information System (INIS)

    Wrzesień, Małgorzata; Napolska, Katarzyna

    2015-01-01

    Positron emission tomography (PET) is now one of the most important methods in the diagnosis of cancer diseases. Due to the rapid growth of PET/CT centres in Poland in less than a decade, radiation protection and, consequently, the assessment of worker exposure to ionising radiation, emitted mainly by the isotope 18 F, have become essential issues. The main aim of the study was to analyse the doses received by workers employed in the Medical Diagnostic Centre. The analysis comprises a physicist, three nurses, three physicians, three technicians, as well as two administrative staff employees. High-sensitivity thermoluminescent detectors (TLDs) were used to measure the doses for medical staff. The personnel was classified into categories, among them employees having direct contact with the ‘source of radiation’— 18 FDG. The TLDs were placed on the fingertips of both hands and they were also attached at the level of eye lenses, thyroid and gonads depending on the assigned category. The highest dose of radiation was observed during the administration of the 18 FDG to the patients. In the case of the physicist, the highest dose was recorded during preparation of the radiopharmaceutical— 18 FDG. The body parts most exposed to ionizing radiation are the fingertips of the thumb, index and middle finger. (paper)

  6. Investigation of radiation protection of medical staff performing medical diagnostic examinations by using PET/CT technique.

    Science.gov (United States)

    Wrzesień, Małgorzata; Napolska, Katarzyna

    2015-03-01

    Positron emission tomography (PET) is now one of the most important methods in the diagnosis of cancer diseases. Due to the rapid growth of PET/CT centres in Poland in less than a decade, radiation protection and, consequently, the assessment of worker exposure to ionising radiation, emitted mainly by the isotope (18)F, have become essential issues. The main aim of the study was to analyse the doses received by workers employed in the Medical Diagnostic Centre. The analysis comprises a physicist, three nurses, three physicians, three technicians, as well as two administrative staff employees. High-sensitivity thermoluminescent detectors (TLDs) were used to measure the doses for medical staff. The personnel was classified into categories, among them employees having direct contact with the 'source of radiation'-(18)FDG. The TLDs were placed on the fingertips of both hands and they were also attached at the level of eye lenses, thyroid and gonads depending on the assigned category. The highest dose of radiation was observed during the administration of the (18)FDG to the patients. In the case of the physicist, the highest dose was recorded during preparation of the radiopharmaceutical-(18)FDG. The body parts most exposed to ionizing radiation are the fingertips of the thumb, index and middle finger.

  7. Predicting medical professionals' intention to allow family presence during resuscitation: A cross sectional survey.

    Science.gov (United States)

    Lai, Meng-Kuan; Aritejo, Bayu Aji; Tang, Jing-Shia; Chen, Chien-Liang; Chuang, Chia-Chang

    2017-05-01

    Family presence during resuscitation is an emerging trend, yet it remains controversial, even in countries with relatively high acceptance of family presence during resuscitation among medical professionals. Family presence during resuscitation is not common in many countries, and medical professionals in these regions are unfamiliar with family presence during resuscitation. Therefore, this study predicted the medical professionals' intention to allow family presence during resuscitation by applying the theory of planned behaviour. A cross-sectional survey. A single medical centre in southern Taiwan. Medical staffs including physicians and nurses in a single medical centre (n=714). A questionnaire was constructed to measure the theory of planned behaviour constructs of attitudes, subjective norms, perceived behavioural control, and behavioural intentions as well as the awareness of family presence during resuscitation and demographics. In total, 950 questionnaires were distributed to doctors and nurses in a medical centre. Among the 714 valid questionnaires, only 11 participants were aware of any association in Taiwan that promotes family presence during resuscitation; 94.7% replied that they were unsure (30.4%) or that their unit did not have a family presence during resuscitation policy (74.8%). Regression analysis was performed to predict medical professionals' intention to allow family presence during resuscitation. The results indicated that only positive attitudes and subjective norms regarding family presence during resuscitation and clinical tenure could predict the intention to allow family presence during resuscitation. Because Family presence during resuscitation practice is not common in Taiwan and only 26.19% of the participants agreed to both items measuring the intention to allow family presence during resuscitation, we recommend the implementation of a family presence during resuscitation education program that will enhance the positive beliefs

  8. Visits to Tier-1 Computing Centres

    CERN Multimedia

    Dario Barberis

    At the beginning of 2007 it became clear that an enhanced level of communication is needed between the ATLAS computing organisation and the Tier-1 centres. Most usual meetings are ATLAS-centric and cannot address the issues of each Tier-1; therefore we decided to organise a series of visits to the Tier-1 centres and focus on site issues. For us, ATLAS computing management, it is most useful to realize how each Tier-1 centre is organised, and its relation to the associated Tier-2s; indeed their presence at these visits is also very useful. We hope it is also useful for sites... at least, we are told so! The usual participation includes, from the ATLAS side: computing management, operations, data placement, resources, accounting and database deployment coordinators; and from the Tier-1 side: computer centre management, system managers, Grid infrastructure people, network, storage and database experts, local ATLAS liaison people and representatives of the associated Tier-2s. Visiting Tier-1 centres (1-4). ...

  9. Patient-centred outcomes research: perspectives of patient stakeholders.

    Science.gov (United States)

    Chhatre, Sumedha; Gallo, Joseph J; Wittink, Marsha; Schwartz, J Sanford; Jayadevappa, Ravishankar

    2017-11-01

    To elicit patient stakeholders' experience and perspectives about patient-centred care. Qualitative. A large urban healthcare system. Four patient stakeholders who are prostate cancer survivors. Experience and perspectives of patient stakeholders regarding patient-centred care and treatment decisions. Our patient stakeholders represented a diverse socio-demographic group. The patient stakeholders identified engagement and dialogue with physicians as crucial elements of patient-centred care model. The degree of patient-centred care was observed to be dependent on the situations. High severity conditions warranted a higher level of patient involvement, compared to mild conditions. They agreed that patient-centred care should not mean that patients can demand inappropriate treatments. An important attribute of patient-centred outcomes research model is the involvement of stakeholders. However, we have limited knowledge about the experience of patient stakeholders in patient-centred outcomes research. Our study indicates that patient stakeholders offer a unique perspective as researchers and policy-makers aim to precisely define patient-centred research and care.

  10. Smart work centres in rural areas

    DEFF Research Database (Denmark)

    Lorentzen, Anne Birte

    This paper discusses the establishment of telework centres as an element in local development strategies in rural areas, with a particular view to two new telework centres in region North Denmark. The paper argues that telework centres do not represent an easy solution to problems of local...... development and environmental sustainability, and further, that technology may not even be the most important feature needed to make them function as such....

  11. Ocular trauma injuries: a 1-year surveillance study in the University of Malaya Medical Centre, Malaysia. 2008.

    Science.gov (United States)

    Soong, Terrence Kwong-Weng; Koh, Alan; Subrayan, Visvaraja; Loo, Angela Voon Pei

    2011-12-01

    To describe the epidemiology of ocular injuries presenting to the University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia. Prospective analysis of all ocular trauma injuries presenting to the Department of Ophthalmology in UMMC from 1 January 2008 to 31 December 2008. A total of 603 eyes of 546 patients were recruited for the study. All patients presenting to the department with ocular trauma injuries were assessed by an ophthalmologist. Data on the type and source of injury, demographic profile of the patients, and clinical presentation were documented using a uniform and validated datasheet. Among eye injury cases, 481 patients (88.1%) were male, with a male-to-female ratio of 7.4:1. Of the patients, 412 (75.5%) were Malaysian while the remaining 134 (24.5%) were of non-Malaysian nationality. The average age was 31.5 years (range 1-81 years). A total of 238 injured eyes (43.6%) were work-related. The common sources of eye trauma include the use of high-powered tools (30.8%), motor vehicle accident (23.1%), and domestic accidents (17.7%). Only six patients (2.5%) reported to having used eye protective device (EPD) at time of their work-related injuries. A major cause of preventable ocular injuries in Malaysia was work-related trauma. Ocular injuries can be reduced by the use of eye protection devices and the implementation of appropriate preventive strategies to address each risk factor. Effective training is an integral part of occupational safety and health, which should be made mandatory at the workplace. In addition, there should be a continual assessment of safety and health issues at the workplace. A long-term database of all ocular injuries in Malaysia is recommended, to aid research on a larger scale and the development of new preventive strategies for ocular injuries.

  12. Prevalence of depression in residents of gerontology centre in Sarajevo

    Directory of Open Access Journals (Sweden)

    Jasmina Mahmutović

    2012-04-01

    Full Text Available Introduction: Depressive disorder, as a major problem of public health, takes high fourth place in its prevalence in general population, and is considered to be the second most frequent health problem of femalepopulation. Depression is the most frequent mental problem of persons in their third age of life. The aim of this study is to evaluate prevalence of depression and establish the ratio between the current number ofdiagnosed and of unrecognised depression among the residents of Gerontology Centre in Sarajevo.Methods: This is a cross-sectional, descriptive, and analytical study undertaken throughout May and June 2011 on the sample of 150 residents of “The Gerontology Centre“ in Sarajevo that were above 65 years of age. The following instruments were used for the research: the Geriatric Depression Scale (GDS, modified questionnaire consisting of two parts (general data and data related to health state, and the medical records of the residents. For statistic analysis of data was used the SPSS program for Windows.Results: According to GDS, prevalence of depression was 65.3%, out of which mild depression occurred in 46.7% cases and severe depression in 18.7%. The prevalence of verified (diagnosed depression was 11.3per cents.Conclusions: According to the GD scale, unrecognised depressions seem to be almost six times more frequent (65.3:11% than is the case with depressions diagnosed in medical records of the protégées of theGerontology Centre in Sarajevo. Timely recognition of depression and its treating in institutions for protection of health of persons in third age of life can substantially improve the quality of life of these patients.

  13. Current discharge management of acute coronary syndromes: data from the Rijnmond Collective Cardiology Research (CCR) study.

    Science.gov (United States)

    Yetgin, T; van der Linden, M M J M; de Vries, A G; Smits, P C; van Mechelen, R; Yap, S C; Boersma, E; Zijlstra, F; van Geuns, R-J M

    2014-01-01

    Medical discharge management of acute coronary syndromes (ACS) remains suboptimal outside randomised trials and constitutes an essential quality benchmark for ACS. We sought to evaluate the rates of key guideline-recommended pharmacological agents after ACS and characteristics associated with optimal treatment at discharge. The Rijnmond Collective Cardiology Research (CCR) registry is an ongoing prospective, observational study in the Netherlands that aims to enrol 4000 patients with ACS. We examined discharge and 1-month follow-up medication use among the first 1000 patients enrolled in the CCR registry. Logistic regression was performed to identify patient and hospital characteristics associated with collective guideline-recommended pharmacotherapy at hospital discharge. At discharge, 94 % of patients received aspirin, 100 % thienopyridines, 80 % angiotensin-converting enzyme inhibitors/angiotensin-II receptor blockers, 87 % β-blockers, 96 % statins, and 65 % the combination of all 5 agents. ST-segment elevation myocardial infarction, hypertension, hypercholesterolaemia, and enrolment in an interventional centre were positive independent predictors of 5-drug combination therapy at discharge. Negative independent predictors were unstable angina and advanced age. Current data from the CCR registry reflect a high quality of care for ACS discharge management in the Rotterdam-Rijnmond region. However, potential still remains for further optimisation.

  14. Nuclear data for medical applications

    International Nuclear Information System (INIS)

    Capote, Roberto

    2011-01-01

    Nuclear science plays an increasingly important role in medical applications, in particular the need for radioisotopes in both cancer therapy and diagnostic techniques is very well established. Over the previous thirty years, many laboratories have reported a significant body of experimental data relevant to medical radionuclide production, and international data centres have compiled most of these data. However, till late 90s no systematic effort had been devoted to their standardization and assembly. These needs are being addressed through three IAEA Coordinated Research Projects on Nuclear Data for the Production of Radionuclides that started in 1999. Monitor cross sections to be used in charged particle measurements have been also evaluated (see http://www-nds.iaea.org/medical/monitor reactions.html). A review of IAEA recommended cross sections for the production of medical radioisotopes will be presented. Theoretical modelling of nuclear reactions will be discussed both for nuclear data evaluation and validation. The role of the Recommended Input Parameter Library (RIPL) in defining the input for production codes like EMPIRE and TALYS will be highlighted. (author)

  15. Medical physics and challenges faced in Africa

    International Nuclear Information System (INIS)

    Nakatudde, R.

    2010-01-01

    Individual medical physicists have presented many challenges which have greatly inhibited their input in patient care and management. To improve the role and recognition of medical physicists in Africa, FAMPO was established. This is the Federation of African Medical Physics Organisations. Its main role is to bridge the gap between individual medical physicists, existing medical physicist bodies and the International Organisation of Medical Physics (IOMP). It is a non profit making organisation. A qualified medical physicist is an individual who is competent to practice independently one or more of the sub fields of medical physics. i.e. therapeutic radiological, diagnostic radiological, medical nuclear and medical health. Their time should on average be distributed equally among three areas, clinical service and consultation, research and development, and teaching. All diagnostic and radiotherapy centres should have a well established comprehensive quality assurance programme in place, which should involve machine installation and calibration, source delivery and safety, operational procedures, clinical dosimetry and the whole treatment planning process. This should be followed according to national and international recommendations. A study was carried out to identify the challenges faced by medical physicists in Africa and the objectives of the study were; To identify the number of qualified medical physicists and their working experience in hospitals in African countries. To identify the level of involvement of medical physicists in the three areas of Nuclear medicine, Radiology and Radiotherapy in hospitals in African countries.To identify countries with recognised professional bodies governing medical physicists in African countries.To identify the challenges faced by medical physicists in African countries Methods and materials The study was conducted on thirteen medical physicists from seven African countries. i.e. Nigeria, Kenya, Libya, Tanzania, Zambia

  16. The ideal Atomic Centre

    International Nuclear Information System (INIS)

    Mas, R.

    1965-01-01

    The author presents considerations which should prove to be of interest to all those who have to design, to construct and to operate a nuclear research centre. A large number of the ideas presented can also be applied to non-nuclear scientific research centres. In his report the author reviews: various problems with which the constructor is faced: ground-plan, infrastructure, buildings and the large units of scientific equipment in the centre, and those problems facing the director: maintenance, production, supplies, security. The author stresses the relationship which ought to exist between the research workers and the management. With this aim in view he proposes the creation of National School for Administration in Research which would train administrative executives for public or private organisations; they would be specialised in the fields of fundamental or applied research. (author) [fr

  17. Beyond lung function in COPD management: effectiveness of LABA/LAMA combination therapy on patient-centred outcomes.

    Science.gov (United States)

    van der Molen, Thys; Cazzola, Mario

    2012-03-01

    Bronchodilators are central to the management of chronic obstructive pulmonary disease (COPD). Clinical studies combining different classes of bronchodilators, in particular a long-acting muscarinic antagonist (LAMA) and a long-acting β2-agonist (LABA), have demonstrated greater improvements in lung function (forced expiratory volume in 1 second, FEV1) in patients with COPD than monotherapy. FEV1 has served as an important diagnostic measurement of COPD, and the majority of clinical studies of currently available pharmacotherapies grade effectiveness of treatment regimens based on improvements in FEV1. However, FEV1 alone may not adequately reflect the overall health status of the patient. Published evidence suggests that LABA/LAMA combination therapies demonstrate greater improvements in patient-centred outcomes such as dyspnoea, symptoms, rescue medication use, and quality of life than individual drugs used alone. Evaluating patient-centred outcomes associated with COPD is likely to play an important role in future research as a measure of overall treatment effectiveness. Raising awareness of the importance of outcomes beyond lung function alone, particularly in primary care where most patients initially present themselves for medical evaluation, should form a fundamental part of a more holistic approach to COPD management.

  18. CENTRE FOR GEOMETRICAL METROLOGY

    DEFF Research Database (Denmark)

    De Chiffre, Leonardo

    The objective of this Annual Report is to give a general introduction to CGM as well as to give an account of the tasks carried out using the facilities of CGM's Instrument Centre during 1998 and 1999.......The objective of this Annual Report is to give a general introduction to CGM as well as to give an account of the tasks carried out using the facilities of CGM's Instrument Centre during 1998 and 1999....

  19. Obligation for transparency regarding treating physician credentials at academic health centres.

    Science.gov (United States)

    Martin, Paul J; Skill, N James; Koniaris, Leonidas G

    2018-02-26

    Academic health centres have historically treated patients with the most complex of diseases, served as training grounds to teach the next generations of physicians and fostered an innovative environment for research and discovery. The physicians who hold faculty positions at these institutions have long understood how these key academic goals are critical to serve their patient community effectively. Recent healthcare reforms, however, have led many academic health centres to recruit physicians without these same academic expectations and to partner with non-faculty physicians at other health systems. There has been limited transparency in regard to the expertise among the physicians and the academic faculty within these larger entities. Such lack of transparency may lead to confusion among patients regarding the qualifications of who is actually treating them. This could threaten the ethical principles of patient autonomy, benevolence and non-maleficence as patients risk making uninformed decisions that might lead to poorer outcomes. Furthermore, this lack of transparency unjustly devalues the achievements of physician faculty members as well as potentially the university they represent. In this paper, it is suggested that academic health centres have an obligation to foster total transparency regarding what if any role a physician has at a university or medical school when university or other academic monikers are used at a hospital. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  20. The impact of a person-centred community pharmacy mental health medication support service on consumer outcomes.

    Science.gov (United States)

    McMillan, Sara S; Kelly, Fiona; Hattingh, H Laetitia; Fowler, Jane L; Mihala, Gabor; Wheeler, Amanda J

    2018-04-01

    Mental illness is a worldwide health priority. As medication is commonly used to treat mental illness, community pharmacy staff is well placed to assist consumers. To evaluate the effectiveness of a multifaceted, community pharmacy medication support service for mental health consumers. Pharmacists and pharmacy support staff in three Australian states were trained to deliver a flexible, goal-oriented medication support service for adults with mental illness over 3-6 months. Consumer-related outcome measures included perceptions of illness and health-related quality of life, medication beliefs, treatment satisfaction and medication adherence. Fifty-five of 100 trained pharmacies completed the intervention with 295 of the 418 recruited consumers (70.6% completion rate); 51.2% of consumers received two or more follow-ups. Significant improvements were reported by consumers for overall perceptions of illness (p Consumers also reported an increase in medication adherence (p = 0.005). A community pharmacy mental health medication support service that is goal-oriented, flexible and individualised, improved consumer outcomes across various measures. While further research into the cost-effectiveness and sustainability of such a service is warranted, this intervention could easily be adapted to other contexts.

  1. Management of non-traumatic chest pain by the French Emergency Medical System: Insights from the DOLORES registry.

    Science.gov (United States)

    Manzo-Silberman, Stéphane; Assez, Nathalie; Vivien, Benoît; Tazarourte, Karim; Mokni, Tarak; Bounes, Vincent; Greffet, Agnès; Bataille, Vincent; Mulak, Geneviève; Goldstein, Patrick; Ducassé, Jean Louis; Spaulding, Christian; Charpentier, Sandrine

    2015-03-01

    The early recognition of acute coronary syndromes is a priority in health care systems, to reduce revascularization delays. In France, patients are encouraged to call emergency numbers (15, 112), which are routed to a Medical Dispatch Centre where physicians conduct an interview and decide on the appropriate response. However, the effectiveness of this system has not yet been assessed. To describe and analyse the response of emergency physicians receiving calls for chest pain in the French Emergency Medical System. From 16 November to 13 December 2009, calls to the Medical Dispatch Centre for non-traumatic chest pain were included prospectively in a multicentre observational study. Clinical characteristics and triage decisions were collected. A total of 1647 patients were included in the study. An interview was conducted with the patient in only 30.5% of cases, and with relatives, bystanders or physicians in the other cases. A Mobile Intensive Care Unit was dispatched to 854 patients (51.9%) presenting with typical angina chest pains and a high risk of cardiovascular disease. Paramedics were sent to 516 patients (31.3%) and a general practitioner was sent to 169 patients (10.3%). Patients were given medical advice only by telephone in 108 cases (6.6%). Emergency physicians in the Medical Dispatch Centre sent an effecter to the majority of patients who called the Emergency Medical System for chest pain. The response level was based on the characteristics of the chest pain and the patient's risk profile. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  2. Barriers to ART adherence & follow ups among patients attending ART centres in Maharashtra, India.

    Science.gov (United States)

    Joglekar, N; Paranjape, R; Jain, R; Rahane, G; Potdar, R; Reddy, K S; Sahay, S

    2011-12-01

    Adherence to ART is a patient specific issue influenced by a variety of situations that a patient may encounter, especially in resource-limited settings. A study was conducted to understand factors and influencers of adherence to ART and their follow ups among patients attending ART centres in Maharashtra, India. Between January and March 2009, barriers to ART adherence among 32 patients at three selected ART centres functioning under national ART roll-out programme in Maharashtra, India, were studied using qualitative methods. Consenting patients were interviewed to assess barriers to ART adherence. Constant comparison method was used to identify grounded codes. Patients reported multiple barriers to ART adherence and follow up as (i) Financial barriers where the contributing factors were unemployment, economic dependency, and debt, (ii) social norm of attending family rituals, and fulfilling social obligations emerged as socio-cultural barriers, (iii) patients' belief, attitude and behaviour towards medication and self-perceived stigma were the reasons for sub-optimal adherence, and (iv) long waiting period, doctor-patient relationship and less time devoted in counselling at the center contributed to missed visits. Mainstreaming ART can facilitate access and address 'missed doses' due to travel and migration. A 'morning' and 'evening' ART centre/s hours may reduce work absenteeism and help in time management. Proactive 'adherence probing' and probing on internalized stigma might optimize adherence. Adherence probing to prevent transitioning to suboptimal adherence among patients stable on ART is recommended.

  3. The "magic" of tutorial centres in Hong Kong: An analysis of media marketing and pedagogy in a tutorial centre

    Science.gov (United States)

    Koh, Aaron

    2014-12-01

    Why do more than three-quarters of Hong Kong's senior secondary students flock to tutorial centres like moths to light? What is the "magic" that is driving the popularity of the tutorial centre enterprise? Indeed, looking at the ongoing boom of tutorial centres in Hong Kong (there are almost 1,000 of them), it is difficult not to ask these questions. This paper examines the phenomenon of tutorial centres in Hong Kong and seeks to understand what draws students to these centres. Combining theories of marketing semiotics and emotion studies, the author investigates the pivotal role of media marketing in generating the "magic" of tutorial centres, whose advertising strategy includes, for example, a display of billboard posters featuring stylishly-dressed "celebrity teachers". The author reviews some of the literature available on the subject of tutorial centres. In a case study approach, he then maps out the pedagogy he observed in an English tutorial class, seeking heuristic insights into the kind of teaching students in the study were looking for. He argues that part of the "magical" attraction of what are essentially "cram schools" is their formulaic pedagogy of teaching and reinforcing exam skills. Finally, the paper considers the social implications of the tutorial centre industry in terms of media marketing of education and unequal access to tutorial services.

  4. Norway's centres for environment-friendly energy research (CEERs)

    Energy Technology Data Exchange (ETDEWEB)

    2009-07-01

    In February 2009 Norway's Minister of Petroleum and Energy announced the establishment of eight new Centres for Environment-friendly Energy Research (CEERs). The centres form national teams within the areas of offshore wind energy, solar energy, energy efficiency, bio energy, energy planning and design, and carbon capture and storage. These centres are: BIGCCS Centre - International CCS Research Centre; Centre for Environmental Design of Renewable Energy (CEDREN); Bioenergy Innovation Centre (CenBio); Norwegian Centre for Offshore Wind Energy (NORCOW E); Norwegian Research Centre for Offshore Wind Technology (NOWITECH); The Norwegian Research Centre for Solar Cell Technology; SUbsurface CO{sub 2} storage - Critical Elements and Superior Strategy (SUCCESS) The Research Centre on Zero Emission Buildings - ZEB (AG)

  5. European Federation of Associations of Families of People with Mental Illness initiatives on person-centred care.

    Science.gov (United States)

    Steffen, Sigrid

    2011-04-01

    European Federation of Associations of Families of People with Mental Illness is working towards the goal of shifting the emphasis of care for people with metal illness from the treatment of the symptoms to a more holistic approach of treating the whole person - in other words 'person-centred care'. It is also working with the Geneva conference on person-centred medicine and various interested groupings and organizations to ensure that the role of the family is fully recognized and supported. By engaging primarily with the medical community in bringing to fruition certain initiatives which European Federation of Associations of Families of People with Mental Illness considers as important to the success of person-centred care. To date, no formal reviews have taken place and feedback from the initiatives has been informal and anecdotal. Early reports from the various initiatives are positive. But they also indicate that there is still much work to be done in order for the concept to become a reality across the majority of European countries. © 2010 Blackwell Publishing Ltd.

  6. [Shared decision-making in medical practice--patient-centred communication skills].

    Science.gov (United States)

    van Staveren, Remke

    2011-01-01

    Most patients (70%) want to participate actively in important healthcare decisions, the rest (30%) prefer the doctor to make the decision for them. Shared decision-making provides more patient satisfaction, a better quality of life and contributes to a better doctor-patient relationship. Patients making their own decision generally make a well considered and medically sensible choice. In shared decision-making the doctor asks many open questions, gives and requests much information, asks if the patient wishes to participate in the decision-making and explicitly takes into account patient circumstances and preferences. Shared decision-making should remain an individual choice and should not become a new dogma.

  7. Introducing the PET Centre Prague

    International Nuclear Information System (INIS)

    Belohlavek, O.

    2001-01-01

    The PET Centre Prague (www.homolka.cz/nm) was established in 1999 as the outcome of a joint project of the public Na Homolce Hospital and the Nuclear Research Institute Rez, plc, the Czech radiopharmaceutical producer. Technical and financial assistance was provided by the International Atomic Energy Agency, which perceived the Centre as its model project that could serve as a guide for the development of PET centres in countries sharing a comparable level of development with the Czech Republic. The article maps the history of the project, its design, workplace lay-out and equipment, radiation protection arrangements and spectrum of the first approx. 3000 investigations. (author)

  8. Logistics centres development in Latvia

    Directory of Open Access Journals (Sweden)

    I. Kabashkin

    2007-12-01

    Full Text Available In the situation where a large increase in trade and freight transport volumes in the Baltic Sea region (BSR is expected and in which the BSR is facing a major economic restructuring, eff orts to achieve more integrated and sustainable transport and communication links within the BSR are needed. One of these eff orts is the development of logistics centres (LCs and their networking, which will continue to have an impact on improving communication links, spatial planning practices and approaches, logistics chain development and the promotion of sustainable transport modes. These factors will refl ect on logistics processes both in major gateway cities and in remote BSR areas. The importance of logistics systems as a whole is not seen clearly enough. Logistics actors see that logistics operations are not appreciated as much as other fi elds of activity. In addition, logistics centres and the importance of logistics activities to the business life of areas and the employment rate should be brought up better. In the paper main goal and tasks of national approach to LCs development are discussed. Strategic focus of new activities in this area is on the integration of various networks within and between logistics centres in order to improve and develop the quality of logistics networks as well as to spatially widen the networking activities. The key objectives are to integrate the links between logistics centres, ports and other logistics operators in a functional and sustainable way, to promote spatial integration by creating sustainable and integrated approaches to spatial planning of logistics centres and transport infrastructure, to improve ICT-based networking and communication practices of the fi elds of transport and logistics and to increase the competence of logistics centres and associated actors by organising educational and training events. The current activities include, for example, the creation of measures for transport networking and

  9. Trends in Data Centre Energy Consumption under the European Code of Conduct for Data Centre Energy Efficiency

    Directory of Open Access Journals (Sweden)

    Maria Avgerinou

    2017-09-01

    Full Text Available Climate change is recognised as one of the key challenges humankind is facing. The Information and Communication Technology (ICT sector including data centres generates up to 2% of the global CO2 emissions, a number on par to the aviation sector contribution, and data centres are estimated to have the fastest growing carbon footprint from across the whole ICT sector, mainly due to technological advances such as the cloud computing and the rapid growth of the use of Internet services. There are no recent estimations of the total energy consumption of the European data centre and of their energy efficiency. The aim of this paper is to evaluate, analyse and present the current trends in energy consumption and efficiency in data centres in the European Union using the data submitted by companies participating in the European Code of Conduct for Data Centre Energy Efficiency programme, a voluntary initiative created in 2008 in response to the increasing energy consumption in data centres and the need to reduce the related environmental, economic and energy supply security impacts. The analysis shows that the average Power Usage Effectiveness (PUE of the facilities participating in the programme is declining year after year. This confirms that voluntary approaches could be effective in addressing climate and energy issue.

  10. Colour centres in germanosilicate glass and optical fibres

    International Nuclear Information System (INIS)

    Neustruev, V.B.

    1994-01-01

    This review presents the state of the art of the study of germanium-related colour centres in silica glass and silica-based fibres. Most attention is concentrated on the dominant colour centres such as the Ge-related oxygen-deficient centres and paramagnetic Ge(n) centres, all of them having ultraviolet absorption bands. The hypothetical models and formation mechanisms proposed so far for these colour centres are discussed in detail. The origins of the models and formation mechanisms and their weak and strong points are analysed. The origin of the less well studied Ge-related colour centres in the visible spectral range (GeH, GeX, drawing-dependent defects) is also discussed. (author)

  11. HISTORIC CENTRE(S OF BARCELONA: PRACTICAL AND SYMBOLIC ELEMENTS IN TRADITIONAL URBAN SPACE

    Directory of Open Access Journals (Sweden)

    Verónica Martínez Robles

    2007-09-01

    The model of compact city that Barcelona aims, has required the renewal of its historical areas, and in order to improve their level of centrality, taking into account, that in addition of its historical centre “Ciutat Vella”, Barcelona contains diverse traditional neighborhoods each of them having their own historical centre. The difference centre‐periphery should also be perceived among these other historical centers. Integration should not be confused with standardization, neither differentiation with segregation.

  12. Person-centred healthcare research: a personal influence

    Directory of Open Access Journals (Sweden)

    * Corresponding author: University of Windesheim, Zwolle, The Netherlands Email: am.vandenberg@windesheim.nl Submitted for publication: 3rd November 2017 Accepted for publication: 12th March 2018 Published: 16th May 2018 https://doi.org/10.19043/ipdj.81.011 Abstract Context: This critical reflection is about the positive effects for educational and research settings of participation in a two-day programme entitled ‘Using participatory action research and appreciative inquiry to research healthcare practice’. Aims: To reflect on the journey of positive developments in research and education that started with participation in this programme. Using Caring Conversations (Dewar, 2011 as a reflective framework of questions, this article discusses the journey in order to encourage others to consider the approach of appreciative inquiry to bring to life the concept of co-creation in research and education. Conclusions and implications for practice: Participation in this programme has led to the implementation of a variety of actions in educational and research settings. Central to all these actions is an appreciative approach to co-creation as a counterpart to today’s prevailing problem-based viewpoint. A possible factor behind these developments was the power of vulnerability experienced during the programme, a shared process of transformational learning. Implications for practice: This critical reflection: Provides an invitation to shift from a problem-based focus to a positive revolution Provides an appreciative reflective story about the power of vulnerability as an inspiration for others to move out of their comfort zone and seek to discover their own exceptionality Supports a shift from a facilitator-led to a co-creation approach in doing research and teaching with older adults Keywords: Emotional touchpoints, appreciative inquiry, Caring Conversations, practice development, co-creation, transformational learning theory   IDEAS AND INFLUENCES Person-centred healthcare research: a personal influence Hazel M. Chapman

    2018-05-01

    Full Text Available This commentary assesses the contribution made by the person-centred healthcare research of McCormack et al (2017 to research methodology and our ability to evaluate an organisation’s claims to be person-centred. It discusses the importance of person-centred ethical approaches within rigorous research methodologies.

  13. Publication pressure and burn out among Dutch medical professors: a nationwide survey.

    Directory of Open Access Journals (Sweden)

    Joeri K Tijdink

    Full Text Available BACKGROUND: Publication of scientific research papers is important for professionals working in academic medical centres. Quantitative measures of scientific output determine status and prestige, and serve to rank universities as well as individuals. The pressure to generate maximum scientific output is high, and quantitative aspects may tend to dominate over qualitative ones. How this pressure influences professionals' perception of science and their personal well-being is unknown. METHODS AND FINDINGS: We performed an online survey inviting all medical professors (n = 1206 of the 8 academic medical centres in The Netherlands to participate. They were asked to fill out 2 questionnaires; a validated Publication Pressure Questionnaire and the Maslach Burnout Inventory. In total, 437 professors completed the questionnaires. among them, 54% judge that publication pressure 'has become excessive', 39% believe that publication pressure 'affects the credibility of medical research' and 26% judge that publication pressure has a 'sickening effect on medical science'. The burn out questionnaire indicates that 24% of medical professors have signs of burn out. The number of years of professorship was significantly related with experiencing less publication pressure. Significant and strong associations between burn out symptoms and the level of perceived publication pressure were found. The main limitation is the possibility of response bias. CONCLUSION: A substantial proportion of medical professors believe that publication pressure has become excessive, and have a cynical view on the validity of medical science. These perceptions are statistically correlated to burn out symptoms. Further research should address the effects of publication pressure in more detail and identify alternative ways to stimulate the quality of medical science.

  14. Adi Quala: application of solar photovoltaic generation in rural medical centres.

    Science.gov (United States)

    Allen, P; Welstead, J

    1994-01-01

    Adi Quala is an Eritrean agricultural town of 14,000 people, and is situated about 70 km south of the capital, Asmara and 30 km from the border with Tigray, Ethiopia. On good days electricity was received from Asmara between 0600 h and 2300 h with nothing available outside these hours. These conditions meant the electricity supply had been a constant problem for the Adi Quala hospital which caters for about 50,000 people with 21 staff. It was for this reason that it was chosen for the first solar system, which provides all essential requirements completely independently from the grid connection. This will in turn enable the hospital to increase the range and reliability of services on offer. Three weeks after the arrival of the equipment the elders were able to have a guided tour of their new local facilities. This included 2kW of photovoltaic panels (installed on the roof), batteries and control equipment powering a range of hospital equipment used in the Mother and Child Health Centre, delivery room, wards, dispensary, clinic and laboratory. Their enormous appreciation was very moving and well articulated in an afternoon of music, speeches and feasting. Eritrea's first solar powered hospital was welcomed into capable hands. The pilot project was successfully installed and commissioned in February 1992, and has performed well to date.

  15. Proceedings of the DMS medical ethics symposium.

    Science.gov (United States)

    O'Reilly, D J

    2011-12-01

    This article presents the proceedings of a symposium on medical ethics held at the Royal Centre for Defence Medicine in October 2010. The nature of current operations continually generates challenging ethical problems, many of which are unique to the military environment. This article is intended to generate a debate on these difficult issues and readers are encouraged to contribute to this debate by emailing the Editor.

  16. A new model of collaborative research: experiences from one of Australia’s NHMRC Partnership Centres for Better Health

    Directory of Open Access Journals (Sweden)

    Sonia Wutzke

    2017-02-01

    Full Text Available There is often a disconnection between the creation of evidence and its use in policy and practice. Cross-sectoral, multidisciplinary partnership research, founded on shared governance and coproduction, is considered to be one of the most effective means of overcoming this research–policy–practice disconnect. Similar to a number of funding bodies internationally, Australia’s National Health and Medical Research Council has introduced Partnership Centres for Better Health: a scheme explicitly designed to encourage coproduced partnership research. In this paper, we describe our experiences of The Australian Prevention Partnership Centre, established in June 2013 to explore the systems, strategies and structures that inform decisions about how to prevent lifestyle-related chronic disease. We present our view on how the Partnership Centre model is working in practice. We comment on the unique features of the Partnership Centre funding model, how these features enable ways of working that are different from both investigator-initiated and commissioned research, and how these ways of working can result in unique outcomes that would otherwise not have been possible. Although not without challenges, the Partnership Centre approach addresses a major gap in the Australian research environment, whereby large-scale, research–policy–practice partnerships are established with sufficient time, resources and flexibility to deliver highly innovative, timely and accessible research that is of use to policy and practice.

  17. Association of anthropometric measures with fat and fat-free mass in the elderly: The Rotterdam study.

    Science.gov (United States)

    Dhana, Klodian; Koolhaas, Chantal M; Schoufour, Josje D; Rivadeneira, Fernando; Hofman, Albert; Kavousi, Maryam; Franco, Oscar H

    2016-06-01

    The decrease in fat-free mass (FFM) seen in many elderly people is usually associated with an increase in fat mass (FM), a state referred to as sarcopenic obesity. It is not clear which anthropometric measures are best used to identify sarcopenic obesity. We therefore evaluated which anthropometric measures are differentially associated with FM and FFM. The anthropometric measures tested were body mass index (BMI), waist circumference (WC), and a body shape index (ABSI = WC/(BMI(2/3)*Height(1/2))). FM and FFM were estimated by dual-energy X-ray absorptiometry. An index-score was calculated for both FM (FMI) and FFM (FFMI) by dividing FM and FFM by height. Multivariable linear regression models were used to assess the associations of BMI, WC and ABSI with FMI and FFMI among 3612 participants (2092 women) from the prospective population-based Rotterdam Study. In multivariate models adjusted for confounders, BMI and WC were positively associated with both FMI and FFMI in men and women. ABSI was positively associated with FMI (β 1.01, 95% confidence interval (95%CI) 0.85, 1.17) and negatively associated with FFMI (β -0.28, 95%CI -0.38, -0.17) in men. In women, ABSI was not associated with FMI and was positively associated with FFMI (β 0.18, 95%CI 0.10, 0.26). While BMI and WC were both positively associated with FM and FFM, ABSI showed a differential association with FM and FFM in men, but not in women. Since sarcopenic obesity is associated with decreased FFM and increased FM, ABSI could be a useful tool for identifying men at higher risk of sarcopenic obesity. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  18. Modelling and measurements of urban aerosol processes on the neighborhood scale in Rotterdam, Oslo and Helsinki

    Science.gov (United States)

    Karl, M.; Kukkonen, J.; Keuken, M. P.; Lützenkirchen, S.; Pirjola, L.; Hussein, T.

    2015-12-01

    This study evaluates the influence of aerosol processes on the particle number (PN) concentrations in three major European cities on the temporal scale of one hour, i.e. on the neighborhood and city scales. We have used selected measured data of particle size distributions from previous campaigns in the cities of Helsinki, Oslo and Rotterdam. The aerosol transformation processes were evaluated using an aerosol dynamics model MAFOR, combined with a simplified treatment of roadside and urban atmospheric dispersion. We have compared the model predictions of particle number size distributions with the measured data, and conducted sensitivity analyses regarding the influence of various model input variables. We also present a simplified parameterization for aerosol processes, which is based on the more complex aerosol process computations; this simple model can easily be implemented to both Gaussian and Eulerian urban dispersion models. Aerosol processes considered in this study were (i) the coagulation of particles, (ii) the condensation and evaporation of n-alkanes, and (iii) dry deposition. The chemical transformation of gas-phase compounds was not taken into account. It was not necessary to model the nucleation of gas-phase vapors, as the computations were started with roadside conditions. Dry deposition and coagulation of particles were identified to be the most important aerosol dynamic processes that control the evolution and removal of particles. The effect of condensation and evaporation of organic vapors emitted by vehicles on particle numbers and on particle size distributions was examined. Under inefficient dispersion conditions, condensational growth contributed significantly to the evolution of PN from roadside to the neighborhood scale. The simplified parameterization of aerosol processes can predict particle number concentrations between roadside and the urban background with an inaccuracy of ∼ 10 %, compared to the fully size-resolved MAFOR model.

  19. Medical management of radiation emergencies

    International Nuclear Information System (INIS)

    Bongirwar, P.R.

    2002-01-01

    This review deals specifically with the medical management of victims, such as, the triage of exposed individuals on the basis of preliminary observations and investigations, planning priority of treatment to different groups, emergency care, and definitive care. The infrastructure for appropriate management involves first aid posts, decontamination centre, Site Hospital and Specialized Central Hospital. Medical management of life threatening radiation doses involve haematological examinations, blood component therapy, treatment with growth factors and if necessary, bone marrow transplantation as the last option. Most of the radiation accidents involving partial body and localized exposures are associated with industrial radiography sources. Such exposures are generally not life threatening but may involve serious skin injury, such as, ulceration, necrosis and gangrene. Methods have been developed to carry out decontamination of skin and decorporation of internally deposited radio nuclides. This article also provides information on the Radiation Emergency Medical Preparedness and Assistance Network and also outlines the role of media in reducing the human suffering in the event of an accident

  20. Het format van de stad. Een evaluatie van recente Nederlandse stadsgeschiedenissen

    Directory of Open Access Journals (Sweden)

    P. Kooij

    2002-01-01

    Full Text Available R. Kunst, Leeuwarden 750-2000. Hoofdstad van Friesland; A. van der Schoor, N. Schadee, Stad in aanwas. Geschiedenis van Rotterdam tot 1813; P. van de Laar, Stad van formaat. Geschiedenis van Rotterdam in de negentiende en twintigste eeuw; R.E. de Bruin, 'Een paradijs vol weelde'. Geschiedenis van de stad Utrecht.The shape of the city. An evaluation of recent historical studies on Dutch townsUrban history in the Netherlands started roundabout 1970. It was initially promoted by mainly economic and social historians who used concepts derived from geography which centred on town and country relations, urban networks, and migration. The spatial factor was considered to be a core feature, also inside the towns and cities. An alternative view, however, argued that a completely introspective urban history, focussing on one city, would result in more integration. This hypothesis has been proved in a number of recent, more or less integral urban histories, commissioned by several independent municipal authorities in individual cities. They show that a combination of internal and external elements offers the best results with regard to integration.

  1. Physical activity derived from questionnaires and wrist-worn accelerometers: comparability and the role of demographic, lifestyle, and health factors among a population-based sample of older adults

    Directory of Open Access Journals (Sweden)

    Koolhaas CM

    2017-12-01

    Full Text Available Chantal M Koolhaas,1 Frank JA van Rooij,1 Magda Cepeda,1 Henning Tiemeier,1–3 Oscar H Franco,1 Josje D Schoufour1 1Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands; 2Department of Child and Adolescent Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands; 3Department of Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands Background: Agreement between questionnaires and accelerometers to measure physical activity (PA differs between studies and might be related to demographic, lifestyle, and health characteristics, including disability and depressive symptoms.Methods: We included 1,410 individuals aged 51–94 years from the population-based Rotterdam Study. Participants completed the LASA Physical Activity Questionnaire and wore a wrist-worn accelerometer on the nondominant wrist for 1 week thereafter. We compared the Spearman correlation and disagreement (level and direction for total PA across levels of demographic, lifestyle, and health variables. The level of disagreement was defined as the absolute difference between questionnaire- and accelerometer-derived PA, whereas the direction of disagreement was defined as questionnaire PA minus accelerometer PA. We used linear regression analyses with the level and direction of disagreement as outcome, including all demographic, lifestyle, and health variables in the model.Results: We observed a Spearman correlation of 0.30 between questionnaire- and accelerometer-derived PA in the total population. The level of disagreement (ie, absolute difference was 941.9 (standard deviation [SD] 747.0 minutes/week, and the PA reported by questionnaire was on average 529.4 (SD 1,079.5 minutes/week lower than PA obtained by the accelerometer. The level of disagreement decreased with higher educational levels. Additionally, participants with obesity, higher disability scores, and more depressive symptoms underestimated their self-reported PA more than their

  2. Upgradation of nuclear medical equipment in the developing countries and its impact in Bangladesh

    CERN Document Server

    Jahangir, S M; Haque, M A S; Hoq, M; Mawla, Y; Morium, T; Uddin, M R; Xie, Y

    2002-01-01

    Bangladesh has thirteen Nuclear Medical Centres and one Institute of Nuclear Medicine in the country which are being run and maintained by the physicians scientists and engineers of Bangladesh Atomic Energy Commission. The peaceful application of atomic energy was initiated through all these Centres with the use of clinical isotopes for thyroid and kidney studies. The equipment used for these purposes were the thyroid uptake system, rectilinear scanner and the multiprobe renogram system. The first gamma camera was installed in the country in 1980 at the Institute of Nuclear Medicine, Dhaka. That was the turning point for the country in the field of nuclear medicine. Presently all the nuclear medical establishments are equipped least with a gamma camera, thyroid uptake system and a renogram system. In the last two decades there has been a tremendous development in the design of nuclear medical equipment. Most of the old equipments were slow and manually operated. In the beginning of nineties of the past centur...

  3. The CCCB is a cultural centre, not a tourist centre

    Directory of Open Access Journals (Sweden)

    Elena Xirau

    2004-04-01

    Full Text Available Last February, Barcelona's Centre of Contemporary Culture (CCCB celebrated its first ten years in existence. During this time, this institution has looked to be a showcase to the most modern and innovative cultural expressions focused on reflecting on the concept of the city. In this interview, Josep Ramoneda offers his personal view, as the CCCB's director. He talks of how this cultural project was born, of how the concept of the institution took shape in the CCCB, of its relations with Barcelona's Strategic Plan, of how the project has evolved, of the architectural remodelling of the Casa de la Caritat building for its conversion into a cultural centre, of the relations with other institutions and its future.

  4. Presentation of TVO's visitor's centre

    International Nuclear Information System (INIS)

    Aemmaelae, V.M.

    1993-01-01

    There are four nuclear power plant units in Finland, two of which are PWR's owned by Imatran Voima Oy. The two BWR units are located at Olkiluoto and owned by Teollisuuden Voima Oy. This presentation tells about TVO's concept of informing the visitors at Olkiluoto. At the site there are located, in addition to the two nuclear power plant units, the intermediate storage for spent fuel, the repository for low and medium-active waste as well as the training centre. At the Olkiluoto Visitor's Centre all the activities of the company are presented using varied audio-visual aids. The centre has several exhibits and there are also different installations to show how the plant works. (author)

  5. Technical support and emergency centre

    International Nuclear Information System (INIS)

    Bohun, L.; Kapisovsk y, M.

    1997-01-01

    This paper presents technical support and emergency management center which will be on two places: Mochovce NPP Emergency Centre (Technical support center and Support working center) and Reserve Emergency Centre in Levice (Reserve emergency center and Environmental Evaluation Center). The main aims of the emergency management centers are: the management and coordination of all persons and organisations; provision of the all information needed to evaluation of the accident and its mitigation; continuous evaluation of the potential or real radiological consequences; taking measure for an early notification of the governmental bodies and the organizations, warning and protection of the public; and other aims. In the next part the data for technical support and emergency centre are discussed

  6. Patient-centred care: a review for rehabilitative audiologists.

    Science.gov (United States)

    Grenness, Caitlin; Hickson, Louise; Laplante-Lévesque, Ariane; Davidson, Bronwyn

    2014-02-01

    This discussion paper aims to synthesise the literature on patient-centred care from a range of health professions and to relate this to the field of rehabilitative audiology. Through review of the literature, this paper addresses five questions: What is patient-centred care? How is patient-centred care measured? What are the outcomes of patient-centred care? What are the factors contributing to patient-centred care? What are the implications for audiological rehabilitation? Literature review and synthesis. Publications were identified by structured searches in PubMed, Cinahl, Web of Knowledge, and PsychInfo, and by inspecting the reference lists of relevant articles. Few publications from within the audiology profession address this topic and consequently a review and synthesis of literature from other areas of health were used to answer the proposed questions. This paper concludes that patient-centred care is in line with the aims and scope of practice for audiological rehabilitation. However, there is emerging evidence that we still need to inform the conceptualisation of patient-centred audiological rehabilitation. A definition of patient-centred audiological rehabilitation is needed to facilitate studies into the nature and outcomes of it in audiological rehabilitation practice.

  7. Estimation of the radiation burden to man caused by phosphogypsum discharges in the New Waterway near Rotterdam

    International Nuclear Information System (INIS)

    Koester, H.W.

    1991-07-01

    The phosphate fertiliser industries near Rotterdam dispose their waste product phosphogypsum as a slurry into the river Rhine. Phospho-gypsum contains elevated levels of several radionuclides of the U-238 series. Consequently radionuclides such as Th-230, Ra-226, Pb-210 and Po-210 are emitted into the Rhine in quantities of some TBq per year. Estimates of the increase of the radiation exposure due to these emissions are calculated for some critical groups. As there are no specific data of activity concentrations in fishproducts nor in soils of polders filled with harbour sludge, these were estimated from data of the activity concentrations in respectively the water and the bottom sediment in the area. A dose of 0,1 mSv.a -1 is estimated for those anglers and fishermen who, fishing in this environment and the nearby coast, consume very frequently a part of their own catch. Locally elevated levels of Ra-226 are likely to occur in harbour sludge soils, which may cause increased levels of Rn-222 in indoor air of houses built on these soils. Consequently, the radiation exposure to inhabitants may increase with more than 1 mSv.a -1 . Radiation exposure estimates for the consumption of drinking water from private wells and from locally produced milk and beef are in the order of 0,1 mSv.a -1 . The radiation exposure estimates are likely to exceed the allowable levels employed by the Dutch Ministry of Housing, Physical Planning and Environment. In order to obtain information on the validity of the estimates further research in the area is required. (author). 26 refs.; 3 tabs

  8. The Aube centre. 1997 statement

    International Nuclear Information System (INIS)

    1998-09-01

    Since January 1992 the Aube centre ensures the storage of 90% of the short life radioactive wastes produced in France. This educational booklet describes the organization of the activities in the centre from the storage of wastes to the radioactivity surveillance of the environment (air, surface and ground waters, river sediments, plants and milk). (J.S.)

  9. Review of CERN Data Centre Infrastructure

    International Nuclear Information System (INIS)

    Andrade, P; Bell, T; Van Eldik, J; McCance, G; Panzer-Steindel, B; Coelho dos Santos, M; Traylen and, S; Schwickerath, U

    2012-01-01

    The CERN Data Centre is reviewing strategies for optimizing the use of the existing infrastructure and expanding to a new data centre by studying how other large sites are being operated. Over the past six months, CERN has been investigating modern and widely-used tools and procedures used for virtualisation, clouds and fabric management in order to reduce operational effort, increase agility and support unattended remote data centres. This paper gives the details on the project's motivations, current status and areas for future investigation.

  10. Review of CERN Data Centre Infrastructure

    CERN Document Server

    Andrade, P; van Eldik, J; McCance, G; Panzer-Steindel, B; Coelho dos Santos, M; Traylen, S; Schwickerath, U

    2012-01-01

    The CERN Data Centre is reviewing strategies for optimizing the use of the existing infrastructure and expanding to a new data centre by studying how other large sites are being operated. Over the past six months, CERN has been investigating modern and widely-used tools and procedures used for virtualisation, clouds and fabric management in order to reduce operational effort, increase agility and support unattended remote data centres. This paper gives the details on the project’s motivations, current status and areas for future investigation.

  11. Bodies or organisms? Medical encounter as a control apparatus at a primary care centre in Barcelona ¿Cuerpos u organismos? El encuentro médico como dispositivo de control en un centro de atención primaria de Barcelona

    Directory of Open Access Journals (Sweden)

    Alejandro Zaballos Samper

    2013-07-01

    Full Text Available Medical practice is driven by technology, discourses, and knowledge about health and illness. This has resulted in its gaining a dominating position in power relations achieved by means of diagnosis, medicalization, and habit and conduct creation and maintenance. Interaction at primary care centres is built on mainstream biomedical views of both the medical discourse and the social practices related to health, illness and the human body. Moreover, it is also rooted on the ideologies conveyed by those social concepts, which in turn, permeate interaction all through with power relations. The present paper takes ethnographic data and in-depth interviews as a departing point to analyse how diagnosis, medicalization, and biopolicies for health prevention and improvement carried out in primary care centres in Barcelona make up a control apparatus. Furthermore, this essay also explores how the apparatus is developed in the medical encounter and turns the body into an organism.Las prácticas de asistencia médica están orientadas por tecnologías, discursos y conocimientos sobre salud/enfermedad produciendo efectos de dominación, mediante la elaboración de diagnósticos, farmacologización, creación y mantenimiento de pautas, hábitos y conductas de vida. La interacción en el dispositivo médico de Atención Primaria, construida con relación a la existencia de un discurso médico y unas prácticas sociales alrededor de la salud, la enfermedad y el cuerpo desde la visión biomédica dominante y el contenido ideológico que éstos contienen, está atravesada por relaciones de poder. A partir de datos etnográficos y entrevistas en profundidad, analizamos en este artículo los diagnósticos, la medicalización y las estrategias biopolíticas de prevención y mejora de la salud desarrolladas desde la consulta de un Centro de Atención Primaria de Barcelona como dinámicas de control producidas en el encuentro médico, que convierten el cuerpo en

  12. Introspection by a Medical Teacher on the Present Status of Medical Education in Libya

    Directory of Open Access Journals (Sweden)

    Sheriff DS

    2009-01-01

    Full Text Available To The Editor: I had the privilege of teaching in Garyounis Medical University and then Al Arab Medical University at Benghazi during its golden period from 1980 to 1990. During that period the university had eminent teachers of great caliber from India, United States of America and the United Kingdom. Around 150 to 200 students were admitted to the course. The medium of instruction was English. The student attendance was compulsory for the practical as well as lecture classes. There were no private centres of instruction. The students were very interested in their education and had shown great interest in learning. Under the tutelage of eminent teachers the students completed their medical training and proudly occupy great positions in leading hospitals and teaching institutions in Libya and all around the globe. It is a proud moment for any teacher to cherish and witness such great achievements accomplished by the students whom he/she has taught. However, it gives me no pleasure to see the standard of the medical education in Libya slipping despite the massive expansion in the number of medical schools resulting in putting enormous pressure on the scarce resources. At present, Libya has 25000 students in nine medical schools [1], compared to just 9000 practicing doctors, and a total population of around 6 million [2]. In this article I would like to propose some practical measures that may help in reviving medical education in Libya.

  13. Comparison of planned menus and centre characteristics with foods and beverages served in New York City child-care centres.

    Science.gov (United States)

    Breck, Andrew; Dixon, L Beth; Kettel Khan, Laura

    2016-10-01

    The present study evaluated the extent to which child-care centre menus prepared in advance correspond with food and beverage items served to children. The authors identified centre and staff characteristics that were associated with matches between menus and what was served. Menus were collected from ninety-five centres in New York City (NYC). Direct observation of foods and beverages served to children were conducted during 524 meal and snack times at these centres between April and June 2010, as part of a larger study designed to determine compliance of child-care centres with city health department regulations for nutrition. Child-care centres were located in low-income neighbourhoods in NYC. Overall, 87 % of the foods and beverages listed on the menus or allowed as substitutions were served. Menu items matched with foods and beverages served for all major food groups by >60 %. Sweets and water had lower match percentages (40 and 32 %, respectively), but water was served 68 % of the time when it was not listed on the menu. The staff person making the food and purchasing decisions predicted the match between the planned or substituted items on the menus and the foods and beverages served. In the present study, child-care centre menus included most foods and beverages served to children. Menus planned in advance have potential to be used to inform parents about which child-care centre to send their child or what foods and beverages their enrolled children will be offered throughout the day.

  14. Comparison of planned menus and centre characteristics with foods and beverages served in New York City child-care centres

    Science.gov (United States)

    Breck, Andrew; Dixon, L Beth; Khan, Laura Kettel

    2016-01-01

    Objective The present study evaluated the extent to which child-care centre menus prepared in advance correspond with food and beverage items served to children. The authors identified centre and staff characteristics that were associated with matches between menus and what was served. Design Menus were collected from ninety-five centres in New York City (NYC). Direct observation of foods and beverages served to children were conducted during 524 meal and snack times at these centres between April and June 2010, as part of a larger study designed to determine compliance of child-care centres with city health department regulations for nutrition. Setting Child-care centres were located in low-income neighbourhoods in NYC. Results Overall, 87% of the foods and beverages listed on the menus or allowed as substitutions were served. Menu items matched with foods and beverages served for all major food groups by > 60%. Sweets and water had lower match percentages (40 and 32%, respectively), but water was served 68% of the time when it was not listed on the menu. The staff person making the food and purchasing decisions predicted the match between the planned or substituted items on the menus and the foods and beverages served. Conclusions In the present study, child-care centre menus included most foods and beverages served to children. Menus planned in advance have potential to be used to inform parents about which child-care centre to send their child or what foods and beverages their enrolled children will be offered throughout the day. PMID:27280341

  15. A reference regional nuclear fuel centre

    International Nuclear Information System (INIS)

    1978-01-01

    A nuclear fuel centre groups the facilities for spent fuel reprocessing, plutonium fuel fabrication, waste conditioning, and interim storage on a single site. The technical aspects of safety and protection, and the socio-economic consequences of two types of centre have been studied. The reference centre has an initial reprocessing capacity of 1500 tonnes. This capacity is quadrupled by the construction of two new units in 15 years. The other centre considered is a quarter of this size. A description is given of the processes used, the personal and capital requirements for construction and operation of the plant, the transport of radioactive waste and products, and the quantities involved. The local radiological impact is low and could be further reduced to a level well below that of natural radioactivity. The resulting increase in economic activity, employment, income redistribution and the new infrastructure requirements are estimated for a rural or semi-rural region. Measures to prevent tension are proposed. The impact of the host country's balance of payments, finances, employment situation and technological knowhow is evaluated. The original centre is compared with equivalent facilities scattered geographically

  16. The Aube storage centre: Annual report 2010

    International Nuclear Information System (INIS)

    2011-01-01

    After a presentation of the Aube storage centre, a storage centre for low and intermediate activity nuclear wastes, this report gives an overview of measures related to nuclear security, to radioprotection and to nuclear safety. It indicates the incidents and accidents which occurred in 2010, describes how the centre's wastes are managed, and indicates the actions performed in terms of public information

  17. Developing the smallest possible medical cyclotron

    CERN Multimedia

    Katarina Anthony

    2011-01-01

    Imagine a portable medical cyclotron operated in a conventional radioactive facility at a hospital. Imagine a nurse or technician switching it on and producing isotopes at the patient’s bedside. Sounds like science fiction? Think again.   CERN has teamed up with Spain’s national scientific research centre (CIEMAT) to develop an avant-garde cyclotron to be used for Positron Emission Tomography (PET). “We plan to make a cyclotron that doesn't need an insulated building or ‘vault’: a cyclotron small enough to fit inside a hospital lift,” explains Jose Manuel Perez, who is leading the CIEMAT/CERN collaboration. “It will be the smallest possible medical cyclotron for single patient dose production and will dramatically reduce costs for hospitals.” While PET technology has transformed imaging techniques, many of its medical benefits have remained confined to highly specialised hospitals. “Studies have foun...

  18. CANDU 9 Control Centre Mockup

    International Nuclear Information System (INIS)

    Webster, A.; Macbeth, M.J.

    1996-01-01

    This paper provides a summary of the design process being followed, the benefits of applying a systematic design using human factors engineering, presents an overview of the CANDU 9 control centre mockup facility, illustrates the control centre mockup with photographs of the 3D CADD model and the full scale mockup, and provides an update on the current status of the project. (author)

  19. Reform in medical and health sciences educational system: a Delphi study of faculty members' views at Shiraz University of Medical Sciences.

    Science.gov (United States)

    Salehi, A; Harris, N; Lotfi, F; Hashemi, N; Kojouri, J; Amini, M

    2014-04-03

    Despite the strengths in the Iranian medical and health sciences educational system, areas in need of improvement have been noted. The purpose of this study was to understand the views of faculty members at Shiraz University of Medical Sciences about current and future needs for medical and health sciences education, with the goal of improving the quality of the educational system. The data were collected using a Delphi consensus method. Analysis of the findings identified the following key themes among the factors likely to contribute to medical and health sciences education and training: adding and/or increasing student numbers in higher degrees in preference to associate degrees; providing more interactive, student-centred teaching methods; improving the educational content with more practical and research-based courses tailored to society's needs; and an emphasis on outcome-based student evaluation techniques. These changes aim to respond to health trends in society and enhance the close relationship between medical education and the needs of the Iranian society.

  20. Leveraging management information in improving call centre productivity

    Directory of Open Access Journals (Sweden)

    Manthisana Mosese

    2016-04-01

    Objectives: This research explored the use of management information and its impact on two fundamental functions namely, improving productivity without compromising the quality of service, in the call centre of a well-known South African fashion retailer, Edcon. Following the implementation of the call centre technology project the research set out to determine how Edcon can transform their call centre to improve productivity and customer service through effective utilisation of their management information. Method: Internal documents and reports were analysed to provide the basis of evaluation between the measures of productivity prior to and post the implementation of a technology project at Edcon’s call centre. Semi-structured in-depth and group interviews were conducted to establish the importance and use of management information in improving productivity and customer service. Results: The results indicated that the availability of management information has indeed contributed to improved efficiency at the Edcon call centre. Although literature claims that there is a correlation between a call centre technology upgrade and improvement in performance, evident in the return on investment being realised within a year or two of implementation, it fell beyond the scope of this study to investigate the return on investment for Edcon’s call centre. Conclusion: Although Edcon has begun realising benefits in improved productivity in their call centre from their available management information, information will continue to play a crucial role in supporting management with informed decisions that will improve the call centre operations. [pdf to follow