Hospitalisation in an emergency department short-stay unit compared to an internal medicine department is associated with fewer complications in older patients - an observational study

DEFF Research Database (Denmark)

Strøm, Camilla; Mollerup, Talie Khadem; Kromberg, Laurits Schou

2017-01-01

Medicine Department (IMD). METHODS: Observational study evaluating adverse events during hospitalisation in non-emergent, age-matched, internal medicine patients ≥75 years, acutely admitted to either the SSU or the IMD at Holbaek Hospital, Denmark, from January to August, 2014. Medical records were......, unplanned readmission, and nosocomial infection. CONCLUSIONS: Adverse events of hospitalisation were significantly less common in older patients acutely admitted to an Emergency Department Short-stay Unit as compared to admission to an Internal Medicine Department.......BACKGROUND: Older patients are at particular risk of experiencing adverse events during hospitalisation. OBJECTIVE: To compare the frequencies and types of adverse events during hospitalisation in older persons acutely admitted to either an Emergency Department Short-stay Unit (SSU) or an Internal...

MERGING conventional and complementary medicine in a clinic department - a theoretical model and practical recommendations.

Science.gov (United States)

Pérard, Marion; Mittring, Nadine; Schweiger, David; Kummer, Christopher; Witt, Claudia M

2015-06-09

Today, the increasing demand for complementary medicine encourages health care providers to adapt and create integrative medicine departments or services within clinics. However, because of their differing philosophies, historical development, and settings, merging the partners (conventional and complementary medicine) is often difficult. It is necessary to understand the similarities and differences in both cultures to support a successful and sustainable integration. The aim of this project was to develop a theoretical model and practical steps that are based on theories from mergers in business to facilitate the implementation of an integrative medicine department. Based on a literature search and expert discussions, the cultures were described and model domains were developed. These were applied to two case studies to develop the final model. Furthermore, a checklist with practical steps was devised. Conventional medicine and complementary medicine have developed different corporate cultures. The final model, which should help to foster integration by bridging between these cultures, is based on four overall aspects: culture, strategy, organizational tools and outcomes. Each culture is represented by three dimensions in the model: corporate philosophy (core and identity of the medicine and the clinic), patient (all characteristics of the professional team's contact with the patient), and professional team (the characteristics of the interactions within the professional team). Overall, corporate culture differs between conventional and complementary medicine; when planning the implementation of an integrative medicine department, the developed model and the checklist can support better integration.

A quality assurance in a Nuclear Medicine Department: Implementation, results and implications

International Nuclear Information System (INIS)

Komninos, C.; Roach, P.J.

1998-01-01

Full text: An increasing emphasis is being placed on quality assurance programs in all areas of health care delivery. We describe our experience with such a program in the Nuclear Medicine Department of a large teaching hospital. We obtained completed patient questionnaires from 92 outpatients referred to the Nuclear Medicine Department. Questions related to areas such as provision of information about the test; patient''s impressions of staff involved with the procedure (doctors, technologists, nurses, secretaries); waiting times and delays; the appearance of the department; and the patients'' general level of satisfaction with their attendance in our department. Suggestions for improvement were specifically encouraged. The results indicated that while there was a high level of satisfaction with the people performing the studies, comments and criticisms were made by a significant number of people in some areas. These included provision of more information about the study prior to and during the test; all staff introducing themselves by name during the procedure; better communication about any delays; and an upgrading in the appearance of the department. Based on the results of this questionnaire, we have been able to implement various changes within the department. Although the results of our survey will apply specifically to this department, we encourage other departments and practices to implement similar patient surveys, thereby potentially improving the quality of service and patient satisfaction

A quality assurance in a Nuclear Medicine Department: Implementation, results and implications

Energy Technology Data Exchange (ETDEWEB)

Komninos, C.; Roach, P.J. [Royal North Shore Hospital, St Leonards, NSW (Australia)

1998-03-01

Full text: An increasing emphasis is being placed on quality assurance programs in all areas of health care delivery. We describe our experience with such a program in the Nuclear Medicine Department of a large teaching hospital. We obtained completed patient questionnaires from 92 outpatients referred to the Nuclear Medicine Department. Questions related to areas such as provision of information about the test; patient``s impressions of staff involved with the procedure (doctors, technologists, nurses, secretaries); waiting times and delays; the appearance of the department; and the patients`` general level of satisfaction with their attendance in our department. Suggestions for improvement were specifically encouraged. The results indicated that while there was a high level of satisfaction with the people performing the studies, comments and criticisms were made by a significant number of people in some areas. These included provision of more information about the study prior to and during the test; all staff introducing themselves by name during the procedure; better communication about any delays; and an upgrading in the appearance of the department. Based on the results of this questionnaire, we have been able to implement various changes within the department. Although the results of our survey will apply specifically to this department, we encourage other departments and practices to implement similar patient surveys, thereby potentially improving the quality of service and patient satisfaction.

Reduction of doses to staff in a nuclear medicine department

International Nuclear Information System (INIS)

Van Every, B.

1982-01-01

Data relating to the radiation protection of staff working in the Department of Nuclear Medicine, Alfred Hospital, Victoria during the period 1977 to 1981 are examined. No member of staff received more than one tenth of the annual whole body dose limit of 5x10 4 μSv. The reduction in the total whole body dose of staff and in the technologist's individual dose is due to relocating the department, using appropriate radiation monitoring equipment, using a staff roster and making staff aware of previous doses

[Racism of "Blood" and colonial medicine - Blood group anthropology studies at Keijo Imperial University Department of Forensic Medicine].

Science.gov (United States)

Jung, Joon Young

2012-12-01

This paper attempts to explore implications of Colonial medicine's Blood Type Studies, concerning the characteristics and tasks of racism in the Japanese Colonial Empire. Especially, it focuses on the Blood Group Anthropology Studies at Keijo Imperial University Department of Forensic Medicine. In Colonial Korea, the main stream of Blood Type Studies were Blood Group Anthropology Studies, which place Korean people who was inferior to Japanese people in the geography of the race on the one hand, but on the other, put Koreans as a missing link between the Mongolian and the Japanese for fulfillment of the Japanese colonialism, that is, assimilationist ideology. Then, Compared to the Western medicine and Metropole medicine of Japan, How differentiated was this tendency of Colonial Medicine from them? In this paper, main issues of Blood Group Anthropology Studies and its colonial implications are examined. The Korean Society for the History of Medicine.

Study of dose levels absorbed by members of the public in the nuclear medicine departments

International Nuclear Information System (INIS)

Cabral, Geovanna Oliveira de Mello

2001-03-01

In nuclear Medicine, radioisotopes are bound to various compounds (called radiopharmaceuticals) for use in various diagnostic and therapeutic applications. These unsealed sources are administered in various forms to patients, who remain radioactive for hours or days, and represent a source of potential radiation exposure for others. Thus, in nuclear medicine departments, radiation protection of workers and members of the public, especially persons accompanying patients, must consider, this exposure. In Brazil, the Comissao Nacional de Energia Nuclear (CNEN) establishes that, in nuclear medicine departments, the patients and persons accompanying should be separated each other. However, this rule is not always followed due to many factors such as physical and emotional conditions of patients. In this context, the aim of this study was the investigation of dose levels, which the persons accompanying patients are exposed to. For monitoring, thermoluminescent dosimeters were employed. The dosimeters were given to 380 persons who were accompanying patients in nuclear medicine departments. Exposure results were lower than 1 mSv. On the basis of CNEN rules, issues regarding stay conditions for members of the public in these departments are discussed. (author)

Is lead dust within nuclear medicine departments a hazard to pediatric patients?

Science.gov (United States)

Hulbert, Shannon M; Carlson, Katherine A

2009-09-01

Because of the penetrating ability of the radiation used in nuclear medicine, metallic lead is widely used as radiation shielding. However, this shielding may present an insidious health hazard because of the dust that is readily removed from the surfaces of lead objects. The lead dust may become airborne, contaminate floors and other nearby surfaces, and be inadvertently inhaled or ingested by patients. We determined if the quantity of lead dust encountered within nuclear medicine departments exceeded Environmental Protection Agency (EPA) standards. For lead dust quantification, professional lead test kits were used to sample fifteen 1-ft(2) sections of different surfaces within the department. Four samples were collected once per week from each site. The samples were then submitted to a National Lead Laboratory-accredited program for a total lead measurement. Lead contamination (mug/ft(2)) for each of the 60 samples was compared with the EPA standards for lead dust. Lead contamination was present at 6 of the 15 sites, and of 60 samples, 18 exceeded the EPA standard of 50 mug/ft(2). Lead contamination is present within nuclear medicine departments, and corrective measures should be considered when dealing with pediatric patients. A larger series needs to be conducted to confirm these findings.

Emergency department discharge prescription interventions by emergency medicine pharmacists.

Science.gov (United States)

Cesarz, Joseph L; Steffenhagen, Aaron L; Svenson, James; Hamedani, Azita G

2013-02-01

We determine the rate and details of interventions associated with emergency medicine pharmacist review of discharge prescriptions for patients discharged from the emergency department (ED). Additionally, we evaluate care providers' satisfaction with such services provided by emergency medicine pharmacists. This was a prospective observational study in the ED of an academic medical center that serves both adult and pediatric patients. Details of emergency medicine pharmacist interventions on discharge prescriptions were compiled with a standardized form. Interventions were categorized as error prevention or optimization of therapy. The staff of the ED was surveyed related to the influence and satisfaction of this new emergency medicine pharmacist-provided service. The 674 discharge prescriptions reviewed by emergency medicine pharmacists during the study period included 602 (89.3%) for adult patients and 72 (10.7%) for pediatric patients. Emergency medicine pharmacists intervened on 68 prescriptions, resulting in an intervention rate of 10.1% (95% confidence interval [CI] 8.0% to 12.7%). The intervention rate was 8.5% (95% CI 6.4% to 11.1%) for adult prescriptions and 23.6% for pediatric prescriptions (95% CI 14.7% to 35.3%) (difference 15.1%; 95% CI 5.1% to 25.2%). There were a similar number of interventions categorized as error prevention and optimization of medication therapy, 37 (54%) and 31 (46%), respectively. More than 95% of survey respondents believed that the new pharmacist services improved patient safety, optimized medication regimens, and improved patient satisfaction. Emergency medicine pharmacist review of discharge prescriptions for discharged ED patients has the potential to significantly improve patient care associated with suboptimal prescriptions and is highly valued by ED care providers. Copyright © 2012. Published by Mosby, Inc.

The nature and causes of unintended events reported at 10 internal medicine departments.

NARCIS (Netherlands)

Lubberding, S.; Zwaan, L.; Timmermans, D.R.M.; Wagner, C.

2011-01-01

Objective: This study aimed to examine the nature and causes of unintended events (UEs) at internal medicine departments (IMD). Methods: An observational study was conducted at 10 IMDs in 8 Dutch hospitals. The study period per participating department was 5 to 14 weeks. During this period, staff

Differential characteristics in polypathological inpatients in internal medicine departments and acute geriatric units: the PLUPAR study.

Science.gov (United States)

Díez-Manglano, Jesús; de Escalante Yangüela, Begoña; García-Arilla Calvo, Ernesto; Ubis Díez, Elena; Munilla López, Eulalia; Clerencia Sierra, Mercedes; Revillo Pinilla, Paz; Omiste Sanvicente, Teresa

2013-12-01

To determine whether there are any differences between polypathological patients attended in Internal Medicine departments and acute Geriatric units. A cross-sectional multicenter study was performed. Polypathological patients admitted to an internal medicine or geriatrics department and attended by investigators consecutively between March 1 and June 30, 2011 were included. Data of age, sex, living in a nursing residence or at home, diagnostic category, use of chronic medication, Charlson, Barthel and Lawton-Brody indexes, Pfeiffer questionnaire, delirium during last admission, need of a caregiver, and having a caregiver were gathered. The need of a caregiver was defined when the Barthel index wasinternal medicine and 144 from geriatrics units were included. Geriatrics inpatients were older and more frequently female. Cardiac (62.1% vs 49.6%; p=.01), digestive (8.3% vs 3.0%; p=.04) and oncohematological diseases (30.2% vs 18.8%; p=.01) were more frequent in patients of internal medicine units and neurological (66.2% vs 40.2%; pinternal medicine inpatients [4.0(2.1) vs 3.5(2.1); p=.04). Patients attended in geriatrics scored higher in Pfeiffer questionnaire [5.5(3.7) vs 3.8(3.3); pinternal medicine and geriatrics departments. © 2013.

Development of RadRob15, A Robot for Detecting Radioactive Contamination in Nuclear Medicine Departments

Directory of Open Access Journals (Sweden)

Shafe A.

2016-09-01

Full Text Available Accidental or intentional release of radioactive materials into the living or working environment may cause radioactive contamination. In nuclear medicine departments, radioactive contamination is usually due to radionuclides which emit high energy gamma photons and particles. These radionuclides have a broad range of energies and penetration capabilities. Rapid detection of radioactive contamination is very important for efficient removing of the contamination without spreading the radionuclides. A quick scan of the contaminated area helps health physicists locate the contaminated area and assess the level of activity. Studies performed in IR Iran shows that in some nuclear medicine departments, areas with relatively high levels of activity can be found. The highest contamination level was detected in corridors which are usually used by patients. To monitor radioactive contamination in nuclear medicine departments, RadRob15, a contamination detecting robot was developed in the Ionizing and Non-ionizing Radiation Protection Research Center (INIRPRC. The motor vehicle scanner and the gas radiation detector are the main components of this robot. The detection limit of this robot has enabled it to detect low levels of radioactive contamination. Our preliminary tests show that RadRob15 can be easily used in nuclear medicine departments as a device for quick surveys which identifies the presence or absence of radioactive contamination.

Occupational exposure at the Department of Nuclear Medicine as a work environment: A 19-year follow-up

OpenAIRE

Piwowarska-Bilska, Hanna; Birkenfeld, Bożena; Gwardyś, Aleksandra; Supińska, Aleksandra; Listewnik, Maria H.; Elbl, Bogumiła; Cichoń-Bańkowska, Katarzyna

2011-01-01

Summary Background: This study assessed the radiation safety at Nuclear Medicine Department being a work environment. Ionizing radiation exposure of the employees in the last 19 years and the effects of legislative changes in radiological protection were analyzed. Material/Methods: All employees of the investigated department were regularly and individually monitored using chest badges equipped with Kodak film type 2. Overall, 629 annual doses of the employees of nuclear medicine department, ...

[Corticosteroid therapy and therapeutic education: experience of an internal medicine department

NARCIS (Netherlands)

Simon, A.; Ane, A.M.; Afroun, A.

2013-01-01

In 2003, we sought to determine what were the needs of patients prescribed with long-term glucocorticoid therapy in our internal medicine department. Following this inventory, we decided to homogenize the medical practices regarding glucocorticoid prescriptions in our institution. We also set up a

Medical and administrative management of a nuclear medicine department with a microcomputer

International Nuclear Information System (INIS)

Legras, B.; Kohler, F.

1984-01-01

The use of a microcomputer for data management in a department of Nuclear Medicine has allowed to reduce considerably office work, and supplies the physicians with very useful statistics on the investigations carried out [fr

Practical radiation protection in hospitals. A view at the nuclear medicine departement of the University Hospital of Cologne

International Nuclear Information System (INIS)

Sudbrock, Ferdinand

2011-01-01

Radiation protection plays a predominant role in nuclear medicine departments as they are installations dealing with open radioactive substances. Many experts in radiation protection who are not directly involved in nuclear medicine may only have a vague insight into the daily routine of such installations. This contribution would like to give an impression by making a virtual tour through the nuclear medicine department of the University Hospital of Cologne - a department that covers a large part of the ability spectrum of this discipline. This tour will show some specialities concerning radiation protection in diagnostic and therapeutic procedures. (orig.)

A comparison of medical litigation filed against obstetrics and gynecology, internal medicine, and surgery departments.

Science.gov (United States)

Hamasaki, Tomoko; Hagihara, Akihito

2015-10-24

The aim of this study was to review the typical factors related to physician's liability in obstetrics and gynecology departments, as compared to those in internal medicine and surgery, regarding a breach of the duty to explain. This study involved analyzing 366 medical litigation case reports from 1990 through 2008 where the duty to explain was disputed. We examined relationships between patients, physicians, variables related to physician's explanations, and physician's breach of the duty to explain by comparing mean values and percentages in obstetrics and gynecology, internal medicine, and surgical departments with the t-test and χ(2) test. When we compared the reasons for decisions in cases where the patient won, we found that the percentage of cases in which the patient's claim was recognized was the highest for both physician negligence, including errors of judgment and procedural mistakes, and breach of the duty to explain, in obstetrics and gynecology departments; breach of the duty to explain alone in internal medicine departments; and mistakes in medical procedures alone in surgical departments (p = 0.008). When comparing patients, the rate of death was significantly higher than that of other outcomes in precedents where a breach of the duty to explain was acknowledged (p = 0.046). The proportion of cases involving obstetrics and gynecology departments, in which care was claimed to be substandard at the time of treatment, and that were not argued as breach of a duty to explain, was significantly higher than those of other evaluated departments (p duty to explain had been breached when seeking patient approval (or not) was significantly higher than in other departments (p = 0.002). It is important for physicians working in obstetrics and gynecology departments to carefully explain the risk of death associated with any planned procedure, and to obtain genuinely informed patient consent.

Etiologies and Management of Aseptic Meningitis in Patients Admitted to an Internal Medicine Department.

Science.gov (United States)

Jarrin, Irène; Sellier, Pierre; Lopes, Amanda; Morgand, Marjolaine; Makovec, Tamara; Delcey, Veronique; Champion, Karine; Simoneau, Guy; Green, Andrew; Mouly, Stéphane; Bergmann, Jean-François; Lloret-Linares, Célia

2016-01-01

Several studies have focused on the clinical and biological characteristics of meningitis in order to distinguish between bacterial and viral meningitis in the emergency setting. However, little is known about the etiologies and outcomes of aseptic meningitis in patients admitted to Internal Medicine.The aim of the study is to describe the etiologies, characteristics, and outcomes of aseptic meningitis with or without encephalitis in adults admitted to an Internal Medicine Department.A retrospective cohort study was conducted in the Internal Medicine Department of the Lariboisière Hospital in Paris, France, from January 2009 to December 2011. Clinical and biological characteristics of aseptic meningitis were recorded. These included cerebrospinal fluid analysis, results of polymerase chain reaction testing, final diagnoses, and therapeutic management.The cohort included 180 patients fulfilling the criteria for aseptic meningitis with (n = 56) or without (n = 124) encephalitis. A definitive etiological diagnosis was established in 83 of the 180 cases. Of the cases with a definitive diagnosis, 73 were due to infectious agents, mainly enteroviruses, Herpes Simplex Virus 2, and Varicella Zoster Virus (43.4%, 16.8%, and 14.5% respectively). Inflammatory diseases were diagnosed in 7 cases. Among the 97 cases without definitive diagnoses, 26 (26.8%) remained free of treatment throughout their management whereas antiviral or antibiotic therapy was initiated in the emergency department for the remaining 71 patients. The treatment was discontinued in only 10 patients deemed to have viral meningitis upon admission to Internal Medicine.The prevalence of inflammatory diseases among patients admitted to internal medicine for aseptic meningitis is not rare (4% of overall aseptic meningitis). The PCR upon admission to the emergency department is obviously of major importance for the prompt optimization of therapy and management. However, meningitis due to viral agents or

Application of medical psychology in the reception of nuclear medicine department

International Nuclear Information System (INIS)

Zhan Hao; Xiong Jie; Huang Daijuan; Yuan Bin; Xu Wendai; Zhang Yongxue

2003-01-01

Reception of nuclear medicine department is often ignored. In fact, it is an important part of clinical work. If the patient's psychological status is understood, and the psychological knowledge is handles and applied in practice, the quality of work can be improved. The personnel in nuclear medicine should recognize the significance of humanity in medical practice and acquire the communication skill between doctors and patients. They should also understand the four aspects of psychological need of patients: The need of being understood and respected; the need of being greeted, accepted and a sense of belonging; the need of being informed; the need of feeling safe and rehabilitated

Utilizing Integrative Medicine in the U.S. Army Medical Department

Science.gov (United States)

2012-05-15

Restoring healing to medicine is like restoring justice to the law.‖ --Dean Ornish, MD1 Introduction The 2009 National Defense Authorization...for all providers as an introduction to IM concepts, areas of practice, and an overview of each modality, with links to further references. This... Shakespeare , Hamlet, I.v.166-67. 67 ―When Congress authorized the USPSTF, it required the Department of Health and Human Services (HHS) to support

Radiopharmaceutical prescription in nuclear medicine departments; La prescription medicale des radiopharmaceutiques au sein d'un service de medecine nucleaire

Energy Technology Data Exchange (ETDEWEB)

Biechlin-Chassel, M.L. [Radiopharmacie, service de pharmacie, Centre hospitalier de Chambery, 73 - Chambery (France); Lao, S. [Service de medecine nucleaire, CHU-Hopital de l' Archet, 06 - Nice (France); Bolot, C. [Service de pharmacie, hospices civiles de Lyon, groupement hospitalier Est, 69 - Bron (France); Francois-Joubert, A. [Service de medecine nucleaire, centre hospitalier de Chambery, 73 - Chambery (France)

2010-11-15

In France, radiopharmaceutical prescription is often discussed depending to which juridical structure the nuclear medicine department is belonging. According to current regulation, this prescription is an obligation in a department linked to hospital with a pharmacy department inside. But situation remains unclear for independent nuclear medicine departments where physicians are not constrained to prescribe radiopharmaceuticals. However, as radiographers and nurses are only authorized to realize theirs acts in front of a medical prescription, one prescription must be realized. Nowadays, computerized prescription tools have been developed but only for radiopharmaceutical drugs and not for medical acts. In the aim to achieve a safer patient care, the prescription regulation may be applied whatever differences between nuclear medicines departments. (authors)

Quality control in Department of Nuclear Medicine, Clinical Center Banja Luka, RS, Bosnia and Herzegovina

International Nuclear Information System (INIS)

Goran Vuleta

2007-01-01

Complete test of publication follows. The aim of this work is to give a review of situations in the Department of Nuclear Medicine in Banja Luka related to quality control. We must perform daily, weekly and monthly control of equipment in the Department of Nuclear Medicine, and we must keep records. In our Department we have equipment from different producers and different year of production: 3 gamma cameras (1973, 1989, 2000); 2 auto gamma counters (2000, 2006); 2 dose calibrators (1973, 2000); 1 thyroid uptake system (2000). Normally procedures for quality control are also different. The situation, according to results of quality control is good. All equipment is working normally and with good performance (except one gamma camera - a problem with hard drive), but we don't have a routine daily control and periodical control for others tests. Keeping a records is another problem. Why? 1. In Bosnia and Herzegovina we don't have Regulatory authority. That means that we don't have legislation, rules, inspection or any other regulatory instruments. 2. There is only school for nurses, we have no special school for medical technician. So, we need an education in that field. 3. Very small number of physicist in hospital, no education for medical and nuclear medicine physicist. Conclusion. Situation in Department of Nuclear Medicine in Banja Luka related to quality control is on the medium level. We are trying to put that on the higher level, but to accomplish that we need additional education for nurses (technicians) and physicist.

Potentially inappropriate prescribing in elderly population: A study in medicine out-patient department

Directory of Open Access Journals (Sweden)

Ajit Kumar Sah

2017-03-01

Full Text Available Background & Objectives: Older individuals often suffer from multiple systemic diseases and are particularly more vulnerable to potentially inappropriate medicine prescribing. Inappropriate medication can cause serious medical problem for the elderly. The study was conducted with objectives to determine the prevalence of potentially inappropriate medicine (PIM prescribing in older Nepalese patients in a medicine outpatient department.Materials & Methods: A prospective observational analysis of drugs prescribed in medicine out-patient department (OPD of a tertiary hospital of central Nepal was conducted during November 2012 to October 2013 among 869 older adults aged 65 years and above. The use of potentially inappropriate medications (PIM in elderly patients was analysed using Beer’s Criteria updated to 2013. Results: In the 869 patients included, the average number of drugs prescribed per prescription was 5.56. The most commonly used drugs were atenolol (24.3%, amlodipine (23.16%, paracetamol (17.6%, salbutamol (15.72% and vitamin B complex (13.26%. The total number of medications prescribed was 4833. At least one instance of PIM was experienced by approximately 26.3% of patients when evaluated using the Beers criteria. Conclusion: Potentially inappropriate medications are highly prevalent among older patients attending medical OPD and are associated with number of medications prescribed. Further research is warranted to study the impact of PIMs towards health related outcomes in these elderly.

Using Lean Management to Reduce Emergency Department Length of Stay for Medicine Admissions.

Science.gov (United States)

Allaudeen, Nazima; Vashi, Anita; Breckenridge, Julia S; Haji-Sheikhi, Farnoosh; Wagner, Sarah; Posley, Keith A; Asch, Steven M

The practice of boarding admitted patients in the emergency department (ED) carries negative operational, clinical, and patient satisfaction consequences. Lean tools have been used to improve ED workflow. Interventions focused on reducing ED length of stay (LOS) for admitted patients are less explored. To evaluate a Lean-based initiative to reduce ED LOS for medicine admissions. Prospective quality improvement initiative performed at a single university-affiliated Department of Veterans Affairs (VA) medical center from February 2013 to February 2016. We performed a Lean-based multidisciplinary initiative beginning with a rapid process improvement workshop to evaluate current processes, identify root causes of delays, and develop countermeasures. Frontline staff developed standard work for each phase of the ED stay. Units developed a daily management system to reinforce, evaluate, and refine standard work. The primary outcome was the change in ED LOS for medicine admissions pre- and postintervention. ED LOS at the intervention site was compared with other similar VA facilities as controls over the same time period using a difference-in-differences approach. ED LOS for medicine admissions reduced 26.4%, from 8.7 to 6.4 hours. Difference-in-differences analysis showed that ED LOS for combined medicine and surgical admissions decreased from 6.7 to 6.0 hours (-0.7 hours, P = .003) at the intervention site compared with no change (5.6 hours, P = .2) at the control sites. We utilized Lean management to significantly reduce ED LOS for medicine admissions. Specifically, the development and management of standard work were key to sustaining these results.

Variation in Emergency Department vs Internal Medicine Excess Charges in the United States.

Science.gov (United States)

Xu, Tim; Park, Angela; Bai, Ge; Joo, Sarah; Hutfless, Susan M; Mehta, Ambar; Anderson, Gerard F; Makary, Martin A

2017-08-01

Uninsured and insured but out-of-network emergency department (ED) patients are often billed hospital chargemaster prices, which exceed amounts typically paid by insurers. To examine the variation in excess charges for services provided by emergency medicine and internal medicine physicians. Retrospective analysis was conducted of professional fee payment claims made by the Centers for Medicare & Medicaid Services for all services provided to Medicare Part B fee-for-service beneficiaries in calendar year 2013. Data analysis was conducted from January 1 to July 31, 2016. Markup ratios for ED and internal medicine professional services, defined as the charges submitted by the hospital divided by the Medicare allowable amount. Our analysis included 12 337 emergency medicine physicians from 2707 hospitals and 57 607 internal medicine physicians from 3669 hospitals in all 50 states. Services provided by emergency medicine physicians had an overall markup ratio of 4.4 (340% excess charges), which was greater than the markup ratio of 2.1 (110% excess charges) for all services performed by internal medicine physicians. Markup ratios for all ED services ranged by hospital from 1.0 to 12.6 (median, 4.2; interquartile range [IQR], 3.3-5.8); markup ratios for all internal medicine services ranged by hospital from 1.0 to 14.1 (median, 2.0; IQR, 1.7-2.5). The median markup ratio by hospital for ED evaluation and management procedure codes varied between 4.0 and 5.0. Among the most common ED services, laceration repair had the highest median markup ratio (7.0); emergency medicine physician review of a head computed tomographic scan had the greatest interhospital variation (range, 1.6-27.7). Across hospitals, markups in the ED were often substantially higher than those in the internal medicine department for the same services. Higher ED markup ratios were associated with hospital for-profit ownership (median, 5.7; IQR, 4.0-7.1), a greater percentage of uninsured patients seen

Technetium99m shortage: Practical solutions to manage lack of the radio-isotope in nuclear medicine departments

International Nuclear Information System (INIS)

Biechlin-Chassel, M.L.; Francois-Joubert, A.; Bolot, C.; Desruet, M.D.; Bourrel, F.; Pelegrin, M.; Couret, I.; Lao, S.; Quelven, I.

2010-01-01

Technetium 99m ( 99m Tc) shortage crisis regularly affect nuclear medicine activity and oblige the community to find solutions in order to perform most of the prescribed exams and avoid systematic substitutions by other non-nuclear medicine techniques. Firstly, some practical solutions can be set up in radiopharmacy departments such as using more than two generators together, realizing fractionated elutions, preparing radiopharmaceuticals with elutions providing from different generators.. Then, it could be interesting to have a reflexion in nuclear medicine departments to convene patients the days when 99m Tc supply is sufficient, to pool some exams or to make substitutions with more available isotopes. (authors)

[Analises of the mortality in aged in an Internal Medicine Department].

Science.gov (United States)

Cinza Sanjurjo, S; Cabarcos Ortiz de Barrón, A; Nieto Pol, E; Torre Carballada, J A

2007-02-01

To establish the characteristics of the deceased and the death causes. Transversal study descriptive, with intake patients elder than 65 years old in an Internal Medicine Department. The variables analized were: age, sex, intake date, discharge date, days of hospital stay, chronic disease previous, admission cause, deceased, diagnoses. The statistical analysis was performed with measures of central tendency and of standard deviation, Chi-cuadrado, Mann-Whitney-Wilcoxon and Kruskal-Wallis. During the revised year, there are 770 patients intaked in Internal Medicine Department and 128 exitus (16.6%). The global average death age was 78.3 +/- 1.3 years: 53.1% (0.44-0.62; p = 0.48) were men and 46.9% were women. The average death intake days was 13.3 +/- 1.7 days (p < 0.001), 3.9% died in less than forty-eight hours after hospitalization. The most frequent admission cause was: dyspnea (46.1%). The most frequent chronic diseases were: ischemic and hypertensive heart disease (18.8%) and chronic obstructive pulmonary disease. The most frequent death cause was respiratory tract infection (43.8%). The prevalence cardiac and pulmonary disease prevalence is high, these diseases are the of the most frequent causes hospital mortality.

Complex decision making in patients with dementia in an internal medicine department.

Science.gov (United States)

Kabelka, Ladislav

2017-10-01

With the increase of polymorbidity, extending life expectancy and improving treatment options for chronic diseases, the care for dementia is moving into other areas of medicine. The length and quality of life with advanced dementia is directly dependent on the quality of medical and nursing care, early detection and treatment of complications, nutritional support and palliative care plan. Significant is also the support for family carers. The key coordinators of care for patients with dementia are general practitioners (GPs), geriatricians, psychiatrists, and an increasingly important role play internists. Case reports of patients admitted to an internal medicine department. Description of clinical experiences with caring on patients with dementia. In the internal departments of regional hospitals, there is a room for adjustment of the care plan, for comprehensive assessment of the patient and for making crucial decisions regarding nutrition, treatment of chronic diseases, consideration of previously expressed wishes in the context of the patient condition, and potential prognostic indicators. This assessment must result in a comprehensive documentation and communication with patients, and in the case of advanced dementia with their family members. The general internal medicine is very often the first place where the patient has a chance to hear about indication for palliative care. Without the availability of a multidisciplinary assessment, good communication and documentation, it is unrealistic to expect that the hospital would provide comprehensive care for patients with dementia.

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

Science.gov (United States)

Okamoto, Yasuyuki

2003-04-01

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

Radiation doses of employees of a nuclear medicine department after implementation of more rigorous radiation protection methods

International Nuclear Information System (INIS)

Piwowarska-Bilska, H.; Supinska, A.; Listewnik, M. H.; Zorga, P.; Birkenfeld, B.

2013-01-01

The appropriate radiation protection measures applied in departments of nuclear medicine should lead to a reduction in doses received by the employees. During 1991-2007, at the Department of Nuclear Medicine of Pomeranian Medical University (Szczecin, Poland), nurses received on average two-times higher (4.6 mSv) annual doses to the whole body than those received by radiopharmacy technicians. The purpose of this work was to examine whether implementation of changes in the radiation protection protocol will considerably influence the reduction in whole-body doses received by the staff that are the most exposed. A reduction in nurses' exposure by ∼63% took place in 2008-11, whereas the exposure of radiopharmacy technicians grew by no more than 22% in comparison with that in the period 1991-2007. Proper reorganisation of the work in departments of nuclear medicine can considerably affect dose reduction and bring about equal distribution of the exposure. (authors)

Complementary and alternative medicine use among paediatric emergency department patients.

Science.gov (United States)

Taylor, David McDonald; Dhir, Reetika; Craig, Simon S; Lammers, Thalia; Gardiner, Kaya; Hunter, Kirrily; Joffe, Paul; Krieser, David; Babl, Franz E

2015-09-01

To determine the period prevalence and nature of complementary and alternative medicine (CAM) use among paediatric emergency department (ED) patients and the perceptions of CAM among the CAM administrators. A survey was undertaken in four Victorian EDs (January to September 2013). A convenience sample of parents/carers accompanying paediatric patients completed a self-administered questionnaire. The main outcome measures were CAM use and perceptions of CAM. The parents/carers of 883 patients participated. Three hundred eighty-eight (43.9%, 95% confidence interval (CI) 40.6-47.3) and 53 (6.0%, 95% CI 4.6-7.8) patients had taken a CAM within the previous 12 months and on the day of presentation, respectively. There were no gender differences between CAM users and non-users (P = 0.83). The use of CAM was significantly more common among older patients (P effective than prescription medicines and safe when taken with prescription medicines. CAM use is common among paediatric ED patients although rarely reported to the ED doctor. Parents/carers who administer CAM have differing perceptions of CAM safety from those who do not. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Economic analysis of bedside ultrasonography (US) implementation in an Internal Medicine department.

Science.gov (United States)

Testa, Americo; Francesconi, Andrea; Giannuzzi, Rosangela; Berardi, Silvia; Sbraccia, Paolo

2015-12-01

The economic crisis, the growing healthcare demand, and Defensive Medicine wastefulness, strongly recommend the restructuring of the entire medical network. New health technology, such as bedside ultrasonography, might successfully integrate the clinical approach optimizing the use of limited resources, especially in a person-oriented vision of medicine. Bedside ultrasonography is a safe and reliable technique, with worldwide expanding employment in various clinical settings, being considered as "the stethoscope of the 21st century". However, at present, bedside ultrasonography lacks economic analysis. We performed a Cost-Benefit Analysis "ex ante", with a break-even point computing, of bedside ultrasonography implementation in an Internal Medicine department in the mid-term. Number and kind estimation of bedside ultrasonographic studies were obtained by a retrospective study, whose data results were applied to the next 3-year period (foresight study). All 1980 foreseen bedside examinations, with prevailing multiorgan ultrasonographic studies, were considered to calculate direct and indirect costs, while specific and generic revenues were considered only after the first semester. Physician professional training, equipment purchase and working time represented the main fixed and variable cost items. DRG increase/appropriateness, hospitalization stay shortening and reduction of traditional ultrasonography examination requests mainly impacted on calculated revenues. The break-even point, i.e. the volume of activity at which revenues exactly equal total incurred costs, was calculated to be 734 US examinations, corresponding to € 81,998 and the time considered necessary to reach it resulting 406 days. Our economic analysis clearly shows that bedside ultrasonography implementation in clinical daily management of an Internal Medicine department can produce consistent savings, or economic profit according to managerial choices (i.e., considering public or private targets

Effect of usual lead apron in decreasing dose rate in nuclear medicine department

Energy Technology Data Exchange (ETDEWEB)

Momennezhad, M.; Ghazikhanloo, K.; Zakavi, S.R. [Mashhad Univ. of Medical Sciences (Iran, Islamic Republic of)

2006-07-01

Full text of publication follows: Introduction: In a busy nuclear medicine department personnel exposure to radiation is inevitable during patient positioning and radiotracer preparation. There is controversy regarding usage of usual lead aprons with respect to penetrating gamma rays used in nuclear medicine departments as well as production of characteristic lead x-ray from aprons.This study tries to evaluate the effect of 0.5 mm lead apron on dose reduction. Methods and materials: We used three point sources usual radioisotopes used in nuclear medicine departments (99 mTc, 201 Tl and 131 I) and a single head L.F.O.V. gamma camera (S.M.V., D.S.X.) was used for counting purposes. The count rate for each source was about 20 K count/sec in air and in a brain water phantom. All point sources were placed at a distance of 3 meters, parallel to the center of the detector. The collimator was removed and imaging was performed for 1 min with and without lead apron on the detector. Lead apron covered all field of view of the detector. Each imaging was repeated 3 times and mean count was obtained for each radioisotope. The measurements were accomplished from full spectrum and specific region of spectrum such as characteristic lead x rays region (88 keV 20%) with and without apron. Result and Discussion: The measurement and comparison of count rates (count/min) for each source in different conditions (with and without apron source in air and in water phantom) showed that count rates were reduced in air about 77.3%, 84.2% and 40.8% for 99 mTc, 201 Tl and 131 I respectively. The reduction in count rates when sources placed in brain water phantom were 83.5%, 87% and 53.7% for the same isotope respectively. As the main source of radiation for personnel is from scattered photon and with respect to about 83% of count rate reduction using lead aprons for 99 mTc, it is expected that wearing lead apron significantly decrease dose rate. Conclusion: Our study showed that lead aprons

Effect of usual lead apron in decreasing dose rate in nuclear medicine department

International Nuclear Information System (INIS)

Momennezhad, M.; Ghazikhanloo, K.; Zakavi, S.R.

2006-01-01

Full text of publication follows: Introduction: In a busy nuclear medicine department personnel exposure to radiation is inevitable during patient positioning and radiotracer preparation. There is controversy regarding usage of usual lead aprons with respect to penetrating gamma rays used in nuclear medicine departments as well as production of characteristic lead x-ray from aprons.This study tries to evaluate the effect of 0.5 mm lead apron on dose reduction. Methods and materials: We used three point sources usual radioisotopes used in nuclear medicine departments (99 mTc, 201 Tl and 131 I) and a single head L.F.O.V. gamma camera (S.M.V., D.S.X.) was used for counting purposes. The count rate for each source was about 20 K count/sec in air and in a brain water phantom. All point sources were placed at a distance of 3 meters, parallel to the center of the detector. The collimator was removed and imaging was performed for 1 min with and without lead apron on the detector. Lead apron covered all field of view of the detector. Each imaging was repeated 3 times and mean count was obtained for each radioisotope. The measurements were accomplished from full spectrum and specific region of spectrum such as characteristic lead x rays region (88 keV 20%) with and without apron. Result and Discussion: The measurement and comparison of count rates (count/min) for each source in different conditions (with and without apron source in air and in water phantom) showed that count rates were reduced in air about 77.3%, 84.2% and 40.8% for 99 mTc, 201 Tl and 131 I respectively. The reduction in count rates when sources placed in brain water phantom were 83.5%, 87% and 53.7% for the same isotope respectively. As the main source of radiation for personnel is from scattered photon and with respect to about 83% of count rate reduction using lead aprons for 99 mTc, it is expected that wearing lead apron significantly decrease dose rate. Conclusion: Our study showed that lead aprons

The main rules regarding the management of solid waste and liquid effluent contaminated during use at nuclear medicine departments

International Nuclear Information System (INIS)

Boudouin, E.

2011-01-01

This article describes the key requirements applicable to the management of contaminated medical waste and effluent from hospitals and health care centres, and more especially from nuclear medicine departments that use radionuclides for the purposes of diagnosis (in vivo or in vitro) or in patient treatment. It also presents the key management regulations, making a distinction between contaminated solid waste and contaminated liquid waste from such nuclear medicine departments. (author)

Plantas medicinais no tratamento do transtorno de ansiedade generalizada: uma revisão dos estudos clínicos controlados Medicinal plants for the treatment of generalized anxiety disorder: a review of controlled clinical studies

Directory of Open Access Journals (Sweden)

Thalita Thais Faustino

2010-12-01

Full Text Available OBJETIVO: Revisar os estudos clínicos controlados sobre a efetividade de plantas medicinais/fitoterápicos no transtorno de ansiedade generalizada. MÉTODO: Realizou-se uma busca (Medline, Web of Science, SciELO, Biblioteca Cochrane por artigos originais utilizando as palavras ["plant OR phytomed* OR extract OR herbal OR medicinal (OR specific name plants"] AND ("anxie* OR anxioly* OR tranquil* OR GAD", delimitada a "human OR clinical trial OR randomized controlled trial OR meta-analysis OR review" e à língua inglesa. Os critérios de inclusão foram: estudos randomizados, comparativos e duplo-cegos. RESULTADOS: Foram selecionados sete dos 267 artigos encontrados. O Piper methysticum (kava-kava foi o fitoterápico mais estudado, sendo sugerido um efeito ansiolítico. Entretanto, a maioria destes estudos incluiu outros transtornos de ansiedade e os dois estudos com transtorno de ansiedade generalizada apresentaram resultados contraditórios. Estudos isolados envolvendo Ginkgo biloba, Galphimia glauca, Matricaria recutita (camomila, Passiflora incarnata e Valeriana officinalis indicaram potencial efeito ansiolítico no transtorno de ansiedade generalizada. A Ginkgo biloba e a Matricaria recutita apresentaram um effect size ('d' de Cohen = 0,47 e 0,87 similar ou superior ao dos ansiolíticos atuais (0,17-0,38. Não foram localizados estudos com outras plantas. CONCLUSÃO: Apesar do potencial terapêutico dos fitoterápicos no transtorno de ansiedade generalizada, poucos ensaios clínicos controlados foram identificados, com a maioria apresentando limitações metodológicas.OBJECTIVE: This work aimed to identify controlled trials, which evaluated effectiveness of herbal medicines in subjects suffering generalized anxiety disorder. METHOD: Controlled studies (randomized, comparative with placebo and/or standard drug, double-blind were sought through electronic and hand-searches. The word strategy used "plant OR phytomed* OR extract OR herbal OR

Level of training and experience in physicians performing interhospital transfers of adult patients in the internal medicine department

DEFF Research Database (Denmark)

Hallas, P; Folkestad, L; Brabrand, M

2009-01-01

AIM: To establish the level of training doctors who participate in interhospital transfers in Denmark. METHODS: A questionnaire was sent to every hospital department in Denmark with acute internal medicine admissions. RESULTS: Eighty-nine internal medicine departments were contacted and 84...... responded (response rate 94.4%). Of the 84 hospitals, 75 (89.3%) indicated that they perform interhospital transfers. Most transfers were performed by interns (61.3%) or senior house officers (10.7%) with only a few months' experience in their current speciality. Training in interhospital transfer...

A computerized faculty time-management system in an academic family medicine department.

Science.gov (United States)

Daugird, Allen J; Arndt, Jane E; Olson, P Richard

2003-02-01

The authors describe the development, implementation, and evaluation of a computerized faculty time-management system (FTMS) in the Department of Family Medicine at the University of North Carolina-Chapel Hill. The FTMS is presented as an integrated set of computerized spreadsheets used annually to allocate faculty time across all mission activities of the department. It was first implemented in 1996 and has been continuously developed since then. An iterative approach has been used to gain consensus among faculty about time resources needed for various tasks of all missions of the department. These time-resource assumptions are used in the computerized system. Faculty time is allocated annually by the department vice chair in negotiation with individual faculty, making sure that the activities planned do not exceed the work time each faculty member has available for the year. During this process, faculty preferences are balanced against department aggregate needs to meet mission commitments and obligations. The authors describe how the computerized FTMS is used for faculty time management and career development, department planning, budget planning, clinical scheduling, and mission cost accounting. They also describe barriers and potential abuses and the challenge of building an organizational culture willing to discuss faculty time openly and committed to developing a system perceived as fair and accurate. The spreadsheet file is available free from the authors for use in other departments.

Integration of PACS and HIS info the workflow of a nuclear medicine department. Experience in Regensburg

International Nuclear Information System (INIS)

Maenner, P.; Fuchs, E.; Marienhagen, J.; Schoenberger, J.; Eilles, C.; Tege, B.; Reicherzer, H.G.; Kurz, M.; Boerner, W.

2006-01-01

Aim: the development of new diagnostic techniques and the implementation of a modern quality control management system requires the continuous adaptation of existing data processing tools to the nuclear medicine diagnostic workflow. Furthermore, PACS connected to HIS facilitates and enhances the transfer of data and pictures, and satisfies the legal requirements for data retention as regulated by law. Therefore, the aim of this work is to present the architecture, structure and results of such a system newly installed in a department of nuclear medicine. Methods: initially, the nuclear medicine workflow was carefully analyzed and each step was correlated to the corresponding module. The standard SAP R/3 and IS-H / IS-H*med based software used for patient administration at the University of Regensburg Hospital was adapted to the needs of the Nuclear Medicine Department. The networking of the imaging systems was done by integration of a PACS. Finally, the PACS was connected to the HIS to allow the attachment of images to the medical report. Results, conclusion: by connecting the HIS to the nuclear medicine PACS, the workflow was significantly improved. The data management sequence starting at the reception desk, continuing through the nuclear medical examination, to the physician's final written and image report is clearly structured. Although high demands exist on technical support and administration the integration of PACS and HIS into the nuclear medicine workflow leads to enhanced efficiency and reduction in hospital costs. Patient and data management are considerably improved in this way. (orig.)

Does Spanish instruction for emergency medicine resident physicians improve patient satisfaction in the emergency department and adherence to medical recommendations?

Directory of Open Access Journals (Sweden)

Stoneking LR

2016-08-01

Full Text Available LR Stoneking,1 AL Waterbrook,1 J Garst Orozco,2 D Johnston,1 A Bellafiore,1 C Davies,3 T Nuño,1 J Fatás-Cabeza,4 O Beita,5 V Ng,1 KH Grall,6 W Adamas-Rappaport7 1Department of Emergency Medicine, University of Arizona, Tucson, AZ, 2Department of Emergency Medicine, Sinai Health System, Chicago, IL, 3Department of Emergency Medicine, Maricopa Medical Center, Phoenix, AZ, 4Department of Spanish and Portuguese, University of Arizona, Tucson, AZ, 5Department of Family and Community Medicine, University of Arizona, Tucson, AZ, 6Department of Emergency Medicine, Regions Hospital, St Paul, MN, 7Department of Surgery, University of Arizona, Tucson, AZ, USA Background: After emergency department (ED discharge, Spanish-speaking patients with limited English proficiency are less likely than English-proficient patients to be adherent to medical recommendations and are more likely to be dissatisfied with their visit.Objectives: To determine if integrating a longitudinal medical Spanish and cultural competency curriculum into emergency medicine residency didactics improves patient satisfaction and adherence to medical recommendations in Spanish-speaking patients with limited English proficiency.Methods: Our ED has two Emergency Medicine Residency Programs, University Campus (UC and South Campus (SC. SC program incorporates a medical Spanish and cultural competency curriculum into their didactics. Real-time Spanish surveys were collected at SC ED on patients who self-identified as primarily Spanish-speaking during registration and who were treated by resident physicians from both residency programs. Surveys assessed whether the treating resident physician communicated in the patient’s native Spanish language. Follow-up phone calls assessed patient satisfaction and adherence to discharge instructions.Results: Sixty-three patients self-identified as primarily Spanish-speaking from August 2014 to July 2015 and were initially included in this pilot study

Analysis of radiation doses to patients from diagnostic department of nuclear medicine

International Nuclear Information System (INIS)

Lepej, L.; Messingerova, M.

1995-01-01

In this paper the values of mean effective dose equivalents per unit activity (H E/1Bq ) were used for the calculation of mean effective dose equivalents for one examination (H E ). The collective effective dose equivalents for each radiopharmaceutical and type of examination (S ER ) and global collective effective dose equivalent for department for all radiopharmaceuticals (S E ) during evaluated period were defined. The data for years from 1992 to 1994 were evaluated and compared with results in literature. The evaluation of radiation doses in nuclear medicine department is useful parameter for internal quality control. Using this method, the radiation dose in this laboratory was changed to minimum (under mean value of Slovak Republic). Unfortunately, the real data of patients radiation doses are different from the calculated one. Due to different kinetic of radiopharmaceuticals in individual patients (influenced by pathology, age, etc.) the evaluation of radiation burden to nuclear medicine patients is problematic. But this approach enable the relative comparison of the changes in values of H E and S E during the observed period. The evaluation of individual (minimal) effective dose equivalent - (H min ) which represents dose calculated under physiologic conditions can be useful for indication of diagnostic examination by physicians. Therefore the systematic registration of H min from all examinations - patient's radiation history. This is specially important in the case of children and young people. The importance of the proposed method, is in regulation of radiation dose from nuclear medicine diagnostic examinations, not only be the control of number and type of examinations, but also by selection of used radiopharmaceuticals and by the way how to use them. (J.K.) 1 fig., 2 refs

Air contamination measurements for the evaluation of internal dose to workers in nuclear medicine departments

Science.gov (United States)

De Massimi, B.; Bianchini, D.; Sarnelli, A.; D'Errico, V.; Marcocci, F.; Mezzenga, E.; Mostacci, D.

2017-11-01

Radionuclides handled in nuclear medicine departments are often characterized by high volatility and short half-life. It is generally difficult to monitor directly the intake of these short-lived radionuclides in hospital staff: this makes measuring air contamination of utmost interest. The aim of the present work is to provide a method for the evaluation of internal doses to workers in nuclear medicine, by means of an air activity sampling detector, to ensure that the limits prescribed by the relevant legislation are respected. A continuous air sampling system measures isotope concentration with a Nal(TI) detector. Energy efficiency of the system was assessed with GEANT4 and with known activities of 18F. Air is sampled in a number of areas of the nuclear medicine department of the IRST-IRCCS hospital (Meldola- Italy). To evaluate committed doses to hospital staff involved (doctors, technicians, nurses) different exposure situations (rooms, times, radionuclides etc) were considered. After estimating the intake, the committed effective dose has been evaluated, for the different radionuclides, using the dose coefficients mandated by the Italian legislation. Error propagation for the estimated intake and personal dose has been evaluated, starting from measurement statistics.

Equivalent doses of ionizing radiation received by medical staff at a nuclear medicine department

International Nuclear Information System (INIS)

Dziuk, E.; Kowalczyk, A.; Siekierzynski, M.; Jazwinski, J.; Chas, J.; Janiak, M.K.; Palijczuk, D.

2002-01-01

Aim: Total annual activity of I-131 used for the treatment of thyroid disorders at the Dept.of Nuclear Medicine, Central Clinical Hospital, Military University School of Medicine, in Warsaw, Poland, equal to 190 GBq; at the same time, total activity of Tc-99m utilized at the same Department for diagnostic purposes reached 1 TBq. As estimated from the radiometer readings, in extreme cases the equivalent at a couple of measurement points at this Department may exceed 200 mSv per year. Thus, in the present study we aimed to assess the potential risk of the exposure of medical personnel of the Department to ionizing radiation. Material and Methods: Polymethacrylate cases each housing four thermoluminescent dosimeters were continuously worn for one year by the nurses and doctors with the dosimeters being replaced by the new ones every three months. In addition, cases containing thermoluminescent dosimeters (three dosimeters per case) were placed in 20 different measurement points across the Department and the monitoring of the doses was carried out continuously for more than six years (from May 1995 to March 2002). Based on the quarterly readings of the dosimeters, equivalent doses were calculated for both the members of the personnel and the measurement space points. Results: The doses registered in the patient rooms ranged 5 to 90 mSv x y -1 , in the application room 10 to 15 mSv x y -1 , in the laboratory rooms 1.5 to 30 mSv x y -1 , and in the waiting room 2 to 6 mSv x y -1 ; no increment above the background level was detected in the nurses' station. Accordingly, the annual doses calculated from the dosimeters worn by the staff ranged 0.2 to 1.1 mSv x y -1 ; these latter findings were confirmed by direct readings from individual film dosimeters additionally worn by the staff members. Conclusion: The obtained results indicate that it is unlikely for the personnel of the monitored Nuclear Medicine Department to receive doses of radiation exceeding 40% of the annual

Radiation safety in the nuclear medicine department: impact of the UK Ionising Radiations Regulations

International Nuclear Information System (INIS)

Harding, L.K.

1987-01-01

The new 1985 regulations and guidance on radiation protection in the U.K. are discussed in relation to the needs for controlled areas in the nuclear medicine department and patient wards, admittance to hospital to comply with legislation, classification of workers, patient waiting rooms, handling flood sources, pregnancy and breast feeding. (U.K.)

Data processing equipment of a Nuclear Medicine Department in 1980 - Introductory Report

International Nuclear Information System (INIS)

Itti, R.; Liehn, J.C.; Valeyre, J.

1979-01-01

A brief history enables the place taken by computers in nuclear medicine to be situated. Three stages are involved: at first, the quantitative functional studies developed (radioisotopic uptake curves) then the morphological studies with the research into increasingly efficient pictures systems and the introduction of data processing to improve the quality of the pictures and, finally, the digital analysis of the pictures leading to the build-up of regional physiological studies. The part played by computer systems in a Nuclear Medicine Department is summarized. The main advantages are emphasized and present possibilities are indicated. The components which make it possible to design a future acquisition and data processing system that may be used not only for routine practice examinations but also for axial scanning studies by emission are presented. The application of hyper-specialized systems using microprocessors is also under consideration [fr

[History of the 4th Department of Internal Medicine of the First Faculty of Medicine at Charles University and the General University Hospital in Prague].

Science.gov (United States)

Bartůněk, Petr

In 2015, the doctors and nurses of the 4th Department of Internal Medicine of the First Faculty of Medicine, Charles University and the General University Hospital in Prague celebrated the 70th anniversary of its founding. The article summarizes the clinics contribution to the field of internal medicine, and particularly to angiology, hepatogastroenterology and lipidology. It comments the clinics current activities and the possibilities of its further development. Attention is also paid to the tradition of high ethical and professional standards of medical care in accordance with the norms established by the clinic's founder, prof. MUDr. Bohumil Prusík.

Mortality risk factors during readmission at the Department of Medicine.

Science.gov (United States)

Trakulthong, Chayanis; Phunmanee, Anakapong

2017-01-01

Readmission is an indicator of quality of inpatient care. A study from Hong Kong found readmission mortality rate to be 5.1%. There are limited reports on risk factors for mortality other than co-morbid diseases in readmission patients. This study, thus, aims to evaluate risk factors for mortality during readmission. This study was conducted at a university hospital in Thailand. The inclusion criteria were patients aged ≥15 years and readmission to internal medicine wards within 28 days after discharge. The outcome of the study was death during readmission. Risk factors for readmission mortality were analyzed using multivariate logistic regression analysis. There were 10,389 admissions to the Department of Medicine, Khon Kaen University, of which 407 required readmission (3.90%). Of those patients, 75 (18.43%) died during readmission. There were 6 independent factors associated with death in patients who were readmitted, including advanced age (>60 years), presence of more than 2 co-morbid diseases, admission duration of >14 days, fever at previous discharge, low hemoglobin (readmission duration, presence of low hemoglobin at previous discharge, and numbers of procedures at readmission were significantly associated with increased mortality risk for readmission patients.

Analysis of radiation doses to patients from diagnostic department of nuclear medicine

Energy Technology Data Exchange (ETDEWEB)

Lepej, L; Messingerova, M [F.D. Rosvelt Hospital, Banska Bystrica (Slovakia). Dept. of Nuclear Medicine; Ftacnikova, S [Inst. of Preventive and Clinical Medicine, Bratislava (Slovakia)

1996-12-31

In this paper the values of mean effective dose equivalents per unit activity (H{sub E/1Bq}) were used for the calculation of mean effective dose equivalents for one examination (H{sub E}). The collective effective dose equivalents for each radiopharmaceutical and type of examination (S{sub ER}) and global collective effective dose equivalent for department for all radiopharmaceuticals (S{sub E}) during evaluated period were defined. The data for years from 1992 to 1994 were evaluated and compared with results in literature. The evaluation of radiation doses in nuclear medicine department is useful parameter for internal quality control. Using this method, the radiation dose in this laboratory was changed to minimum (under mean value of Slovak Republic). Unfortunately, the real data of patients radiation doses are different from the calculated one. Due to different kinetic of radiopharmaceuticals in individual patients (influenced by pathology, age, etc.) the evaluation of radiation burden to nuclear medicine patients is problematic. But this approach enable the relative comparison of the changes in values of H{sub E} and S{sub E} during the observed period. The evaluation of individual (minimal) effective dose equivalent - (H{sub min}) which represents dose calculated under physiologic conditions can be useful for indication of diagnostic examination by physicians. Therefore the systematic registration of H{sub min} from all examinations - patient`s radiation history. This is specially important in the case of children and young people. The importance of the proposed method, is in regulation of radiation dose from nuclear medicine diagnostic examinations, not only be the control of number and type of examinations, but also by selection of used radiopharmaceuticals and by the way how to use them. (J.K.) 1 fig., 2 refs.

222Radon concentration and irradiation dose inside the department of nuclear medicine in Wuhan

International Nuclear Information System (INIS)

Cheng Xiaoli; Wang Changyin; Gao Jianhua; Zou Xiaofeng

2002-01-01

Objective: Inspecting the high radioactivity area in department of nuclear medicine in Wuhan region and estimating the irradiation dose on relevant doctors. Methods: Select six 'three A' hospitals' high radioactivity area in department of nuclear medicine and common residential houses as examples. A half-year surveillance using 222 Rn detector (type LIH-2) was performed. Results: In high radioactivity rooms, imaging rooms residential houses, the average 222 Rn concentration are 27.8, 48.2, 27.1 (Bq·m -3 ) respectively. Effective dose equivalent absorbed by doctors in high radioactivity room and imaging room are 0.16 and 0.28 mSv. The authors estimated that the effective dose equivalent of doctors in these two room and common residents per year are 0.84, 0.70 and 0.64 mSv respectively. Conclusions: Doctors in imaging room and high radioactivity room are exposed to a relatively higher annual effective dose than common residents. But they are still within the normal range. Only two imaging rooms have high 222 Rn concentrations, which will cause potential harm

Mentorship in an academic department of family medicine.

Science.gov (United States)

Riley, Margaret; Skye, Eric; Reed, Barbara D

2014-01-01

Lack of quality mentorship has been identified as an impediment to a successful academic career. This study serves as a needs assessment to understand baseline mentoring among faculty in an academic department of family medicine and the existing relationships between mentorship, job satisfaction, and academic productivity before the department begins a structured mentorship program. All faculty received an anonymous online survey inquiring about their current mentorship and their perception of the importance of mentorship, in addition to measures of job satisfaction and academic productivity. Of 62 faculty members completing the survey (83% of faculty), almost all indicated it is very or somewhat important to have a mentor (97%, n=60), although only 45% (n=28) reported having a current mentor. Junior faculty were less likely than senior faculty to be satisfied with their mentorship, particularly if they did not have a current mentor. Job satisfaction was high and was not associated with having a mentor. Faculty members with mentors were more likely to have presented a talk or poster nationally, to have taken on a new educational or leadership role, and to have had a greater volume of academic activities overall. Although faculty believe mentorship is important, less than half have a current mentor. Junior faculty are disproportionately dissatisfied by lack of mentorship. Mentorship was associated with some elements of academic productivity but not with job satisfaction. Further study of the impact of a more structured mentorship program is needed.

Using the framework of corporate culture in “mergers” to support the development of a cultural basis for integrative medicine – guidance for building an integrative medicine department or service

Directory of Open Access Journals (Sweden)

Witt CM

2015-01-01

Full Text Available Claudia M Witt,1–3 Marion Pérard,2 Brian Berman,3,4 Susan Berman,4 Timothy C Birdsall,5 Horst Defren,6 Sherko Kümmel,7 Gary Deng,8 Gustav Dobos,9 Atje Drexler,10 Christine Holmberg,2 Markus Horneber,11 Robert Jütte,9 Lori Knutson,12 Christopher Kummer,13 Susanne Volpers,14 David Schweiger15 1University Hospital Zurich, Institute for Complementary and Integrative Medicine, Zurich, Switzerland; 2Institute for Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin, Berlin, Germany; 3University of Maryland School of Medicine, Center for Integrative Medicine, Baltimore, Maryland, USA; 4The Institute for Integrative Health, Baltimore, USA; 5Cancer Treatment Centers of America, Goodyear, Arizona, USA, 6Kliniken Essen Mitte, Evang, Huyssen-Stiftung/Knappschaft GmbH Patientenmanagement, Essen, Germany; 7Department of Senology, Breast Center, Kliniken Essen-Mitte, Evang. Huyssens Stiftung, Knappschaft GmbH, Essen, Germany; 8Memorial Sloan-Kettering Cancer Center, New York, USA; 9Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Academic Teaching Hospital of the University of Duisburg-Essen, Germany; 10Robert Bosch Foundation GmbH, Stuttgart, Germany; 11Department of Internal Medicine, Division of Oncology and Hematology, Paracelsus Medical University, Klinikum Nürnberg, Germany; 12Integrative Healthcare Solutions, Minneapolis, Minnesota, USA; 13Institute of Mergers, Acquisitions and Alliances (IMAA, Zurich, Switzerland; 14Frauenselbsthilfe nach Krebs, Bonn, Germany; 15Schweiger, Schweiger & Associates, Hilton Head Island, South Carolina, USA Background: An increasing number of clinics offer complementary or integrative medicine services; however, clear guidance about how complementary medicine could be successfully and efficiently integrated into conventional health care settings is still lacking. Combining conventional and complementary medicine into integrative medicine can be regarded as a kind of

Implementing a comprehensive relative-value-based incentive plan in an academic family medicine department.

Science.gov (United States)

Cramer, J S; Ramalingam, S; Rosenthal, T C; Fox, C H

2000-12-01

The authors describe the implementation and first three years (1997-1999) of a department-wide incentive plan of the Department of Family Medicine at the State University of New York at Buffalo School of Medicine and Biomedical Sciences. By using a consensus approach, a representative elected committee designed a clinical relative value unit (explained in detail) that could be translated to equally value and reward faculty efforts in patient care, education, and research and which allowed the department to avoid the imposition of a model that could have undervalued scholarship and teaching. By 1999, the plan's goal of eight patient-care-equivalent points per four-hour session had been exceeded for pure clinical care. Clearly, only a small financial incentive was necessary (in 1999, an incentive pool of 4% of providers' gross salary) to motivate the faculty to be more productive and to self-report their efforts. Long-term productivity for pure clinical care rose from 9.8 points per session in 1997 to 10.4 in 1999. Of the mean total of 3,980 points for the year 1999, the contribution from teaching was 1,146, or 29%, compared with 25% in 1997. For scholarship, the number of points was 775, or 20%, in 1999, compared with 11% in 1997. The authors describe modifications to the original plan (e.g., integration of quality measures) that the department's experience has fostered. Problems encountered included the lack of accurate and timely billing information from the associated teaching hospitals, the inherent problems of self-reported information, difficulties of gaining buy-in from the faculty, and inherent risks of a pay-for-performance approach. But the authors conclude that the plan is fulfilling its goal of effectively and fairly quantifying all areas of faculty effort, and is also helping the department to more effectively demonstrate clinical productivity in negotiations with teaching hospitals.

Java-based remote viewing and processing of nuclear medicine images: toward "the imaging department without walls".

Science.gov (United States)

Slomka, P J; Elliott, E; Driedger, A A

2000-01-01

In nuclear medicine practice, images often need to be reviewed and reports prepared from locations outside the department, usually in the form of hard copy. Although hard-copy images are simple and portable, they do not offer electronic data search and image manipulation capabilities. On the other hand, picture archiving and communication systems or dedicated workstations cannot be easily deployed at numerous locations. To solve this problem, we propose a Java-based remote viewing station (JaRViS) for the reading and reporting of nuclear medicine images using Internet browser technology. JaRViS interfaces to the clinical patient database of a nuclear medicine workstation. All JaRViS software resides on a nuclear medicine department server. The contents of the clinical database can be searched by a browser interface after providing a password. Compressed images with the Java applet and color lookup tables are downloaded on the client side. This paradigm does not require nuclear medicine software to reside on remote computers, which simplifies support and deployment of such a system. To enable versatile reporting of the images, color tables and thresholds can be interactively manipulated and images can be displayed in a variety of layouts. Image filtering, frame grouping (adding frames), and movie display are available. Tomographic mode displays are supported, including gated SPECT. The time to display 14 lung perfusion images in 128 x 128 matrix together with the Java applet and color lookup tables over a V.90 modem is remote nuclear medicine viewing station using Java and an Internet or intranet browser. Images can be made easily and cost-effectively available to referring physicians and ambulatory clinics within and outside of the hospital, providing a convenient alternative to film media. We also find this system useful in home reporting of emergency procedures such as lung ventilation-perfusion scans or dynamic studies.

Evaluation of the radiological protection in several departments of nuclear medicine

International Nuclear Information System (INIS)

Lopez Bejerano, G.; Jova Sed, L.

2001-01-01

For the evaluation of radiation protection, in several departments of nuclear medicine a survey was elaborated and applied that includes mainly: aspects of the licence and compliance with the requirements settled down in this, the program of individual radiological surveillance and their evaluation, functions that it completes the service of radiation protection, training program and the personnel's training, equipment and means of radiation protection, radiological surveillance program of the work areas, characteristics of the installation, radioactive waste management, quality assurance program, relative aspects to radiation protection in the procedures of diagnoses, as well as to pregnant patients and those related with the investigation of accidental medical exposures. The work makes a systematization and discussion of the state of compliance of the radiation protection requirements reflected in the International Basic Safety Standards for Protection against Ionizing Radiation and for the Safety of Radiation Sources (BSS) and the main recommendations are exposed to achieve in these departments the optimization of the radiation protection. (author)

Organ retention and communication of research use following medico-legal autopsy: a pilot survey of university forensic medicine departments in Japan.

Science.gov (United States)

Tsujimura-Ito, Takako; Inoue, Yusuke; Yoshida, Ken-ichi

2014-09-01

This study investigated the circumstances and problems that departments of forensic medicine encounter with bereaved families regarding samples obtained from medico-legal autopsies. A questionnaire was posted to all 76 departments of forensic medicine performing medico-legal autopsies in Japan, and responses were received from 48 (63.2%). Of the respondents, 12.8% had approached and communicated with bereaved families about collecting samples from the deceased person during an autopsy and the storage of the samples. In addition, 23.4% of these had informed families that samples might be used in research. Eighteen departments had received enquiries and requests from families about the samples, with most requests concerning their return. The response to such requests varied according to the department. Few departments interacted with the bereaved families regarding the procedure for obtaining autopsy samples, and their methods for handling family concerns differed depending on the person within the department authorised to contact the family. Moreover, the procedures for engaging in such communication have long been unclear, and no legal or ethical consensus or agreement with the general public has been established. It is important for researchers to further discuss the correct way for forensic medicine departments to communicate with bereaved families. 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.

Behavioral Medicine and University Departments of Family Practice

OpenAIRE

Grantham, Peter

1983-01-01

Behavioral medicine brings knowledge and skills from the social sciences to the practice of medicine. Modifying behavior which causes a health problem, disease prevention and health promotion, improving the relationship between patients and health professionals, understanding cultural and ethical issues, and the effect of illness on behavior are all aspects of behavioral medicine. Such `whole person' medicine fits well into family practice. However, careful consideration of the risks, challen...

Introduction of the Balanced Scorecard into an academic department of medicine: creating a road map to success.

Science.gov (United States)

Bouland, Daniel L; Fink, Ed; Fontanesi, John

2011-01-01

In this paper, we describe: 1) the environmental forces driving performance measurement and management in the University of California San Diego Department of Medicine; 2) the systematic process used by the department to implement a Balanced Scorecard; 3) the initial direct and indirect outcomes of this effort; 4) the opportunities and challenges to the Balanced Scorecard as a management directive; and 5) future directions.

Key formal and legal aspects of acquiring radiopharmaceuticals used in nuclear medicine departments

International Nuclear Information System (INIS)

Kapuscinski, J.

2007-01-01

The article presents the key both Polish and EU legal regulation concerning terms and conditions of acquiring radiopharmaceuticals, i.e. isotope labelled compounds used for diagnostic and/ therapeutic purposes in nuclear medicine departments. The emphasis was put on the requirements regarding provision of the medicaments' safety in broad meaning of the term, which are important factors in providing patients' safety. Legal acts discussed in the article remain valid as of May 2007. (author)

Occupational exposure at the Department of Nuclear Medicine as a work environment: A 19-year follow-up

International Nuclear Information System (INIS)

Piwowarska-Bilska, H.; Birkenfeld, B.; Gwardys, A.; Listewnik, M. H.; Elbl, B.; Cichon-Bankowska, K.; Supinska, A.

2011-01-01

Background: This study assessed the radiation safety at Nuclear Medicine Department being a work environment. Ionizing radiation exposure of the employees in the last 19 years and the effects of legislative changes in radiological protection were analyzed. Material/Methods: All employees of the investigated department were regularly and individually monitored using chest badges equipped with Kodak film type 2. Overall, 629 annual doses of the employees of nuclear medicine department, registered in the period 1991 - 2009, were analyzed statistically. Results: Technicians were found to be the largest exposed professional group, whereas nurses received the highest annual doses. Physicians received an average annual dose at the border detection methods. Ancillary and administration staff occasionally received doses above the method detection limit (MDL). The average annual dose for all dosimetry records was 0.7 mSv, and that for dosimetry records equal and higher than MDL was 2.2 mSv. Conclusions: There was no case of an exceeded dose limit for a worker. Furthermore, improvement of radiological protection had a significant impact on the reduction of doses for the most exposed employees. (authors)

Workplace monitoring at the nuclear medicine department of IPO-CROL

International Nuclear Information System (INIS)

Rezio, M.T.; Vieira, M.R.; Alves, J.G.

2005-01-01

Full text: The Nuclear Medicine Department of the Portuguese Institute of Oncology in Lisboa (IPO-CROL, SA) has recently acquired a new type of equipment for workplace monitoring: TAM radiation meter system (Tema Sinergy, Italy). It consists of a Geiger-Mueller detector with a dose rate range between 0.1 μSv.h -1 to 0.02 Sv.h -1 and sensitive to energies between 50 keV to 1 MeV. Eight detectors were installed in the most important areas of our department, namely, radiopharmacy, waiting room for accompanying persons, waiting room of injected patients (at two points), room of injected patients, PET radiopharmacy, PET commands room, and waiting room of PET injected patients. The dose rate measured by the equipment is collected on a computer on a 24-hour basis. The system allows an online visualization of the measurements as well as the storage on a database for evaluation. In this work the data collected with this equipment is analyzed. The system gives us the dose rate average, for example, in the PET commands room (0,186 μSv.h -1 ) and in the PET radiopharmacy (0,240 μSv.h -1 ). The results show that the dose rate limits established by law for this type of installations (0.4 mSv.week -1 for professionally exposed workers and 0.02 mSv.week -1 for the general public) are not exceeded. The aim of this work is to demonstrate there are presently good radiation protection conditions at our department. (author)

U.S. Department of Energy Office of Occupational Medicine and Medical Surveillance 1995--1997 triannual report

Energy Technology Data Exchange (ETDEWEB)

NONE

1998-08-01

From 1995 through 1997 the Office of Occupational Medicine and Medical Surveillance (EH-61) has made numerous achievements that have enhanced the performance of the office and more importantly, the Department of Energy (DOE). This report provides specific information about program activities and accomplishments, as well as individual contacts for each program. The mission of EH-61 is the prevention of worker illness by fostering outstanding occupational medicine and medical surveillance programs within the DOE complex. This mission is being realized as a result of efforts in four main business lines: (1) Surveillance; (2) Research, (3) Policy/Technical Support; and (4) Information/Communication.

Use of Standard Guidelines for Department of Medicine Summary Letters.

Science.gov (United States)

Fitz, Matthew; La Rochelle, Jeffrey; Lang, Valerie; DeWaay, Deborah; Adams, William; Nasraty, Farah

2018-04-12

Phenomenon: Fourth-year medical students obtain Department of Medicine (DOM) letters ("Chair" letters) to support their residency applications. Writing and interpreting DOM letters are challenging. There is heterogeneity in the letters that makes it difficult to both write and read these letters. The purpose of this study is to determine the value of new guidelines developed by a task force of clerkship directors and program directors in internal medicine and assess the implementation of these guidelines. The Clerkship Directors in Internal Medicine performed a cross-sectional survey of internal medicine clerkship directors at U.S. and Canadian medical schools in 2014. In addition, the primary author's institution reviewed 1,347 DOM letters between 2012 and 2014 to assess the implementation of these guidelines. The survey response rate was 78%. DOM letter writers reported the guidelines were better, easier to implement, and more compatible with the purpose of DOM letters than previously. Most letter readers reported that letters using the guidelines were more credible. Writers of DOM letters in lower academic ranks rated the letters with guidelines higher in several domains than those in higher academic ranks. Readers of DOM letters in higher academic ranks rated the letters with guidelines higher in several domains than those in lower academic ranks. In the DOM letters examined, the odds of meeting each guideline increased with each additional year. However, for 3 guidelines there was an initial decline in adherence from 2012 to 2013 before increasing again in 2014-the recommended length, clerkship description, and detailed narrative guidelines. Letters solely written by a chair were less likely to incorporate the guidelines. Insights: Clerkship directors often write the DOM letters and identify with the purpose of the guidelines. As writers, lower ranking academic faculty value the guidelines more than higher ranking academic faculty. As readers of DOM letters

The design of a purpose-built nuclear medicine department

International Nuclear Information System (INIS)

Dixon, J.; Walker, B.

1999-01-01

Full text: In December 1997, the Department of Nuclear Medicine relocated to new purpose-built premises. Two years of detailed planning preceded this move. Several innovative features were incorporated in the design. The 6 gamma camera rooms are arranged in pairs with shared shielded console areas, around a central 'staff-only' corridor with the radiopharmacy dispensing room (RP) at one end. This allows for direct staff access between these rooms while preserving the privacy of the patients. Hatches from the RP to the stress lab and procedures rooms allow for minimal carrying of doses. A separate hotlab adjoining the RP with a dedicated dose calibrator is used for preparations of all therapy doses and 18 F. A 'no return' policy was adopted for the RP. A separate isolated radioactive waste storage room (WSR) has an easily accessible anteroom used only for 99 Tc m , which allows efficient management of this short-lived waste. The nurses' station visualizes all waiting facilities, which include separate areas for trolley and ambulant patients as well as a playroom for the paediatric patients. An area for resting 18 F patients is located away from the general waiting areas and close to the coincidence detection camera room. After 1 year of operation, these specific design features have proved successful. They have led to improvement in the efficiency of operation of the department for the staff and increased comfort for the patients

[Physical medicine in hospital. Minimum standards in a physical medical department in acute inpatient areas in rheumatology].

Science.gov (United States)

Reißhauer, A; Liebl, M E

2012-07-01

Standards for what should be available in terms of equipment and services in a department of physical medicine caring for acute inpatients do not exist in Germany. The profile of a department determines the therapeutic services it focuses on and hence the technical facilities required. The German catalogue of operations and procedures defines minimum thresholds for treatment. In the opinion of the authors a department caring for inpatients with acute rheumatic diseases must, as a minimum, have the facilities and equipment necessary for offering thermotherapeutic treatment. Staff trained in physical therapeutic procedures and occupational therapy is also crucial. Moreover, it is desirable that the staff should be trained in manual therapy.

Forensic Emergency Medicine - Six-Year Experience of 13823 Cases in a University Emergency Department

OpenAIRE

DEMİRCAN, Ahmet; KELEŞ, Ayfer; GÜRBÜZ, Neslihan; BİLDİK, Fikret

2008-01-01

Aims: Clinical forensic medicine deals with cases involving both the legal and medical aspects of patient care, such as motor vehicle trauma or poisoning. In this study, we aimed to draw attention to the forensic issues by retrospective investigation of 13823 emergency cases and to share our experiences on this topic. Materials and Methods: This retrospective study was conducted in a university Emergency Department (ED) in Ankara, Turkey. The data were collected from official hospital polic...

Considering context in academic medicine: differences in demographic and professional characteristics and in research productivity and advancement metrics across seven clinical departments.

Science.gov (United States)

Warner, Erica T; Carapinha, René; Weber, Griffin M; Hill, Emorcia V; Reede, Joan Y

2015-08-01

To understand the disciplinary contexts in which faculty work, the authors examined demographics, professional characteristics, research productivity, and advancement across seven clinical departments at Harvard Medical School (HMS) and nationally. HMS analyses included faculty from seven clinical departments-anesthesiology, medicine, neurology, pediatrics, psychiatry, radiology, and surgery-in May 2011 (N = 7,304). National analyses included faculty at 141 U.S. medical schools in the same seven departments as of December 31, 2011 (N = 91,414). The authors used chi-square and Wilcoxon Mann-Whitney tests to compare departmental characteristics. Heterogeneity in demographics, professional characteristics, and advancement across departments was observed in HMS and national data. At HMS, psychiatry had the highest percentage of underrepresented minority faculty at 6.6% (75/1,139). In anesthesiology, 24.2% (128/530) of faculty were Asian, whereas in psychiatry only 7.9% (90/1,139) were (P advancement across clinical departments at HMS and nationally. The context in which faculty work, of which department is a proxy, should be accounted for in research on faculty career outcomes and diversity inclusion in academic medicine.

The Effect of Emergency Department Overcrowding on Efficiency of Emergency Medicine Residents’ Education

Directory of Open Access Journals (Sweden)

Anita Sabzghabaei

2014-09-01

Full Text Available Introduction: Creating a calm and stress-free environment affects education significantly. The effects of the emergency department overcrowding (EDO on the training of emergency medicine residents (EMR is a highly debated subject. Therefore, this study aimed to evaluate the effect of EDO on efficiency of EMR’s education. Methods: In this cross-sectional study, the effects of overcrowding on EMR’s education in the resuscitation room and acute care unit. Data collection was done using a questionnaire, which was filled out by the second year EMRs.  The crowding level was calculated based on the national emergency department overcrowding scale (NEDOCS. The relationship between the two studied variables was evaluated using independent sample t-test and SPSS 21 statistical software. Results: 130 questionnaires were filled out during 61 shifts. 47 (77.05% shifts were overcrowded. The attend’s ability to teach was not affected by overcrowding in the resuscitation room (p=0.008. The similar results were seen regarding the attend’s training ability in the acute care unit. Conclusion: It seems that the emergency department overcrowding has no effect on the quality of education to the EMRs.

The medical physicist in a nuclear medicine department; El fisico medico en un departamento de medicina nuclear

Energy Technology Data Exchange (ETDEWEB)

Trujillo Z, F.E.; Gomez A, E. [Instituto nacional de Cancerologia, 14000 Mexico D.F. (Mexico)

2007-07-01

The diagnostic studies and therapeutic treatments carried out in a Nuclear Medicine department make use of radioactive material. For such a reason it becomes necessary to take a strict control in the reception, use and waste that are generated of the typical works inside the department. Also, work related with the quality control of the equipment dedicated to produce images and of those not image formers, need to carry out to guarantee its maximum performance; as well as quality of the diagnostic and of the therapy imparted in patients. Additionally its are needed to make originated works of the individual procedures to patient and of the acquisition of radioactive materials and removal of the waste or radioactive contaminations. Presently work the recommendations of the American College of Radiology (ACR), the European Federation of Organizations for Medical Physics (EFOMP) and of the Mexican Official Standards relating to the functions that should be observed in a Nuclear Medicine Department are exposed. The ACR and the EFOMP, conclude in their recommendations that the medical physicist fulfills with the suitable profile and likewise they describe in detail the actions and functions that he should supervise, to carry out, to document and to inform. (Author)

Evaluation of radiation doses received by the staff in nuclear medicine department of Rick

International Nuclear Information System (INIS)

Ali, Naemat Abdalla Mohamed

2001-01-01

Environmental monitoring in nuclear medicine rooms at Radiation and Isotopes Center Khartoum RICK were carried out using survey meter and thermoluminescent dosimetry. Staff bodies and hands doses measurements are being conducted using thermoluminescent dosimetry. The purpose of the study is to evaluate the radiation received by the staff work in the nuclear medicine department at RICK. Survey meter (RDS-120) and TLD clips of LiF. (Mg.Ti) were used to measure the environment leading of the staff. The associated annual doses have been determined to the staff bodies and hands. It was found that the dose-equivalent rates from bodies and hands of the staff obtained through this work using TLD clips are: nuclear medicine technologist body reading 6.75 mSv per year, physicist body reading 7.89 mSv per year, chemist body reading 6.1 mSv per year, and nurse body reading 8.1 mSv per year. On the other hand the nuclear medicine technologist hands reading 24.19 mSv per year, physicist hands reading 19.15 mSv per year, chemist hands reading 14.616 mSv per year, and nurse hands reading 277.96 mSv per year. All the staff reading in this study agree with the national regulations and international recommendations. It is clear that the dose of nurse hands is the highest one, this is because when they inject the patient with the Tc-99 m they use to spend relatively long time. (Author)

Evaluation of management of radioactive waste in nuclear medicine department of radiation and isotopes center, Khartoum

International Nuclear Information System (INIS)

Ahmed, Amel Bushra Abaker

2001-01-01

Evaluation of management of radioactive waste in nuclear medicine department of radiation and isotopes center in Khartoum, Sudan, was conducted using radiation survey meter. The purpose of this study is to provide protection of workers, patients, co patients, an the environment by introducing good practice in management of radioactive waste generated in this lab. In this work measurement of radiation effective dose at different locations in the department were carried out. These locations were selected around the radioactive liquid and solid waste disposal position. It was found that the effective doses per year from radioactive wastes obtained through this work using the survey meter RDS-120 at these locations, are 1.47 mSv/y at the neighbouring patients room, 5.47 mSv/y at the hot lab., 0.09 mSv/y at the neighbouring toilet, 0.321 mSv/y at the water closet, and 1.4 mSv/y at the place down water closet. The results obtained shows that the dose levels waste at the location not exceed the recommended dose limits for workers 20 mSv/y, that set by basic safety standards (Bss 115) which published by the international atomic energy agency. Also it s comply with the national regulation, regulation on basic radiation protection requirement and dose limits 1996, issued by sudan atomic energy commission act 1996. The annual dose calculated for the patients and co-patients at rooms around the nuclear medicine department, the results shows that dose are fairly high. Measure should taken to improve the waste management in the department for better protection of workers, patients and co patients. (Author)

Environmental dose in the Nuclear Medicine Department of the National Institute of Cancer

International Nuclear Information System (INIS)

Torres U, C. L.; Avila A, O. L.; Medina V, L. A.; Buenfil B, A. E.; Brandan S, M. E.; Trujillo Z, F. E.; Gamboa de Buen, I.

2009-01-01

The dosimeters TLD-100 and TLD-900 were used to know the levels of environmental dose in areas of the Nuclear Medicine Department of the National Institute of Cancer. The dosimeters calibration was carried out in the Metrology Department of the National Institute of Nuclear Research. The radioisotopes used in the studied areas are 131 I, 18 F, 67 Ga, 99m Tc, 111 In, 201 Tl and 137 Cs with gamma energies between 93 and 662 KeV. Dosimeters were placed during five months in the diagnostic, injection, waiting and PET rooms as well as hot room, waste room, enclosed corridors to patient rooms treated with 131 I and 137 Cs and witness dosimeters to know the bottom. The values found vary between 0.3 and 70 major times that those of bottom. The maximum doses were measured in the waste room and in the enclosed corridor to the patient rooms with cervical uterine cancer treated with 137 Cs. (Author)

Emergency department operations and management education in emergency medicine training

Institute of Scientific and Technical Information of China (English)

Bret A Nicks; Darrell Nelson

2012-01-01

BACKGROUND:This study was undertaken to examine the current level of operations and management education within US-based Emergency Medicine Residency programs.METHODS:Residency program directors at all US-based Emergency Medicine Residency programs were anonymously surveyed via a web-based instrument.Participants indicated their levels of residency education dedicated to documentation,billing/coding,core measure/quality indicator compliance,and operations management.Data were analyzed using descriptive statistics for the ordinal data/Likert scales.RESULTS:One hundred and six(106)program directors completed the study instrument of one hundred and fifty-six(156)programs(70%).Of these,82.6%indicated emergency department(ED)operations and management education within the training curriculum.Dedicated documentation training was noted in all but 1 program(99%).Program educational offerings also included billing/coding(83%),core measure/quality indicators(78%)and operations management training(71%).In all areas,the most common means of educating came through didactic sessions and direct attending feedback or 69%-94%and 72%-98%respectively.Residency leadership was most confident with resident understanding of quality documentation(80%)and less so with core measures(72%),billing/coding/RVUs(58%),and operations management tools(23%).CONCLUSIONS:While most EM residency programs integrate basic operational education related to documentation and billing/coding,a smaller number provide focused education on the dayto-day management and operations of the ED.Residency leadership perceives graduating resident understanding of operational management tools to be limited.All respondents value further resident curriculum development of ED operations and management.

Magistral preparation in nuclear medicine departments: Requirements for their realization

International Nuclear Information System (INIS)

Desruet, M.D.; Bolot, C.; Bourrel, F.; Francois-Joubert, A.; Biechlin-Chassel, M.L.; Couret, I.; Pelegrin, M.; Lao, S.; Ouhayon, E.; Sauvan, R.

2010-01-01

Use of radiopharmaceuticals in French nuclear medicine departments depends on marketing authorization and their development may be compromised by a limited return on investment. As an alternative, radiopharmaceuticals may also be prepared in the form of a magistral preparation, like in some European countries. In this case, these preparations are subjected to restrictions and requirements for radio-pharmacies relating to quality assurance, facilities and equipment, quality of starting materials and final radiopharmaceutical products defined in French good preparation practice. Labelled tracers used as magistral preparations have to be prepared under the full responsibility of a radio-pharmacist and used under the responsibility of the prescribing physician. Conditions of sufficient guarantees for the safety of the patient and adherence to pharmaceutical rules must be evaluated individually. However, this form of preparation intends to supply specific medical needs for an individual patient and is not an answer in the framework of development of radiopharmaceuticals. (authors)

Establishment of national diagnostic reference level for renal doses in nuclear medicine departments at Khartoum-Sudan

International Nuclear Information System (INIS)

Alameen, Suhaib; Hamid, Alhadi; Rushdi, M. A. H.

2016-01-01

In this work we established a diagnostic reference level (DRL) for patient dose focusing on the investigation of activity to the kidneys during(99mTc-DTPA) kidney scan, selected two department nuclear medicine in main hospitals in Khartoum state. The DRLs is an investigational level used to identify unusually high radiation doses for common diagnostic medical in Nuclear Medicine procedures and suggested action levels above which a facility should review its methods and determine if acceptable image quality can be achieved at lower doses. The high specific activity of 99mTc makes it suitable as a first pass agent, for multiple or sequential studies, 99mTc diethylenetriaminepentaacetic acid (DTPA) is preferred to 99mTc-pertechnetate. Patients who had been prepared for the kidney scan 99mTc- DTPA were divided to three groups. The first group received dose less than 5 mCi, are represent (27.03%) from all patients, second group received dose 5 to 5.5 mCi are represent(66.67%) and the third group received dose from 5.6 to 6.2 mCi are represent (6.31%) from all patients 99mTc-DTPA. And according to the IAEA recommendation for adult doses(5-10mCi) this study show that about 93.1% of the sample examines by dose less than 5.5 mCi. The results presented will serve as a baseline data needed for deriving reference doses for renal examinations for nuclear medicine departments in Sudan.(Author)

Links between nuclear medicine and radiopharmacy

International Nuclear Information System (INIS)

Pelegrin, M.; Francois-Joubert, A.; Chassel, M.L.; Desruet, M.D.; Bolot, C.; Lao, S.

2010-01-01

Radiopharmaceuticals are nowadays under the responsibility of the radio-pharmacist because of their medicinal product status. Radiopharmacy belongs to the hospital pharmacy department, nevertheless, interactions with nuclear medicine department are important: rooms are included or located near nuclear medicine departments in order to respect radiation protection rules, more over staff, a part of the material and some activities are shared between the two departments. Consequently, it seems essential to formalize links between the radiopharmacy and the nuclear medicine department, setting the goals to avoid conflicts and to ensure patients' security. Modalities chosen for this formalization will depend on the establishment's organization. (authors)

Using the framework of corporate culture in "mergers" to support the development of a cultural basis for integrative medicine - guidance for building an integrative medicine department or service.

Science.gov (United States)

Witt, Claudia M; Pérard, Marion; Berman, Brian; Berman, Susan; Birdsall, Timothy C; Defren, Horst; Kümmel, Sherko; Deng, Gary; Dobos, Gustav; Drexler, Atje; Holmberg, Christine; Horneber, Markus; Jütte, Robert; Knutson, Lori; Kummer, Christopher; Volpers, Susanne; Schweiger, David

2015-01-01

An increasing number of clinics offer complementary or integrative medicine services; however, clear guidance about how complementary medicine could be successfully and efficiently integrated into conventional health care settings is still lacking. Combining conventional and complementary medicine into integrative medicine can be regarded as a kind of merger. In a merger, two or more organizations - usually companies - are combined into one in order to strengthen the companies financially and strategically. The corporate culture of both merger partners has an important influence on the integration. The aim of this project was to transfer the concept of corporate culture in mergers to the merging of two medical systems. A two-step approach (literature analyses and expert consensus procedure) was used to develop practical guidance for the development of a cultural basis for integrative medicine, based on the framework of corporate culture in "mergers," which could be used to build an integrative medicine department or integrative medicine service. Results include recommendations for general strategic dimensions (definition of the medical model, motivation for integration, clarification of the available resources, development of the integration team, and development of a communication strategy), and recommendations to overcome cultural differences (the clinic environment, the professional language, the professional image, and the implementation of evidence-based medicine). The framework of mergers in corporate culture provides an understanding of the difficulties involved in integrative medicine projects. The specific recommendations provide a good basis for more efficient implementation.

[Assessing research productivity in Department of Internal Medicine, University of Zagreb, School of Medicine and University Hospital Centre Zagreb].

Science.gov (United States)

Petrak, Jelka; Sember, Marijan; Granić, Davorka

2012-01-01

Bibliometric analysis may give an objective information about publishing activity, citation rate and collaboration patterns of individuals, groups and institutions. The publication productivity of the present medical staff (79 with specialist degree and 22 residents) in Department of Internal Medicine, University of Zagreb School of Medicine in University Hospital Centre Zagreb was measured by the number of papers indexed by Medline, their impact was measured by the number of times these papers had subsequently been cited in the medical literature, while the collaboration pattern was estimated by the authors' addresses listed in the papers. PubMed database was a source for verifying the bibliographic data, and the citation data were searched via Thomson Web of Scence (WoS) platform. There were a total of 1182 papers, published from 1974 to date. The number of papers per author ranged from 0 to 252. Sixty of papers were published in English, and 39% in Croatian language. The roughly equal share was published in local and foreign journals. The RCT studies and practice guidelines were among the most cited papers and were at the same time published by the highly ranked journals. The collaboration analysis confirmed the extensive involment in the international multicentric clinical trials as well as in the development of international/local practice guidelines.

Music and medicine

Directory of Open Access Journals (Sweden)

Donatella Lippi

2010-08-01

Full Text Available Donatella Lippi1, Paolo Roberti di Sarsina2, John Patrick D’Elios11History of Medicine, Department of Anatomy, Histology, and Forensic Medicine, University of Florence, Florence, Italy; 2Health Local Unit, Department of Mental Health, Bologna, ItalyAbstract: Healing sounds have always been considered in the past an important aid in medical practice, and nowadays, medicine has confirmed the efficacy of music therapy in many diseases. The aim of this study is to assess the curative power of music, in the frame of the current clinical relationship.Keywords: history of medicine, medical humanities, healing music

The radiation dose to accompanying nurses, relatives and other patients in a nuclear medicine department waiting room

Energy Technology Data Exchange (ETDEWEB)

Harding, L K; Harding, N J; Warren, H; Mills, A; Thomson, W H [Dudley Road Hospital, Birmingham (UK)

1990-01-01

The radiation dose to accompanying nurses, relatives and other patients in a nuclear medicine department waiting room was assessed at 5 min intervals by observing the seating arrangement. The total radiation dose to each person was calculated, using fixed values of dose rate per 100 MBq activity for radionuclides, and applying the inverse square law. Radioactive decay and attenuation effects due to intervening persons were also taken into account. The median radiation doses to accompanying nurses, relatives and other patients were 2.3, 2.0 and 0.2 {mu}Sv with maximum values of 17, 33 and 5 {mu}Sv respectively. In all cases, the radiation dose received by patients was less than 0.2% of the radiation dose resulting from their own investigation. Also, the maximum radiation dose received by an accompanying norse or friend was less than 1% of their appropriate annual dose limit. Similar values were obtained with calculations based on a 15 min time interval. The radiation doses received by those in a nuclear medicine department waiting room are small, and separate waiting room facilities for radioactive patients are unnecessary. (author).

The effect of daily small text message reminders for medicine compliance amongst young people connected with the outpatient department for child and adolescent psychiatry

DEFF Research Database (Denmark)

Bjørnholt, Karsten; Christiansen, Erik; Attermann Stokholm, Kristine

2016-01-01

after 6 months. Aim: In this study we investigated whether text message reminders could improve medicine compliance amongst vulnerable young people with psychiatric disorders who were being treated in the outpatient department for child and adolescent psychiatry and who either are under or were......Background: Many patients with psychiatric illnesses have difficulty maintaining medication over time. Many take their medicine irregularly and studies show that it is the most vulnerable patients who have the greatest problems adhering to treatment. Often only 50% are still under medical treatment...... to commence medicinal treatment. Methods: This study was conducted as a randomized controlled trial including all non-acute referrals to an outpatient department for adolescent psychiatry within a group aged 15-20 years starting medical treatment. The patients were followed until the end of their treatment...

LITERACY AND FOREIGN LANGUAGE TEACHING AS KEY FACTORS FOR SOCIO-ECONOMIC ADAPTATION OF STUDENTS’ POPULATION - CHARACTERISTICS OF LITERACY AMONG DIFFERENT DEPARTMENTS AT THE FACULTY OF MEDICINE

Directory of Open Access Journals (Sweden)

Boris Djindjic

2007-01-01

Full Text Available Language and communication are at the heart of the human experience. Reading and writing are the most powerful modes of formal learning and they are fundamental to intellectual inquiry and creativity in all disciplines. Literacy comprises not only reading and writing skills but also understanding of human communication needs and the way of social functioning. The aim of this study was to determine the importance of foreign language learning for students’ socio-economic adaptation. The study investigated the relationship between students’ foreign language literacy and their achievements in medical studies.The investigation is a prospective study carried out among students of the Faculty of Medicine in Nis during June, 2006. The investigation included 312 students of all departments (medicine, dentistry, pharmacy and nursing and was conducted by means of a questionnaire. We determined students’ socio-economic adaptation, literacy in the mother tongue and foreign language (reading, writing, speaking and listening, and the ability of using modern technological achievements (computer work, Internet and SMS correspondence.Writing and listening skills of the mother tongue are significantly lower at the Department of Nursing. There is no difference in using post-correspondence among groups, whereby dentistry students most often used modern means of communication. The percentage of students satisfied with their social status is the highest among students of medicine and pharmacy and the lowest among students at the Department of Nursing. The percentage of students satisfied with the economic status is the highest among students of medicine, slightly lower among students of dentistry and pharmacy, and the lowest among nurses. The average grade of achievements at the Faculty is the highest in the group of nurses, slightly lower in the group of pharmacy, and the lowest in the group of medicine and dentistry. Generally, the grades for foreign language

Dose received by occupationally exposed workers at a nuclear medicine department

Science.gov (United States)

Ávila, O.; Sánchez-Uribe, N. A.; Rodríguez-Laguna, A.; Medina, L. A.; Estrada, E.; Buenfil, A. E.; Brandan, M. E.

2012-10-01

Personal Dose Equivalent (PDE) values were determined for occupational exposed workers (OEW) at the Nuclear Medicine Department (NMD) of "Instituto Nacional de Cancerología" (INCan), Mexico, using TLD-100 thermoluminescent dosemeters. OEW at NMD, INCan make use of radiopharmaceuticals for diagnosis and treatment of diseases. Radionuclides associated to a pharmaceutical compound used at this Department are 131I, 18F, 68Ga, 99mTc, 111In and 11C with main gamma emission energies between 140 and 511 keV. Dosemeter calibration was performed at the metrology department of "Instituto Nacional de Investigaciones Nucleares" (ININ), Mexico. Every occupational worker used dark containers with three dosimeters which were replaced monthly for a total of 5 periods. Additionally, control dosemeters were also placed at a site free of radioactive sources in order to determine the background radiation. Results were adjusted to find PDE/day and estimating annual PDE values in the range between 2 mSv (background) and 9 mSv. The mean annual value is 3.51 mSv and the standard deviation SD is 0.78 mSv. Four of the 16 OEW received annual doses higher than the average +1 SD (4.29 mSv). Results depend on OEW daily activities and were consistent for each OEW for the 5 studied periods as well as with PDE values reported by the firm that performs the monthly service. All obtained values are well within the established annual OEW dose limit stated in the "Reglamento General de Seguridad Radiológica", México (50 mSv), as well as within the lower limit recommended by the "International Commission on Radiation Protection" (ICRP), report no.60 (20 mSv). These results verify the adequate compliance of the NMD at INCan, Mexico with the norms given by the national regulatory commission.

Occupational radiation exposure in nuclear medicine department in Kuwait

Science.gov (United States)

Alnaaimi, M.; Alkhorayef, M.; Omar, M.; Abughaith, N.; Alduaij, M.; Salahudin, T.; Alkandri, F.; Sulieman, A.; Bradley, D. A.

2017-11-01

Ionizing radiation exposure is associated with eye lens opacities and cataracts. Radiation workers with heavy workloads and poor protection measures are at risk for vision impairment or cataracts if suitable protection measures are not implemented. The aim of this study was to measure and evaluate the occupational radiation exposure in a nuclear medicine (NM) department. The annual average effective doses (Hp[10] and Hp[0.07]) were measured using calibrated thermos-luminescent dosimeters (TLDs; MCP-N [LiF:Mg,Cu,P]). Five categories of staff (hot lab staff, PET physicians, NM physicians, technologists, and nurses) were included. The average annual eye dose (Hp[3]) for NM staff, based on measurements for a typical yearly workload of >7000 patients, was 4.5 mSv. The annual whole body radiation (Hp[10]) and skin doses (Hp[0.07]) were 4.0 and 120 mSv, respectively. The measured Hp(3), Hp(10), and Hp(0.07) doses for all NM staff categories were below the dose limits described in ICRP 2014 in light of the current practice. The results provide baseline data for staff exposure in NM in Kuwait. Radiation dose optimization measures are recommended to reduce NM staff exposure to its minimal value.

Twenty years of operation of the Radioisotope Department of the 3rd Medical Clinic, Faculty of General Medicine, Charles University in Prague

International Nuclear Information System (INIS)

Kapitola, J.

1983-01-01

Twenty years ago a radioisotope department was established in the old building of the 3rd Medical Clinic in Prague 2. The department is suitably placed and meets present requirements. It was set up as part of the 3rd Medical Clinic and of the Laboratory for endocrinology and Metabolism which gave it its main orientation and scope. Its present scope is much broader. In the twenty years since it was established 115,800 examinations were carried out, some 40 examination methods were introduced, 103 publications published, members of the department were co-authors of another 113 publications, they completed 11 research projects. The production of the department represents a substantial part of laboratory material especially in the diagnosis of endocrinopathy and metabolic disorders at the Clinic and is a significant part of the material of a number of research projects. The department has significantly contributed to the development of nuclear medicine in the Czechoslovak Socialist Republic in thyroid diagnosis, by the first introduction of radioimmunoassay methods, by the introduction of certain other special examination and laboratory methods and is currently taking part in the fulfilment of tasks given by the zoning of nuclear medicine in health care in Czechoslovakia in general and in Prague in particular. (author)

Clinical audit of emergency unit before and after establishment of the emergency medicine department.

Science.gov (United States)

Amini, Afshin; Dindoost, Payam; Moghimi, Mehrdad; Kariman, Hamid; Shahrami, Ali; Dolatabadi, Ali Arhami; Ali-Mohammadi, Hossein; Alavai-Moghaddam, Mostafa; Derakhshanfar, Hojjat; Hatamabadi, HamidReza; Heidari, Kamran; Alamdari, Shahram; Meibodi, Mohammad Kalantar; Shojaee, Majid; Foroozanfar, Mohammad Mehdi; Hashemi, Behrooz; Sabzeghaba, Anita; Kabir, Ali

2012-02-01

To assess the deficiencies and potential areas through a medical audit of the emergency departments, in six general hospitals affiliated to Shahid Beheshti University of Medical Sciences at Tehran, Iran, after preparing specific wards-based international standards. A checklist was completed for all hospitals which met our eligibility criteria mainly observation and interviews with head nurses and managers of the emergency medicine unit of the hospitals before (2003) and after (2008) the establishment of emergency departments there. Domains studied included staffing, education and continuing professional development (CPD), facility (design), equipment, ancillary services, medical records, manuals and references, research, administration, pre-hospital care, information systems, disaster planning, bench-marking and hospital accreditation. Education and CPD (p = 0.042), design and facility (p = 0.027), equipment (p = 0.028), and disaster (p = 0.026) had significantly improved after the establishment of emergency departments. Nearly all domains showed a positive change though it was non-significant in a few. In terms of observation, better improvement was seen in disaster, security, design, and research. According to the score for each domain compared to what it was in the earlier phase, better improvement was observed in hospital accreditation, information systems, security, disaster planning, and research. Security, disaster planning, research, design and facility had improved in hospitals that wave studied, while equipment, records, ancillary services, administration and bench-marking had the lowest improvement even after the establishment of emergency department, and, hence, needed specific attention.

On a Work Expected to the Department of Emergency and Critical Care Medicine and the Emergency Unit of the Niigata University Hospital

OpenAIRE

小山, 真; Koyama, Shin

2001-01-01

The author would like to celebrate the start of the Department of emergency and critical care medicine and the Emergency unit of the Niigata University Hospital. The author also wishes to express his opinion, which is mentioned below, on preparing the Department and the Emergency unit for their future activity. 1 . The stuff members of the Department are expected to instruct undergraduate students in the knowledge and technique of Triage and the first aid in emergency exactly. 2 . The Emergen...

WEST AFRICAN JOURNAL OF MEDICINE

African Journals Online (AJOL)

user1

the Unified Parkinson Disease Rating Scale (UPDRS) motor ... †Neurology Unit, Department of Medicine, ‡Department of Chemical Pathology, College of Medicine, University of Lagos & Lagos ... Study Site and Recruitment Method. The study ...

Bedside ultrasonography (US), Echoscopy and US point of care as a new kind of stethoscope for Internal Medicine Departments: the training program of the Italian Internal Medicine Society (SIMI).

Science.gov (United States)

Arienti, Vincenzo; Di Giulio, Rosella; Cogliati, Chiara; Accogli, Esterita; Aluigi, Leonardo; Corazza, Gino Roberto

2014-10-01

In recent years, thanks to the development of miniaturized ultrasound devices, comparable to personal computers, tablets and even to smart phones, we have seen an increasing use of bedside ultrasound in internal medicine departments as a novel kind of ultrasound stethoscope. The clinical ultrasound-assisted approach has proved to be particularly useful in assessing patients with nodules of the neck, dyspnoea, abdominal pain, and with limb edema. In several cases, it has allowed a simple, rapid and precise diagnosis. Since 2005, the Italian Society of Internal Medicine and its Ultrasound Study Group has been holding a Summer School and training courses in ultrasound for residents in internal medicine. A national network of schools in bedside ultrasound was then organized for internal medicine specialists who want to learn this technique. Because bedside ultrasound is a user-dependent diagnostic method, it is important to define the limits and advantages of different new ultrasound devices, to classify them (i.e. Echoscopy and Point of Care Ultrasound), to establish appropriate different levels of competence and to ensure their specific training. In this review, we describe the point of view of the Italian Internal Medicine Society on these topics.

A framework for implementation, education, research and clinical use of ultrasound in emergency departments by the Danish Society for Emergency Medicine

DEFF Research Database (Denmark)

Laursen, Christian B; Nielsen, Klaus; Riishede, Minna

2014-01-01

The first Danish Society for Emergency Medicine (DASEM) recommendations for the use of clinical ultrasound in emergency departments has been made. The recommendations describes what DASEM believes as being current best practice for training, certification, maintenance of acquired competencies...

Measurement of beta emitting radionuclides in dose calibrators routinely used in nuclear medicine departments

International Nuclear Information System (INIS)

Tastan, S.; Soylu, A.; Kucuk, O.; Ibis, E.

2004-01-01

Full text: Radionuclides for diagnostics purposes like Tc-99m, Tl-201, Ga-67 and In-111 are measured by using ionization type of dose calibrators. Therapeutic radionuclides, which emit both beta and gamma rays are detected by the same type of dose calibrators. Other therapeutic products like Y-90, P-32 and Sr-89 are pure beta emitters and they are gaining wider utility because various new therapy radiopharmaceuticals are being developed. The type of container material, like glass or plastic, may seriously affect radioactivity measurement due to attenuation, Since it is crucial to give the exact amount of radioactivity to the patient for therapy purposes, dedicated dose calibrators are specially manufactured for the measurement of these radionuclides. But these measuring systems are not widely available in nuclear medicine centers where therapy is applied to the patient. It is a known fact that dose calibrators routinely used in nuclear medicine departments can be calibrated for vials and syringes using standard sources of the same radioisotope. The method of calibration of Y-90 measurement for two ionization chamber dose calibrators available in the institute will be summarized in this presentation

Measurement of beta emitting radionuclides in dose calibrators routinely used in nuclear medicine departments

International Nuclear Information System (INIS)

Tastan, S.; Soylu, A.; Kucuk, O.; Ibis, E.

2004-01-01

Radionuclides for diagnostics purposes like Tc-99m, Tl-201, Ga-67 and In-111 are measured by using ionization type of dose calibrators. Therapeutic radionuclides, which emit both beta and gamma rays are detected by the same type of dose calibrators. Other therapeutic products like Y-90, P-32 and Sr-89 are pure beta emitters and they are gaining wider utility because various new therapy radiopharmaceuticals are being developed. The type of container material, like glass or plastic, may seriously affect radioactivity measurement due to attenuation, Since it is crucial to give the exact amount of radioactivity to the patient for therapy purposes, dedicated dose calibrators are specially manufactured for the measurement of these radionuclides. But these measuring systems are not widely available in nuclear medicine centers where therapy is applied to the patient. It is a known fact that dose calibrators routinely used in nuclear medicine departments can be calibrated for vials and syringes using standard sources of the same radioisotope. The method of calibration of Y-90 measurement for two ionization chamber dose calibrators available in the institute will be summarized in this presentation. (author)

The nuclear medicine department in the emergency management plan: a referent structure for the nuclear and radiological risks

International Nuclear Information System (INIS)

Barat, J.L.; Ducassou, D.; Lesgourgues, P.; Zamaron, S.; Boulard, G.

2006-01-01

Each french public or private hospital has to establish guidelines for an immediate response to mass casualties (Emergency Management Plan or 'White' Plan). For a nuclear accident or terrorist attack, the staff of the Nuclear Medicine Department may be adequately prepared and equipped. This paper presents the nuclear and radiological risks section of the final draft of the White Plan developed at Bordeaux University Hospital. (author)

Quality assessment according to DIN EN ISO 9001:2000. Certification in a nuclear medicine department

International Nuclear Information System (INIS)

Doebert, N.; Osterloh, M.; Menzel, C.; Gruenwald, F.; Kahla-Witzsch, H.A.

2005-01-01

In the year 2002 our department started to inaugurate a quality management system. The certification according to DIN EN ISO 9001:2000 as required by the hospital management was achieved in August 2004. The aim was the optimisation of internal operating schedules and the standardisation of procedures according to logistic interfaces with external structures. Since 2000 the implementation of an internal quality management system is required by German law (SGB V paragraph 135) and threatened by penalty in case of non-implementation (SGB V paragraph 137). Beside a basic audit and optimisation of all organisational procedures all core processes of our department were determined and the approvals were checked. These aims concern i.e. both the quality of our diagnostics of nuclear medicine and of the in vitro laboratory and the aspects of service such as quickness of scheduling and forwarding of reports and economic and efficient aspects of our work. An important role plays the department of ''quality management'', whose main tasks are the professional guidance and the training of the quality management representatives. The realisation of the new regulations and the restructuring resulted in an increase of effectiveness and in an improvement of operational procedures in our department. Especially the patients and the staff granted from the reorganised and modified sequence of operations. Implementation of a quality management system takes some efforts but the positive aspects for the structure and the flow of work are predominant so that the inauguration of a quality management system in the different departments of a hospital are recommendable. (orig.)

Limitation of therapeutic effort in patients hospitalised in departments of internal medicine.

Science.gov (United States)

García Caballero, R; Herreros, B; Real de Asúa, D; Gámez, S; Vega, G; García Olmos, L

There is little information on the limitation of therapeutic effort (LTE) in patients admitted to hospital internal medicine units. To describe the indicated LTE regimens in the departments of internal medicine and the characteristics of the patients who undergo them. An observational, descriptive retrospective study was conducted on 4 hospitals of the Community of Madrid. The study collected demographic and comorbidity data and the LTE orders prescribed for all patients who died during a period of 6 months. The study included 382 patients with a mean age of 85±10 years; 204 were women (53.4%) and 222 (58.1%) came from their homes. Some 51.1% of the patients were terminal, 43.2% had moderate to severe dementia, and 95.5% presented at least moderate comorbidity. Some type of LTE was performed in 318 patients (83.7%); the most common orders were "No cardiopulmonary resuscitation" (292 patients, 76.4%; 95% CI 72.1-80.8), "Do not use aggressive measures" (113 patients, 16.4%; 95% CI 13.7-19.4) and "Do not transfer to an intensive care unit" (102 cases, 14.8%, 95% CI 12.3-17.7). Some type of LTE was performed in 318 patients (83.7%); the most common orders were "No cardiopulmonary resuscitation" (292 patients, 76.4%; 95% CI 72.1-80.8), "Do not use aggressive measures" (113 patients, 16.4%; 95% CI 13.7-19.4) and "Do not transfer to an intensive care unit" (102 cases, 14.8%, 95% CI 12.3-17.7). LTE is common among patients who die in Internal Medicine. The most widely used regimens were "No CPR" and the unspecific statement "Do not use aggressive measures". The patients were elderly and had significant comorbidity, terminal illness and advanced dementia. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

Using the framework of corporate culture in “mergers” to support the development of a cultural basis for integrative medicine – guidance for building an integrative medicine department or service

Science.gov (United States)

Witt, Claudia M; Pérard, Marion; Berman, Brian; Berman, Susan; Birdsall, Timothy C; Defren, Horst; Kümmel, Sherko; Deng, Gary; Dobos, Gustav; Drexler, Atje; Holmberg, Christine; Horneber, Markus; Jütte, Robert; Knutson, Lori; Kummer, Christopher; Volpers, Susanne; Schweiger, David

2015-01-01

Background An increasing number of clinics offer complementary or integrative medicine services; however, clear guidance about how complementary medicine could be successfully and efficiently integrated into conventional health care settings is still lacking. Combining conventional and complementary medicine into integrative medicine can be regarded as a kind of merger. In a merger, two or more organizations − usually companies − are combined into one in order to strengthen the companies financially and strategically. The corporate culture of both merger partners has an important influence on the integration. Purpose The aim of this project was to transfer the concept of corporate culture in mergers to the merging of two medical systems. Methods A two-step approach (literature analyses and expert consensus procedure) was used to develop practical guidance for the development of a cultural basis for integrative medicine, based on the framework of corporate culture in “mergers,” which could be used to build an integrative medicine department or integrative medicine service. Results Results include recommendations for general strategic dimensions (definition of the medical model, motivation for integration, clarification of the available resources, development of the integration team, and development of a communication strategy), and recommendations to overcome cultural differences (the clinic environment, the professional language, the professional image, and the implementation of evidence-based medicine). Conclusion The framework of mergers in corporate culture provides an understanding of the difficulties involved in integrative medicine projects. The specific recommendations provide a good basis for more efficient implementation. PMID:25632226

Does Academic Blogging Enhance Promotion and Tenure? A Survey of US and Canadian Medicine and Pediatric Department Chairs.

Science.gov (United States)

Cameron, Christian Blake; Nair, Vinay; Varma, Manu; Adams, Martha; Jhaveri, Kenar D; Sparks, Matthew A

2016-06-23

Electronic educational (e-learning) technology usage continues to grow. Many medical journals operate companion blogs (an application of e-learning technology) that enable rapid dissemination of scientific knowledge and discourse. Faculty members participating in promotion and tenure academic tracks spend valuable time and effort contributing, editing, and directing these medical journal blogs. We sought to understand whether chairs of medicine and pediatric departments acknowledge blog authorship as academic achievement. The authors surveyed 267 chairs of US and Canadian medicine and pediatric departments regarding their attitudes toward the role of faculty participation in e-learning and blogging in the promotion and tenure process. The survey completion rate was 22.8% (61/267). A majority of respondents (87%, 53/61) viewed educational scholarship as either important or very important for promotion. However, only 23% (14/61) perceived importance to faculty effort in producing content for journal-based blogs. If faculty were to participate in blog authorship, 72% (44/61) of surveyed chairs favored involvement in a journal-based versus a society-based or a personal (nonaffiliated) blog. We identified a "favorable group" of chairs (19/59, 32%), who rated leadership roles in e-learning tools as important or very important, and an "unfavorable group" of chairs (40/59, 68%), who rated leadership roles in e-learning tools as somewhat important or not important. The favorable group were more likely to be aware of faculty bloggers within their departments (58%, 11/19 vs 25%, 10/40), viewed serving on editorial boards of e-learning tools more favorably (79%, 15/19 vs 31%, 12/39), and were more likely to value effort spent contributing to journal-based blogs (53%, 10/19 vs 10%, 4/40). Our findings demonstrate that although the majority of department chairs value educational scholarship, only a minority perceive value in faculty blogging effort.

Hospital-Acquired Urinary Tract Infections: Results of a Cohort Study Performed in an Internal Medicine Department.

Science.gov (United States)

Lobão, Maria João; Sousa, Paulo

2017-09-29

Urinary tract infections are the most frequent healthcare associated infections, being related to both high costs and morbidity. Our intention was to carry out an epidemiological characterization of hospital acquired urinary tract infections that occurred in an internal medicine department of a Portuguese hospital. Retrospective cohort study (historic cohort). Data were analysed from a systematic random sample of 388 patients, representative of the 3492 admissions occurred in 2014 in that department. One in four patients underwent the placement of a bladder catheter [24.7% (n = 96); 95% CI: 20% - 29%], 36.5% (95% CI: 33% - 48%) of which in the absence of clinical criteria for that procedure. The global cumulative incidence rate for nosocomial urinary tract infections was 4.6% (95% CI: 2.5% - 6.7%). Most hospital acquired urinary tract infections (61.1%) were related to bladder catheter use. We quantified 3.06 infections / 1000 patient-days and 14.5 infections / 1000 catheter-days. Catheter associated urinary tract infection occurred at an early stage of hospitalization. The vast majority of patients (66.7%) that developed a catheter associated urinary tract infection were subjected to bladder catheter placement at emergency department. Seventy one per cent of catheter associated urinary tract infection occurred in patients that were subjected to bladder catheter placement without criteria. These results point to an excessive and inadequate use of urinary catheters, highlighting the need for judicious use taking into account the formal clinical indications. The incidence of catheter associated urinary tract infection is similar to what we found in other studies. Nevertheless we found a very high incidence density per catheter-days that may foresee a problem probably related to the absence of early withdrawal of the device, and to both bladder catheter placement and maintenance practices. A significant part of catheter associated urinary tract infection

The economic role of the Emergency Department in the health care continuum: applying Michael Porter's five forces model to Emergency Medicine.

Science.gov (United States)

Pines, Jesse M

2006-05-01

Emergency Medicine plays a vital role in the health care continuum in the United States. Michael Porters' five forces model of industry analysis provides an insight into the economics of emergency care by showing how the forces of supplier power, buyer power, threat of substitution, barriers to entry, and internal rivalry affect Emergency Medicine. Illustrating these relationships provides a view into the complexities of the emergency care industry and offers opportunities for Emergency Departments, groups of physicians, and the individual emergency physician to maximize the relationship with other market players.

[Investigation of the burnout syndrome among the employees of the Department of Emergency Medicine at the University of Szeged].

Science.gov (United States)

Hompoth, Emőke Adrienn; Töreki, Annamária; Pető, Zoltán

2018-01-01

Burnout has been described as a growing problem amongst healthcare workers. Emergency department staffs experience the burden of stress day by day, yet only a few studies have examined their burnout. In this study we wanted to investigate the burnout and its relations to other variables amongst the employees of the Department of Emergency Medicine in Szeged. Cross-sectional design utilizing a self-administered questionnaire was used to collect data from the staff of the Department. Burnout was measured using the Maslach Burnout Inventory. Burnout is considerably prevalent among the workers of the Emergency Department, especially nurses and physicians. The study found negative relation between burnout and age, number of children, number of years in the healthcare system, number of physical symptoms, social support and psychological immune system. Being single was a risk factor. The risks and protective factors found to be associated with burnout in this study might help to set up institutional prevention and intervention strategies. Orv Hetil. 2018; 159(3): 113-118.

Chronic obstructive pulmonary disease pathways as a tool to improve appropriateness in Internal Medicine Departments

Directory of Open Access Journals (Sweden)

Francesco Ventrella

2014-09-01

Full Text Available In recent decades, in the medical field, criteria and methods of decision-making have radically changed, going from an environment dominated by opinions and knowledge transmitted from experts to a context of evidence-based medicine, that finds its practical realization in the drafting of guidelines (GL. However, GL have a poor implementation in the real world for several factors. In the field of chronic obstructive pulmonary disease (COPD, there are already many GL, international, national, regional and by specific scientific societies. This multiplicity, while it responds to the legitimate needs to respect the diversity of interpretation of the available scientific data, on the other hand, however, can be an element of confusion for physicians. In this varied scenery we have tried to create some new tools, easy and quick to use, in order to improve the local application of existing GL on COPD, by planning a limited number of pathways in the management of acute exacerbation of COPD, which focus on the fundamental diagnostic and therapeutic aspects, as a tool to improve appropriateness in Internal Medicine Departments. These pathways, reported on individual sheets, which can be distributed to medical personnel of wards/units involved in the care of patients with COPD (First Aid, Internal Medicine, Geriatrics, Pulmonology, Intensive Respiratory Care Unit, Resuscitation, are useful to support the physician in the decision-making process and help you to resolve any disputes.

[The evaluation of academic emergency department design].

Science.gov (United States)

Deniz, Turgut; Aydinuraz, Kuzey; Oktay, Cem; Saygun, Meral; Ağalar, Fatih

2007-01-01

In our study which was based upon a questionnaire, the inner and outer architectural designs of emergency services of Emergency Medicine Departments were investigated. In this descriptive study, a standard questionnaire was sent to 26 Emergency Medicine Departments which were operating at that time. In the questionnaire, the internal, external architectural and functional features were questioned. Answers of 22 Emergency Medicine Departments were analysed. Two Emergency Medicine Departments that were not operating at that time were not included in the study. The analysis of the replies revealed that only 59% (n=13) of the Emergency Medicine Departments were designed as an emergency service prior to the construction. The ambulance parking areas were not suitable in 77% of the emergency units while only 54.5% (n=12) had protection against adverse weather conditions. In only 59% (n=13) of the emergency units, a triage unit was present and in only one of the in only one (4.5%), a decontamination room was available. It was understood that only 32% (n=8) of the emergency units were appropriate in enlarging their capacity taking the local risk factors into consideration. There was a toilette for disabled patients in only 18% (n=4) of the units as well. Considering a 12-year of history of the Emergency Medicine in Turkey, the presence of a lecture room is still 68% (n=15) in emergency departments which reflects that academic efforts in this field is emerging in challenging physical conditions. The results of our study revealed that emergency service architecture was neglected in Turkey and medical care given was precluded by the insufficient architecture. The design of emergency services has to be accomplished under guidance of scientific data and rules taking advices of architects who have knowledge and experience on this field.

Management of Pneumothorax in Emergency Medicine Departments: Multicenter Trial

Science.gov (United States)

Ince, Abdulkadir; Ozucelik, Dogac Niyazi; Avci, Akkan; Nizam, Ozgur; Dogan, Halil; Topal, Mehmet Ali

2013-01-01

Background: Pneumothorax is common and life-threatening clinical condition which may require emergency treatment in Emergency Medicine Departments. Objectives: We aimed to reveal the epidemiological analysis of the patients admitted to the Emergency Department with pneumothorax. Material and Methods: This case-control and multi-center study was conducted in the patients treated with the diagnosis of pneumothorax between 01.01.2010-31.12.2010. Patient data were collected from hospital automation system. According to the etiology of the pneumothorax, study groups were arranged like spontaneous pneumothorax and traumatic pneumothorax. Results: 82.2% (n = 106) of patients were male and 17.8% (n = 23) of patients were female and mean age were 31.3 ± 20,2 (Minimum: 1, Maximum: 87). 68.2% (n = 88) of patients were spontaneous pneumothorax (61.36%, n=79 were primary spontaneous pneumothorax) and 31.8% (n = 41) of patients were traumatic pneumothorax (21.95% were iatrogenic pneumothorax). Main complaint is shortness of breath (52.3%, n=67) and 38% (n=49) of patients were smokers. Posteroanterior (PA) Chest X-Ray has been enough for 64.3% (n = 83) of the patients' diagnosis. Tube thoracostomy is applied to 84.5% (n = 109) of patients and surgery is applied to 9.3% (n = 12) of patients and 6.2% (n = 8) of patients were discharged with conservative treatment. Spontaneous pneumothorax showed statistically significant high recurrence compared with traumatic pneumothorax (P = 0.007). 4.65% of (n = 6) patients died. The average age of those who died (9.3 ± 19.9), statistically were significantly lower the mean age of living patients (32.4 ± 19.7) (t test, P = 0,006). 83.33% of the patients who died were neonatals and in the 0-1 years age group, and five of these patients were secondary spontaneous pneumothorax, and one of these patients were iatrogenic pneumothorax due to mechanical ventilation. Conclusions: Pneumothorax in adults can be treated by tube thoracostomy or

Quality assessment according to DIN EN ISO 9001:2000. An experience and development report of a nuclear medicine department

International Nuclear Information System (INIS)

Glawe, M.

2005-01-01

In 2001 the Department of Nuclear Medicine of the University Hospital Hamburg-Eppendorf was the first department in Germany certified by DIN EN ISO 9001:2000. Since then the quality management system (QM-system) was adapted to the needs and demands of our nuclear medicine department and of our team members. For easy access to all documents the whole system was put on a digital basis. Considering the meeting structure of our clinic the guidance of documents and the history of documents was integrated in a digital system. Revisions were made step-by-step with the objective to remove and avoid redundancies. To realise this requirement the investigation documentation (paragraph 85-sheet) was integrated in the QM-system in form and content complementing the guidelines of the corresponding Standard Operating Procedures (SOPs). The configuration of the SOPs has modified in the course of time and was tightened. A text module system was developed to assure a standardized quality of discharge letters and diagnostic findings. At regular intervals internal und external audits were performed. The exposure to so called ''undesired incidences'' has taken an important focus in our established QM-system. For a professional handling with mistakes we introduced a new system that also provides potential legal coverage. The critical examination of the own achievement and the professional handling of weak points is the major obstacle of a QM-system based on long-term considerations. (orig.)

Scientific publications from departments of clinical physiology and nuclear medicine in Denmark. A bibliometric analysis of "impact' in the years 1989-1994

DEFF Research Database (Denmark)

Hansen, HB; Brinch, K; Henriksen, Jens Henrik Sahl

1996-01-01

This study reports a bibliometric analysis of scientific publications emanating from departments of clinical physiology and nuclear medicine, Denmark, during the years 1989-1994. The total number of publications during this period was 860 (763 scientific journal papers, 71 book/book chapters and 26...... a collaboration between two or more departments of clinical physiology and nuclear medicine, but the collaboration with other medical specialities and institutions was much greater (85%). The 763 papers were published in 239 different scientific journals, 80% in journals with an official 'impact factor......', a bibliometric measure of quality (the average number of times a paper is cited in a journal in the publishing year and the subsequent year). Twenty per cent (20%) and 8.4% were printed in journals with an impact factor, respectively, of above 2.1 (the 500 journals most cited) and 3.7 (the 200 most cited), which...

Beijing nuclear medicine survey 2005: general information

International Nuclear Information System (INIS)

Geng Jianhua; Si Hongwei; Chen Shengzu

2008-01-01

Objective: To evaluate the status of nuclear medicine department in Beijing area. Methods: Staff, equipment and clinical applications of nuclear medicine departments in Beijing area during 2005 were evaluated by postal questionnaires. Results: Thirty nuclear medicine departments responded to our survey. In these departments, 321 staff, 141 doctors, 122 technicians, 7 physicists, 22 nurses and 29 other staff were employed; and 41 large imaging equipments, 37 SPECT, 3 PET, 1 PET-CT were equipped. During 2005, 88135 radionuclide imaging (84734 for SPECT, 3401 for PET), 462246 radioimmunoassay and 2228 radionuclide therapies (the most for Graves' disease, the second for thyroid cancer, the third for bone metastasis) were performed. For only 41.5% and 22.0% equipments the daily quality control (QC) and weekly QC were conducted. Conclusions Staff, equipments and activities of nuclear medicine department in Beijing were in a considerable scale, but did not balance among hospitals. Most departments should increase the number of physicists and the equipment QC procedures to improve the image quality. (authors)

Contribuições da antropologia à medicina: uma revisão de estudos no Brasil Contributions from anthropology to medicine: a bibliographic review in Brazil

Directory of Open Access Journals (Sweden)

Marcos de Souza Queiroz

1986-04-01

Full Text Available Foi feita revisão e análise, sob um ponto de vista antropológico, da literatura mais representativa sobre saúde e doença e práticas de cura no Brasil. Nessa literatura, em primeiro lugar, houve a preocupação de coletar documentos sobre as tradições regionais do mundo rural, expressando uma ampla variedade de pontos de vista. Em geral, "medicina popular" era vista como um conjunto de práticas e idéias rudes e imitativas, provenientes tanto da medicina erudita do passado como das tradições étnicas brasileiras. Em segundo lugar, as ciências sociais exerceram uma grande influência neste tipo de estudo. Depois dos anos 30 e, principalmente, dos anos 40 aos 70, um número importante de trabalhos tiveram lugar nesse campo de estudo, influenciados pelas posturas acadêmicas como, por exemplo, o funcionalismo, a teoria da aculturação, e as teorias do desenvolvimento. Durante os anos 70 o campo atingiu a sua maturidade com um grande número de pesquisas sob várias influências teóricas. As teorias estruturalistas e funcional-estruturalistas (que variam entre o formalismo abstrato e o substantivismo tiveram um peso mais consistente nessa década. Três importantes estudos recentes foram também analisados, e as principais tendências abertas nesse campo foram também discutidas, particularmente as tentativas marxistas de análise.An analysis was made of the most representative literature both on health and illness representations and on practices of cure in Brazil from an anthropological point of view. Firsttly, there was in this litterature the concern of collecting the folk traditions from the rural world, expressing a great variety of viewpoints. In general, "popular medicine" was seen as a set of rude and imitative ideas and practices stemming from both the erudite medicine of the past and Brazilian ethnic traditions. Secondly, social sciences have had a great influence on this kind of study. After the 30's, particularly from the

[Conversion disorder in an internal medicine department: A series of 37 cases].

Science.gov (United States)

Régny, P; Cathébras, P

2016-04-01

To describe the clinical characteristics of a series of patients presenting conversion disorder in a general internal medicine ward and outpatient clinic, the arguments retained by the physicians in favour of the diagnosis, the somatic and psychiatric co-morbidities, the management and the outcome of the disorder. We report the study of 37 patients diagnosed with conversion disorder in an internal medicine department of a French university hospital over a period of 14 years. We retrospectively reviewed the charts of the patients and contacted their primary care physicians to obtain follow-up data. No structured instrument was used for the diagnosis of conversion disorder or for the assessment of psychiatric comorbidities. As expected, patients were mostly young females, although a great variety of age, gender, and socio-cultural background was observed. Motor symptoms predominated (62%). A relevant psychogenic factor was explicitly mentioned in only 43% of the cases. In many cases, organic disease was also present, and an organic cause for the symptom initially considered as conversion was suspected in 3 cases. Depressive and anxious disorders were present respectively in 38% and 35% of cases. A pain complaint was associated in half of the cases. Among patients for whom follow-up data is available, conversion symptoms persisted or recurred in 70% of cases and were associated with a poor quality of life. This case series confirms that the DSM-IV-TR criterion of "psychogenicity" (later abandoned in DSM-5) is highly problematic in clinical practice. It suggests a close relationship between conversion disorder and unexplained chronic pain. Copyright © 2015 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

State of emergency medicine in Azerbaijan

OpenAIRE

Sule, Harsh; Kazimov, Shirin; Shahmaliyev, Oktay; Sirois, Adam

2008-01-01

Background There has been no previous study into the state of emergency medicine in Azerbaijan. As a legacy of the Soviet Semashko system, the ?specialty? model of emergency medicine and integrated emergency departments do not exist here. Instead, pre-hospital emergency care is delivered by ambulance physicians and in-hospital care by individual departments, often in specialty hospitals. Emergency care is therefore fragmented, highly specialized and inefficient. Aims The Emergency Medicine De...

[Clinical and economic analysis of an internal medicine-infectious disease department at a university general hospital (2005-2006)].

Science.gov (United States)

Gómez, Joaquín; García-Vázquez, Elisa; Antonio Puertas, José; Ródenas, Julio; Herrero, José Antonio; Albaladejo, Carmen; Baños, Víctor; Canteras, Manuel; Alcaraz, Manolo

2009-02-01

Comparative study in patients with infectious diseases admitted to a specialized Internal Medicine-Infectious Diseases Department (IMID) versus those admitted to other medical departments in a university general hospital, investigating quality and cost-effectiveness. Analysis of patients in 10 principle diagnosis-related groups (DRGs) of infectious diseases admitted to the IMID were compared to those admitted to other medical departments (2005-2006). The DRG were divided in 4 main groups: respiratory infections (DGR 88, 89, 90, 540), urinary infections (DRG 320, 321), sepsis (DRG 416, 584), and skin infections (DRG 277, 278). For each group, quality variables (mortality and readmission rate), efficacy variables (mean hospital stay and mean DRG-based cost per patient) and complexity variables (case mix, relative weight, and functional index) were analyzed. 542 patients included in the 10 main infectious disease DRGs were admitted to IMID and 2404 to other medical departments. After adjusting for DRG case mix (case mix 0.99 for IMID and 0.89 for others), mean hospital stay (5.11 days vs. 7.65 days), mortality (3.5% vs. 7.9%) and mean DRG-based economic cost per patient (1521euro/patient vs. 2952euro/patient) was significantly lower in the group of patients hospitalized in IMID than the group in other medical departments (peconomic cost per patient. Creation and development of IMID departments should be an essential objective to improve healthcare quality and respond to social demands.

15th Anniversary of the Molecular Techniques Unit at the Department of Forensic Medicine at Wroclaw Medical University.

Science.gov (United States)

Pluta, Dominika; Tokarski, Miron; Karpiewska, Anna; Dobosz, Tadeusz

2017-01-01

Molecular Techniques Unit at the Department of Forensic Medicine, Wroclaw Medical University has been operating since December 2003. Soon it will be 15 years since its establishment. This anniversary become an inspiration to write down the story of this institution whose origins illustrate the immense changes that have taken place in forensic genetics. The aim of our work was also to consolidate the professional achievements of Professor Tadeusz Dobosz, chief of the Unit, one of the pioneers of introducing DNA testing technology into Polish forensic medicine. The most important achievements of the Unit include participation in two EU research projects, the development of a non-destructive method of extraction of genetic material, research in field of gene therapy and certification of the Laboratory of the Molecular Techniques Unit by the Polish Accreditation Center (PCA) confirming compliance with the requirements of the PN-EN ISO/IEC 17025:2005 standard.

Preventive and Community Medicine in Primary Care. Teaching of Preventive Medicine Vol. 5.

Science.gov (United States)

Barker, William H., Ed.

This monograph is the result of a conference on the role of preventive and community medicine in primary medical care and education. The following six papers were presented at the conference: (1) Roles of Departments of Preventive Medicine; (2) Competency-Based Objectives in Preventive Medicine for the Family Physician; (3) Preventive Medicine…

Development of a novel sports medicine rotation for emergency medicine residents

Directory of Open Access Journals (Sweden)

Waterbrook AL

2016-04-01

Full Text Available Anna L Waterbrook,1 T Gail Pritchard,2 Allison D Lane,1 Lisa R Stoneking,1 Bryna Koch,2 Robert McAtee,1 Kristi H Grall,1 Alice A Min,1 Jessica Prior,1 Isaac Farrell,1 Holly G McNulty,1 Uwe Stolz1 1Department of Emergency Medicine, 2Office of Medical Student Education, The University of Arizona, Tucson, AZ, USA Abstract: Musculoskeletal complaints are the most common reason for patients to visit a physician, yet competency in musculoskeletal medicine is invariably reported as a deficiency in medical education in the USA. Sports medicine clinical rotations improve both medical students' and residents' musculoskeletal knowledge. Despite the importance of this knowledge, a standardized sports medicine curriculum in emergency medicine (EM does not exist. Hence, we developed a novel sports medicine rotation for EM residents to improve their musculoskeletal educational experience and to improve their knowledge in musculoskeletal medicine by teaching the evaluation and management of many common musculoskeletal disorders and injuries that are encountered in the emergency department. The University of Arizona has two distinct EM residency programs, South Campus (SC and University Campus (UC. The UC curriculum includes a traditional 4-week orthopedic rotation, which consistently rated poorly on evaluations by residents. Therefore, with the initiation of a new EM residency at SC, we replaced the standard orthopedic rotation with a novel sports medicine rotation for EM interns. This rotation includes attendance at sports medicine clinics with primary care and orthopedic sports medicine physicians, involvement in sport event coverage, assigned reading materials, didactic experiences, and an on-call schedule to assist with reductions in the emergency department. We analyzed postrotation surveys completed by residents, postrotation evaluations of the residents completed by primary care sports medicine faculty and orthopedic chief residents, as well as the

Evaluation of radiation protection in nuclear medicine diagnostic procedures

International Nuclear Information System (INIS)

Mohammed, Ezzeldien Mohammed Nour

2013-05-01

This study conducted to evaluate the radiation protection in nuclear medicine diagnostic procedures in four nuclear medicine departments in Sudan. The evaluated procedures followed in these departments were in accordance with the standards, International Recommendations and code of practice for radiation protection in nuclear medicine. The evolution included the optimum design for diagnostic nuclear medicine departments, dealing with radioactive sources, quality assurance and quality control, training and responsibilities for radiation worker taking into account economic factors in Sudan. Evaluation of radiation protection procedures in diagnostic investigations was carried out by taken direct measurements of dose rate and the contamination level in some areas where radiation sources, radiation workers and public are involved. Designated questionnaires covered thirteen areas of radiation protection based on inspection check list for nuclear medicine prepared by the International Atomic Energy Agency (IAEA) and American Association of Physicist in Medicine (AAPM) were used in the evaluation. This questionnaire has been Filled by Radiation Protection Officer (RPO), nuclear medicine technologist, nuclear medicine specialist in the nuclear medicine departments. Four hospitals, two governmental hospital and two private hospitals, have been assisted, the assessment shows that although the diagnostic nuclear medicine department in Sudan are not applying a fully safety and radiation protection procedures, but the level of radiation dose and the contamination level were found within acceptable limits. The private hospital D scored the higher level of protection (85.25%) while the governmental hospital C scored the lower level of protection (59.02%). Finally, this study stated some recommendations that if implemented could improve the level of radiation protection in nuclear medicine department. One of the most important recommendations is that a proper radiation protection

Geographical distribution of torture: An epidemiological study of torture reported by asylum applicants examined at the Department of Forensic Medicine, University of Copenhagen

DEFF Research Database (Denmark)

Busch, Johannes Rødbro; Hansen, Steen Holger; Hougen, Hans Petter

2015-01-01

Using reports from 154 examinations of alleged torture victims among asylum applicants to Denmark conducted by the Department of Forensic Medicine, Univer- sity of Copenhagen, between 2001 and 2013, we have categorized the victims into four geographical regions, as well as according to the conflict...

Results of the evaluation of the radiation protection in several nuclear medicine departments and recommendations for its optimization

International Nuclear Information System (INIS)

Bejerano, Gladys Lopez; Jova Sed, Luis; Diaz, Efren; jova@cphr.edu.cu

2001-01-01

For the evaluation of the radiological safety in several Nuclear Medicine departments a survey was processed and applied that gathers the related mainly to: aspect of the licensing and fulfillment of the establish in this, the program of individual radiologic monitoring and his evaluation, functions that serve to the radiologic protection system, program of qualification and training of the personnel, equipment and mean of radiation protection, program of monitoring of the area of work, characteristic of the premises, management of remainder radioactive, program of quality control, aspect related to the radiation protection in the procedure of diagnosis with the investigation; as well as to pregnant patients and those related to the investigation to accidental medical exhibitions. In the work a systematization of the main results had been done, insisting on the evaluation of the doses received by the workers occupational exposed. A comparison of the activities administered to the patients by different departments and the internationally recommended ones, explaining the found differences. In addition the main recommendations were exposed to obtain in these departments an optimization of the radiological safety

Nuclear medicine

International Nuclear Information System (INIS)

Chamberlain, M.J.

1986-01-01

Despite an aggressive, competitive diagnostic radiology department, the University Hospital, London, Ontario has seen a decline of 11% total (in vivo and in the laboratory) in the nuclear medicine workload between 1982 and 1985. The decline of in vivo work alone was 24%. This trend has already been noted in the U.S.. Nuclear medicine is no longer 'a large volume prosperous specialty of wide diagnostic application'

Spinal cord infarction: a rare cause of admission to Internal Medicine Departments but a condition with relevant systemic complications

Directory of Open Access Journals (Sweden)

Daniela Galimberti

2013-04-01

Full Text Available BACKGROUND Spinal cord infarction is a rare cause of admission to Internal Medicine Departments as it is of infrequent occurrence and it is usually addressed to Neurologic Units. Diagnosis at admission however may be challenging expecially in the elderly because of several co-morbidities and variable presentation. Clinical course is often complicated by autonomic, infective and cardiovascular problems as well as a long stay-in-bed period. Outcome is poor in case of severe motor, autonomic (bladder and bowel and sensitive impairment at presentation, it’s related to anatomic damage site and extension and it’s worse in case of anterior bilateral infarcts. CLINICAL CASE The authors describe the case of an 81- year-old woman who was admitted to an Internal Medicine Department because of cervical spinal cord infarction. The diagnostic evaluation as well as the management of cardiovascular, infective, rheumatologic and autonomic complications needed skillful internistic competence and a long in-hospital period. MR allowed a correct diagnosis a few hours after presentation, but the pathogenesis was never clearly established. The most invalidating symptoms were loss of bowel control lasting for several weeks during hospitalization and neuropathic pain still present at discharge. As for the outcome, the patient was able to go home after 3 months from admission able to walk with aids, with full bowel and bladder control and no sensitive impairment.

A DICOM based PACS for nuclear medicine

International Nuclear Information System (INIS)

Lassmann, M.; Reiners, C.

2002-01-01

The installation of a radiology information system (RIS) connected to a hospital information system (HIS) and a picture archiving and communications system (PACS) seems mandatory for a nuclear medicine department in order to guarantee a high patient throughput. With these systems a fast transmission of reports, images to the in- and out-patients' wards and private practitioners is realized. Therefore, since April 2000, at the department of nuclear medicine of the university of Wuerzburg a completely DICOM based PACS has been implemented in addition to the RIS. With this system a DICOM based workflow is realized throughout the department of nuclear medicine for reporting and archiving. The PACS is connected to six gamma-cameras, a PET scanner, a bone densitometry system and an ultrasound device. The volume of image data archived per month is 4 GByte. Patient demographics are provided to the modalities via DICOM-Worklist. With these PACS components a department specific archive purely based on DICOM can be realized. During the installation process problems occurred mainly because of the complex DICOM standard for nuclear medicine. Related to that is the problem that most of the software implementations still contain bugs or are not adapted to the needs of a nuclear medicine department (particularly for PET). A communication software for the distribution of nuclear medicine reports and images based on techniques used for the worldwide web is currently tested. (orig.) [de

Setting up and functioning of an Emergency Medicine Department: Lessons learned from a preliminary study

Directory of Open Access Journals (Sweden)

K Asish

2016-01-01

Full Text Available Background and Aims: Tertiary care teaching hospitals remain referral centres for victims of trauma and mass casualty. Often specialists from various disciplines manage these crowded casualty areas. These age old casualty areas are being replaced, throughout the country by Emergency Medicine Departments (EMDs, presumed to be better planned to confront a crisis. We aimed to gather basic data contributive in setting up of an EMD at a tertiary care teaching hospital from the lessons learned from functioning existent systems. Methods: This is primarily a questionnaire-based descriptive study at tertiary care referral centres across the country, which was purposively selected.The study models included one from a hospital without designated EMD and the other four from hospitals with established EMDs. Direct observation and focus group meetings with experienced informants at these hospitals contributed to the data. In the absence of a validated hospital preparedness assessment scale, comparison was done with regard to quantitative, qualitative and corroborative parameters using descriptive analysis. Results: The EMDs at best practice models were headed by specialist in Emergency Medicine assisted by organised staff, had protocols for managing mass casualty incident (MCI, separate trauma teams, ergonomic use of infrastructure and public education programmes. In this regard, these hospitals seemed well organised to manage MCIs and disasters. Conclusion: The observation may provide a preliminary data useful in setting up an EMD. In the absence of published Indian literature, this may facilitate further research in this direction. Anaesthesiologists, presently an approved Faculty in Emergency Medicine training can provide creative input with regard to its initial organisation and functioning, thus widening our horizons in a country where there is a severe dearth of trained emergency physicians.

Development of a novel sports medicine rotation for emergency medicine residents.

Science.gov (United States)

Waterbrook, Anna L; Pritchard, T Gail; Lane, Allison D; Stoneking, Lisa R; Koch, Bryna; McAtee, Robert; Grall, Kristi H; Min, Alice A; Prior, Jessica; Farrell, Isaac; McNulty, Holly G; Stolz, Uwe

2016-01-01

Musculoskeletal complaints are the most common reason for patients to visit a physician, yet competency in musculoskeletal medicine is invariably reported as a deficiency in medical education in the USA. Sports medicine clinical rotations improve both medical students' and residents' musculoskeletal knowledge. Despite the importance of this knowledge, a standardized sports medicine curriculum in emergency medicine (EM) does not exist. Hence, we developed a novel sports medicine rotation for EM residents to improve their musculoskeletal educational experience and to improve their knowledge in musculoskeletal medicine by teaching the evaluation and management of many common musculoskeletal disorders and injuries that are encountered in the emergency department. The University of Arizona has two distinct EM residency programs, South Campus (SC) and University Campus (UC). The UC curriculum includes a traditional 4-week orthopedic rotation, which consistently rated poorly on evaluations by residents. Therefore, with the initiation of a new EM residency at SC, we replaced the standard orthopedic rotation with a novel sports medicine rotation for EM interns. This rotation includes attendance at sports medicine clinics with primary care and orthopedic sports medicine physicians, involvement in sport event coverage, assigned reading materials, didactic experiences, and an on-call schedule to assist with reductions in the emergency department. We analyzed postrotation surveys completed by residents, postrotation evaluations of the residents completed by primary care sports medicine faculty and orthopedic chief residents, as well as the total number of dislocation reductions performed by each graduating resident at both programs over the last 5 years. While all residents in both programs exceeded the ten dislocation reductions required for graduation, residents on the sports medicine rotation had a statistically significant higher rate of satisfaction of their educational

The Symbiotic Relationship Between Operational Military Medicine, Tactical Medicine, and Wilderness Medicine: A View Through a Personal Lens.

Science.gov (United States)

Llewellyn, Craig H

2017-06-01

There are direct and indirect linkages and a form of symbiosis between operational military medicine from World War II and present wilderness medicine, from the beginnings to contemporary practice, and the more recently evolved field of tactical emergency medical support. Each of these relationships will be explored from the historical perspective of the Department of Military & Emergency Medicine, Uniformed Services University of the Health Sciences from 1982 to the present. Copyright © 2017 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

History, Principles, and Policies of Observation Medicine.

Science.gov (United States)

Ross, Michael A; Granovsky, Michael

2017-08-01

The history of observation medicine has paralleled the rise of emergency medicine over the past 50 years to meet the needs of patients, emergency departments, hospitals, and the US health care system. Just as emergency departments are the safety net of the health system, observation units are the safety net of emergency departments. The growth of observation medicine has been driven by innovations in health care, an ongoing shift of patients from inpatient to outpatient settings, and changes in health policy. These units have been shown to provide better outcomes than traditional care for selected patients. Copyright © 2017 Elsevier Inc. All rights reserved.

50th Year Anniversary of Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University.

Science.gov (United States)

Lertakyamanee, Jariya

2016-05-01

Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, has started to be a formal anesthesia division, divided from division of Surgery in 1965; hence our 50th year anniversary in 2015. Research is now a priority and mandatory mission, according to the vision of Mahidol University. Second mission is to teach and train, and we produce the highest number of states-of-the-art anesthesiologists and anesthetic nurses each year Curriculum and training are being continuously improved. From a small unit, now it is one of the largest departments and extends the service, our third mission, to more than only in the operating theaters. We look after pre-anesthesia assessment, inside and outside operating room anesthesia, post-operative pain relief Intensive Care Unit, and chronic pain management. The number of patients and their diseases increase; so do the complexities of surgeries. There are tremendous changes in drugs and equipment. There is the fourth mission on administration, IT and resource management. And the fifth mission which is corporate social responsibility. However, we still believe that compassion, responsibility and integrity are most important. We have taught and tried to live by the teaching of HRH the King's Father. And these will contribute to our progress and shine in the next 50 years.

Radiation hazards in the nuclear medicine

International Nuclear Information System (INIS)

Roo, M.J.K. de

1981-01-01

After a survey of the actual situation of nuclear medicine in Belgium, the evolution of nuclear medicine is studied with regard to quantitative aspects (tracerquantities, number of radioisotopic explorations, number of certified doctors) and qualitative aspects (use of short living isotopes emitting low energy radiation, introduction of in vitro tests). Taking these data into consideration, the exposure of nuclear medicine staff by external or internal radiation is evaluated. From this study it appears that the radiation exposure of the personnel of nuclear medicine departments remains low if proper manipulation methods and simple protective devices are used and if there is an efficient collaboration with an active health physics department or radiation control organism. (author)

American Internal Medicine in the 21st Century

Science.gov (United States)

Huddle, Thomas S; Centor, Robert; Heudebert, Gustavo R

2003-01-01

American internal medicine suffers a confusion of identity as we enter the 21st century. The subspecialties prosper, although unevenly, and retain varying degrees of connection to their internal medicine roots. General internal medicine, identified with primary care since the 1970s, retains an affinity for its traditional consultant-generalist ideal even as primary care further displaces that ideal. We discuss the origins and importance of the consultant-generalist ideal of internal medicine as exemplified by Osler, and its continued appeal in spite of the predominant role played by clinical science and accompanying subspecialism in determining the academic leadership of American internal medicine since the 1920s. Organizing departmental clinical work along subspecialty lines diminished the importance of the consultant-generalist ideal in academic departments of medicine after 1950. General internists, when they joined the divisions of general internal medicine that appeared in departments of medicine in the 1970s, could sometimes emulate Osler in practicing a general medicine of complexity, but often found themselves in a more limited role doing primary care. As we enter the 21st century, managed care threatens what remains of the Oslerian ideal, both in departments of medicine and in clinical practice. Twenty-first century American internists will have to adjust their conditions of work should they continue to aspire to practice Oslerian internal medicine. PMID:12950486

Emergency department crowding in Singapore: Insights from a systems thinking approach.

Science.gov (United States)

Schoenenberger, Lukas K; Bayer, Steffen; Ansah, John P; Matchar, David B; Mohanavalli, Rajagopal L; Lam, Sean Sw; Ong, Marcus Eh

2016-01-01

Emergency Department crowding is a serious and international health care problem that seems to be resistant to most well intended but often reductionist policy approaches. In this study, we examine Emergency Department crowding in Singapore from a systems thinking perspective using causal loop diagramming to visualize the systemic structure underlying this complex phenomenon. Furthermore, we evaluate the relative impact of three different policies in reducing Emergency Department crowding in Singapore: introduction of geriatric emergency medicine, expansion of emergency medicine training, and implementation of enhanced primary care. The construction of the qualitative causal loop diagram is based on consultations with Emergency Department experts, direct observation, and a thorough literature review. For the purpose of policy analysis, a novel approach, the path analysis, is applied. The path analysis revealed that both the introduction of geriatric emergency medicine and the expansion of emergency medicine training may be associated with undesirable consequences contributing to Emergency Department crowding. In contrast, enhancing primary care was found to be germane in reducing Emergency Department crowding; in addition, it has apparently no negative side effects, considering the boundary of the model created. Causal loop diagramming was a powerful tool for eliciting the systemic structure of Emergency Department crowding in Singapore. Additionally, the developed model was valuable in testing different policy options.

Prescription appropriateness of empiric antibiotic therapy: survey in the internal medicine departments of the Emilia Romagna region

Directory of Open Access Journals (Sweden)

Giovanni Pedretti

2014-05-01

Full Text Available The article reports the results of an observational study conducted in 53 internal medicine departments of the Emilia Romagna region based on the answers to 54 questions administered in a questionnaire, submitted electronically, based on the type of center (large >250 beds, small <250 beds, laboratory equipment, management aspects, pharmacological and clinical/economic aspects and use of antibiotics in the empirical treatment of severe infections. The result is a snapshot of the existing situation which shows a substantial availability of resources and a good level of expertise in the field of infectious disease management, despite some areas still need improvement. It also highlights some differences in terms of procedures amongst large hospitals, where infectious diseases are treated by an ad hoc specialized staff, and the small ones, where the internist is generally involved, being responsible for both direct management of severe infections and giving advice to other departments (emergency or surgery. It emerged that, both in small and large hospitals, more discussion and continuous assessment are needed to apply the appropriate protocols based on reference checklists.

Use of dual-head gamma camera in radionuclide internal contamination monitoring on radiation workers from a nuclear medicine department

International Nuclear Information System (INIS)

Rodriguez-Laguna, A.; Brandan, M.E.

2008-01-01

As a part of an internal dosimetry program that is performed at the Mexican National Institute of Cancerology - Nuclear Medicine Department, in the present work we suggest a procedure for the routinely monitoring of internal contamination on radiation workers and nuclear medicine staff. The procedure is based on the identification and quantification of contaminating radionuclides in human body by using a dual-head whole-body gamma camera. The results have shown that the procedures described in this study can be used to implement a method to quantify minimal accumulated activity in the main human organs to evaluate internal contamination with radionuclides. The high sensitivity of the uncollimated gamma camera is advantageous for the routinely detection and identification of small activities of internal contamination. But, the null spatial resolution makes impossible the definition of contaminated region of interest. Then, the use of collimators is necessary to the quantification of incorporated radionuclides activities in the main human organs and for the internal doses assessment. (author)

Ana Carolina Escosteguy: Cenários dos estudos culturais

Directory of Open Access Journals (Sweden)

Thaisa Cristina Bueno

2015-12-01

Full Text Available Autora do livro “Cartografia dos Estudos Culturais”, “Comunicação e recepção” (em coautoria com Nilda Jacks, “Leituras em comunicação, cultura e tecnologia”, além de coautora e organizadora em outras obras de referência sobre o tema cultura e comunicação no Brasil, Ana Carolina Escosteguy é hoje um dos nomes mais importantes quando se pensa em Estudos Culturais no país. Doutora em Ciências da Comunicação pela Universidade de São Paulo (2000, com pós-doutorado no CAMRI (Communication and Media Research Institute, associado ao Department of Journalism and Mass Communication da School of Media, Art and Design da University of Westminster (UK, Ana Carolina Escosteguy é professora titular da Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS e bolsista produtividade em pesquisa do CNPq, desde março 2001. Nesta entrevista ela discute pontos sensíveis da área, entre eles o pouco destaque das pesquisas desse campo têm tido no Jornalismo, o fato de a base teórica ser bem mais ampla que os tradicionais estudos de recepção a que são comumente aproximados, não se nega a tratar das confusões com a folkcomunicação, bem como as próprios limites e intersecções desse campo de estudos. Durante esta conversa, aproveita para apontar as obras que considera essenciais para adentrar na área e mostra coragem e segurança para se colocar como uma pesquisadora que busca entender o tempo atual, as tecnologias e as rupturas a partir da perspectiva do usuário. Confiram:

Extracts from IAEA's Resources Manual in Nuclear Medicine. Part-3: Establishing Nuclear Medicine Services

International Nuclear Information System (INIS)

2003-01-01

In the past, consideration was given to the categories of nuclear medicine ranging from simple imaging or in-vitro laboratories, to more complex departments performing a full range of in-vitro and in-vivo procedures that are also involved in advanced clinical services, training programmes, research and development. In developing countries, nuclear medicine historically has often been an offshoot of pathology, radiology or radiotherapy services. These origins are currently changing as less radioimmunoassay is performed and fully-fledged, independent departments of nuclear medicine are being set up. The trend appears to be that all assays (radioassay or ELISA) are done in a biochemistry laboratory whereas nuclear medicine departments are involved largely in diagnostic procedures, radionuclide therapy and non-imaging in-vitro tests. The level of nuclear medicine services is categorized according to three levels of need: Level 1: Only one gamma camera is needed for imaging purposes. The radiopharmaceutical supply, physics and radiation protection services are contracted outside the centre. Other requirements include a receptionist and general secretarial assistance. A single imaging room connected to a shared reporting room should be sufficient, with a staff of one nuclear medicine physician and one technologist, with back-up. This level is appropriate for a small private practice. Level 2: This is suitable for a general hospital where there are multiple imaging rooms where in-vitro and other non-imaging studies would generally be performed as well as radionuclide therapy. Level 3: his is appropriate for an academic institution where there is a need for a comprehensive clinical nuclear medicine service, human resource development and research programmes. Radionuclide therapy for in-patients and outpatients is provided

Application of case analysis teaching method in nursing teaching in Department of Internal Medicine

Directory of Open Access Journals (Sweden)

Zhang-xiu SHENG

2014-04-01

Full Text Available Objective:In order to adapt to the modern occupation education teaching idea, to stimulate students’ interest in learning, training students' comprehensive quality, improve the students' active participation, understanding, analysis and problem solving skills. Methods: I In the course of different stages using teaching methods of case analysis: case introduction before class teaching method, case analysis during and after class teaching method, and case analysis of the whole chapter after class teaching method.  Results and Conclusion: Through the course of different stages of using case analysis teaching method, we can launch the students’ active learning, stimulate the students' interest in learning, activate classroom atmosphere, train students' independent thinking, strengthen the problems solving ability, improve the self-learning ability of students, activate their participation and awareness, analysis, judgment, introduction, and strengthen students' exam ability, improve the test scores of students and the teaching effect of nursing in Department of internal medicine.

Images in medicine

African Journals Online (AJOL)

ebutamanya

2016-01-08

Jan 8, 2016 ... TSH secreting adenoma: a rare cause of severe headache. Serdar Olt1,&, Mehmet Şirik2. 1Adıyaman University Medical Faculty Department of Internal Medicine, Adıyaman, Turkey, 2Adıyaman University Medical Faculty Department of. Radiology, Adıyaman, Turkey. &Corresponding author: Serdar Olt, ...

Nuclear Medicine in a developing country

International Nuclear Information System (INIS)

Wenzel, K.S. von; Rubow, S.M.; Ellmann, A.; Ghoorun, S.

2002-01-01

Namibia is a country with 1,8 million inhabitants, of whom the majority has limited access to first world facilities. Nevertheless, medical services of high standard are offered. A Nuclear Medicine Department was established at Windhoek Central Hospital in 1982. A nuclear physician, two nuclear medicine radiographers and a nursing sister staff the department. Equipment includes a Siemens Orbiter and an Elscint Apex SPX Helix gamma camera. Radiopharmaceuticals are obtained from suppliers in South Africa. Investigations performed include musculoskeletal, liver, hepatobiliary, thyroid, renal studies, ventilation perfusion lung scans as well as the following Nuclear Cardiology studies: Gated blood pool scans, Tc-99m pyrophosphate hot spot scans, Tl-201 myocardial perfusion studies, Tc-99m MIBI myocardial perfusion studies and Tl-201 rest-redistribution studies. Problems experienced at the Windhoek Nuclear Medicine department include: Lack of funding and high cost of equipment and radiopharmaceuticals, lack of understanding of Nuclear Medicine by the hospital management and health administrators, and difficulties in procuring short-lived radiopharmaceuticals. Furthermore, the absence of company representatives and spare parts in Namibia leads to loss of time whenever equipment needs to be repaired. Working as the only nuclear medicine physician in a country also poses major problems. Careful management of resources and information drives have helped to sustain the Nuclear Medicine service despite economic problems in the country. Installation of a tele-link between the department in Windhoek Hospital and Tygerberg Hospital in South Africa has greatly assisted to overcome the problem of isolation and lack of back up from fellow specialists. The IAEA has equipped both departments with Hermes workstations (Nuclear Diagnostics) and a tele-link is maintained via modem. The current software provided with the Hermes system is ideally suited to processing of data such as gated

Operational measurements during medical examinations: nuclear medicine department

International Nuclear Information System (INIS)

Gardin, I.

2009-01-01

After having briefly recalled the nuclear medicine principles and objectives, and the main radiations used for different purposes (positrons for diagnosis, photons for diagnosis, electrons for therapy or diagnosis), the author presents the principle of determination of the absorbed dose: how this dose is expressed, how it is calculated per cumulative activity unit, how cumulative activity is determined. Then, she discusses some practical aspects of dosimetric assessments during diagnosis or therapeutic examinations

Increasing medical student exposure to musculoskeletal medicine: the initial impact of the Orthopaedic Surgery and Sports Medicine Interest Group

Directory of Open Access Journals (Sweden)

Mickelson DT

2017-07-01

Full Text Available Dayne T Mickelson,1 Philip K Louie,2 Kenneth R Gundle,3 Alex W Farnand,4 Douglas P Hanel5 1Department of Orthopedic Surgery and Sports Medicine, Duke University, Durham, NC, USA; 2Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA; 3Department of Orthopedics and Rehabilitation, Oregon Health and Science University, Portland, OR, USA; 4Department of General Surgery, Presence Saint Joseph Hospital – Chicago, Chicago, IL, USA; 5Department of Orthopedic Surgery and Sports Medicine, University of Washington, Harborview Medical Center, Seattle, WA, USA Purpose: To investigate the impact of the Orthopaedic Surgery and Sports Medicine Interest Group (OSSMIG on medical student interest and confidence in core musculoskeletal (MSK concepts through supplemental education and experiences at a single tertiary, academic institution.Methods: Medical student OSSMIG members at various levels of training were anonymously surveyed at the beginning and end of the 2014–2015 academic year.Results: Eighteen (N=18 medical student interest group members completed the survey. Significant improvement in their level of training was observed with regard to respondents’ self-assessed competence and confidence in MSK medicine (p<0.05. Additionally, respondents’ attitudes toward exposure and support from the interest group were significantly higher than those provided by the institution (p<0.05. Members believed OSSMIG increased interest in MSK medicine, improved confidence in their ability to perform orthopedics-related physical exams, strengthened mentorship with residents and attendings, and developed a connection with the Department of Orthopedic Surgery and its residents (median “Strongly Agree”, interquartile range one and two scale items.Conclusion: Since its inception 8 years ago, OSSMIG has been well received and has positively impacted University of Washington School of Medicine students through various interventions

Teaching Humanities in Medicine: The University of Massachusetts Family Medicine Residency Program Experience

Science.gov (United States)

Silk, Hugh; Shields, Sara

2012-01-01

Humanities in medicine (HIM) is an important aspect of medical education intended to help preserve humanism and a focus on patients. At the University of Massachusetts Family Medicine Residency Program, we have been expanding our HIM curriculum for our residents including orientation, home visit reflective writing, didactics and a department-wide…

Checklists for quality assurance and audit in nuclear medicine

International Nuclear Information System (INIS)

Williams, E.D.; Harding, L.K.; McKillop, J.H.

1989-01-01

A series of checklists are given which aim to provide some guidance to staff in determining whether their working procedures in nuclear medicine are likely to produce a good service and avoid mistakes. The checklists relate to the special equipment used in nuclear medicine departments, radiopharmaceuticals, nuclear medicine staff, services to medical and other hospital staff and finally the service to patients. The checklists are relevant to an average nuclear medicine department performing less than 2000 imaging studies per year. (U.K.)

External validation of the PROFUND index in polypathological patients from internal medicine and acute geriatrics departments in Aragón.

Science.gov (United States)

Díez-Manglano, Jesús; Cabrerizo García, José Luis; García-Arilla Calvo, Ernesto; Jimeno Saínz, Araceli; Calvo Beguería, Eva; Martínez-Álvarez, Rosa M; Bejarano Tello, Esperanza; Caudevilla Martínez, Aránzazu

2015-12-01

The objective of the study was to validate externally and prospectively the PROFUND index to predict survival of polypathological patients after a year. An observational, prospective and multicenter study was performed. Polypathological patients admitted to an internal medicine or geriatrics department and attended by investigators consecutively between March 1 and June 30, 2011 were included. Data concerning age, gender, comorbidity, Barthel and Lawton-Brody indexes, Pfeiffer questionnaire, socio-familial Gijon scale, delirium, number of drugs and number of admissions during the previous year were gathered for each patient. The PROFUND index was calculated. The follow-up lasted 1 year. A Cox proportional regression model was calculated, and was used to analyze the association of the variables to mortality and C-statistic. 465 polypathological patients, 333 from internal medicine and 132 from geriatrics, were included. One-year mortality is associated with age [hazard ratio (HR) 1.52 95 % CI 1.04-2.12; p = 0.01], presence of neoplasia [HR 2.68 95 % CI 1.71-4.18; p = 0.0001] and dependence for basic activities of daily living [HR 2.34 95 % CI 1.61-3.40; p = 0.0009]. In predicting mortality, the PROFUND index shows good discrimination in patients from internal medicine (C-statistics 0.725 95 % CI 0.670-0.781), but a poor one in those from geriatrics (0.546 95 % CI 0.448-0.644). The PROFUND index is a reliable tool for predicting mortality in internal medicine PP patients.

Through a Gender Lens: A View of Gender and Leadership Positions in a Department of Medicine.

Science.gov (United States)

Monroe, Anne K; Levine, Rachel B; Clark, Jeanne M; Bickel, Janet; MacDonald, Susan M; Resar, Linda M S

2015-10-01

Despite increasing numbers in academic medicine, women remain underrepresented in top leadership positions. The objectives of this study were to characterize leadership positions held by department of medicine (DOM) faculty at all ranks at one Academic Health Center and to compare leadership positions held by male and female faculty. This was a cross-sectional survey to collect information on all leadership positions from 16 divisions in the DOM at the Johns Hopkins University School of Medicine in early 2012, including type of position, method used to fill the position, and financial compensation. Chi-square testing was used to compare leadership position characteristics by rank and gender. The study included 474 DOM faculty at the rank of instructor or higher; 38% were women. Of the 258 leadership positions identified, 35% were held by women. More leadership positions among assistant professors were held by women compared with men (56% of positions vs. 44%), with women assistant professors more likely to hold a leadership position than men (p=0.03). Numbers of women faculty declined at higher ranks, with leadership positions remaining proportionate to faculty representation. Most division director positions (88%) were held by men, and most leadership positions were compensated (89%) and appointed by the DOM chair or a division director (80%). Leadership positions held by women and men were proportionate to faculty representation, although the top leadership positions were held almost exclusively by men. While female assistant professors were more likely to hold leadership positions than male assistant professors, these positions appear to be low status positions and it is not clear that they contribute to professional advancement, as few women hold the rank of full professor. Effective interventions are needed to address the gender disparity in top leadership positions.

Oral mucosa lesion prevalence at Department of Oral Medicine, Halimah Daeng Sikati dental hospital in Makassar

Directory of Open Access Journals (Sweden)

Ayub Irmadani Anwar

2016-06-01

Full Text Available Oral soft tissue lesions based on clinical picture can be grouped in the form of discoloration, vesicles, tumor, erosion and ulceration. The purpose of this study is to provide apicture of people with oral mucosal lesions, including the factors thought to be the cause of the lesions listed in Department ofOral Medicine RSGMP Hj. Halimah Dg.Sikati, Makassar. This type of study is a descriptive observational study with cross-sectional research design study. This study showed that of 819 subjects, as many as 450 people were women with an average age of 15-49 years. Nutritional deficiency is one of the factors suspected to be causing the face of oral lesions in addition to other factors. These results are some what different from the results of several previous studies.

WEST AFRICAN JOURNAL OF MEDICINE

African Journals Online (AJOL)

user1

Departments of *Medicine, University of Benin Teaching Hospital, Benin City, Edo State, †Medicine, College of Health Sciences,. Benue State University, Makurdi, Benue State, Nigeria. *Correspondence: Dr Andrew Edo, PO BOX 10458, Ugbowo, Benin City, Edo State. E-mail: osayumen@yahoo.com. Tel No.

Analysis of research ethics board approval times in an academic department of medicine.

Science.gov (United States)

Tsang, Teresa S M; Jones, Meaghan; Meneilly, Graydon S

2015-04-01

As part of an ongoing effort to better understand barriers to academic research, we reviewed and analyzed the process of research ethics applications, focusing on ethics approval time, within the Department of Medicine from 2006 to 2011. A total of 1,268 applications for approval to use human subjects in research were included in our analysis. Three variables, risk category (minimal vs. non-minimal risk), type of funding, and year of submission, were statistically significant for prediction of ethics approval time, with risk status being the most important of these. The covariate-adjusted mean time for approval for minimal risk studies (35.7 days) was less than half that of non-minimal risk protocols (76.5 days). Studies funded through a for-profit sponsor had significantly longer approval times than those funded through other means but were also predominantly (87%) non-minimal risk protocols. Further investigations of the reasons underlying the observed differences are needed to determine whether improved training for research ethics board (REB) members and/or greater dialogue with investigators may reduce the lengthy approval times associated with non-minimal risk protocols. © The Author(s) 2015.

[Implementation of a quality management system according to the UNE-UN-ISO 9001:2008 standard in a nuclear medicine department].

Science.gov (United States)

Poblete García, V M; Talavera Rubio, M P; Palomar Muñoz, A; Pilkington Woll, J P; Cordero García, J M; García Vicente, A M; Bellón Guardia, M; González García, B; Cañuelo Merino, T; Núñez García, A; Peiró Valgañón, V; Soriano Castrejón, A M

2013-01-01

To describe the process of implementing a quality management system according to UNE-EN-ISO 9001:2008 standard in a Nuclear Medicine Department. In February 2008, the committee on internal quality of the Department was established, naming a responsible physician. The general operating plan was drawn up, following the requirements established by the ISO 9001:2008 standard. It defined the scope of the standard, defining, preparing and transcribing the various activities of our Department. Four training sessions were carried out. A total of nine general and two specific procedures were documented in which all the activities performed in our Department were included. Personnel records of each worker were created, including their profiles and training plan. A record of the equipment and service providers was created, as well as issues with the latter. Satisfaction surveys were obtained from external (patients) and internal customers (faculty applicants). Targets for improvement and activity markers were established. Two audits were performed to complete the process, one internal and one external. The Department was accredited in April 2010. The quality accreditation process is a tool that requires reflection on how we do things and how they can be improved. It makes it possible to measure what we do, to analyze and introduce improvement measures, and therefore, to achieve a higher level of quality in the service we provide our customers. The involvement of the Department workers with a commitment to team performance was essential. Copyright © 2011 Elsevier España, S.L. and SEMNIM. All rights reserved.

[Spanish doctoral theses in emergency medicine (1978-2013)].

Science.gov (United States)

Fernández-Guerrero, Inés María

2015-01-01

To quantitatively analyze the production of Spanish doctoral theses in emergency medicine. Quantitative synthesis of productivity indicators for 214 doctoral theses in emergency medicine found in the database (TESEO) for Spanish universities from 1978 to 2013. We processed the data in 3 ways as follows: compilation of descriptive statistics, regression analysis (correlation coefficients of determination), and modeling of linear trend (time-series analysis). Most of the thesis supervisors (84.1%) only oversaw a single project. No major supervisor of 10 or more theses was identified. Analysis of cosupervision indicated there were 1.6 supervisors per thesis. The theses were defended in 67 departments (both general and specialist departments) because no emergency medicine departments had been established. The most productive universities were 2 large ones (Universitat de Barcelona and Universidad Complutense de Madrid) and 3 medium-sized ones (Universidad de Granada, Universitat Autónoma de Barcelona, and Universidad de La Laguna). Productivity over time analyzed as the trend for 2-year periods in the time-series was expressed as a polynomial function with a correlation coefficient of determination of R2 = 0.80. Spanish doctoral research in emergency medicine has grown markedly. Work has been done in various university departments in different disciplines and specialties. The findings confirm that emergency medicine is a disciplinary field.

The liquidation of liquid radioactive waste on nuclear medicine departments

International Nuclear Information System (INIS)

Fueriova, A.

1995-01-01

The most serious problems for Clinic of Nuclear Medicine of National Oncological Institute, Bratislava (CNM) is the localization of CNM in the downtown, inside the hospital area with the dilution water deficit. This department is the only one in Slovak Republic performing therapeutical applications. To be able to perform the necessary amount of therapies and also to introduce a new therapeutical methods, in 1992-1994 the old liquidation waste disposal station (LWDS) was reconstructed with the aim to satisfy the newest requirements of radiation hygiene. LWDS is the 5-floor object partly underground which satisfied the requirements for liquidation of radioactive liquid waste from diagnostic procedures(annually 5000 patients) and also from 200 therapeutical applications annually (15 beds, 720 GBq iodine-131). The capacity of LWDS is able to store about 90 m 3 liquid radioactive waste. Part of the underground spaces are used for the storage of solid radioactive trash. The liquid waste from CNM is collected through isolated metal sewage system to the storage with continuous observation of water specific activity. According to the activity, the liquid waste is placed to the 5 decay storages with the volume about 15 m 3 . The six one serves for the case of technical accident. When the activity declines, the liquid waste is diluted with non active medical trash to the level which is acceptable by low about radiation hygiene protection. The storage walls are made from barium-concrete 25-50 cm thick which is enough for sufficient protection of operation staff and also for walking around persons. Double-layer high quality chemical material prevents the water leak and diffusion of radionuclides into the concrete. Technology consists of cast-iron drains, powerful slush pumps, operation valves, regulation technology from dosimetric system for continuous monitoring of specific activity, for managing system with powerful industrial computer

The liquidation of liquid radioactive waste on nuclear medicine departments

Energy Technology Data Exchange (ETDEWEB)

Fueriova, A [National Oncological Institue, Bratislava (Slovakia). Hospital St. Elis, Clinic of Nuclear Medicine

1996-12-31

The most serious problems for Clinic of Nuclear Medicine of National Oncological Institute, Bratislava (CNM) is the localization of CNM in the downtown, inside the hospital area with the dilution water deficit. This department is the only one in Slovak Republic performing therapeutical applications. To be able to perform the necessary amount of therapies and also to introduce a new therapeutical methods, in 1992-1994 the old liquidation waste disposal station (LWDS) was reconstructed with the aim to satisfy the newest requirements of radiation hygiene. LWDS is the 5-floor object partly underground which satisfied the requirements for liquidation of radioactive liquid waste from diagnostic procedures(annually 5000 patients) and also from 200 therapeutical applications annually (15 beds, 720 GBq iodine-131). The capacity of LWDS is able to store about 90 m{sup 3} liquid radioactive waste. Part of the underground spaces are used for the storage of solid radioactive trash. The liquid waste from CNM is collected through isolated metal sewage system to the storage with continuous observation of water specific activity. According to the activity, the liquid waste is placed to the 5 decay storages with the volume about 15 m{sup 3}. The six one serves for the case of technical accident. When the activity declines, the liquid waste is diluted with non active medical trash to the level which is acceptable by low about radiation hygiene protection. The storage walls are made from barium-concrete 25-50 cm thick which is enough for sufficient protection of operation staff and also for walking around persons. Double-layer high quality chemical material prevents the water leak and diffusion of radionuclides into the concrete. Technology consists of cast-iron drains, powerful slush pumps, operation valves, regulation technology from dosimetric system for continuous monitoring of specific activity, for managing system with powerful industrial computer.

Links between nuclear medicine and radiopharmacy; Structuration des liens entre medecine nucleaire et radiopharmacie

Energy Technology Data Exchange (ETDEWEB)

Pelegrin, M. [Inserm, U896, CRLC Val-d' Aurelle-Paul-Lamarque, institut de recherche en cancerologie de Montpellier (IRCM), universite Montpellier 1, 34 - Montpellier (France); Francois-Joubert, A. [Service de medecine nucleaire, centre hospitalier de Chambery, 73 - Chambery (France); Chassel, M.L. [Radiopharmacie, service de pharmacie, centre hospitalier de Chambery, 73 - Chambrry (France); Desruet, M.D. [Service de radiopharmacie et service pharmaceutique, clinique universitaire de medecine nucleaire, CHU de Grenoble, 38 - Grenoble (France); Bolot, C. [Service de radiopharmacie, service pharmaceutique, centre de medecine nucleaire, groupement hospitalier Est, 69 - Bron (France); Lao, S. [Service de radiopharmacie, medecine nucleaire, hopital de l' Archet, 06 - Nice (France)

2010-11-15

Radiopharmaceuticals are nowadays under the responsibility of the radio-pharmacist because of their medicinal product status. Radiopharmacy belongs to the hospital pharmacy department, nevertheless, interactions with nuclear medicine department are important: rooms are included or located near nuclear medicine departments in order to respect radiation protection rules, more over staff, a part of the material and some activities are shared between the two departments. Consequently, it seems essential to formalize links between the radiopharmacy and the nuclear medicine department, setting the goals to avoid conflicts and to ensure patients' security. Modalities chosen for this formalization will depend on the establishment's organization. (authors)

Fundamentals of nuclear medicine

Energy Technology Data Exchange (ETDEWEB)

Alazraki, N.P.; Mishkin, F.S.

1984-01-01

This guidebook for clinical nuclear medicine is written as a description of how nuclear medicine procedures should be used by clinicians in evaluating their patients. It is designed to assist medical students and physicians in becoming acquainted with nuclear medicine techniques for detecting and evaluating most common disorders. The material provides an introduction to, not a textbook of, nuclear medicine. Each chapter is devoted to a particular organ system or topic relevant to the risks and benefits involved in nuclear medicine studies. The emphasis is on presenting the rationales for ordering the various clinical imaging procedures performed in most nuclear medicine departments. Where appropriate, alternative imaging modalities including ultrasound, computed tomography imaging, and radiographic special procedures are discussed. Comparative data between nuclear medicine imaging and other modalities are presented to help guide the practicing clinician in the selection of the most appropriate procedure for a given problem.

[Development and status of intensive care medicine in internal medicine at the Karl Marx University in Leipzig].

Science.gov (United States)

Engelmann, L; Schneider, D

1989-01-15

Issuing from the accomplishments of Köhler for the development of the intensive medicine in internal medicine-in 1964 he performed the first long-term respiration at the then Medical Clinic of the Karl Marx University, in 1969 he institutionalized the young subdiscipline at the clinic, in 1978 he founded the department for intensive medicine and is at work by his decisions concerning the development of young scientists, by the handbook "Intensive Medicine. Internal Medicine and Adjacent Subjects" as well as a member of the presidium of the GDR Society for Internal Medicine for the development of the internal intensive medicine-a description of the development of the department, its achievements and problems is given. The promotion of the intensive medicine by Köhler results, as we think, also from the comprehension that it has the duty to perform a function integrating the subdisciplines, which the modern internal medicine oriented to organs and systems threatens to lose, which, however, makes its self-apprehension, which the patient wishes and the teaching is demanding. From this and from the charge for a highly specialized care of patients who life-threateningly fell ill with internal diseases as well as from the duty to create a scientific forerunning results the stringent necessity of the development of the non-operative, in reality internal intensive medicine in the clinics for internal medicine of the county hospitals and university institutions as well as the greater identification of the internist with the subdiscipline in the district hospitals dealing with multidisciplinary intensive medicine.

Erasmus exchange in the field of family medicine in Slovenia.

Science.gov (United States)

Rotar-Pavlič, Danica

2012-01-01

The purpose of this paper is to analyze the Erasmus exchange of students at the University of Ljubljana, Department of family medicine in the period from 2005 to 2010. The beginnings of an Erasmus exchange in the field of family medicine in Europe are described. Ljubljana Medical School has currently 60 bilateral agreements with universities or medical faculties in the EU and EFTA countries. We collected data of all students who come from the foreign faculties to the Department of family medicine and those from Slovenia who went to study abroad. In addition to basic descriptive statistics, we used the elements of qualitative analysis, where we reviewed the reports of the Slovenian Erasmus students, who went on exchange in the field of family medicine. Department of family medicine cooperated with 14 foreign medical schools since 2005. 42 Slovenian students went on academic exchange in the field of family medicine. 21 foreign students came to Department of family medicine in Ljubljana. Female students were more frequent in exchange compared with male students. The largest proportion of students went abroad in 2009. Most foreign students visited Department of Family medicine in Ljubljana in 2011. Reports of students show that they learned a lot. Students were able to compare the organization of health care in a foreign country and Slovenian health care system. Erasmus exchange has proven to be an important addition to the existing educational system. Students are acquainted with the progress of health care in Europe in this way. They are able to compare the benefits and disadvantages of foreign health care systems with home health care organization. Copyright 2012 by Academy of Sciences and Arts of Bosnia and Herzegovina.

Code of practice for radiation protection in nuclear medicine

International Nuclear Information System (INIS)

Hamed, M. I.

2010-05-01

In aim of this study was to develop a draft for a new code practice for radiation protection in nuclear medicine that meets the current relevant international recommendation. The draft includes the following main fields: methods of radiation protection for workers, patients and public. Also, the principles of safe design of nuclear medicine departments, quality assurance program, proper manipulation of radiation sources including radioactive waste and emergency preparedness and response. The practical part of this study includes inspections of three nuclear medicine departments available in Sudan so as to assess the degree of compliance of those departments with what is stated in this code. The inspection missions have been conducted using a checklist that addresses all items that may affect radiation raincoat issues in addition to per formin area radiation monitoring around the installation of the radioactive sources. The results of this revealed that most of the departments do not have effective radiation protection program which in turn could lead to unnecessary exposure to patients, public and workers. Finally, some recommendations are given that - if implemented - could improve the status of radiation protection in nuclear medicine department. (Author)

The main rules regarding the management of solid waste and liquid effluent contaminated during use at nuclear medicine departments; Les principales regles de gestion des dechets solides et des effluents liquides contamines dans les services de medecine nucleaire

Energy Technology Data Exchange (ETDEWEB)

Boudouin, E. [Autorite de Surete Nucleaire, Direction des rayonnements ionisants et de la sante, 75 - Paris (France)

2011-02-15

This article describes the key requirements applicable to the management of contaminated medical waste and effluent from hospitals and health care centres, and more especially from nuclear medicine departments that use radionuclides for the purposes of diagnosis (in vivo or in vitro) or in patient treatment. It also presents the key management regulations, making a distinction between contaminated solid waste and contaminated liquid waste from such nuclear medicine departments. (author)

The revolving door syndrome in internal medicine: a study on 11,846 subjects discharged from all Internal Medicine Departments of Tuscany with diagnosis of heart failure and pneumonia

Directory of Open Access Journals (Sweden)

Matteo Tellini

2015-05-01

Full Text Available Rehospitalization is the return of a patient to a surgical or medical department within 30 days from discharge. We have limited information on the frequency and patterns of rehospitalization in Italy. Our purpose is to describe this phenomenon in Tuscany. We analyzed regional hospital discharge abstract data in Tuscany 2012, to describe 30-day all cause readmissions. We studied patients aged 18 or more (11,846 discharged with diagnoses of heart failure and pneumonia from Internal Medicine Departments. Relationships between 30-day readmission rates, demographic and clinical characteristics have been analyzed. 18% and 15% of subjects respectively discharged with diagnosis of heart failure and pneumonia were readmitted within 30 days. Risk factors significantly related to readmissions were longer length of stay, increasing number of different medications taken during the year preceding hospitalization and greater number of hospitalizations during the semester preceding admission. From the analysis of risk factors we found that frailty and complexity of patients (identified by long hospitalization stays, high number of drugs and previous admissions are the most important factors for unplanned readmissions.

Check-up and follow-up of papillary and follicular thyroid carcinoma in the department of nuclear medicine at Ibn Sina hospital Rabat

International Nuclear Information System (INIS)

Ben Rais Aouad, N.; Ghfir, I.; Guerrouj, H.; Fellah, S.; Rahali, J.; Ksyar, R.; Missoum, F.; Bssis, A.; Azrak, S.

2009-01-01

In the department of nuclear medicine at Ibn Sina university hospital. Thyroid carcinoma follow-up strategy has been modified and includes cervical ultrasonography and thyroglobulin measurement. The role of radio-iodine scanning in the management of differentiated thyroid carcinoma is decreasing. Papillary and follicular carcinoma have good prognosis but late metastases exist and can lead to death. A lifelong follow-up is therefore mandatory. The main goal of follow-up is to detect earlier persistent or recurrent disease. (authors)

Images in medicine

African Journals Online (AJOL)

abp

2016-04-15

Apr 15, 2016 ... 1Department of Oral Medicine and Radiology MNR Dental College and Hospital, ... A 38 year old male patient presented to a radiology center for cone beam computed tomography (CBCT) and the working maxillofacial.

Nuclear Medicine in Turkey

International Nuclear Information System (INIS)

Durak, H.

2001-01-01

Nuclear Medicine is a medical specialty that uses radionuclides for the diagnosis and treatment of diseases and it is one of the most important peaceful applications of nuclear sciences. Nuclear Medicine has a short history both in Turkey and in the world. The first use of I-131 for the treatment of thyrotoxicosis in Turkey was in 1958 at the Istanbul University Cerrahpasa Medical School. In 1962, Radiobiological Institute in Ankara University Medical School was established equipped with well-type counters, radiometers, scalers, external counters and a rectilinear scanner. In 1965, multi-probe external detection systems, color dot scanners and in 1967, anger scintillation camera had arrived. In 1962, wet lab procedures and organ scanning, in 1965 color dot scanning, dynamic studies (blood flow - renograms) and in 1967 analogue scintillation camera and dynamic camera studies have started. In 1974, nuclear medicine was established as independent medical specialty. Nuclear medicine departments have started to get established in 1978. In 1974, The Turkish Society of Nuclear Medicine (TSNM) was established with 10 members. The first president of TSNM was Prof. Dr. Yavuz Renda. Now, in the year 2000, TSNM has 349 members. Turkish Society of Nuclear Medicine is a member of European Association of Nuclear Medicine (EANM), World Federation of Nuclear Medicine and Biology (WFNMB) and WFNMB Asia-Oceania. Since 1974, TSNM has organized 13 national Nuclear Medicine congresses, 4 international Nuclear Oncology congresses and 13 nuclear medicine symposiums. In 1-5 October 2000, 'The VII th Asia and Oceania Congress of Nuclear Medicine and Biology' was held in Istanbul, Turkey. Since 1992, Turkish Journal of Nuclear Medicine is published quarterly and it is the official publication of TSNM. There are a total of 112 Nuclear Medicine centers in Turkey. There are 146 gamma cameras. (52 Siemens, 35 GE, 16 Elscint, 14 Toshiba, 10 Sopha, 12 MIE, 8 Philips, 9 Others) Two cyclotrons are

Philanthropic endowments in general internal medicine.

Science.gov (United States)

Murden, R A; Lamb, J F

1999-04-01

We performed two surveys to uncover the status of philanthropic endowments in general internal medicine divisions. The initial survey of U.S. medical school departments of medicine found that only 14.1% of general internal medicine divisions hold endowments versus 21.9% of all other divisions, and that endowment sources for general medicine are atypical. The second survey of successfully endowed divisions found that sympathetic administrators and active pursuit of endowments were associated with endowment success. Aggressive pursuit of endowments, publicizing successes of general medicine, and consideration of endowment sources noted in this study are recommended to improve philanthropic contributions to general internal medicine.

Ambient radiation dose reduction within a newly remodeled Nuclear Medicine Department

International Nuclear Information System (INIS)

Lai, Y.C.; Chen, Y.W.; Huang, Y.F.

2008-01-01

Full text: Ambient radiation levels at the patient waiting areas have been greatly reduced after remodeling of our Nuclear Medicine Department (NMD) based on the ALARA consideration. Complete ambient radiation monitoring of our NMD before remodeling had been characterized and published earlier by the same authors elsewhere. The NMD outpatients, with an initial dose of up to 740 MBq (20 mCi) per case, may wait around and incidentally congest in one place that could cause an unexpected higher exposure level in public access areas. In this new surveillance study after remodeling, the ambient radiation time-profile, peak dose rates and daily doses have been re-evaluated by using high sensitivity, digital survey dosimeters. As a preliminary result, with our newly improved facility in operation, we have demonstrated the NMD waiting room average daily dose has dropped from about 3.0 μSv to 0.42 μSv during most of busy days in comparison. The hourly peak dose rate detected in patient waiting areas has also reduced to a factor of more than two, from maximum dose rate of 40.4 μSv/h to 15.4 μSv/h, during one worst case scenario. The great reduction of the environment dose was achieved mainly by using larger room space with thicker lead wall, from previous 2-mm to new 5-mm in lead thickness, and by increasing patient waiting rooms/areas with less chairs available in each seating location. Other NMD administrative control measure of our dose reduction program has also been emphasized in better patient routing, scheduling and less waiting time for the diagnostic patients. (author)

Radiation exposure of workers in nuclear medicine

International Nuclear Information System (INIS)

Bujnova, A.

2008-01-01

Nuclear medicine is an interdisciplinary department that deals with diagnosis and therapy using open sources. Therefore workers in nuclear medicine are in daily contact with ionizing radiation and thus it is essential to monitor a radiation load. Each work must therefore carry out monitoring of workers. It monitors compliance with the radiation limits set by law, allows an early detection of deviations from normal operation and to demonstrate whether the radiation protection at the workplace is optimized. This work describes the principles of monitoring of workers in nuclear medicine and monitoring methods for personal dosimetry. In the next section the author specifically deals with personal dosimetry at the Department of Nuclear Medicine St. Elizabeth Cancer Institute, Bratislava (KNM-Ba-OUSA). The main part of the work is to evaluate the results of a one-year monitoring of radiation workers KNM-Ba-OUSA. (author)

Marketing herbal medicines.

Science.gov (United States)

Lazarus, M

1999-01-01

HIV-positive support groups, together with hospital pharmacists in Thailand are fighting the high cost and lack of access to pharmaceuticals by producing and distributing herbal medicines. In Theung district, Chiang Rai province, members of the local support group for people with HIV produce their own, low-cost, herbal medicines. Although the herbal medicines they produce do not provide a cure for HIV/AIDS, they do offer relief for some of the symptoms of opportunistic infections. The herbs are prepared by the group members under the supervision of the pharmacy department at the district hospital. Local people judge their effectiveness by hearing testimonials from people who have witnessed improvement in symptoms. In response to the popularity and effectiveness of herbal medicines, the Ministry of Public Health has approved plans to sell products derived from local herbs in the pharmacies of government hospitals.

[Introduction of a quality management system compliant with DIN EN 9001:2000 in a university department of nuclear medicine].

Science.gov (United States)

Jansen-Schmidt, V; Paschen, U; Kröger, S; Bohuslavizki, K H; Clausen, M

2001-12-01

In 1995, the management of the University Clinic Hamburg-Eppendorf proposed to establish a total quality assurance (QA) system. A revised QA-system has been introduced stepwise in the department of nuclear medicine since 1997, and certification was achieved in accordance with DIN EN ISO 9001:2000 on February 14, 2001. The QA-handbook is divided into two parts. The first part contains operational (diagnostic and therapeutic) procedures in so-called standard operating procedures (SOP). They describe the indication of procedures as well as the competences and time necessary in a standardized manner. Up to now, more than 70 SOPs have been written as a collaborative approach between technicians and physicians during daily clinical routine after analysing and discussing the procedures. Thus, the results were more clearly defined processes and more satisfied employees. The second part consists of general rules and directions concerning the security of work and equipment as well as radiation protection tasks, hygiene etc. as it is required by the law. This part was written predominantly by the management of the department of nuclear-medicine and the QA-coordinator. Detailed information for the patients, documentation of the work-flows as well as the medical report was adopted to the QM-system. Although in the introduction phase of a QA-system a vast amount of time is necessary, some months later a surplus for the clinical workday will become available. The well defined relations of competences and procedures will result in a gain of time, a reduction of costs and a help to ensure the legal demands. Last but not least, the QA-system simply helps to build up confidence and acceptance both by the patients and the referring physicians.

O silêncio dos inocentes: por um estudo narrativo da prática médica

Directory of Open Access Journals (Sweden)

Fabiana Buitor Carelli

Full Text Available Embora absolutamente pertinente, a relação entre texto e medicina ainda é pouco pesquisada no meio acadêmico brasileiro. Não obstante, é fato que toda prática médica é permeada de narrativas, quer sejam as dos pacientes, que contam aos médicos as histórias de suas doenças, quer as dos médicos, que recontam essas histórias de acordo com modelos científicos aprendidos e com sua experiência clínica. Inspirado na Narrative-Based Medicine, campo teórico já consolidado no meio anglófono, e em algumas teorias provenientes dos Estudos Literários e das Ciências Sociais, este artigo busca discutir, introdutoriamente, algumas possibilidades para a consolidação de um estudo interdisciplinar das narrativas relacionadas à área médica no âmbito acadêmico brasileiro.

O silêncio dos inocentes: por um estudo narrativo da prática médica

Directory of Open Access Journals (Sweden)

Fabiana Buitor Carelli

2013-09-01

Full Text Available Embora absolutamente pertinente, a relação entre texto e medicina ainda é pouco pesquisada no meio acadêmico brasileiro. Não obstante, é fato que toda prática médica é permeada de narrativas, quer sejam as dos pacientes, que contam aos médicos as histórias de suas doenças, quer as dos médicos, que recontam essas histórias de acordo com modelos científicos aprendidos e com sua experiência clínica. Inspirado na Narrative-Based Medicine, campo teórico já consolidado no meio anglófono, e em algumas teorias provenientes dos Estudos Literários e das Ciências Sociais, este artigo busca discutir, introdutoriamente, algumas possibilidades para a consolidação de um estudo interdisciplinar das narrativas relacionadas à área médica no âmbito acadêmico brasileiro.

[Common household traditional Chinese medicines].

Science.gov (United States)

Zhang, Shu-Yuan; Li, Mei; Fu, Dan; Liu, Yang; Wang, Hui; Tan, Wei

2016-02-01

With the enhancement in the awareness of self-diagnosis among residents, it's very common for each family to prepare common medicines for unexpected needs. Meanwhile, with the popularization of the traditional Chinese medicine knowledge, the proportion of common traditional Chinese medicines prepared at residents' families is increasingly higher than western medicines year by year. To make it clear, both pre-research and closed questionnaire research were adopted for residents in Chaoyang District, Beijing, excluding residents with a medical background. Based on the results of data, a analysis was made to define the role and influence on the quality of life of residents and give suggestions for relevant departments to improve the traditional Chinese medicine popularization and promote the traditional Chinese medicine market. Copyright© by the Chinese Pharmaceutical Association.

Technetium{sup 99m} shortage: Practical solutions to manage lack of the radio-isotope in nuclear medicine departments; Penurie de technetium{sup 99m}: des pistes pratiques pour gerer les periodes de crise dans les services de medecine nucleaire

Energy Technology Data Exchange (ETDEWEB)

Biechlin-Chassel, M.L. [Radiopharmacie, service de pharmacie, centre hospitalier de Chambery, 73 - Chambery (France); Francois-Joubert, A. [Service de medecine nucleaire, centre hospitalier de Chambery, 73 - Chambery (France); Bolot, C. [Service de radiopharmacie, service pharmaceutique, centre de medecine nucleaire, groupement hospitalier Est, 69 - Bron (France); Desruet, M.D. [Radiopharmacie, service de medecine nucleaire, CHU de Grenoble, 38 - Grenoble (France); Bourrel, F. [Services de pharmacie et medecine nucleaire, centre hospitalier d' Avignon, 84 - Avignon (France); Pelegrin, M. [Institut de recherche en cancerologie (IRCM), 34 - Montpellier (France); Inserm U896, universite Montpellier 1, 34 - Montpellier (France); CRLC Val d' Aurelle Paul-Lamarque, 34 - Montpellier (France); Couret, I. [Service de medecine nucleaire, hopital Lapeyronie, 34 - Montpellier (France); Lao, S. [Service de medecine nucleaire, CHU Hopital de l' Archet, 06 - Nice (France); Quelven, I. [Faculte de medecine, 87 - Limoges (France)

2010-11-15

Technetium{sup 99m} ({sup 99m}Tc) shortage crisis regularly affect nuclear medicine activity and oblige the community to find solutions in order to perform most of the prescribed exams and avoid systematic substitutions by other non-nuclear medicine techniques. Firstly, some practical solutions can be set up in radiopharmacy departments such as using more than two generators together, realizing fractionated elutions, preparing radiopharmaceuticals with elutions providing from different generators.. Then, it could be interesting to have a reflexion in nuclear medicine departments to convene patients the days when {sup 99m}Tc supply is sufficient, to pool some exams or to make substitutions with more available isotopes. (authors)

Coordination compounds in nuclear medicine

International Nuclear Information System (INIS)

Jurisson, S.; Berning, D.; Wei Jia; Dangshe Ma

1993-01-01

Radiopharmaceuticals, drugs containing a radionuclide, are used routinely in nuclear medicine departments for the diagnosis of disease and are under investigation for use in the treatment of disease. Nuclear medicine takes advantage of both the nuclear properties of the radionuclide and the pharmacological properties of the radiopharmaceutical. Herein lies the real strength of nuclear medicine, the ability to monitor biochemical and physiological functions in vivo. This review discusses the coordination chemistry that forms the basis for nuclear medicine applications of the FDA-approved radiopharmaceuticals that are in clinical use, and of the most promising diagnostic and therapeutic radiopharmaceuticals that are in various stages of development. 232 refs

Analysis of Prescriptions of Alpha-Blockers and Phosphodiesterase 5 Inhibitors from the Urology Department and Other Departments

Directory of Open Access Journals (Sweden)

Dong Hyuk Kang

2011-12-01

Full Text Available PurposeWe analyzed the prescriptions of alpha-blockers and phosphodiesterase 5 inhibitors (PDE5Is in the urology department as well as in other departments of the general hospital.MethodsWe investigated the frequency of prescription of alpha-blockers and PDE5Is from 3 general hospitals from January 1, 2007 to December 31, 2009. For alpha-blockers, data were collected from patients to whom alpha-blockers were prescribed from among patients recorded as having benign prostatic hyperplasia according to the 5th Korean Standard Classification of Diseases. For PDE5Is, data were collected from patients to whom PDE5Is were prescribed by the urology department and by other departments. Alpha-blockers were classified into tamsulosin, alfuzosin, doxazosin, and terazosin, whereas PDE5Is were classified into sildenafil, tadalafil, vardenafil, udenafil, and mirodenafil.ResultsAlpha-blockers were prescribed to 11,436 patients in total over 3 years, and the total frequency of prescriptions was 68,565. Among other departments, the nephrology department had the highest frequency of prescription of 3,225 (4.7%, followed by the cardiology (3,101, 4.5%, neurology (2,576, 3.8%, endocrinology (2,400, 3.5%, pulmonology (1,102, 1.6%, and family medicine (915, 1.3% departments in order. PDE5Is were prescribed to 2,854 patients in total over 3 years, and the total frequency of prescriptions was 10,558. The prescription frequency from the urology department was 4,900 (46.4%. Among other departments, the endocrinology department showed the highest prescription frequency of 3,488 (33.0%, followed by the neurology (542, 5.1%, cardiology (467, 4.4%, and family medicine (407, 3.9% departments in order.ConclusionsA high percentage of prescriptions of alpha-blockers and PDE5Is were from other departments. For more specialized medical care by urologists is required in the treatment of lower urinary tract symptoms and erectile dysfunction.

Occupational exposure of nuclear medicine personnel

International Nuclear Information System (INIS)

Roessler, M.

1982-01-01

The results are given of measurements of the radiation burden of personnel in departments of nuclear medicine in the years 1979 to 1981 using film dosemeters and ring thermoluminescence dosemeters evaluated by the national personnel dosemeter service. The relations are examined of the exposure of hands and the preparation of radiopharmaceuticals and especially their use for examinations. Certain organizational measures are indicated for reducina radiation burden in a laboratory for the preparation of radiopharmaceuticals. The results of measurements and evaluations of radiation burden of personnel of nuclear medicine departments are confronted with conclusions published in the literature. (author)

Graduate Medical Education Funding and Curriculum in Physical Medicine and Rehabilitation: A Survey of Physical Medicine and Rehabilitation Department Chairs.

Science.gov (United States)

Perret, Danielle; Knowlton, Tiffany; Worsowicz, Gregory

2018-03-01

This national survey highlights graduate medical education funding sources for physical medicine and rehabilitation (PM&R) residency programs as well as perceived funding stability, alignment of the current funding and educational model, the need of further education in postacute care settings, and the practice of contemporary PM&R graduates as perceived by PM&R department/division chairs. Approximately half of the reported PM&R residency positions seem to be funded by Centers of Medicare and Medicaid Services; more than 40% of PM&R chairs believe that their residency program is undersized and nearly a quarter feel at risk for losing positions. A total of 30% of respondents report PM&R resident experiences in home health, 15% in long-term acute care, and 52.5% in a skilled nursing facility/subacute rehabilitation facility. In programs that do not offer these experiences, most chairs feel that this training should be included. In addition, study results suggest that most PM&R graduates work in an outpatient setting. Based on the results that chairs strongly feel the need for resident education in postacute care settings and that most graduates go on to practice in outpatient settings, there is a potential discordance for our current Centers of Medicare and Medicaid Services graduate medical education funding model being linked to the acute care setting.

The development of nuclear medicine in Slovenia and Ljubljana; half a century of nuclear medicine in Slovenia

International Nuclear Information System (INIS)

Slavec, Zvonka Zupanic; Gaberscek, Simona; Slavec, Ksenija

2012-01-01

Nuclear medicine began to be developed in the USA after 1938 when radionuclides were introduced into medicine and in Europe after radionuclides began to be produced at the Harwell reactor (England, 1947). Slovenia began its first investigations in the 1950s. This article describes the development of nuclear medicine in Slovenia and Ljubljana. The first nuclear medicine interventions were performed in Slovenia at the Internal Clinic in Ljubljana in the period 1954–1959. In 1954, Dr Jože Satler started using radioactive iodine for thyroid investigations. In the same year, Dr Bojan Varl, who is considered the pioneer of nuclear medicine in Slovenia, began systematically introducing nuclear medicine. The first radioisotope laboratories were established in January 1960 at the Institute of Oncology and at the Internal Clinic. Under the direction of Dr. Varl, the laboratory at the Internal Clinic developed gradually and in 1973 became the Clinic for Nuclear Medicine with departments for in vivo and in vitro diagnostics and for the treatment of inpatients and outpatients at the thyroid department. The Clinic for Nuclear Medicine became a teaching unit of the Medical Faculty and developed its own post-graduate programme – the first student enrolled in 1972. In the 1960s, radioisotope laboratories opened in the general hospitals of Slovenj Gradec and Celje, and in the 1970s also in Maribor, Izola and Šempeter pri Novi Gorici. Nowadays, nuclear medicine units are modernly equipped and the staff is trained in morphological, functional and laboratory diagnostics in clinical medicine. They also work on the treatment of cancer, increased thyroid function and other diseases

Czechoslovak nuclear medicine, development and present state

Energy Technology Data Exchange (ETDEWEB)

Hupka, S [Ustav Klinickej Onkologie, Bratislava (Czechoslovakia)

1981-01-01

The growth is described of nuclear medicine departments and units in Czechoslovakia in the past 25 years of the existence of the Czechoslovak Society for Nuclear Medicine and Radiation Hygiene, the numbers of personnel and their qualifications. While only three nuclear medicine units were involved in the use of radioisotopes for diagnostic and therapeutic purposes in the 1950's, 29 specialized departments and 15 laboratories are now in existence with a staff of 299 medical doctors and other university graduates and 365 technicians and nurses. They operate all possible instruments, from simple detector devices via gamma cameras to computer tomographs. Briefly, the involvement of the Society is described in coordinated research programs, both with institutions in the country and with the other CMEA countries and IAEA.

Center for Neuroscience & Regenerative Medicine

Data.gov (United States)

Federal Laboratory Consortium — The Center for Neuroscience and Regenerative Medicine (CNRM) was established as a collaborative intramural federal program involving the U.S. Department of Defense...

The perceived organizational impact of the gender gap across a Canadian department of medicine and proposed strategies to combat it: a qualitative study.

Science.gov (United States)

Pattani, Reena; Marquez, Christine; Dinyarian, Camellia; Sharma, Malika; Bain, Julie; Moore, Julia E; Straus, Sharon E

2018-04-10

Despite the gender parity existing in medical schools for over three decades, women remain underrepresented in academic medical centers, particularly in senior ranks and in leadership roles. This has consequences for patient care, education, research, and workplace culture within healthcare organizations. This study was undertaken to explore the perspectives of faculty members at a single department of medicine on the impact of the existing gender gap on organizational effectiveness and workplace culture, and to identify systems-based strategies to mitigate the gap. The study took place at a large university department of medicine in Toronto, Canada, with six affiliated hospitals. In this qualitative study, semi-structured individual interviews were conducted between May and September 2016 with full-time faculty members who held clinical and university-based appointments. Transcripts of the interviews were analyzed using thematic analysis. Three authors independently reviewed the transcripts to determine a preliminary list of codes and establish a coding framework. A modified audit consensus coding approach was applied; a single analyst reviewed all the transcripts and a second analyst audited 20% of the transcripts in each round of coding. Following each round, inter-rater reliability was determined, discrepancies were resolved through discussion, and modifications were made as needed to the coding framework. The analysis revealed faculty members' perceptions of the gender gap, potential contributing factors, organizational impacts, and possible solutions to bridge the gap. Of the 43 full-time faculty members who participated in the survey (29 of whom self-identified as female), most participants were aware of the existing gender gap within academic medicine. Participants described social exclusion, reinforced stereotypes, and unprofessional behaviors as consequences of the gap on organizational effectiveness and culture. They suggested improvements in (1) the

OrdoCMN: a communication tool for nuclear medicine

International Nuclear Information System (INIS)

Lamy, P.; Bizollon, C.; Damien, J.; Itti, R.

1997-01-01

OrdoCMN is a computer software which offers an easy solution for the management of a nuclear medicine department. It has been developed using a data management tool: 4. Dimension. This network based software acts mainly as a communication tool between the various parts of the nuclear medicine department. It provides time saving and optimisation for the interdependent operations which are necessary when performing a scintigraphy study. In addition, it has all the functionalities which are needed to manage the data concerning a scintigraphy examination: study planing, patient files, radiopharmaceuticals prescription edition, labels and report printing, and radiopharmaceuticals management. Centered around the patient's file, it guaranties the confidentiality and security of the informations through several levels of security: passwords, data coding, etc. Since further evolution is specially easy, thanks to its modular structure, it may be adapted to the specific needs of any nuclear medicine department. (authors)

77 FR 38848 - Library of Medicine Notice of Meeting

Science.gov (United States)

2012-06-29

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Library of Medicine Notice... National Library of Medicine will be closed to the public in accordance with the provisions set forth in... potential titles to be indexed by the National Library of Medicine, the discussions, and the presence of...

Academic Medicine Meets Traditional African Healing

Science.gov (United States)

Lindow, Megan

2008-01-01

Cyril Naidoo, who directs the department of family medicine at the University of KwaZulu-Natal's Nelson R. Mandela School of Medicine, conducts workshops to traditional healers on how to help patients with AIDS and HIV. In Dr. Naidoo's workshop, the group discusses how to counsel patients about HIV and AIDS, how to refer them for testing, and then…

Evaluation and management of acute abdominal pain in the emergency department

Directory of Open Access Journals (Sweden)

Macaluso CR

2012-09-01

Full Text Available Christopher R Macaluso, Robert M McNamaraDepartment of Emergency Medicine, Temple University School of Medicine, Philadelphia, PA, USAAbstract: Evaluation of the emergency department patient with acute abdominal pain is sometimes difficult. Various factors can obscure the presentation, delaying or preventing the correct diagnosis, with subsequent adverse patient outcomes. Clinicians must consider multiple diagnoses, especially those life-threatening conditions that require timely intervention to limit morbidity and mortality. This article will review general information on abdominal pain and discuss the clinical approach by review of the history and the physical examination. Additionally, this article will discuss the approach to unstable patients with abdominal pain.Keywords: acute abdomen, emergency medicine, peritonitis

ECAT ART - a continuously rotating PET camera: performance characteristics, initial clinical studies, and installation considerations in a nuclear medicine department

International Nuclear Information System (INIS)

Bailey, D.L.; Young, H.; Bloomfield, P.M.; Meikle, S.R.; Glass, D.; Myers, M.J.; Spinks, T.J.; Watson, C.C.; Luk, P.; Peters, A.M.; Jones, T.

1997-01-01

Advances in image reconstruction techniques have permitted the development of a commercial, rotating, partial ring, fully 3D scanner, the ECAT ART. The system has less than one-half the number of bismuth germanate detectors compared with a full ring scanner with the equivalent field of view, resulting in reduced capital cost. The performance characteristics, implications for installation in a nuclear medicine department, and clinical utility of the scanner are presented in this report. The sensitivity (20 cm diameter x 20 cm long cylindrical phantom, no scatter correction) is 11400 cps.kBq -1 .ml -1 . This compares with 5800 and 40500 cps.kBq -1 .ml -1 in 2D and 3D respectively for the equivalent full ring scanner (ECAT EXACT). With an energy window of 350-650 keV the maximum noise equivalent count (NEC) rate was 27 kcps at a radioactivity concentration of ∝15 kBq .ml -1 in the cylinder. Spatial resolution is ∝6 mm full width at half maximum on axis degrading to just under 8 mm at a distance of 20 cm off axis. Installation and use within the nuclear medicine department does not appreciably increase background levels of radiation on gamma cameras in adjacent rooms and the dose rate to an operator in the same room is 2 μSv .h -1 for a typical fluorine-18 fluorodeoxyglucose ( 18 F-FDG) study with an initial injected activity of 370 MBq. The scanner has been used for clinical imaging with 18 F-FDG for neurological and oncological applications. Its novel use for imaging iron-52 transferrin for localising erythropoietic activity demonstrates its sensitivity and resolution advantages over a conventional dual-headed gamma camera. The ECAT ART provides a viable alternative to conventional full ring PET scanners without compromising the performance required for clinical PET imaging. (orig.). With 9 figs., 3 tabs

Violence against health workers in Family Medicine Centers

OpenAIRE

Al-Turki, Nouf; Afify, Ayman AM; AlAteeq, Mohammed

2016-01-01

Nouf Al-Turki,1 Ayman AM Afify,1 Mohammed AlAteeq2 1Family Medicine Department, Prince Sultan Military Medical City, 2Department of Family Medicine and PHC, King Abdul-Aziz Medical City, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia Background: Health care violence is a significant worldwide problem with negative consequences on both the safety and well-being of health care workers as well as workplace activities. Reports examining health care violence in Saudi Arabia are lim...

78 FR 36555 - National Library of Medicine; Notice of Meetings

Science.gov (United States)

2013-06-18

... performance, and competence of individual investigators. Place: National Library of Medicine, Building 38, 2nd... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Library of Medicine... evaluation of individual intramural programs and projects conducted by the NATIONAL LIBRARY OF MEDICINE...

Dose measurement received by the exposed occupationally personnel of the nuclear medicine department of the INCan

International Nuclear Information System (INIS)

Sanchez U, N. A.

2011-01-01

Personal dose equivalent (PDE) values were determined for occupational exposed workers (OEW) at the Nuclear Medicine Department (NMD) of Instituto Nacional de Cancerologia (INCan), Mexico, using TLD-100 thermoluminescent dosemeters. OEW at NMD, INCan make use of radiopharmaceuticals for diagnosis and treatment of diseases. Radionuclides associated to a pharmaceutical compound used at this Department are 131 I, 18 F, 67 Ga, 99m Tc, 111 In and 201 Tl with main gamma emission energies between 93 and 511 keV. Dosemeter calibration was performed at the metrology department of Instituto Nacional de Investigaciones Nucleares, Mexico. Every occupational worker used dark containers with three dosemeters which were replaced monthly for a total of 5 periods. Additionally, control dosemeters were also placed at a site free of radioactive sources in order to determine the background radiation. Results were adjusted to find PDE/day and estimating annual PDE values in the range between 2 mSv (background) and a maximum of 9 mSv. Two of the 16 members of the OEW receive high estimated annual doses (6-9 mSv), other 5 receive annual doses between 3 and 5 mSv, other 3 between 2.5 and 3 mSv, and the rest receive dose values consistent with background radiation. These values are dependent on their daily activities and it is clear that the maximum doses are received by those OEW who perform nursing duties and receive radiopharmaceuticals for daily use. All obtained values are well within the established annual OEW dose limit stated in the General Regulation of Radiological Protection, Mexico (50 mSv) as well as within the lower limit recommended by the International Commission on Radiation Protection, report no. 60 (20 mSv). Additionally, consistence was found between measured monthly values and those reported by the firm that performs the monthly service. These results verify the adequate compliance of the NMD at INCan, Mexico with the standards given by the national regulatory

Radiation protection on nuclear medicine services

International Nuclear Information System (INIS)

Anon

2000-01-01

Nuclear medicine is a sector of the medicine that studies and applies radionuclide in diagnosis and therapy. Nuclear medicine is a very specific area of the medicine, making use of non-sealed radioactive sources which are prescribed to the patient orally or are injected. Special procedures in radiation protection are required in nuclear medicine to manipulate these kind of sources and to produce technetium-99m through molybdenum generator. The present paper addresses the them radiation protection in a Nuclear Medicine Department (NMD), showing the main requirements of the CNEN- National Commission of Nuclear Energy and the Public Health. Radiation protection procedures adopted in assembling a NMD, as well the daily techniques for monitoring and for individual dosimetry are discussed. Past and present analyses in a level of radiation protection are presented. (author)

Estudos de atmosfera

Directory of Open Access Journals (Sweden)

Carlos Eduardo Riccioppo

2016-11-01

Full Text Available Joker e Estudos de balística possuíam formas distintas dos cadernos ou livros quando foram exibidos pela primeira vez, na mostra Dual Overdrive. De algum modo, o flagrante das imagens dos cartazes da campanha política parisiense e daquelas cusparadas sobre o asfalto era preservado no modo como eram mostrados os trabalhos, que repunham não apenas a orientação espacial dos objetos fotografados, mas, igualmente, sua escala: Joker apresentava-se na parede, em dimensões relativamente próximas às dos cartazes lambe-lambe que retratavam; e Estudos de balística, no chão da galeria, também com ampliação suficiente para que se tivesse a impressão de que se tratava de imagens “em tamanho real”.

The impact of the improvement in internal medicine consultation process on ED length of stay.

Science.gov (United States)

Shin, Sangheon; Lee, Soo Hoon; Kim, Dong Hoon; Kim, Seong Chun; Kim, Tae Yun; Kang, Changwoo; Jeong, Jin Hee; Lim, Daesung; Park, Yong Joo; Lee, Sang Bong

2018-04-01

Although consultations are essential for delivering safe, high-quality care to patients in emergency departments, they contribute to emergency department patient flow problems and overcrowding which is associated with several adverse outcomes, such as increases in patient mortality and poor quality care. This study aimed to investigate how time flow metrics including emergency department length of stay is influenced by changes to the internal medicine consultation policy. This study is a pre- and post-controlled interventional study. We attempted to improve the internal medicine consultation process to be more concise. After the intervention, only attending emergency physicians consult internal medicine chief residents, clinical fellows, or junior staff of each internal medicine subspecialty who were on duty when patients required special care or an admission to internal medicine. Emergency department length of stay of patients admitted to the department of internal medicine prior to and after the intervention decreased from 996.94min to 706.62min. The times from consultation order to admission order and admission order to emergency department departure prior to and after the intervention were decreased from 359.59min to 180.38min and from 481.89min to 362.37min, respectively. The inpatient mortality rates and Inpatient bed occupancy rates prior to and after the intervention were similar. The improvements in the internal medicine consultation process affected the flow time metrics. Therefore, more comprehensive and cooperative strategies need to be developed to reduce the time cycle metrics and overcrowding of all patients in the emergency department. Copyright © 2017 Elsevier Inc. All rights reserved.

Part-time careers in academic internal medicine: A report from the association of specialty professors part-time careers task force on behalf of the alliance for academic internal medicine

OpenAIRE

Linzer, M; Warde, C; Alexander, RW; DeMarco, DM; Haupt, A; Hicks, L; Kutner, J; Mangione, CM; Mechaber, H; Rentz, M; Riley, J; Schuster, B; Solomon, GD; Volberding, P; Ibrahim, T

2009-01-01

To establish guidelines for more effectively incorporating part-time faculty into departments of internal medicine, a task force was convened in early 2007 by the Association of Specialty Professors. The task force used informal surveys, current literature, and consensus building among members of the Alliance for Academic Internal Medicine to produce a consensus statement and a series of recommendations. The task force agreed that part-time faculty could enrich a department of medicine, enhan...

Experience with Nuclear Medicine Information System

Directory of Open Access Journals (Sweden)

Bilge Volkan-Salanci

2012-12-01

Full Text Available Objective: Radiology information system (RIS is basically evolved for the need of radiologists and ignores the vital steps needed for a proper work flow of Nuclear Medicine Department. Moreover, CT/MRI oriented classical PACS systems are far from satisfying Nuclear Physicians like storing dynamic data for reprocessing and quantitative analysis of colored images. Our purpose was to develop a workflow based Nuclear Medicine Information System (NMIS that fulfills the needs of Nuclear Medicine Department and its integration to hospital PACS system. Material and Methods: Workflow in NMIS uses HL7 (health level seven and steps include, patient scheduling and retrieving information from HIS (hospital information system, radiopharmacy, acquisition, digital reporting and approval of the reports using Nuclear Medicine specific diagnostic codes. Images and dynamic data from cameras of are sent to and retrieved from PACS system (Corttex© for reprocessing and quantitative analysis. Results: NMIS has additional functions to the RIS such as radiopharmaceutical management program which includes stock recording of both radioactive and non-radioactive substances, calculation of the radiopharmaceutical dose for individual patient according to body weight and maximum permissible activity, and calculation of radioactivity left per unit volume for each radionuclide according their half lives. Patient scheduling and gamma camera patient work list settings were arranged according to specific Nuclear Medicine procedures. Nuclear Medicine images and reports can be retrieved and viewed from HIS. Conclusion: NMIS provides functionality to standard RIS and PACS system according to the needs of Nuclear Medicine. (MIRT 2012;21:97-102

ESTUDOS ESTILÍSTICOS NO BRASIL

Directory of Open Access Journals (Sweden)

Carlos Eduardo Falcão Uchôa

2013-06-01

Full Text Available Este artigo objetiva mostrar os inícios e a progressão dos estudos estilísticos no Brasil. Após uma introdução sobre o surgimento, na Europa, da Estilística como disciplina de pesquisa no campo da linguagem, detém-se, sucessivamente, nas contribuições de filólogos, linguistas, teóricos da literatura e gramáticos para o estudo dos mais variados recursos estilísticos ocorrentes sobretudo em autores brasileiros.

Nuclear Medicine National Headquarter System

Data.gov (United States)

Department of Veterans Affairs — The Nuclear Medicine National HQ System database is a series of MS Excel spreadsheets and Access Database Tables by fiscal year. They consist of information from all...

Availability of oncological nuclear medicine in the regions of Slovakia

International Nuclear Information System (INIS)

Lepej, J.; Kaliska, L.

2004-01-01

Full text: Nuclear medicine (NM) imaging technology, alone and in combination with other imaging modalities, provides clinically significant and useful information in the staging and treatment of the oncological diseases. The main objective of our study was to find out and present the situation vis-a-vis nuclear medicine facilities in the Central European country that soon becomes the new member of EU. For the purposes statistical data of WHO, Slovak Republic (SR) and nuclear medicine department (NMD) were evaluated for the period 1995-2001. Comparison with Czech Republic (CR) was done because of almost similar occurrence of the malignant diseases in these two republics that were a one country till separation in 1993. First nuclear medicine department in Czechoslovakia was established about 55 years ago. Comparing to CR the expenditures on health care per capita in SR is only 67% of CR. The number of gamma cameras, physicians and number of investigations are far from good standard of CR. The number NM departments are significantly low and growth of only 29% compared to CR is alarming. The one main reason is inadequate financial support to the health care and high debts of hospitals running nuclear medicine facilities. Providing radiology departments with new CT and MRI scanners is another reason of less nuclear medicine facilities. During the last five years, though the number of gamma cameras increased by 10%, but the number of investigations did not rise accordingly. Because of bad management of health care services in Slovakia, the latest facilities availability is greatly delayed. However, the exception is the installation of a new PET scanner in 2001. Of late, sentinel lymph node detection was started only with the help of IAEA. Data shows that most of the nuclear medicine centers are around the state capital. It is imperative to have sufficient diagnostic and therapeutic facilities in each region so as to make these available to patients living away from the

Designing a clinical dashboard to fill information gaps in the emergency department.

Science.gov (United States)

Swartz, Jordan L; Cimino, James J; Fred, Matthew R; Green, Robert A; Vawdrey, David K

2014-01-01

Data fragmentation within electronic health records causes gaps in the information readily available to clinicians. We investigated the information needs of emergency medicine clinicians in order to design an electronic dashboard to fill information gaps in the emergency department. An online survey was distributed to all emergency medicine physicians at a large, urban academic medical center. The survey response rate was 48% (52/109). The clinical information items reported to be most helpful while caring for patients in the emergency department were vital signs, electrocardiogram (ECG) reports, previous discharge summaries, and previous lab results. Brief structured interviews were also conducted with 18 clinicians during their shifts in the emergency department. From the interviews, three themes emerged: 1) difficulty accessing vital signs, 2) difficulty accessing point-of-care tests, and 3) difficulty comparing the current ECG with the previous ECG. An emergency medicine clinical dashboard was developed to address these difficulties.

O desamparo aprendido revisitado: estudos com animais

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Maria Helena Leite Hunziker

Full Text Available O desamparo aprendido tem sido definido como a dificuldade de aprendizagem apresentada por indivíduos que tiveram experiência prévia com estímulos aversivos incontroláveis. O objetivo deste trabalho é fazer uma revisão crítica dos estudos sobre o desamparo aprendido, com animais. Nessa análise, são considerados aspectos conceituais e metodológicos dos estudos em questão e as interpretações teóricas sobre esse efeito comportamental. Aborda-se a evolução histórica desses estudos, bem como alguns aspectos controversos das publicações que se acumularam ao longo de quatro décadas de pesquisa. A associação do desamparo aprendido com a depressão clínica é analisada criticamente, destacando-se a necessidade de maior rigor metodológico e conceitual nos estudos da área.

COMMUNITY MEDICINE & PRIMARY HEALTH CARE

African Journals Online (AJOL)

ajiboro

3Department of Community and Primary Health Care, College of Medicine, University of Lagos, Idiaraba, ... Some of the participants (45.3%) carry out physical exercises such as walking ..... hypertension, continuous effective management of.

Teaching emergency medicine with workshops improved medical student satisfaction in emergency medicine education

Directory of Open Access Journals (Sweden)

Sricharoen P

2015-02-01

Full Text Available Pungkava Sricharoen,1 Chaiyaporn Yuksen,1 Yuwares Sittichanbuncha,1 Kittisak Sawanyawisuth2,3 1Department of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; 2Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; 3The Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH, Khon Kaen University, Khon Kaen, Thailand Background: There are different teaching methods; such as traditional lectures, bedside teaching, and workshops for clinical medical clerkships. Each method has advantages and disadvantages in different situations. Emergency Medicine (EM focuses on emergency medical conditions and deals with several emergency procedures. This study aimed to compare traditional teaching methods with teaching methods involving workshops in the EM setting for medical students. Methods: Fifth year medical students (academic year of 2010 at Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand participated in the study. Half of students received traditional teaching, including lectures and bedside teaching, while the other half received traditional teaching plus three workshops, namely, airway workshop, trauma workshop, and emergency medical services workshop. Student evaluations at the end of the clerkship were recorded. The evaluation form included overall satisfaction, satisfaction in overall teaching methods, and satisfaction in each teaching method. Results: During the academic year 2010, there were 189 students who attended the EM rotation. Of those, 77 students (40.74% were in the traditional EM curriculum, while 112 students were in the new EM curriculum. The average satisfaction score in teaching method of the new EM curriculum group was higher than the traditional EM curriculum group (4.54 versus 4.07, P-value <0.001. The top three highest average satisfaction scores in the new EM curriculum group were trauma

75 FR 45647 - National Library of Medicine; Notice of Closed Meeting

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2010-08-03

... personal privacy. Name of Committee: National Library of Medicine Special Emphasis Panel, Conflicted... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Library of Medicine... applications. Place: National Library of Medicine, 6705 Rockledge Drive, Suite 301, Bethesda, MD 20817...

Control of the individual exposure in the practice of a nuclear medicine department

International Nuclear Information System (INIS)

Hernandez, J.M.; Castro Crespo, D.; Naranjo Cardentey, O.

1996-01-01

In Cuba, since the beginning of the 50 s radioisotopes and radiopharmaceutical have been used for medical purposes to diagnose different diseases. At present about 21 modules of Nuclear Medicine are available for this type of medical assistance service. Use of these substances has increased notably as years passed by, being it an important source of exposure to ionizing radiation. Therefore we were interested in knowing the behaviour of the distribution of equivalent doses during the procedures that are performed in one of such typical modules of nuclear medicine

Implementing the 2009 Institute of Medicine recommendations on resident physician work hours, supervision, and safety

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Blum AB

2011-06-01

Full Text Available Alexander B Blum1, Sandra Shea2, Charles A Czeisler3,4, Christopher P Landrigan3-5, Lucian Leape61Department of Health and Evidence Policy, Mount Sinai School of Medicine, New York, NY, USA; 2Committee of Interns and Residents, SEIU Healthcare Division, Service Employees International Union, New York, NY, USA; 3Harvard Work Hours, Health and Safety Group, Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA; 4Division of Sleep Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; 5Division of General Pediatrics, Department of Medicine, Children's Hospital Boston, Harvard Medical School, Boston, MA, USA; 6Department of Health Policy and Management, Harvard School of Public Health, Boston, MA, USAAbstract: Long working hours and sleep deprivation have been a facet of physician training in the US since the advent of the modern residency system. However, the scientific evidence linking fatigue with deficits in human performance, accidents and errors in industries from aeronautics to medicine, nuclear power, and transportation has mounted over the last 40 years. This evidence has also spawned regulations to help ensure public safety across safety-sensitive industries, with the notable exception of medicine.

76 FR 31621 - National Library of Medicine; Notice of Closed Meeting

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2011-06-01

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2011-03-30

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2012-08-30

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2010-02-05

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2011-01-18

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2013-04-24

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2012-04-26

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2011-02-01

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Measurements Of Fingers Doses Of Staff Members In Nuclear Medicine Department

International Nuclear Information System (INIS)

AL LEHYANI, S.H.; SHOUSHA, H.A.; HASSAN, R.A.

2009-01-01

For some occupationally radiation exposed groups, the hands are more heavily exposed to ionizing radiation than the rest of the body. The Egyptian Atomic Energy Authority runs an extensive personal dosimetry service in Egypt, but finger doses have not been measured to a wide extent. In this study, the finger doses were measured for five different nuclear medicine staff occupational groups for which heavy irradiation of the hands was suspected. Finger doses were measured for nuclear medicine physicians, technologists, nurses and physicists. The nuclear medicine staff working with the radioactive materials wears two TLD dosimeters during the whole period, which lasted from 1 to 4 weeks. The staff performs their work on a regular basis throughout the month, and means annual doses were calculated for these groups. The doses to the fingers for the 99m Tc technologists and nurses of groups (2) and (3) were observed to be 30.24 ± 14.5 μSv/GBq (mean ± SD) and 30.37 ± 17.5 μSv/GBq, respectively. Similarly, the dose to the fingers for the 131 I technologists in group (5) was estimated to be 126.13 ± 38.2μSv/GBq. Finger doses for the physicians could not be calculated per unit of activity because they did not handle the radiopharmaceuticals directly but their doses were reported in millisieverts that accumulated in 1 week. The doses to the fingers of the physicist were 16.3±7.7 μSv/GBq. The maximum average finger dose in this study was found to be 2.8 mSv for the technologists handled therapeutic 131 I (group 5). It could be concluded that the maximum expected annual dose to the extremities appeared to be less than the annual limit (500 mSv/y).

78 FR 77475 - National Library of Medicine; Notice of Closed Meeting

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2013-12-23

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2011-12-12

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2013-09-10

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2011-02-16

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2012-12-05

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2012-03-26

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Use of complementary/alternative medicine among paediatric patients

DEFF Research Database (Denmark)

Madsen, Hanne; Andersen, Susie; Nielsen, Rasmus Gaardskaer

2003-01-01

Hospital during a 2 week period in the autumn of 2001 were asked to participate. In total, 622 (92%) patients participated. The data were collected in an interviewer administered questionnaire during a short structured interview with the patient and parents. CAM was divided into herbal medicine (herbal......UNLABELLED: The use of complementary/alternative medicine (CAM) is increasing. The aim was to characterise the use of CAM among patients in a paediatric department. All patients (aged 0-18 years), out-patients or hospitalised, in contact with the Department of Paediatrics, Odense University...... patients suffering from gastrointestinal diseases or hospitalised for observation. More than 50% of the users experienced positive effects and 6% had side-effects from AM. Of the CAM users, 11% or 2% of the total paediatric population used CAM instead of conventional medicines. CONCLUSION...

Occupational exposure in nuclear medicine in Portugal in the 1999-2003 period

International Nuclear Information System (INIS)

Martins, M. B.; Alves, J. G.; Abrantes, J. N.; Roda, A. R.

2007-01-01

The annual doses received by the staff of nuclear medicine departments from public hospitals and private clinics and evaluated by the Individual Monitoring Service of the Radiological Protection and Nuclear Safety Dept. (DPRSN) of the Nuclear and Technological Inst. (ITN) in Portugal, in the 5 y period from 1999 to 2003, are analysed and presented in this paper. In the 1999-2003 period, ITN-DPRSN monitored on an average 462 workers from nuclear medicine departments, which represents 6% of the 8000 workers of the medical field (approximately). The medical sector represents 80-85% of all the monitored population in Portugal. The professions of the monitored workers at nuclear medicine departments were identified by the respective departments as administrative, auxiliary, medical doctor, nuclear medicine technician, nurse, pharmacist and physicist. This information was collected at the onset of the monitoring and was updated over the last 3 y. The annual whole-body doses evaluated in the period 1999-2003 were used to derive the distribution of workers by dose intervals for every profession. The respective annual average doses and annual collective doses, as well as, the total average and total collective doses for the nuclear medicine sector were also determined and are presented. Internal radiation hasn't been monitored. (authors)

SARIS: a tool for occupational radiation protection improvement in a Nuclear Medicine Department

International Nuclear Information System (INIS)

Lopez Diaz, A.

2015-01-01

Self-assessment is an organization's internal process to review its current status. The IAEA has developed the SARIS system (Self-Assessment of the Regulatory Infrastructure for Safety) with the objective to improve and encourage the compliment of safety requirements and recommendations of the international safety standards. With the purpose to improve the effectiveness and efficiency of the occupational radiation protection structure in the Nuclear Medicine Department (from 'Hermanos Ameijeiras' Hospital), we applied 3 questionnaires of the Occupational Radiation Protection Module of SARIS. During the answering phase we provided factual responses to questions, appended all necessary documentary evidence and avoided opinion that cannot be objectively supported by evidence. In the analysis phase we identified the strengths and weaknesses, the opportunities for improvement and the risks if action is not taken. We look the expert's opinion and made recommendations to prepare an action plan for improvement. The Cuban regulations have more strengths than weakness. The major weakness founded was: the documental evidence of the knowledge about the legislative safety responsibility of the management structure and workers could be improved. Upon completion of the self-assessment analysis phase, was developed an action plan, trying to cover all the discovered weakness, making emphasis in the improvement of all documental issue related to radiation safety responsibilities. Were defined the responsibilities and activities in the short, medium and long terms. The SARIS self-assessment tools let us to learn more about our organization and provided us the key elements for the organization's continuous development and improvement. (Author)

Communication between nurses and physicians: strategies to surviving in the emergency department trenches.

Science.gov (United States)

Abourbih, Daniel; Armstrong, Sherry; Nixon, Kirsty; Ackery, Alun D

2015-02-01

The emergency department (ED) is a challenging and stressful work environment where communication lapses can lead to negative health outcomes. This article offers strategies to Emergency Medicine residents, nurses and staff physicians on how to improve communication to optimize patient care. © 2014 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Factors influencing selection of internal medicine residency--a prospective study.

Science.gov (United States)

Pereg, David; Gronich, Naomi; Lishner, Michael

2006-08-01

Recently, the popularity of internal medicine residency has been decreasing. We studied the effect of an improved working environment and a decrease in residents' workload on the selection of internal medicine residency. An organizational diagnosis team joined our department and identified several causes for residents' heavy workload. These findings were subsequently discussed in a workshop and led to a modification of the daily routine and a parallel decrease in workload and rise in residents' satisfaction. Following these changes, the demand for residency in our department rose. We conclude that an improvement in the working environment and workload during residency increases the residents' satisfaction and the demand for residency in internal medicine.

Investigation of public exposure resulted from the radioiodine delay tank facility of nuclear medicine department

Energy Technology Data Exchange (ETDEWEB)

Yusof, Mohd Fahmi Mohd, E-mail: mfahmi@usm.my; Ali, Abdul Muhaimin Mat; Abdullah, Reduan; Idris, Abdullah Waidi [School of Health Sciences, Universiti Sains Malaysia, 16150 Kota Bharu, Kelantan (Malaysia)

2016-01-22

The study is carried out to assess the exposure rate that could contribute to public exposure in a radioiodine ward delay tank facility of Radiotherapy, Oncology and Nuclear Medicine, Department, Hospital Universiti Sains Malaysia (HUSM). The exposure rate at several locations including the delay tank room, doorway and at the public walking route was measured using Victoreen 415P-RYR survey meter. The radioactive level of the {sup 131}I waste was measured using Captus 3000 well counting system. The results showed that exposure rate and total count of the delay tank sample increased when the radioiodine ward was fully occupied with patient and reduced when the ward was vacant. Occupancy of radioiodine ward for two consecutive weeks had dramatically increased the exposure rate around the delay tank and radioactive level of {sup 131}I waste. The highest exposure rate and radioactive level was recorded when the ward was occupied for two consecutive weeks with 177.00 µR/h and 58.36 kcpm respectively. The exposure rate decreased 15.76 % when the door of the delay tank room was closed. The exposure rate at public walking route decreased between 15.58 % and 36.92 % as the distance increased between 1 and 3 m.

More about ... Nuclear medicine

African Journals Online (AJOL)

Thyroid scintigraphy. In neonates with hypothyroidism detected on neonatal screening and confirmed by subsequent testing, a radionuclide thyroid scan should be performed as soon as possible. It must be undertaken in all nuclear medicine departments as a matter of urgency. Any delay in treatment should be avoided.

75 FR 54157 - National Library of Medicine; Notice of Closed Meeting

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2010-09-03

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76 FR 49779 - National Library of Medicine; Notice of Closed Meeting

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2011-08-11

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75 FR 13769 - National Library of Medicine; Notice of Closed Meetings

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2010-03-23

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20 CFR 10.809 - How are payments for medicinal drugs determined?

Science.gov (United States)

2010-04-01

... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false How are payments for medicinal drugs determined? 10.809 Section 10.809 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF... for medicinal drugs determined? Payment for medicinal drugs prescribed by physicians shall not exceed...

Radioactive isotopes in clinical medicine and research. Abstracts

International Nuclear Information System (INIS)

2005-01-01

The contribution displays 44 abstracts and 35 posters from the 27th International Symposium on ''radioactive isotopes in clinical medicine and research'', organized by the Austrian society of nuclear medicine and the department of nuclear medicine and the center for biomedical engineering and physics of the Vienna medical university. The abstracts are sorted according to lecture headers: radiopharmaceutical sciences, endocrinology, clinical PET, neurology, oncology, physics and instrumentation, cardiology, inflammation, therapy and varia. (uke)

Factors affecting patients’ satisfaction in nuclear medicine department in Egypt

Directory of Open Access Journals (Sweden)

Maged Abdel Galil Hamed

2014-03-01

Conclusions: Patients’ satisfaction was high in perceiving the infrastructure of the department while waiting time and giving information before examination were the least satisfied to the patients.

Medicine Bow wind project

Science.gov (United States)

Nelson, L. L.

1982-05-01

The Bureau of Reclamation (Bureau) conducted studies for a wind turbine field of 100 MW at a site near Medicine Bow, WY, one of the windiest areas in the United States. The wind turbine system would be electrically interconnected to the existing Federal power grid through the substation at Medicine Bow. Power output from the wind turbines would thus be integrated with the existing hydroelectric system, which serves as the energy storage system. An analysis based on 'willingness to pay' was developed. Based on information from the Department of Energy's Western Area Power Administration (Western), it was assumed that 90 mills per kWh would represent the 'willingness to pay' for onpeak power, and 45 mills per kWh for offpeak power. The report concludes that a 100-MW wind field at Medicine Bow has economic and financial feasibility. The Bureau's construction of the Medicine Bow wind field could demonstrate to the industry the feasibility of wind energy.

The medicines refrigerator and the importance of the cold chain in the safe storage of medicines.

Science.gov (United States)

Hatchett, Richard

2017-10-04

The medicines refrigerator is a common piece of equipment found in clinical areas. It is used to ensure specific medicines are safely stored within a narrow temperature range in line with manufacturers' instructions; this is usually between +2˚C and +8˚C, and ideally +5˚C. Drugs stored in the medicines refrigerator include: vaccines; insulin; chemotherapy drugs; topical preparations, such as some types of eye drops; and other treatments such as glucagon, which is used to manage severe hypoglycaemia. This article reviews the function of the medicines refrigerator and the checks required by healthcare practitioners to ensure that medicines remain safely stored and their effectiveness is maintained. It also outlines the medicines refrigeration procedure known as the 'cold chain', which includes the use of cold boxes or vaccine carriers to maintain the required temperature of medicines during transport from the manufacturer to user, or between healthcare departments. ©2012 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

Clinical indications and perceived effectiveness of complementary and alternative medicine in departments of obstetrics in Germany: a questionnaire study.

Science.gov (United States)

Münstedt, Karsten; Brenken, Anja; Kalder, Matthias

2009-09-01

Our earlier study on complementary and alternative medicine (CAM) methods showed that acupuncture, homeopathy, and aromatherapy are available in most obstetrics departments in Germany but it did not evaluate the clinical indications for using CAM. The present study aimed to explore further the effectiveness of CAM use in obstetrics. We sent all departments of obstetrics in North Rhine-Westphalia a questionnaire designed to delineate their use of acupuncture, homeopathy, and aromatherapy during childbirth. It sought details on who provided the CAM therapy (midwife or physician). We asked respondents to indicate on a five-point scale how reasonable or otherwise they would consider the provision of CAM in each of six common problem situations and to estimate for each the proportion of patients given the CAM treatment. Respondents were also asked about the rationale for offering CAM, quality assurance and side effects. Spearman's bivariate correlation, cross-tabulation and Pearson's chi(2) test were used for statistical analysis. About 73.4% (138/187) of the departments responded. Acupuncture and homoeopathy were most widely used. Although obstetricians are responsible for patient care, decisions to provide CAM were largely taken by midwives, and the midwives' belief in the methods' effectiveness and patient demand were the principle motivating factors. Rates of CAM use in the six problem scenarios evaluated were directly related to practitioners' perceptions of the methods' therapeutic effectiveness. CAM methods were widely offered despite the lack of evidence of effectiveness or information on adverse consequences. In Germany, including CAM in the mandatory national quality assurance measures and perinatal surveys would provide valuable information; CAM use elsewhere merits further study.

75 FR 13136 - National Library of Medicine; Notice of Closed Meeting

Science.gov (United States)

2010-03-18

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Library of Medicine...: National Library of Medicine, Building 38, 2nd Floor, Board Room, 8600 Rockville Pike, Bethesda, MD 20892...: National Library of Medicine, Building 38, 2nd Floor, Board Room, 8600 Rockville Pike, Bethesda, MD 20892...

COMMUNITY MEDICINE & PRIMARY HEALTH CARE

African Journals Online (AJOL)

ajiboro

2Department of Community Medicine & Primary Care, Faculty of Clinical Sciences, ... It may result from road traffic accident, near saving basic principles in emergency care that even drowning, electric ... (4.3%) at place of work, 8 (11.4%) at.

Need of Department of General Practice / Family Medicine at AIIMS (All India Institute of Medical Sciences): Why the apex medical institute in India should also contribute towards training and education of general practitioners and family physicians.

Science.gov (United States)

Pal, Ranabir; Kumar, Raman

2017-01-01

Family medicine or general practice is the practicing discipline of the majority doctors in India, however formal academic departments of general practice (or family medicine) do not exist in India, as it is not a mandatory requirement as prescribed by the Medical Council of India; the principal regulator of medical education. Currently India has capacity to produce more than 60,000 medical graduates per year, majority of whom are expected to become general practitoners or primary care doctors without under going any vocational training in general practice or family medicine. The 92 nd parliamentary standing committee report (on health and family welfare) of the Indian Parliament recommended that Government of India in coordination with State Governments should establish robust postgraduate programs in Family Medicine and facilitate introducing Family Medicine discipline in all medical colleges. This will not only minimize the need for frequent referrals to specialist and decrease the load on tertiary care but also provide continuous health care for the individuals and families. The authors concur with the parliament of India and strongly feel that "Family Medicine" (community-based comprehensive clinical practice) deserves dedicated and distinct department at all medical colleges in India in order to availability of qualified medical doctors in the community-based health system. AIIMS, New Delhi, along with other newly established AIIMS, should rise to their foundation mandate of supporting excellence in all disciplines of medical science and to this historic responsibility; and not just remain an ivory tower of tertiary care based fragmented (into sub specialties) hospital culture.

Present situation and proposal for nuclear medicine development

International Nuclear Information System (INIS)

Oliva Gonzalez, Juan P.

2003-01-01

In the present paper, the current situation of the Cuban nuclear medicine, after its introduction in the country in the 40s of the 20 th century and its expansion since 1962 and, particularly, from the installation of the first gamma camera in 1980, is analyzed. Nowadays, there is a total 14 Nuclear Medicine Departments or Services in our country within the National Oncology Networks and national Health System (SNS), which provide medical attention to the population depending on the nuclear equipment available A Program for the medical and technical personnel's training is proposed, as well as for gradual development of nuclear medicine department's (including the installation of gamma cameras, divided into two stages: 2003-2004 and 2005-2006). The prospective results of the proposed program are analyzed, as well as the impact on the populations health

Flipped classroom model for learning evidence-based medicine

OpenAIRE

Rucker, Sydney Y; Ozdogan, Zulfukar; Al Achkar, Morhaf

2017-01-01

Sydney Y Rucker,1 Zulfukar Ozdogan,1 Morhaf Al Achkar2 1School of Education, Indiana University, Bloomington, IN, 2Department of Family Medicine, School of Medicine, University of Washington, Seattle, WA, USA Abstract: Journal club (JC), as a pedagogical strategy, has long been used in graduate medical education (GME). As evidence-based medicine (EBM) becomes a mainstay in GME, traditional models of JC present a number of insufficiencies and call for novel models of instruction. A flipped cla...

The Frontlines of Medicine Project: a proposal for the standardized communication of emergency department data for public health uses including syndromic surveillance for biological and chemical terrorism.

Science.gov (United States)

Barthell, Edward N; Cordell, William H; Moorhead, John C; Handler, Jonathan; Feied, Craig; Smith, Mark S; Cochrane, Dennis G; Felton, Christopher W; Collins, Michael A

2002-04-01

The Frontlines of Medicine Project is a collaborative effort of emergency medicine (including emergency medical services and clinical toxicology), public health, emergency government, law enforcement, and informatics. This collaboration proposes to develop a nonproprietary, "open systems" approach for reporting emergency department patient data. The common element is a standard approach to sending messages from individual EDs to regional oversight entities that could then analyze the data received. ED encounter data could be used for various public health initiatives, including syndromic surveillance for chemical and biological terrorism. The interlinking of these regional systems could also permit public health surveillance at a national level based on ED patient encounter data. Advancements in the Internet and Web-based technologies could allow the deployment of these standardized tools in a rapid time frame.

Integrative medicine for chronic pain: A cohort study using a process-outcome design in the context of a department for internal and integrative medicine.

Science.gov (United States)

Saha, Felix J; Brüning, Alexander; Barcelona, Cyrus; Büssing, Arndt; Langhorst, Jost; Dobos, Gustav; Lauche, Romy; Cramer, Holger

2016-07-01

Integrative medicine inpatient treatment has been shown to improve physical and mental health in patients with internal medicine conditions. The aim of this study was to investigate the effectiveness of a 2-week integrative medicine inpatient treatment in patients with chronic pain syndromes and the association of treatment success with patient-related process variables. Inpatients with chronic pain syndromes participating in a 2-week integrative medicine inpatient program were included. Patients' pain intensity, pain disability, pain perception, quality of life, depression, and perceived stress were measured on admission, discharge, and 6 months after discharge. Likewise process variables including ability and will to change, emotional/rational disease acceptance, mindfulness, life and health satisfaction, and easiness of life were assessed. A total of 310 inpatients (91% female, mean age 50.7 ± 12.4 year, 26.5% low back pain, and 22.9% fibromyalgia) were included. Using mixed linear models, significant improvements in pain intensity, pain disability, pain perception, quality of life, depression, and perceived stress were found (all P medicine inpatient treatment can benefit patients with chronic pain conditions. Functional improvements are associated with improved ability to change and implementation, disease acceptance, and satisfaction.

Radiation doses to patients from nuclear medicine examinations

International Nuclear Information System (INIS)

Boehm, K.; Boehmova, I.

2014-01-01

Public Health Authority of the Slovak Republic, Bratislava The exposure of the population to ionizing radiation is rising rapidly, nearly exclusively due to increasing medical use of radiation, including diagnostic methods of nuclear medicine. In 2012 Public health authority of the Slovak republic (PHA SR) performed a survey about the population exposure from nuclear medicine procedures. The primary objectives of this survey were to assess the frequency of different nuclear medicine procedures, determine the average activities administered by nuclear medicine procedures and compare them with the national diagnostic reference levels and determine the annual collective effective dose to the Slovak population from nuclear medicine. The effective dose calculation was based on the methodology of the ICRP32, ICRP80 and ICRP106. In Slovak republic are 11 nuclear medicine departments. The collected data of activities administered by different procedures correspond to 100 % of nuclear medicine departments. The total number of procedures included in the study was 36 250. The most commonly performed procedure was bone scintigraphy (35.9%), followed by lung perfusion and ventilation scintigraphy (17.0%), static and dynamic renal scintigraphy (13.0%), whole-body positron emission tomography of tumors with PET radiopharmaceuticals (11.6%), myocardial perfusion (8.8%), thyroid scintigraphy (6.2%), parathyroid scintigraphy (2.1%), scintigraphy of tumors (2.1%), scintigraphy of the liver and spleen (0.8%), brain perfusion (0.7%) and examination of the gastrointestinal system (0.3%). (authors)

An estimate of the maximal doses incurred by persons accompanying patients in the waiting area of a nuclear medicine department

International Nuclear Information System (INIS)

Dzik-Jurasz, A.S.K.; Farwell, J.

1997-01-01

The aim of the study was to make an estimate of the maximal doses that might be incurred by persons accompanying active patients in a nuclear medicine department waiting area. This was in order to determine whether the dose to such individuals approached current legislative or recently recommended limits. Thermoluminescent dosemeters were taped to the walls of the waiting area at waist level to the sitting individual, such that their record would reflect as closely as possible the dose incurred by an individual sitting next to an active patient. Dividing the recorded dose with the total occupancy time of that seat derived an average dose rate. Maximal doses were estimated by the product of the latter and maximal occupancy times. It was assumed that an accompanying individual would have been sitting next to the active patient for their whole duration of stay. The maximum estimates were 278 μSv and 103.2 μSv. These values are likely to be overestimates by the virtue of the TLD integrating the whole dose of its surrounds, especially adjacent active individuals. By current legislation and recent recommendations the values are reassuringly low, but idiosyncrasies in local practice might need to be considered in individual departments. (author)

[General survey and protection of intangible cultural heritage in traditional medicine in Zhejiang Province].

Science.gov (United States)

Zhu, D M

2017-07-28

From January 2003 to October 2008, the Zhejiang Provincial Department of Culture, together with the Intangible Cultural Heritage Management Department of 11 cities and counties, including Hangzhou, Ningbo, Wenzhou, Huzhou, Jiaxing, Shaoxing, Jinhua, Quzhou, Zhoushan, Taizhou, Lishui, surveyed the Province's intangible cultural heritage in traditional medicine, with a total of 7849 items, including 7 kinds of traditional medicine in 8 major categories: living Chinese medicine culture, ethnic medicine, acu-moxibustion, osteopathic therapy, unique therapies, and Chinese crude drugs, herbal medicine and traditional Chinese medicine preparation, TCM processing.Among them, 9 items have been included in the Representative Project List of National Traditional Medicine Intangible Cultural Heritage, 18 items were listed in Representative Project Directory of Zhejiang Traditional Medicine Intangible Cultural Heritage.Theprotection and inheritance of traditional of the intangible heritage of traditional medicine in Zhejiang province are mainly through the 4 batches of master guidance apprentices.In addition, protection is carried out through organizational support, literature systematization and other measures.

[Regular discussion of serious complications during admission to an internal medicine department].

NARCIS (Netherlands)

Janssen, M.C.H.; Koopmans †, P.P.; Gurp, P.J.M. van

2010-01-01

Three patients, two women aged 54 and 84 years, and a man aged 76 years, had serious complications during a stay in an internal medicine ward. The complications were discussed at monthly multidisciplinary complication meetings, which we organise from 2007 and which are aimed at improving care

Complications of aesthetic medicine procedures: five case studies.

Science.gov (United States)

Smędra, A; Szustowski, S; Klemm, J; Jurczyk, A; Zalewska-Janowska, A; Berent, J

2015-01-01

The paper presents the cases of five patients who developed complications after aesthetic medicine procedures. Four of the cases involved women who reported to the Department of Forensic Medicine, Medical University of Lodz, for a description and legal qualification of bodily injuries suffered as a result of aesthetic medicine procedures, whereas one was related to the assessment of accuracy of medical management at the request of the prosecutor handling the case. The reported cases concerned acid exfoliation treatments, photoepilation and cryotherapy. The authors attempt to discuss the most common complications that may occur after aesthetic medicine procedures, and measures to avoid them.

Nuclear medicine in Tunisia : current status and prospects

International Nuclear Information System (INIS)

Hammami, Hatem

2013-01-01

Nuclear medicine is concerned with the utilisation of radioactivity in vivo or in vitro for diagnostic or therapeutic purposes. In Tunisia, there are four public departments of nuclear medicine and seven private clinics. 50% of the population is localized in the north, which justifies the existence of 7 public and private departments of nuclear medicine with nine gamma cameras in this region. In the south, there are 30 pour cent of the population that goes to Sfax and 20 pour cent to Sousse where we count two departments with gamma cameras in public services and one in the private sector. The nuclear medicine services in the public sector have 4 SPECT / CT. Siemens is the leading provider of gamma cameras and occupies 73 pour cent of market share, subsequently ranks SMV (13 pour cent) and (GE and GAEDE) have the same proportion of the market share (7 pour cent). For radio-protected rooms, there is a single center with a single chamber from four public services. On the other hand, there are 2/7 private centers that are equipped with five radio-protected electrically rooms. Concerning the human resources, there are 26 doctors and 24 technicians in the public sector. The private sector has 6 doctors and 12 technicians. In 2012, there has been 22000 examinations (diagnostic and therapeutic procedures) in which 14,600 in nuclear medicine departments of public hospitals. Bone scintigraphy ranks first, with a relative frequency of 40-80 pour cent thereafter ranks renal scintigraphy (10-15 pour cent) and then the thyroid scintigraphy (8-12 pour cent). The waiting period is a major problem, especially in the public sector. Taking as an example, for the therapy of thyroid, injection of 100 mCi of I-131 requires a period of waiting more than six months and waiting more than three months for the bone scan. The second problem for patient with cancer is the distance, there are 11 centers concentrated in 3 coastal cities and none in the inner areas of the country, no regional

Internal dosimetry in nuclear medicine procedures

International Nuclear Information System (INIS)

Carrera Magarino, F.; Salgado Garcia, C.; Ruiz Manzano, P.; Rivas Ballarin, M. A.; Jimenez Hefernan, A.; Sanchez Segovia, J.

2011-01-01

The Department of Radio Physics and Radiation Protection, University Hospital Lozano Blesa Zaragoza presented a calculus textbook to estimate patient doses in diagnostic nuclear medicine. In this paper present an updated referred Book of calculation.

Psychology departments in medical schools: there's one in Canada, eh?

Science.gov (United States)

McIlwraith, Robert D

2014-12-01

Comments on the original article by Robiner et al. (see record 2014-07939-001) regarding psychologists in medical schools and academic medical center settings. Robiner et al. reported that their extensive review "revealed no independent departments of psychology in U.S. medical schools." The current authors note north of the border in Canada there is one department of psychology in a medical school. The Department of Clinical Health Psychology has been a department within the Faculty of Medicine of the University of Manitoba since 1995. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

[Costing nuclear medicine diagnostic procedures].

Science.gov (United States)

Markou, Pavlos

2005-01-01

To the Editor: Referring to a recent special report about the cost analysis of twenty-nine nuclear medicine procedures, I would like to clarify some basic aspects for determining costs of nuclear medicine procedure with various costing methodologies. Activity Based Costing (ABC) method, is a new approach in imaging services costing that can provide the most accurate cost data, but is difficult to perform in nuclear medicine diagnostic procedures. That is because ABC requires determining and analyzing all direct and indirect costs of each procedure, according all its activities. Traditional costing methods, like those for estimating incomes and expenses per procedure or fixed and variable costs per procedure, which are widely used in break-even point analysis and the method of ratio-of-costs-to-charges per procedure may be easily performed in nuclear medicine departments, to evaluate the variability and differences between costs and reimbursement - charges.

77 FR 39715 - National Library of Medicine; Notice of Meeting

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2012-07-05

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Library of Medicine... space available. Individuals who plan to attend and need special assistance, such as sign language... of individual intramural programs and projects conducted by the National Library of Medicine...

76 FR 51994 - National Library of Medicine Notice of Meeting

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2011-08-19

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76 FR 80953 - National Library of Medicine Notice of Meeting

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2011-12-27

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75 FR 78720 - National Library of Medicine; Notice of Meeting

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2010-12-16

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78 FR 13362 - National Library of Medicine; Notice of Meeting

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2013-02-27

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78 FR 76846 - National Library of Medicine; Notice of Meeting

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2013-12-19

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77 FR 37684 - National Library of Medicine; Notice of Meetings

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2012-06-22

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Library of Medicine... attendance limited to space available. Individuals who plan to attend and need special assistance, such as... National Library of Medicine, including consideration of personnel qualifications and performance, and the...

75 FR 42102 - National Library of Medicine; Notice of Meeting

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2010-07-20

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Nuclear medicine: the Philippine Heart Center experience

International Nuclear Information System (INIS)

Cancino, E.L.

1994-01-01

The following is a report of a three (3) months on-the-job training in Nuclear Medicine at the Nuclear Medicine Department of the Philippine Heart Center. The hospital has current generation nuclear medicine instruments with data processor and is capable of a full range of in vivo and in vitro procedures. Gamma camera is the principal instrument for imaging in nuclear medicine used in the Philippine Heart Center. Thyroid scanning procedure is being performed with these instruments. Also the cardiovascular procedures, the pulmonary, skeletal, renal and hepatobiliary procedures were being performed with the use of gamma camera. Special emphasis is on nuclear cardiology since the PHC attends primarily to cardiovascular patients. (auth.)

[Appropriateness of the prescriptions of conventional versus new oral anticoagulants at discharge from a department of internal medicine].

Science.gov (United States)

Bochatay, L; Beney, J; Jordan-von Gunten, V; Petignat, P A; Roulet, L

2016-09-01

The recently introduced oral direct anticoagulants (ODAs), presumably safer, and with comparable efficacy to the vitamin K antagonists (VKAs), may reshape the world of anticoagulation medicine. This study aimed to assess the prescription appropriateness of ODAs and VKAs at discharge from hospital. We performed a one year retrospective study between August 2012 and July 2013 in the department of internal medicine of a regional hospital (HVs Sion) using Electronic Medical Records. All patients receiving an ODA were included and matched to a patient treated with a VKA. The appropriateness of prescription at discharge was defined by an adequate indication and dosing, the absence of contraindication, a minimal risk of drug-drug interactions and no major bleeding or venous thromboembolism during the hospitalization. The bleeding risk was evaluated with the HAS-BLED score when the indication was atrial fibrillation (AF). Out of the 44patients included (22 with an ODA and 22 with a VKA), 38 received an appropriate prescription according to all criteria. Two patients had an inadequate dosing. A potential drug-drug interaction was detected in 3patients receiving a VKA and in 1patient receiving an ODA. No major contraindication was found, but a relative contraindication was discussed in 3cases. The majority of patients receiving an ODA for an AF had a minor bleeding risk. No significant difference was ascertained between the two groups regarding the appropriateness of prescription. Our results suggest that ODAs were cautiously used in our setting. Copyright © 2015 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Uma ferramenta para planejamento de estudos para concursos

Directory of Open Access Journals (Sweden)

Leonardo Pimentel

2015-11-01

Full Text Available De acordo com a constituição brasileira, a única forma de se tornar um empregado do governo é passar em um concurso público. O exame de conhecimento do cargo é um dos componentes mais importantes de um concurso. Estudar para esse exame é uma tarefa que requer planejamento. Um meio de obter um bom planejamento é construir uma grade de horários que relacione as matérias a serem estudadas com os respectivos horários disponíveis para o estudo. Esse tipo de problema se assemelha bastante à gerência de projetos, em que se procura estabelecer a distribuição das atividades ao longo do tempo disponível. Assim, torna-se interessante explorar a dinâmica de estudos para concursos como um projeto. O presente trabalho apresenta a ferramenta de apoio ao estudos - Passe-me, baseada no ciclo PDCA (do inglês, Plan-Do-Check-Act. Por se tratar de uma ferramenta web, o tempo de resposta para produzir uma grade de estudos é fundamental. A ferramenta faz uso de algoritmo genético para calcular a grade de horários priorizando a velocidade de resposta. A ferramenta foi avaliada em diferentes cenários de uso e obteve desempenho satisfatório durante a produção da grade de estudos.

Hospitalist workload influences faculty evaluations by internal medicine clerkship students

OpenAIRE

Robinson, Robert

2015-01-01

Robert L Robinson Department of Internal Medicine, Southern Illinois University School of Medicine, Springfield, Illinois, USA Background: The last decade has brought significant changes to internal medicine clerkships through resident work-hour restrictions and the widespread adoption of hospitalists as medical educators. These key medical educators face competing demands for quality teaching and clinical service intensity. Objective: The study reported here was conducted to explore the rel...

India mainstreams medicinal plants | IDRC - International ...

International Development Research Centre (IDRC) Digital Library (Canada)

2011-02-03

Feb 3, 2011 ... ... India's efforts to develop medicinal plant gathering, processing, and marketing into a ... while protecting indigenous knowledge, some based on age-old texts. ... To date, his department has helped about a million people in ...

75 FR 62549 - National Library of Medicine; Notice of Meeting

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2010-10-12

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Library of Medicine... available. Individuals who plan to attend and need special assistance, such as sign language interpretation... medical genetics area. Place: National Library of Medicine, Building 38, 2nd Floor, Board Room, 8600...

Interest of the Department of Energy in production and development of short-lived radionuclides

International Nuclear Information System (INIS)

Thiessen, J.W.

1985-01-01

The Department of Energy has developed production of potentially useful radionuclides for applications in medicine. The Department's financial commitment and the short-lived radionuclide production program, with emphasis on iodine-123, is discussed

Incidence of refeeding syndrome in internal medicine patients.

Science.gov (United States)

Kraaijenbrink, B V C; Lambers, W M; Mathus-Vliegen, E M H; Siegert, C E H

2016-03-01

Refeeding syndrome is a potentially fatal shift of fluids and electrolytes that may occur after reintroducing nutrition in a malnourished patient. Its incidence in internal medicine patients is not known. We aimed at determining the incidence in a heterogeneous group of patients acutely admitted to a department of internal medicine. All patients acutely admitted to the department of internal medicine of a teaching community hospital in Amsterdam, the Netherlands, between 22 February 2011 and 29 April 2011, were included. We applied the National Institute for Health and Care Excellence (NICE) criteria for determining people at risk of refeeding syndrome and took hypophosphataemia as the main indicator for the presence of this syndrome. Of 178 patients included in the study, 97 (54%) were considered to be at risk of developing refeeding syndrome and 14 patients actually developed the syndrome (14% of patients at risk and 8% of study population). Patients with a malignancy or previous malignancy were at increased risk of developing refeeding syndrome (p refeeding syndrome. The Short Nutritional Assessment Questionnaire score had a positive and negative predictive value of 13% and 95% respectively. The incidence of refeeding syndrome was relatively high in patients acutely admitted to the department of internal medicine. Oncology patients are at increased risk of developing refeeding syndrome. When taking the occurrence of hypophosphataemia as a hallmark, no other single clinical or composite parameter could be identified that accurately predicts the development of refeeding syndrome.

Debates críticos: os Estudos de Segurança e o futuro dos Estudos da Paz e dos Conflitos 10.5102/uri.v11i2.2526

Directory of Open Access Journals (Sweden)

André Barrinha

2013-11-01

Full Text Available Irremediavelmente ligados pela proximidade dos respetivos objetos de estudo, Estudos de Segurança e Estudos da Paz e dos Conflitos constituíram-se e evoluíram ao longo da Guerra Fria como disciplinas antagónicas. Essa divisão operou-se sobretudo na Europa, onde Galtung e seus discípulos encaminharam o estudo das questões da guerra e da paz para uma agenda claramente normativa e crítica, enquanto o estudo das questões de segurança se centrava numa abordagem orientada para o policy-making. Como é defendido neste artigo, o final do conflito bipolar correspondeu, até certo ponto, a uma inversão de papéis, com os Estudos da Paz e dos Conflitos acomodados a um empirismo desprovido de normatividade e os Estudos de Segurança, pelo menos na Europa, a abrirem-se a novas abordagens de cariz mais crítico. É aqui sugerido que esta inversão contém, em si, importantes lições para os Estudos da Paz e da Segurança, nomeadamente sobre a centralidade da teoria na definição de uma nova agenda crítica que permita uma aproximação entre as duas disciplinas.

Explaining the Learning Experiences of Clinical Procedures of the Internal Medicine Residents at Department of Gastroenterology

Directory of Open Access Journals (Sweden)

Mansoureh Taghavinia

2012-07-01

Full Text Available Introduction: the method and way of learning and teaching are effective in acquiring clinical skills, and identifying the shortcomings of learning and teaching will lead to better planning. The purpose of this study was to explain the experiences of the learning clinical procedures of the internal medicine residents in gastroenterology department. Methods: qualitative study using content thematic analysis was done. Six fourth-year residents were selected and interviewed considering purposive sampling. The data of the interviews were transcribed and analyzed after rereading. Results: the collected data are divided into three categories: learning and experience with the following four categories (learning time and experiencing, leaning and experiencing times, learning and experiencing opportunities, training and the lack of the training of some procedures. These categories are explained by using some quotes derived from the data. Conclusion: the results of this study suggest that the administrative management of internal residency is poor and should get seriously in implementation and application of intended instructions existing in the prepared program of Medical Education and Specialized Council of internal residency period. The attending physicians and residents must be aware of the content of education program at the beginning of the residency periods and the trainers must try to supervise the residents’ education.

Current role of the radiographers in imaging diagnostics, nuclear medicine and radiotherapy in modern departments

International Nuclear Information System (INIS)

Karidova, S.; Velkova, K.; Panamska, K.; Petkova, K.

2006-01-01

Full text: In the communication we set out to focus the attention of the medical staff and the public on the place and the constantly growing role (relative burden) of the radiographers in imaging diagnostics, nuclear medicine and radiotherapy in the field of modern medicine. The advanced radiographers level and rapid development of the contemporary equipment and apparatuses used in imaging diagnostics, nuclear medicine and radiotherapy, as well as the methods of their utilization, presuppose very good and constantly improving theoretical and practical training of the imaging technician. The radiographer fulfills responsible tasks under the guidance of the physician or independently and bears specific responsibilities. Having mastered the fundamentals of radiation protection, the imaging technician protects both himself and the patient from the impact of ionizing radiation. To be able to fulfill his/her constantly increasing duties and obligations, the imaging radiographer has acquired wide knowledge of general education subjects, subjects of general medicine and special subjects. The radiographer has a good knowledge of Latin and a modern foreign language, and he is also computer literate so as to be able to cope with the widely spread visualizing methods. The radiographer acquires additional post-graduate training to work in narrowly specialized fields as well as to improve his/her qualifications

Just allocation and team loyalty: a new virtue ethic for emergency medicine

Science.gov (United States)

Girod, J; Beckman, A

2005-01-01

When traditional virtue ethics is applied to clinical medicine, it often claims as its goal the good of the individual patient, and focuses on the dyadic relationship between one physician and one patient. An alternative model of virtue ethics, more appropriate to the practice of emergency medicine, will be outlined by this paper. This alternative model is based on the assumption that the appropriate goal of the practice of emergency medicine is a team approach to the medical wellbeing of individual patients, constrained by the wellbeing of the patient population served by a particular emergency department. By defining boundaries and using the key virtues of justice and team loyalty, this model fits emergency practice well and gives care givers the conceptual clarity to apply this model to various conflicts both within the department and with those outside the department. PMID:16199595

Efficacy of traditional Chinese herbal medicine in the treatment of ...

African Journals Online (AJOL)

Department, 3Department of Vascular Surgery, The Teaching Hospital of Chengdu University of Traditional Chinese Medicine,. Chengdu, Sichuan ... Background: The rate of gastrointestinal adenomatous polyps, often regarded as precancerous lesions, developing ..... Ling-Bai-Zhu on promoting apoptosis of transplanted.

78 FR 18358 - National Library of Medicine; Notice of Meeting

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2013-03-26

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76 FR 16431 - National Library of Medicine; Notice of Meeting

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2011-03-23

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2010-03-24

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77 FR 17488 - National Library of Medicine Notice of Meetings

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2012-03-26

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2010-12-23

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76 FR 54778 - National Library of Medicine; Notice of Meetings

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2011-09-02

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77 FR 17488 - National Library of Medicine; Notice of Meeting

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2012-03-26

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Library of Medicine.... Individuals who plan to attend and need special assistance, such as sign language interpretation or other...: Review and Analysis of Systems. Place: National Library of Medicine, Building 38, 2nd Floor, Board Room...

78 FR 76845 - National Library of Medicine; Notice of Meeting

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2013-12-19

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Evaluation of Performance Indexes of Emergency Department

Directory of Open Access Journals (Sweden)

Alireza Baratloo

2015-02-01

Full Text Available Introduction: The importance of evaluating performance indicators in the emergency department, as one of the most important departments of hospital, is obvious to everyone. Therefore, in this study we aimed to appraise the five performance indicators, approved by the ministry of health, in Shohadaye Tajrish hospital, Tehran, Iran. Methods: In a descriptive cross-sectional study based on the profiles of all the patients admitted to the emergency department, performance indicators in the emergency department were evaluated. The study was divided into 2 parts about the establishment of emergency medicine system and training the medical staff: the first 6 months of 1392 and the second. Then these 2 periods were compared using Mann-Whitney U test while P< 0.05 was considered as the level of significance. Results: Of the studied indicators, mean triage time was 6.04 minutes in the first 6 months which was reduced to 1.5 minutes in the second 6 months (p=0.016. In addition, the percentage of patients who moved out of the department in 12 hours was lowered from 97.3% in the first period to 90.4% in the second (p=0.004. While, the percentage of patients who were decided upon in 6 hours (p=0.2, unsuccessful CPR percentage (p=0.34 and patients discharged against medical advice (p=0.42 showed no significant difference. Conclusion: The results of this study showed that the establishment of the emergency medicine system in the emergency department could lead to more efficient triage. Due to the differences made after their establishment including: different pattern of the patients admitted, increased stay of the patients in the department due to their need for prolonged intensive care, a raise in patient referral to the hospital by pre-hospital services and a higher percentage of occupied hospital beds, other indicators have not shown a significant improvement.

Nuclear medicine training and practice in Poland

International Nuclear Information System (INIS)

Teresinska, Anna; Birkenfeld, Bozena; Krolicki, Leszek; Dziuk, Miroslaw

2014-01-01

In Poland, nuclear medicine (NM) has been an independent specialty since 1988. At the end of 2013, the syllabus for postgraduate specialization in NM has been modified to be in close accordance with the syllabus approved by the European Union of Medical Specialists and is expected to be enforced before the end of 2014. The National Consultant in Nuclear Medicine is responsible for the specialization program in NM. The Medical Center of Postgraduate Training is the administrative body which accepts the specialization programs, supervises the training, organizes the examinations, and awards the specialist title. Specialization in NM for physicians lasts for five years. It consists of 36 months of training in a native nuclear medicine department, 12 months of internship in radiology, 3 months in cardiology, 3 months in endocrinology, 3 months in oncology, and 3 months in two other departments of NM. If a NM trainee is a specialist of a clinical discipline and/or is after a long residency in NM departments, the specialization in NM can be shortened to three years. During the training, there are obligatory courses to be attended which include the elements of anatomy imaging in USG, CT, and MR. Currently, there are about 170 active NM specialists working for 38.5 million inhabitants in Poland. For other professionals working in NM departments, it is possible to get the title of a medical physics specialist after completing 3.5 years of training (for those with a master's in physics, technical physics or biomedical engineering) or the title of a radiopharmacy specialist after completing 3 years of training (for those with a master's in chemistry or biology). At present, the specialization program in NM for nurses is being developed by the Medical Centre of Postgraduate Education. Continuing education and professional development are obligatory for all physicians and governed by the Polish Medical Chamber. The Polish Society of Nuclear Medicine (PTMN) organizes regular

Nuclear medicine training and practice in Poland

Energy Technology Data Exchange (ETDEWEB)

Teresinska, Anna [Institute of Cardiology, Department of Nuclear Medicine, Warsaw (Poland); Birkenfeld, Bozena [Pomeranian Medical University, Department of Nuclear Medicine, Szczecin (Poland); Krolicki, Leszek [Warsaw Medical University, Department of Nuclear Medicine, Warsaw (Poland); Dziuk, Miroslaw [Military Institute of Medicine, Department of Nuclear Medicine, Warsaw (Poland)

2014-10-15

In Poland, nuclear medicine (NM) has been an independent specialty since 1988. At the end of 2013, the syllabus for postgraduate specialization in NM has been modified to be in close accordance with the syllabus approved by the European Union of Medical Specialists and is expected to be enforced before the end of 2014. The National Consultant in Nuclear Medicine is responsible for the specialization program in NM. The Medical Center of Postgraduate Training is the administrative body which accepts the specialization programs, supervises the training, organizes the examinations, and awards the specialist title. Specialization in NM for physicians lasts for five years. It consists of 36 months of training in a native nuclear medicine department, 12 months of internship in radiology, 3 months in cardiology, 3 months in endocrinology, 3 months in oncology, and 3 months in two other departments of NM. If a NM trainee is a specialist of a clinical discipline and/or is after a long residency in NM departments, the specialization in NM can be shortened to three years. During the training, there are obligatory courses to be attended which include the elements of anatomy imaging in USG, CT, and MR. Currently, there are about 170 active NM specialists working for 38.5 million inhabitants in Poland. For other professionals working in NM departments, it is possible to get the title of a medical physics specialist after completing 3.5 years of training (for those with a master's in physics, technical physics or biomedical engineering) or the title of a radiopharmacy specialist after completing 3 years of training (for those with a master's in chemistry or biology). At present, the specialization program in NM for nurses is being developed by the Medical Centre of Postgraduate Education. Continuing education and professional development are obligatory for all physicians and governed by the Polish Medical Chamber. The Polish Society of Nuclear Medicine (PTMN) organizes

Clinical implications for substandard, nonproprietary medicines in multiple sclerosis: focus on fingolimod

Directory of Open Access Journals (Sweden)

Correale J

2016-06-01

Full Text Available Jorge Correale,1 Erwin Chiquete,2 Alexey Boyko,3 Roy G Beran,4–6 Jorge Barahona Strauch,7,8 Snezana Milojevic,9 Nadina Frider101Department of Neurology, Raúl Carrea Institute for Neurological Research, Foundation for the Fight against Infant Neurological Illnesses (FLENI, Buenos Aires, Argentina; 2Department of Neurology and Psychiatry, Salvador Zubirán National Institute of Medical Sciences and Nutrition, Mexico City, Mexico; 3Clinical and Research Center “MS and Other Demyelinating Diseases” at the Neuroclinical Hospital, Department of Neurology, Neurosurgery and Medical Genetics of the Pirogov Russian National Research Medical University, Moscow, Russia; 4South Western Clinical School, University of New South Wales, Liverpool, 5Department of Neurology, Liverpool Hospital, Sydney, NSW, 6School of Medicine, Griffith University, Southport, QLD, Australia; 7Department of Neurology, Clínica Alemana de Santiago, 8School of Medicine, Universidad del Desarrollo, Santiago, Chile; 9Novartis Pharma AG, Basel, Switzerland; 10Novartis Latin America and Canada Region, Buenos Aires, ArgentinaAbstract: Both proprietary and nonproprietary medicines are expected to undergo rigorous preapproval testing and both should meet stringent health authority regulatory requirements related to quality to obtain approval. Nonproprietary (also known as copy, or generic medicines, which base their authorization and use on the proprietary documentation and label, are often viewed as a means to help lower the cost and, thus, increase patient access. If these medicines fail to meet quality standards, such as good manufacturing practice and bioequivalence (in humans, they are then defined as substandard copies and can pose serious risks to patients in terms of safety and efficacy. Potentially noncontrolled or different manufacturing process and excipients in nonproprietary medicines may result in poor batch-to-batch reproducibility (accurate and consistent quantity of

Recent perspectives on the medicinal potential of ginger

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Gunathilake KDPP

2015-10-01

Full Text Available KDPP Gunathilake,1 HP Vasantha Rupasinghe2 1Department of Food Science and Technology, Faculty of Livestock, Fisheries and Nutrition, Wayamba University of Sri Lanka, Makandura, Gonawila, Sri Lanka; 2Department of Environmental Sciences, Faculty of Agriculture, Dalhousie University, Truro, NS, Canada Abstract: Ginger (Zingiber officinale is a globally known food and flavoring ingredient which is also reputed for its wide range of medicinal properties. The rhizome of ginger consists of a unique homologous series of compounds, gingerols, which are the major phenolic plant secondary metabolites responsible for its unique flavor and health benefits. Over the last 2 decades, extensive research has been conducted to identify bioactive constituents and medicinal potential of ginger. This review deliberates chemical composition as well as the most recent research findings on potential health benefits of ginger, including its antimicrobial, anti-inflammatory, blood pressure-lowering, cholesterol-lowering, antiplatelet aggregation, chemopreventive, antioxidant, and hypoglycemic properties. Keywords: ginger, gingerols, medicinal properties, Zingiber officinale, health

Assessment of OEP health's risk in nuclear medicine

International Nuclear Information System (INIS)

Santacruz-Gomez, K.; Manzano, C.; Melendrez, R.; Castaneda, B.; Barboza-Flores, M.; Pedroza-Montero, M.

2012-01-01

The use of ionizing radiation has been increased in recent years within medical applications. Nuclear Medicine Department offers both treatment and diagnosis of diseases using radioisotopes to controlled doses. Despite the great benefits to the patient, there is an inherent risk to workers which remains in contact with radiation sources for long periods. These personnel must be monitored to avoid deterministic effects. In this work, we retrospectively evaluated occupationally exposed personnel (OEP) to ionizing radiation in nuclear medicine during the last five years. We assessed both area and personal dosimetry of this department in a known Clinic in Sonora. Our results show an annual equivalent dose average of 4.49 ± 0.70 mSv in OEP without showing alarming changes in clinical parameters analyzed. These results allow us to conclude that health of OEP in nuclear medicine of this clinic has not been at risk during the evaluated period. However, we may suggest the use of individual profiles based on specific radiosensitivity markers.

Pensamento, Teoria e Estudos Latino-americanos

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Jacques de Novion

2014-12-01

Full Text Available RESUMO O presente trabalho configura como artigo inicial do Dossiê Especial – Pensamento, Teoria e Estudos Latino-americanos, organizado conjuntamente por nós, a pedido da Revista de Estudos e Pesquisas sobre as Américas (CEPPAC, do Instituto de Ciências Sociais (ICS, da Universidade de Brasília (UnB. De forma breve, este artigo apresenta a importância alcançada pelo Pensamento, pela Teoria, e, sobre tudo, pelos Estudos Latino-americanos nas últimas décadas. Em seguida, o artigo apresenta os quatorze trabalhos e uma resenha que compõem este Dossiê, resultado da contribuição de diferentes pesquisadores de distintas localidades da região, organizados em três blocos: Ciências Sociais Latino-americanas, Pensamento e Estudos. PALAVRAS CHAVE: Ciências Sociais Latino-americanas; Pensamento Latino-americanos; Teoria Latino-americana; Estudos Latino-americanos. --- RESUMEN El presente trabajo configura como articulo inicial del Dossier Especial – Pensamiento Teoría y Estudios Latinoamericanos, organizado conjuntamente por nosotros, a pedido de la Revista de Estudos e Pesquisas sobre as Américas (CEPPAC, del Instituto de Ciências Sociais (ICS, de la Universidade de Brasília (UnB. De forma breve, este articulo presenta la importancia alcanzada por el Pensamiento, por la Teoría, y, sobre todo, por los Estudios Latinoamericanos en las últimas décadas. En seguida, el articulo presenta los catorce trabajos e una reseña que componen este Dossier, resultado de la contribución de diferentes investigadores de distintas localidades de la región, organizados en tres bloques: Ciencias Sociales Latinoamericanas, Pensamiento y Estudios. PALABRAS CLAVE: Ciencias Sociales Latinoamericanas; Pensamiento Latinoamericano; Teoría Latinoamericana; Estudios Latinoamericanos. --- ABSTRACT This paper is set up as the initial article of this Special Dossier - Thought, Theory and Latin American Studies, which we organized collectively, at the request

Waste water management in radiation medicine laboratories

International Nuclear Information System (INIS)

Song Miaofa

1990-01-01

A new building has been used since 1983 in the department of radiation medicine of Suzhou Medical College. Management, processing facilities, monitoring, discharge and treatment of 147 Pm contaminated waste water are reported

76 FR 78672 - National Library of Medicine; Notice of Meetings

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2011-12-19

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75 FR 13136 - National Library of Medicine; Notice of Meetings

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2010-03-18

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2013-06-18

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2012-12-05

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2013-12-19

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2013-06-18

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2012-12-05

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2010-07-20

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2013-03-26

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76 FR 45842 - National Library of Medicine Notice of Meetings

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2011-08-01

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2010-12-16

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2012-03-26

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2012-07-05

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2010-07-29

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2011-03-17

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2013-03-26

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7 CFR 160.94 - Spirits of turpentine for medicinal use.

Science.gov (United States)

2010-01-01

... 7 Agriculture 3 2010-01-01 2010-01-01 false Spirits of turpentine for medicinal use. 160.94 Section 160.94 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING... for medicinal use. Spirits of turpentine so packed, described, labeled, or sold as to indicate that it...

State of emergency medicine in Azerbaijan.

Science.gov (United States)

Sule, Harsh; Kazimov, Shirin; Shahmaliyev, Oktay; Sirois, Adam

2008-04-01

There has been no previous study into the state of emergency medicine in Azerbaijan. As a legacy of the Soviet Semashko system, the "specialty" model of emergency medicine and integrated emergency departments do not exist here. Instead, pre-hospital emergency care is delivered by ambulance physicians and in-hospital care by individual departments, often in specialty hospitals. Emergency care is therefore fragmented, highly specialized and inefficient. The Emergency Medicine Development Initiative (EMDI) of the International Medical Corps (IMC) was designed to improve the quality of emergency care in four pilot regional centers in Azerbaijan. The objective of this study was to assess the baseline emergency medical capacity of these four centers. EMDI staff conducted a four-part baseline survey in April 2006 to assess emergency care in Ganja (the second largest city in Azerbaijan), Kurdamir, Shamkir and Yevlakh. Data collection involved interviews with relevant personnel and a retrospective records review in each city. Pre-hospital: The number of ambulance teams per 10,000 inhabitants is below the number required by local regulations. On average, 45% of 27 medications and 37% of 17 pieces of critical equipment were available. Of the emergency procedures, 21% could be performed in the pre-hospital setting. In-hospital: Admission rates were near 100% for the admissions department-an area that is supposed to function as an emergency department would. On average 57% of 40 medications and 42% of 22 pieces of critical equipment were available. Of the emergency procedures, 62% could be performed in the in-hospital setting. The emergency medical system surveyed in Azerbaijan is inefficiently organized, under-financed, poorly equipped and lacks adequately trained staff. Reforms need to be directed towards achieving international standards, while adapting new models for service delivery into the existing framework and improving system capacity as highlighted by this baseline

Increasing emergency medicine residents' confidence in disaster management: use of an emergency department simulator and an expedited curriculum.

Science.gov (United States)

Franc, Jeffrey Michael; Nichols, Darren; Dong, Sandy L

2012-02-01

Disaster Medicine is an increasingly important part of medicine. Emergency Medicine residency programs have very high curriculum commitments, and adding Disaster Medicine training to this busy schedule can be difficult. Development of a short Disaster Medicine curriculum that is effective and enjoyable for the participants may be a valuable addition to Emergency Medicine residency training. A simulation-based curriculum was developed. The curriculum included four group exercises in which the participants developed a disaster plan for a simulated hospital. This was followed by a disaster simulation using the Disastermed.Ca Emergency Disaster Simulator computer software Version 3.5.2 (Disastermed.Ca, Edmonton, Alberta, Canada) and the disaster plan developed by the participants. Progress was assessed by a pre- and post-test, resident evaluations, faculty evaluation of Command and Control, and markers obtained from the Disastermed.Ca software. Twenty-five residents agreed to partake in the training curriculum. Seventeen completed the simulation. There was no statistically significant difference in pre- and post-test scores. Residents indicated that they felt the curriculum had been useful, and judged it to be preferable to a didactic curriculum. In addition, the residents' confidence in their ability to manage a disaster increased on both a personal and and a departmental level. A simulation-based model of Disaster Medicine training, requiring approximately eight hours of classroom time, was judged by Emergency Medicine residents to be a valuable component of their medical training, and increased their confidence in personal and departmental disaster management capabilities.

Desafios dos Estudos Gays, Lésbicos e Transgêneros

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Denilson Lopes

2008-09-01

Full Text Available Resumo: Este ensaio introduz algumas questões relativas aos estudos feministas, gays, lésbicos, transgênecos e teoria queer na busca de contribuições teórico-metodológicas na análise da cultura contemporânea. Palavras-chave: Estudos gays e lésbicos, estudos transgêneros, teoria queer, cultura. Abstrat: This essay introduces some issues related tofeminist studies, gay and lesbian studies, transgender studies and queer theory in the search of theoretical and methodological contributions in the analysis of contemporary culture. Key-words: Gay and Lesbian Studies, transgender studies, queer theory, culture

Staff radiation doses associated with nuclear medicine procedures - a review of some recent measurements

International Nuclear Information System (INIS)

Harding, L.K.; Mostafa, A.B.; Thomson, W.H.

1990-01-01

Despite publication of the Approved Code of Practice and the Notes for Guidance, implementation of the UK Ionising Radiation Regulations has required local interpretation by nuclear medicine departments. One problem has been the lack of data upon which decisions can be based. In the last five years we and others have made a number of measurements of radiation doses to staff relating to nuclear medicine practice. This paper collates, summarizes and comments on this information. Where possible, results have been expressed in relation to the workload of an average nuclear medicine department. (author)

Sintomas depressivos em crianças: estudos com duas versões do CDI

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Miriam Cruvinel

Full Text Available O objetivo deste estudo foi identificar o número de crianças com sintomas depressivos em duas amostras de estudantes da cidade de campinas. Utilizou-se, no estudo 1, a versão brasileira do Inventário de Depressão Infantil (CDI e, no estudo 2, a versão original. Do estudo 1, realizado em 2001, participaram 169 estudantes de 3ª, 4ª e 5ª séries, e, do estudo 2, conduzido em 2005, 157 alunos de 3ª e 4ª séries. A prevalência de sintomatologia depressiva no estudo 1 foi de 3,55%, e, no estudo 2, de 17%. Em ambos os estudos, não foram encontradas diferenças significativas entre a média no CDI em relação às variáveis demográficas. conclui-se pela necessidade de mais estudos nacionais de prevalência no ensino fundamental e de esforços direcionados não só para a identificação dos fatores de risco, de proteção e das variáveis associadas mas também do refinamento dos instrumentos de medidas da depressão infantil.

Medicinal plants from Mali: Chemistry and biology.

Science.gov (United States)

Wangensteen, Helle; Diallo, Drissa; Paulsen, Berit Smestad

2015-12-24

Mali is one of the countries in West Africa where the health system rely the most on traditional medicine. The healers are mainly using medicinal plants for their treatments. The studies performed being the basis for this review is of importance as they will contribute to sustaining the traditional knowledge. They contribute to evaluate and improve locally produced herbal remedies, and the review gives also an overview of the plant preparations that will have the most potential to be evaluated for new Improved Traditional Medicines. The aim of this review is to give an overview of the studies performed related to medicinal plants from Mali in the period 1995-2015. These studies include ethnopharmacology, chemistry and biological studies of the plants that were chosen based on our interviews with the healers in different regions of Mali, and contribute to sustainable knowledge on the medicinal plants. The Department of Traditional Medicine, Bamako, Mali, is responsible for registering the knowledge of the traditional healers on their use of medicinal plants and also identifying compounds in the plants responsible for the bioactivities claimed. The studies reported aimed at getting information from the healers on the use of medicinal plants, and study the biology and chemistry of selected plants for the purpose of verifying the traditional use of the plants. These studies should form the basis for necessary knowledge for the development of registered Improved Traditional Medicines in Mali. The healers were the ethnopharmacological informants. Questions asked initially were related to wound healing. This was because the immune system is involved when wounds are healed, and additionally the immune system is involved in the majority of the illnesses common in Mali. Based on the results of the interviews the plant material for studies was selected. Studies were performed on the plant parts the healers were using when treating their patients. Conventional chromatographic

The Radiation Hygiene Department's activity in period of 1980-1994

International Nuclear Information System (INIS)

Bahnarel, I.

2009-01-01

The paper analyzes 15 years activity of the Radiation Hygiene Department of the National Scientific-Practical Centre of Preventive Medicine, Republic of Moldova: historical aspect, personnel management, equipment, international cooperation, projects, advances and problems

estudo comparativo

OpenAIRE

Álvaro, Rocha

2005-01-01

O sítio web é um importante meio de comunicação e competitividade das universidades. Há diferentes razões para acreditar que os sítios possam variar entre universidades, mas contudo há certeza da existência de requisitos de qualidade comuns e transversais a todas. Este estudo visou avaliar, de forma quantitativa e objectiva, o cumprimento de requisitos de qualidade pelos sítios web das Universidades Portuguesas, com base nas características de alto nível da norma ISO 9126-1 que interessam aos...

Analysis of changed bio-signal to radiation exposure of nuclear medicine worker

International Nuclear Information System (INIS)

Lee, Hwun Jae; Lee, Sang Bock

2007-01-01

In this paper, we are evaluated about bio-signal between general workers and nuclear medicine workers which is more radiation exposure relatively. In order to reciprocal evaluated two group, we experimented nuclear medicine workers in Chung-Buk National University Hospital at department of nuclear medicine and worker in Chon-Nam National University Hospital at CT room, general radiographic room, medical recording room, receipt room, general office room. Used of experimental equipments as follows, for a level of radiation measurement by pocket dosimeter which made by Arrow-Tech company, for heart rate and blood pressure measurement by TONOPORT V which made by GE medical systems company, for heat flux and skin temperature and energy expenditure measurement by Armband senseware 2000 which made by Bodymedia company. Result of experiment obtains as follows : 1) Individual radiation exposure is recorded 3.05 uSv at department of nuclear medicine and order as follows CT room, general radiograpic room, medical recording room, receipt room, general office room. Department of nuclear medicine more 1.5 times than other places. 2) Radiation accumulated dose is not related to Heat flux, Skin temperature, Energy expenditure. 3) Blood pressure is recorded equal to nuclear medical workers, general officer, general people about systolic blood pressure and diastolic blood pressure. Compared to blood pressure between nuclear medical works which is more radiation exposure and other workers was not changed. Consequently, more radiation exposed workers at nuclear medicine field doesn't have hazard

Workplace violence in emergency medicine

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A. Chatterjee*

2013-12-01

Conclusion: Violence against ED health care workers is a real problem with significant implications to the victims, patients, and departments/institutions. ED WPV needs to be addressed urgently by stakeholders through continued research on effective interventions specific to Emergency Medicine. Coordination, cooperation, and active commitment to the development of such interventions are critical.

Expedition medicine: A southern African perspective

African Journals Online (AJOL)

adventure tourists with adequate financial means. ... made wilderness expeditions much safer, they have not been able ... to space – the unifying characteristics of expedition medicine remain ... 4 Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Cape Town, ... Therefore, while learning.

The pregnancy question: a survey regarding the establishment of whether females of childbearing age are or may be pregnant prior to radiation exposures in diagnostic radiology and nuclear medicine departments in the UK

International Nuclear Information System (INIS)

Lewis, C.; Arscott, T.

2008-01-01

Full text: In the UK, the Ionising Radiation (Medical Exposure) Regulations 2000 state that 'the written procedure for medical exposures shall include...procedures for making enquiries of females of childbearing age to establish whether the individual is or may be pregnant...'. Despite the importance of this question and the potential for causing great distress and anxiety if an examination involving ionising radiation is performed on a pregnant patient, the guidance available is vague and there is no universally accepted procedure on when and how to ask this difficult question. Anecdotal evidence suggests that the procedure for enquiring about possible pregnancy varies from department to department. To investigate this further, we devised a questionnaire to send out to diagnostic radiology and nuclear medicine departments across the UK. Questions asked related to the department's written procedure, the examinations for which the question would be asked, the age of women asked and the recording of whether the question was asked and the outcome. Responses were received from over 300 individuals from 66 different hospitals. The majority (73.5%) were from X-ray departments, 14.0% were from nuclear medicine and the remaining 12.5% included computed tomography, neuroradiology, angiography and cardiac catheter labs. 97.0% have a written procedure, 1.2% do not, 0.9% do not know and 0.9% gave no response. Of the responses from X-ray departments, 17% ask the question for all examinations, while 83% ask for examinations of specific body regions. Several body regions were stated and were divided into 9 categories with the main one being diaphragm to knees (45%). Nuclear medicine departments ask for all examinations. With regard to establishing the 'childbearing age', 5% state that for younger and older patients they ascertain whether the female has started/stopped menstruation before asking the pregnancy question (no age range given), and 95% state an age range of the females

76 FR 14036 - National Library of Medicine; Notice of Closed Meetings

Science.gov (United States)

2011-03-15

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Library of Medicine.... Individuals who plan to attend and need special assistance, such as sign language interpretation or other...: Review and Analysis of Systems. Place: National Library of Medicine, Building 38, 2nd Floor, Board Room...

[In vivo mutagenicity and clastogenicity of ionizing radiation in nuclear medicine

International Nuclear Information System (INIS)

1989-01-01

The overall goals of our research remains to investigate the mutagenic and clastogenic effects of exposure to low levels of ionizing radiation in human lymphocytes. We are studying hospital patients referred to a nuclear medicine department for diagnostic cardiac imaging and nuclear medicine technologists who administer radionuclides

Group Peer Mentoring: An Answer to the Faculty Mentoring Problem? A Successful Program at a Large Academic Department of Medicine.

Science.gov (United States)

Pololi, Linda H; Evans, Arthur T

2015-01-01

To address a dearth of mentoring and to avoid the pitfalls of dyadic mentoring, the authors implemented and evaluated a novel collaborative group peer mentoring program in a large academic department of medicine. The mentoring program aimed to facilitate faculty in their career planning, and targeted either early-career or midcareer faculty in 5 cohorts over 4 years, from 2010 to 2014. Each cohort of 9-12 faculty participated in a yearlong program with foundations in adult learning, relationship formation, mindfulness, and culture change. Participants convened for an entire day, once a month. Sessions incorporated facilitated stepwise and values-based career planning, skill development, and reflective practice. Early-career faculty participated in an integrated writing program and midcareer faculty in leadership development. Overall attendance of the 51 participants was 96%, and only 3 of 51 faculty who completed the program left the medical school during the 4 years. All faculty completed a written detailed structured academic development plan. Participants experienced an enhanced, inclusive, and appreciative culture; clarified their own career goals, values, strengths and priorities; enhanced their enthusiasm for collaboration; and developed skills. The program results highlight the need for faculty to personally experience the power of forming deep relationships with their peers for fostering successful career development and vitality. The outcomes of faculty humanity, vitality, professionalism, relationships, appreciation of diversity, and creativity are essential to the multiple missions of academic medicine. © 2015 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital Medical Education.

Aligning clinical compensation with clinical productivity: design and implementation of the financial value unit (FVU) system in an academic department of internal medicine.

Science.gov (United States)

Stites, Steven; Steffen, Patrick; Turner, Scott; Pingleton, Susan

2013-07-01

A new metric was developed and implemented at the University of Kansas School of Medicine Department of Internal Medicine, the financial value unit (FVU). This metric analyzes faculty clinical compensation compared with clinical work productivity as a transparent means to decrease the physician compensation variability and compensate faculty equitably for clinical work.The FVU is the ratio of individual faculty clinical compensation compared with their total work relative value units (wRVUs) generated divided by Medical Group Management Association (MGMA) salary to wRVUs of a similar MGMA physician.The closer the FVU ratio is to 1.0, the closer clinical compensation is to that of an MGMA physician with similar clinical productivity. Using FVU metrics to calculate a faculty salary gap compared with MGMA median salary and wRVU productivity, a divisional production payment was established annually.From FY 2006 to FY 2011, both total faculty numbers and overall clinical activity increased. With the implementation of the FVU, both clinical productivity and compensation increased while, at the same time, physician retention rates remained high. Variability in physician compensation decreased. Dramatic clinical growth was associated with the alignment of clinical work and clinical compensation in a transparent and equable process.

ACREDITAÇÃO HOSPITALAR: UM ESTUDO DE CASO

Directory of Open Access Journals (Sweden)

Felipe Antunes

2005-06-01

Full Text Available Este artigo aborda a qualidade e acreditação hospitalar através do Manual das Organizações Prestadoras de Serviços Hospitalares, desenvolvido pela Organização Nacional de Acreditação (ONA. O objetivo geral deste trabalho é avaliar o processo de acreditação, identificando dificuldades e benefícios advindos da implantação deste  Manual. Após a realização de uma revisão bibliográfica sobre qualidade em hospitais e normas da qualidade aplicáveis a hospitais, é feita uma análise crítica teórica do Manual das Organizações Prestadoras de Serviços Hospitalares. Tal análise crítica inclui um estudo comparativo entre os requisitos do Manual e da norma NBR ISO 9001/2000. A seguir, a análise teórica é complementada através de um estudo de caso contemplando a implantação do Manual junto a um hospital de grande porte. Finalmente, são apresentadas as conclusões, baseadas tanto no estudo teórico como no estudo prático.

Medicine Clerkship Implementation in a Hospitalist Group: Curricular Innovation and Review

Science.gov (United States)

Carter, William J.

2016-01-01

Background: In 2008, the Department of Hospital Medicine at Ochsner Clinic Foundation in New Orleans, LA, began training its own students for the first time as a result of the partnership between our institution and the University of Queensland (UQ) in Brisbane, Australia, that established a global medical school. The Department of Hospital Medicine is responsible for the Medicine clerkship for third-year medical students. We have 5 resident teams at the main hospital in the system, but the majority of our hospitalists work alone. Because of staffing issues, we have had to change our mentality from having teaching hospitalists and nonteaching hospitalists to viewing all hospitalists as potential educators. Methods: The department has slowly increased the number of students in the Medicine clerkship each year with the goal of training 120 third-year students in the New Orleans area in 2016. The students in the Medicine clerkship will be divided into five 8-week rotations, allowing for 25 students to be trained at one time. Results: The UQ curriculum is similar to that of most 4-year American schools, but some differences in methods, such as a heavy emphasis on bedside instruction and oral summative assessments, are novel to us. These differences have provided our department with new goals for professional and instructor development. For the actual instruction, we pair students one on one with hospitalists and also assign them to resident teams. Student placement has been a challenge, but we are making improvements as we gain experience and explore opportunities for placement at our community hospitals. Conclusion: Our arrangement may be adapted to other institutions in the future as the number of students increases and the availability of resident teachers becomes more difficult nationwide. PMID:27046406

A postal survey of quality assurance in nuclear medicine imaging in the UK during 1988

International Nuclear Information System (INIS)

Williams, E.D.; Harding, L.K.; McKillop, J.H.

1989-01-01

A questionnaire was sent to all the estimated 200 hospital departments providing nuclear medicine imaging services in the UK. Replies were received from 162 (81%). The questionnaire was brief, but covered a wide range of aspects of a nuclear medicine service. While all responses showed departments to have some quality control procedures in operation, they were often not used correctly. In most departments there appears to be scope for improvement so that departmental managers can monitor more closely the quality of service provided. (author)

A cohort study to analyze the risk of venous thromboembolism mortality in patients admitted to the general medicine department, tan tock seng hospital, singapore.

Science.gov (United States)

Sule, Ashish Anil; Chin, Tay Jam; Sinnathamby, Letchumi; Lee, Hwei Khien; Earnest, Arul

2011-06-01

The purpose of this study was to assess the risk of venous thromboembolism (VTE) in patients admitted to the Tan Tock Seng Hospital (TTSH), Singapore during October and November 2009. The primary outcome assessed was mortality due to VTE, or development of deep vein thrombosis or pulmonary embolism (PE) within 3 months from the day of admission. Both univariate and multivariate analyses were performed for all-cause mortality and deaths associated with PE. Seven hundred twenty-one patients admitted to the 5th floor of the General Medicine Department, TTSH, during the 2 months were analyzed. There were 368 (51.04%) female patients and 353 (48.96%) male patients. As per race distribution, 566 (78.50%) patients were Chinese, 100 (13.86%) patients were Malaysians, 46 (6.38%) patients were Indians, and 9 (1.26%) were other races. Four hundred ninety-two (68.24%) were independent for activities of daily living (ADL) and 229 (31.76%) were dependent for all ADL. There were in all 42 deaths. There were definite PE deaths in 2 (4.76%) patients, probable PE deaths in 3 (7.14%) patients, and suspected PE deaths in 8 (19.05%) patients. Twenty (47.62%) deaths were due to pneumonia, 3 (7.14%) deaths were due to urinary tract infections, and 4 (9.52%) deaths were due to other infections. Two (4.76%) deaths were due to myocardial infarction. The risk of VTE was high in acutely ill patients admitted to the General Medicine Department, TTSH, Singapore. The factors that predispose patients to a very high risk are ADL dependence, acute heart failure, past history of VTE, or if they are clinically dehydrated and have acute renal failure. This warrants increased awareness and need for VTE prophylaxis.

Integrating complementary/alternative medicine into primary care: evaluating the evidence and appropriate implementation

Directory of Open Access Journals (Sweden)

Wainapel SF

2015-12-01

Full Text Available Stanley F Wainapel,1 Stephanie Rand,1 Loren M Fishman,2 Jennifer Halstead-Kenny1 1The Arthur S Abramson Department of Physical Medicine and Rehabilitation, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, 2Department of Rehabilitation and Regenerative Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, USA Abstract: The frequency with which patients utilize treatments encompassed by the term complementary/alternative medicine (CAM is well documented. A number of these therapies are beginning to be integrated into contemporary medical practice. This article examines three of them: osteopathic manipulation, yoga, and acupuncture, with a focus on their physiological effects, efficacy in treating medical conditions commonly encountered by practitioners, precautions or contraindications, and ways in which they can be incorporated into clinical practice. Physicians should routinely obtain information about use of CAM as part of their patient history and should consider their role based on physiological effects and clinical research results. Keywords: integrative medicine, osteopathic manipulation, yoga, acupuncture therapy

Overview of radiation protection programme in nuclear medicine facility for diagnostic procedures

International Nuclear Information System (INIS)

Ahmed, Ezzeldein Mohammed Nour Mohammed

2015-02-01

This project was conducted to review Radiation Protection Program in Nuclear Medicine facility for diagnostic procedures which will provide guide for meeting the standard and regulatory requirements in diagnostic nuclear medicine. The main objective of this project is to keep dose to staff, patient and public as low as reasonably achievable (ALARA). The specific objectives were to review the Radiation Protection Program (RPP) in diagnostic nuclear medicine and to make some recommendation for improving the level of radiation protection in diagnostic nuclear medicine that will help to control normal exposure and prevent or mitigate potential exposure. The methodology used is review of various documents. The review showed that if the Radiation Protection Program is inadequate it leads to unjustified exposure to radiation. Finally, this study stated some recommendations that if implemented could improve the level of radiation protection in nuclear medicine department. One of the most important recommendations is that a qualified Radiation Protection Officer (RPO) should be appointed to lay down and oversee a radiation protection in the nuclear medicine department. The RPO must be given the full authority and the adequate time to enable him to perform his duties effectively. (au)

Impact of the prospective payment system on the delivery of nuclear medicine services

International Nuclear Information System (INIS)

Crucitti, T.W.; Pappas, V.M.

1986-07-01

The study evaluates the effect of the Medicare Prospective Payment System (PPS) on nuclear medicine technologists and services. Since 80% of nuclear medicine technologists work in hospitals, a large segment of the professionals would be affected by the new system. The survey was designed to assess the PPSs effect on nuclear medicine departments at the early implementation stage

Qualitative Research on Emergency Medicine Physicians

DEFF Research Database (Denmark)

Paltved, Charlotte; Musaeus, Peter

2012-01-01

Aim: This study aims to systematically review the qualitative research studying Emergency Medicine (EM) physicians in Emergency Departments (ED). Background: Qualitative research aims to study complex social phenomena. EM is a highly complex medical and social environment that can be investigated...... with qualitative research. Methods: Electronic databases of English peer-reviewed articles were searched from 1971 to 2012 using Medline through PubMed and PsychINFO. This search was supplemented with hand-searches of Academic Emergency Medicine and Emergency Medicine Journal from 1999 to 2012 and cross references...... and training, communication, professional roles, and organizational factors, and into 12 sub-themes. Conclusion: The strength of qualitative research is its ability to grasp and operationalize complex relations within EM. Although qualitative research methodologies have gained in rigour in recent years and few...

[Lung abscess and thoracic empyema: retrospective analysis in an internal medicine department].

Science.gov (United States)

Monteiro, Rita; Alfaro, Tiago M; Correia, Lurdes; Simão, Adélia; Carvalho, Armando; Costa, J Nascimento

2011-12-01

Lung abscess is a collection of necrotic and suppurated tissue located at the pulmonary parenchyma. Empyema is defined as the presence of pus in the pleural space. To study the clinical and microbiological characteristics, treatment and prognosis of patients with lung abscess and/or empyema admitted to an Internal Medicine ward. A retrospective analysis of medical records was performed, including all patients admitted to an Internal Medicine ward for lung abscess or empyema, between 2000 and 2008. Thirty patients were included (22 males/ eight females), accounting for 0.18% of all patients admitted in this ward in the same period. Three patients had pulmonary abscess, 18 empyema, and nine both diseases. The average age was 68.5 years (31 to 90). The most frequent complaints were dyspnoea (90%), fever (73.3%), cough (66.7%), weight loss (60%) and chest pain (53.3%). The most frequent associated disorders were stroke associated disability (46.7%), heart failure (43.3%) and arterial hypertension (33.3%). Thoracentesis was performed in all patients with empyema. In one patient with lung abscess an anaerobic microorganism was identified. In patients with empyema, cultures were positive in 61.1% of cases, with a slight predominance of methicillin-resistant Staphylococcus aureus (27.3%) and Prevotella intermedia (18.2%). In patients with both abscess and empyema, cultures of the abscess were positive in 44.4% and of the pleural fluid in 33.3%, with no predominant microorganism. Empiric antimicrobial therapy was started in all patients and later adapted to the antibiotic sensitivity test results. Surgery was performed in three patients. Seven patients (23.3%) died during admission. The average age of the patients who died was 81.3 years and of those who survived was 64.5 years. Lung abscess and empyema are infrequent diseases in an Internal Medicine ward, affect mostly males and have unspecific clinical manifestations. The chest X-ray, computed tomography (CT) and

The application of nuclear-medicine methods in veterinary medicine

International Nuclear Information System (INIS)

Simpraga, M.; Kraljevic, P.; Dodig, D.

1996-01-01

X-radiography and ultrasound imaging are well established and widely used in veterinary practice, but it is not the same situation with radioisotope imaging. In veterinary practice the above mentioned methods of nuclear medicine are developed only in two countries in Europe. That is not doubt due, so bar, to the difficulties in obtaining satisfactory supply of radioisotopes and to the relatively high cost of scanning equipment. However, in collaboration with the Department of Radiation Protection and Nuclear Medicine of the Medical Faculty in Zagreb, Croatia, we have chance to develop the use of those methods in clinical veterinary practice in Zagreb. That is way in this paper an overview of the application of radioisotopes imaging in veterinary medicine is given. In small animals skeletal changes, lung perusions, brain lesions, space occupying lesions in the liver and its function and hearth function can be usefully searched by a gamma camera and its associated computer. In equine practice scintigraphy of bones, liver, hearth, pulmonary circulation and ventilation is described. The largest amount of radioactive material is used during gamma camera scanning of the skeletons of horses. In this cases the radiation dose 1-2 m from the animal is approximately 3 μSv/h. That is why the protection of personal involved in radioisotope scanning in veterinary medicine must be also regulated by low of radiation protection. Also, the animals should be confined to a controlled area for 2-3 days after scanning before being returned to their owners. After this period the area must be cleaned. (author)

Evolution of family medicine in Kenya (1990s to date): a case study

African Journals Online (AJOL)

PM Chege

1999-08-26

Aug 26, 1999 ... aDepartment of Family Medicine, Moi University College of Health, Eldoret, Kenya. bDepartment ... The challenges include the lack of Kenyan teachers of the programme and the introduction ... in the establishment of FM departments in medical schools in .... Kenya Commission for Higher Education (CHE).

Marketing do mercado de luxo: Estudo de caso Victoria's Secret

OpenAIRE

Ana Francisca Giuliani

2013-01-01

Este artigo teve por objetivo identificar quais são as estratégias de marketing utilizadas pela empresa varejista Victoria’s Secret para a fidelização do consumidor de luxo em nível global. O estudo caracterizou-se como uma pesquisa qualitativa, utilizando-se como estratégia de campo o estudo de caso de caráter ilustrativo. Para o alcance do objetivo proposto, dividiu-se o estudo em duas fases. Na primeira, denominada exploratória, buscou-se em dados secundários o embasamento para a construçã...

76 FR 78234 - Medicine Bow-Routt National Forests and Thunder Basin National Grassland, Campbell County, WY...

Science.gov (United States)

2011-12-16

... DEPARTMENT OF AGRICULTURE Forest Service Medicine Bow-Routt National Forests and Thunder Basin... Supervisor, Medicine Bow-Routt National Forests and Thunder Basin National Grassland, 2250 East Richards.... Responsible Official Richard Cooksey, Deputy Forest Supervisor, Medicine Bow-Routt National Forests and...

Optimization of radiation protection (OPR) of workers in nuclear medicine department occupationally to ionizing radiation

International Nuclear Information System (INIS)

Ugrinska, Ana; Crcareva, Biljana; Andonovski, Boris

2010-01-01

Occupational radiation exposure of nuclear medicine personnel arise either from external irradiation during the handling or from the entry of radioactive substances in the body; the major source of external irradiation is the patient that has received a radiopharmaceutical for diagnostic or therapeutic purposes. In this study we present the dosimetry monitoring of the personnel at the Institute of Pathophysiology and Nuclear Medicine in Skopje (IPNM) before and after the implementation the methods of ORP. Twenty-seven employees were optimized with standard TLD card, monthly, expressed as whole body personal dose in the period of use of dosimeter. Annual Effective Doses (AED) are presented for years: 2001, 2004, 2005, 2006, 2007, 2008. In the year 2005, after measurement from Technical Service Organization, IPNM Radiation Protection Officer (RPO) designed and implemented new recommendation and modality such as: designation of areas, introducing ambiental dose measurements, classification of employees, personnel rotation, risk assessment, occupational dose constraints, education of personnel, compliance with written procedures and establishing the Programme for Radiation Protection (RP). ORP measures were applied during the year of 2006, so the results of 2001, 2004 and 2005 correspond to unopimized RP. We were evaluated three groups: radiopharmacy laboratory (RPL), nuclear medicine technologist (NMT) and medical doctors. The third group was further divided according to the AED in group with AED bellow 1.6 mSv (MD1), and group with AED above this level (MD2). The average AED in the NMT group for 2005 was 3.59 mSv, while in 2008 it was 1.8 mSv; for MD1 group in 2005 was 1.5 mSv and in MD2 was 3.0 mSv. The average AED in 2008 for MD1 was 1.1 mSv, while MD2 group comprised of only one subject with annual effective dose of 1.76 mSv. The most exposed groups were nuclear medicine technologists (NMT) and medical doctors routinely involved in everyday nuclear medicine

Family medicine in Republic of Srpska

Directory of Open Access Journals (Sweden)

Račić Maja

2015-01-01

Full Text Available The Family Medicine Development Project in Republic of Srpska was an initiative funded by the Canadian International Development Agency (CIDA. The project introduced family medicine into undergraduate curricula, established three-years long program of residency in family medicine in 1999, created departments of family medicine in both medical schools, helped with the process of establishing a professional association of family physicians, worked with Ministries of health and social welfare to establish supportive policies for these activities, and regularly provided continuing medical education programs for family practitioners during the 13 years of the project. Today, three family medicine teaching centers exist in RS (Primary health care centers Banja Luka, Foča and Bijeljina where more than 600 physicians were educated either through residency or additional training program in family medicine. Almost 1000 primary care nurses completed additional training. Family medicine centered primary health care reform was a complex innovation, involving organizational, financial, clinical and relational changes. An important factor influencing the adoption of this complex innovation in RS was the perceived benefits of the innovation: benefits which accrue to the users, family physicians, nurses and policy makers. With political commitment, an enabling economic environment and equitable distribution of resources, comprehensive primary health has proved to be a better strategy in achieving the goal of health for all. However, although family medicine passed through long journey from imposition to partnership, there is still large place for the improvement.

76 FR 71345 - Patient Safety Organizations: Voluntary Relinquishment From Emergency Medicine Patient Safety...

Science.gov (United States)

2011-11-17

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations: Voluntary Relinquishment From Emergency Medicine Patient Safety Foundation AGENCY: Agency for... notification of voluntary relinquishment from Emergency Medicine Patient Safety Foundation of its status as a...

Evaluation of radiation shielding rate of lead aprons in nuclear medicine

Energy Technology Data Exchange (ETDEWEB)

Han, Sang Hyun; Han, Beom Heui; Lee, Sang Ho [Dept. of Radiological Science, Seonam University, Asan (Korea, Republic of); Hong, Dong Heui [Dept. of Radiological Science, Far East University, Eumseong (Korea, Republic of); Kim, Gi Jin [Dept. of Nuclear Medicine, Konyang University Hospital, Daejeon (Korea, Republic of)

2017-03-15

Considering that the X-ray apron used in the department of radiology is also used in the department of nuclear medicine, the study aimed to analyze the shielding rate of the apron according to types of radioisotopes, thus γ ray energy, to investigate the protective effects. The radioisotopes used in the experiment were the top 5 nuclides in usage statistics {sup 99m}Tc, {sup 18}F, {sup 131}I, {sup 123}I, and {sup 201}Tl, and the aprons were lead equivalent 0.35 mmPb aprons currently under use in the department of nuclear medicine. As a result of experiments, average shielding rates of aprons were {sup 99m}Tc 31.59%, {sup 201}Tl 68.42%, and {sup 123}I 76.63%. When using an apron, the shielding rate of {sup 13}'1I actually resulted in average dose rate increase of 33.72%, and {sup 18}F showed an average shielding rate of –0.315%, showing there was almost no shielding effect. As a result, the radioisotopes with higher shielding rate of apron was in the descending order of {sup 123}I, {sup 201}Tl, {sup 99m}Tc, {sup 18}F, {sup 131}I. Currently, aprons used in the nuclear medicine laboratory are general X-ray aprons, and it is thought that it is not appropriate for nuclear medicine environment that utilizes γ rays. Therefore, development of nuclear medicine exclusive aprons suitable for the characteristics of radioisotopes is required in consideration of effective radiation protection and work efficiency of radiation workers.

Pragmatismo e os pragmáticos nos estudos organizacionais

Directory of Open Access Journals (Sweden)

Francis Kanashiro Meneghetti

Full Text Available O objetivo central deste ensaio teórico é avaliar as contribuições do pragmatismo nos Estudos Organizacionais e, os específicos, avaliar se as contribuições teóricas de Charles Peirce e John Dewey possibilitam afirmar o pragmatismo como senso comum, ciência ou teoria do conhecimento; analisar as contribuições - possibilidadese limites - do pragmatismo como conhecimento científico; compreender os percursos do pragmatismo nos Estudos Organizacionais. Chaga-se a conclusão de que ser pragmático é diferente de conceber estudos articulados no campo epistemológico do pragmatismo. O sujeito pragmático vê na sua utilidade e na necessidade deação, o ponto de tensão que coloca em dúvida a veracidade dos pressupostos do pragmatismo como ciência. O que ocorre nos Estudos Organizacionais éa conversão do pragmatismo como conhecimento científico emsubordinação irracional à utilidade e à ação prática, sobretudo, no campo da economia, da política, da ciência, da cultura, da educação, e assim por diante.

THE ROLE OF THE N.V. SKLIFOSOVSKY RESEARCH INSTITUTE FOR EMERGENCY MEDICINE IN THE CREATION OF DISASTER MEDICINE IN THE COUNTRY

Directory of Open Access Journals (Sweden)

M. S. Khubutiya

2016-01-01

Full Text Available The occurrence  of large-scale emergencies with great  human  losses  and the  absence of a unified authority  of the country health  system which would manage  its medical and sanitary consequences required  the  creation  of special  units to provide emergency  health  services (EHS in mass injuries. The disaster  medicine  became  attractive for the N.V. Sklifosovsky Research  Institute  for Emergency Medicine in the 70s of the last century. Originally, the Department for Disaster Medicine was established at the  Institute  in 1987. At the  Department, the  extensive  work was performed  to shorten  a time gap between the delivery of medical care and the beginning  of a disaster  as much as possible. It was based  on a created  concept  for organization of medical  assistance and evacuation,  methods of its expertise and the  development of technical  means  for phased  medical  and evacuatiol  support of victims. The organizational and medical-diagnostic specificity of EHS in emergencies and its delivery were analyzed  in order to reduce  the severity of consequences. The health  care experience in emergencies has been  enriched  by the staff of the Institute  (who were not employees  of the Department  actively involved in the management of mass injuries and poisonings via air ambulance at the accident site and in the treatment of victims admitted to the Institute  from sites of emergencies. Consequently, the N.V. Sklifosovsky Research Institute  for Emergency Medicine developed and offered the  scientific and organizational basis  for EHS in emergencies which made  a significant  practical contribution to the creation  of public services for disaster  medicine in the country.

Advanced Bayesian processing of clinical data in nuclear medicine

International Nuclear Information System (INIS)

Jirsa, L.

1999-11-01

The Bayesian methodology was applied with a view to improving the quality of thyroid gland disease treatment at a nuclear medicine department. The specific tasks included: formulation of the estimation tasks from the theoretical point of view; elaborating algorithms to estimate various physical, medical and dosimetric quantities used in radiodiagnosis and radiotherapy of thyroid gland diseases; testing their numerical precision; testing their numerical stability on a large set of clinical data; implementation of the algorithms at a level applicable in routine conditions of the nuclear medicine department and replace by them the data processing methods used there so far; exploring and testing the quality improvement of the estimates; and in dependence on the results, proposing hints where improvement of the data measurement methodology is necessary

Transformation and trends in preventive and social medicine education at the undergraduate level in a Brazilian medical school.

Science.gov (United States)

Forster, A C; Passos, A D; Dal-Fabbro, A L; Laprega, M R

2001-01-01

In the present study we discuss some transformations in undergraduate training in Preventive and Social Medicine in the Department of Social Medicine of the Faculty of Medicine of Ribeiro Preto, University of So Paulo, from 1993 to 1999. Aspects of the relationship between medical training and the reorganization of local services of the Brazilian national health system, and between graduate teaching in Preventive and Social Medicine and medical education as a whole are discussed. The crisis in Preventive and Social Medicine and its influence of medical training are evaluated. Trends for the application of a body of knowledge of the specialty and for the relationship between the department and the medical school are discussed.

Why aren't there more women leaders in academic medicine? the views of clinical department chairs.

Science.gov (United States)

Yedidia, M J; Bickel, J

2001-05-01

A scarcity of women in leadership positions in academic medicine has persisted despite their increasing numbers in medical training. To understand the barriers confronting women and potential remedies, clinical department chairs with extensive leadership experience were interviewed. In 1998-99, open-ended interviews averaging 80 minutes in length were conducted with 34 chairs and two division chiefs in five specialties. Individuals were selected to achieve a balance for gender, geographic locale, longevity in their positions, and sponsorship and research intensity of their institutions. The interviews were audiotaped and fully transcribed, and the themes reported emerged from inductive analysis of the responses using standard qualitative techniques. The chairs' responses centered on the constraints of traditional gender roles, manifestations of sexism in the medical environment, and lack of effective mentors. Their strategies for addressing these barriers ranged from individual or one-on-one interventions (e.g., counseling, confronting instances of bias, and arranging for appropriate mentors) to institutional changes (e.g., extending tenure probationary periods, instituting mechanisms for responding to unprofessional behavior, establishing mentoring networks across the university). The chairs universally acknowledged the existence of barriers to the advancement of women and proposed a spectrum of approaches to address them. Individual interventions, while adapting faculty to requirements, also tend to preserve existing institutional arrangements, including those that may have adverse effects on all faculty. Departmental or school-level changes address these shortcomings and have a greater likelihood of achieving enduring impact.

Overview. Department of Nuclear Physical Chemistry. Section 9

Energy Technology Data Exchange (ETDEWEB)

Szeglowski, Z. [Institute of Nuclear Physics, Cracow (Poland)

1995-12-31

In the papers presented bellow the activities of the Department of Nuclear Physical Chemistry in 1994 are presented. A further effort was made towards routine production of neutron-deficient isotopes for nuclear medicine - and namely {sup 67} Ga and {sup 139} Ce. Small activities of {sup 111} In were produced by the {alpha} bombardment of Ag target. In order to improve the {sup 111} In production the deuterons reaction with cadmium target was studied. The other field of the Department research is studying of the physicochemical properties of transactinoid elements (104,105, 106). The Department is also engaged in works of the National Network of Early Detection of Radioactive Contamination in Air. In this section, apart of the detail descriptions of mentioned activities, the information about personnel employed in the Department, papers and reports published in 1994, contribution to conferences and grants are also given.

Overview. Department of Nuclear Physical Chemistry. Section 9

Energy Technology Data Exchange (ETDEWEB)

Szeglowski, Z [Institute of Nuclear Physics, Cracow (Poland)

1996-12-31

In the papers presented bellow the activities of the Department of Nuclear Physical Chemistry in 1994 are presented. A further effort was made towards routine production of neutron-deficient isotopes for nuclear medicine - and namely {sup 67} Ga and {sup 139} Ce. Small activities of {sup 111} In were produced by the {alpha} bombardment of Ag target. In order to improve the {sup 111} In production the deuterons reaction with cadmium target was studied. The other field of the Department research is studying of the physicochemical properties of transactinoid elements (104,105, 106). The Department is also engaged in works of the National Network of Early Detection of Radioactive Contamination in Air. In this section, apart of the detail descriptions of mentioned activities, the information about personnel employed in the Department, papers and reports published in 1994, contribution to conferences and grants are also given.

Quality management audits in nuclear medicine practices

International Nuclear Information System (INIS)

2008-12-01

An effective management system that integrates quality management (QM) is essential in modern nuclear medicine departments in Member States. The IAEA, in its Safety Standards Series, has published a Safety Requirement (GS-R-3) and a Safety Guide (GS-G-3.1) on management systems for all facilities. These publications address the application of an integrated management system approach that is applicable to nuclear medicine organizations as well. Quality management systems are maintained with the intent to continuously improve effectiveness and efficiency, enabling nuclear medicine to achieve the expectations of its quality policy, and to satisfy its customers. The IAEA has a long history of providing assistance in the field of nuclear medicine to its Member States. Regular quality audits and assessments are essential for modern nuclear medicine departments. More importantly, the entire QM and audit process has to be systematic, patient oriented and outcome based. The management of services should also take into account the diversity of nuclear medicine services around the world and multidisciplinary contributions. The latter include clinical, technical, radiopharmaceutical and medical physics procedures. Aspects of radiation safety and patient protection should also be integral to the process. Such an approach ensures consistency in providing safe, quality and superior services to patients. Increasingly standardized clinical protocol and evidence based medicine is used in nuclear medicine services, and some of these are recommended in numerous IAEA publications, for example, the Nuclear Medicine Resources Manual. Reference should also be made to other IAEA publications such as the IAEA Safety Standards Series, which include the regulations for the safe transport of nuclear material and on waste management as all of these have an impact on the provision of nuclear medicine services. The main objective of this publication is to introduce a routine of conducting an

[Adverse drug reaction reporting in emergency medicine].

Science.gov (United States)

Milojevic, Kolia; Chassagnol, Isabelle; Brion, Nathalie; Cléro, Joël; Degrèze, Nathalie; Lambert, Yves

2004-01-01

A regional survey was performed between June and September 2002, to evaluate knowledge and attitudes of emergency physicians regarding adverse drug reaction (ADR) reporting in a French district. 100 questionnaires completed by physicians working in emergency departments and/or mobile intensive care units were analysed. The frequency of ADRs encountered by emergency practitioners was estimated at > or = 0.73 per year and per physician. The ADR notification rate in emergency medicine was estimated at advertising ADR reporting procedures could help to improve the notification rate in emergency medicine.

78 FR 64963 - National Center for Complementary & Alternative Medicine; Amended Notice of Meeting

Science.gov (United States)

2013-10-30

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Center for Complementary & Alternative Medicine; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Center for Complementary and Alternative Medicine Special Emphasis Panel, October...

75 FR 69686 - Advisory Committee on Training in Primary Care Medicine and Dentistry

Science.gov (United States)

2010-11-15

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Advisory Committee on Training in Primary Care Medicine and Dentistry AGENCY: Health Resources and Services... of the Advisory Committee on Training in Primary Care Medicine and Dentistry, November 15, 2010, 8:30...

Personality profile and coping resources of family medicine ...

African Journals Online (AJOL)

2009-09-14

Sep 14, 2009 ... A cross-sectional study of 44 out of 45 (98% response rate) family medicine vocational trainees at the Medical ... b Department of Psychology, University of Limpopo (Medunsa Campus), Pretoria ... The cultural diversity of the.

Understanding the concept and challenges of palliative care medicine

African Journals Online (AJOL)

MJP

2015-06-25

Jun 25, 2015 ... 2 Nephrology Unit, Department of Internal Medicine, Federal Medical Centre Umuahia, Abia ... Key words: Palliative care, pain control, hospice, spirituality, cancer, end-stage organ ... surgeons, nurses, pharmacists, laboratory.

Integrating family medicine and complementary medicine in cancer care: a cross-cultural perspective.

Science.gov (United States)

Ben-Arye, Eran; Israely, Pesi; Baruch, Erez; Dagash, Jamal

2014-10-01

In this paper, we describe the case study of a 27 year-old Arab female patient receiving palliative care for advanced breast cancer who was referred to complementary medicine (CM) consultation provided within a conventional oncology department. We explore the impact of the integrative CM practitioners' team of three family physicians and one Chinese medicine practitioner on the patient's well-being and specifically on the alleviation of her debilitating hot flashes and insomnia. This quality of life improvement is also affirmed by comparing the Edmonton Symptom Assessment Scale (ESAS) and Measure Yourself Concerns and Well-being (MYCAW) questionnaires administered at the initial and follow-up assessment sessions. In conclusion, we suggest that family physicians trained in evidence-based complementary medicine are optimal integrators of holistic patient-centered supportive care. The inclusion of trained CM practitioners in a multi-disciplinary integrative team may enhance the bio-psycho-social-spiritual perspective, and provide additional practical therapies that improve the quality of life of patients confronting cancer. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Nuclear Medicine on the net

International Nuclear Information System (INIS)

Graney, K.; Lin, P.C.; Chu, J.; Sathiakumur, C.

2003-01-01

Full text: To gain insight into Internet usage as a potential means of communicating with clinicians. Method: 200 clinicians within the South Western Sydney Health Area were surveyed by mail. Questionnaire details included Internet access, frequency of access, interest in department web site, suitability of content and interest in electronic bookings. The total response rate was 37% (74/200). General Practitioners comprised 46% of the respondents, and specialists 54%. All respondents had access to the Internet (44% from home only, 8% from work, 48% from both locations), with 57% accessing the Web daily. There was a high overall interest by respondents in accessing a Nuclear medicine web site, particularly for information and results, but a relative reluctance to consider electronic bookings. The following table outlines the respondents in detail. Our results indicate that a Nuclear Medicine web site has the potential to be an effective means of communicating with clinicians. Copyright (2003) The Australian and New Zealand Society of Nuclear Medicine Inc

Radiation protection in nuclear medicine

International Nuclear Information System (INIS)

Seeburrun, V.

2013-04-01

Radiation protection in nuclear medicine in this project is concerned with the reduction of doses to workers, patients and members of the public. Protection of workers is achieved by adopting good personal habits, good housekeeping, proper use of personal protective devices and equipment, attend training and have continuous education. Exposure to radiation of workers and the members of the public are minimised by proper management of radioactive waste and safe transport of radioactive material. The design and shielding of a nuclear medicine department shall further provide for the protection of the worker, the patient and the general public. Protection of patient is achieved by justifying the procedure, delivering the minimum radiation dose possible to the patient while obtaining the best image quality and applying guidance levels. Special considerations shall be given to pregnant and breast-feeding patients. Quality assurance programme through image quality, radiopharmaceutical quality and patient records on nuclear medicine procedures shall provide assurance to the patient. (au)

Assessment of OEP health's risk in nuclear medicine

Energy Technology Data Exchange (ETDEWEB)

Santacruz-Gomez, K.; Manzano, C.; Melendrez, R.; Castaneda, B.; Barboza-Flores, M.; Pedroza-Montero, M. [Departamento de Fisica, Universidad de Sonora. A.P. 1626 Hermosillo, Sonora, Mexico and Centro de Investigacion en Materiales Avanzados CIMAV, A.C. Chihuahua, Chihuahua (Mexico); Centro de Diagnostico Integral del Noroeste, Luis Donaldo Colosio 23 83000 Centro Hermosillo, Sonora (Mexico); Departamento de Investigacion en Fisica, Universidad de Sonora. A. P. 5-088 Hermosillo, Sonora (Mexico); Departamento de Fisica, Universidad de Sonora. A.P. 1626 Hermosillo, Sonora (Mexico); Departamento de Investigacion en Fisica, Universidad de Sonora. A. P. 5-088 Hermosillo, Sonora (Mexico)

2012-10-23

The use of ionizing radiation has been increased in recent years within medical applications. Nuclear Medicine Department offers both treatment and diagnosis of diseases using radioisotopes to controlled doses. Despite the great benefits to the patient, there is an inherent risk to workers which remains in contact with radiation sources for long periods. These personnel must be monitored to avoid deterministic effects. In this work, we retrospectively evaluated occupationally exposed personnel (OEP) to ionizing radiation in nuclear medicine during the last five years. We assessed both area and personal dosimetry of this department in a known Clinic in Sonora. Our results show an annual equivalent dose average of 4.49 {+-} 0.70 mSv in OEP without showing alarming changes in clinical parameters analyzed. These results allow us to conclude that health of OEP in nuclear medicine of this clinic has not been at risk during the evaluated period. However, we may suggest the use of individual profiles based on specific radiosensitivity markers.

The Frederic Joliot hospital department

International Nuclear Information System (INIS)

1999-02-01

The Service Hospitalier Frederic Joliot (SHFJ) of the CEA, has got a scientific and a medical mission: to develop techniques allowing the functional study of human organs. The paper presents the main activities of this department: the positron emission tomography to visualize in real time markers in the organism in neurology and cardiology, researches on epilepsy to localize the epileptic centre, the nuclear medicine in cardiology with the use of the gamma photon emission tomography and the radiopharmacology to visualize the drugs effects in the organism. (A.L.B.)

A Teoria Queer e os Estudos Organizacionais: Revisando Conceitos sobre Identidade

Directory of Open Access Journals (Sweden)

Eloisio Moulin de Souza

2017-05-01

Full Text Available A teoria queer desenvolveu-se incialmente na década de noventa, nas ciências sociais e humanas, principalmente nos estudos literários e linguísticos, sendo posteriormente incorporada aos estudos organizacionais. Entretanto, apesar de sua aplicação aos estudos organizacionais, ainda existe uma lacuna acerca do debate sobre seus conceitos e significados. Por isso, este artigo objetiva aprofundar e revisar o debate sobre os aspectos desenvolvidos por essa teoria, focando-se nos conceitos relacionados à produção identitária e subjetiva. Para cumprir este intento, as ideias queer sobre identidade, sujeito, performatividade, performance e identificação são apresentadas e debatidas. Defende-se que a teoria queer é um verbo (ação ao invés de um substantivo (identidade e a aplicação de seus conceitos não se restringe somente aos estudos sobre gênero, sexualidade e minorias. Por fim, discute-se a expansão da utilização dos conceitos queer no estudo de outras formas hegemônicas de categorias identitárias presentes no mundo corporativo.

Nuclear medicine training and practice in the Czech Republic

International Nuclear Information System (INIS)

Kaminek, Milan; Koranda, Pavel

2014-01-01

Nuclear medicine in the Czech Republic is a full specialty with an exclusive practice. Since the training program was organized and structured in recent years, residents have had access to the specialty of nuclear medicine, starting with a two-year general internship (in internal medicine or radiology). At present, nuclear medicine services are provided in 45 departments. In total, 119 nuclear medicine specialists are currently registered. In order to obtain the title of Nuclear Medicine Specialist, five years of training are necessary; the first two years consist of a general internship in internal medicine or radiology. The remaining three years consist of training in the nuclear medicine specialty itself, but includes three months of practice in radiology. Twenty-one physicians are currently in nuclear medicine training and a mean of three specialists pass the final exam per year. The syllabus is very similar to that of the European Union of Medical Specialists (UEMS), namely concerning the minimum recommended numbers for diagnostic and therapeutic procedures. In principle, the Czech law requires continuous medical education for all practicing doctors. The Czech Medical Chamber has provided a continuing medical education (CME) system. Other national CMEs are not accepted in Czech Republic. (orig.)

Nuclear medicine training and practice in the Czech Republic

Energy Technology Data Exchange (ETDEWEB)

Kaminek, Milan; Koranda, Pavel [University Hospital Olomouc, Department of Nuclear Medicine, Olomouc (Czech Republic)

2014-08-15

Nuclear medicine in the Czech Republic is a full specialty with an exclusive practice. Since the training program was organized and structured in recent years, residents have had access to the specialty of nuclear medicine, starting with a two-year general internship (in internal medicine or radiology). At present, nuclear medicine services are provided in 45 departments. In total, 119 nuclear medicine specialists are currently registered. In order to obtain the title of Nuclear Medicine Specialist, five years of training are necessary; the first two years consist of a general internship in internal medicine or radiology. The remaining three years consist of training in the nuclear medicine specialty itself, but includes three months of practice in radiology. Twenty-one physicians are currently in nuclear medicine training and a mean of three specialists pass the final exam per year. The syllabus is very similar to that of the European Union of Medical Specialists (UEMS), namely concerning the minimum recommended numbers for diagnostic and therapeutic procedures. In principle, the Czech law requires continuous medical education for all practicing doctors. The Czech Medical Chamber has provided a continuing medical education (CME) system. Other national CMEs are not accepted in Czech Republic. (orig.)

Preliminary results of the analysis of the administered activities in diagnostic studies of nuclear medicine

International Nuclear Information System (INIS)

Lopez Bejerano, G.; Sed, L.J.

2001-01-01

The worldwide use of Nuclear Medicine diagnostic procedures and the tendency to its increment, infers an important exposure of the population to ionising radiation; it has motivated that the IAEA in the International Basic Safety Standards (BSS), emits recommendations for the establishment of guidance levels of activities administered to the patients in diagnostic procedures. Taking into account the above-mentioned and that in Cuba there exist 20 departments of Nuclear Medicine that in the majority possess equipment with more than 20 years of operation, which influences directly the medical exposure. A survey was designed and applied in 10 of these departments. The survey evaluates the compliance with the BSS requirements, and specifically, the activities administered to the patients in Nuclear Medicine diagnostic procedures are analysed. In the present work the obtained preliminary results of the statistical analysis carried out on the activity values used in Nuclear Medicine departments are presented, and comparisons made for a proposal of guidance levels for the national practice, which is compared with those recommended internationally. (author)

Magistral preparation in nuclear medicine departments: Requirements for their realization; Preparations magistrales en radiopharmacie: contraintes liees a la mise en place

Energy Technology Data Exchange (ETDEWEB)

Desruet, M.D. [Radiopharmacie, clinique universitaire de medecine nucleaire, CHU de Grenoble, 38 - Grenoble (France); Bolot, C. [Radiopharmacie, hospices civils de Lyon, groupement hospitalier Est, 69 - Bron (France); Bourrel, F. [Services de pharmacie et medecine nucleaire, centre hospitalier d' Avignon, 84 - Avignon (France); Francois-Joubert, A.; Biechlin-Chassel, M.L. [Medecine nucleaire et Radiopharmacie, centre hospitalier de Chambery, 73 - Chambery (France); Couret, I. [Service de medecine nucleaire, hopital Lapeyronie, 34 - Montpellier (France); Pelegrin, M. [Institut de recherche en cancerologie (IRCM), 34 - Montpellier (France); Service de medecine nucleaire, hopital Purpan, 31 - Toulouse (France); Lao, S. [Service de medecine nucleaire, CHU Hopital de l' Archet, 06 - Nice (France); Ouhayon, E.; Sauvan, R. [Service de medecine nucleaire, institut Paoli-Calmettes, 13 - Marseille (France)

2010-11-15

Use of radiopharmaceuticals in French nuclear medicine departments depends on marketing authorization and their development may be compromised by a limited return on investment. As an alternative, radiopharmaceuticals may also be prepared in the form of a magistral preparation, like in some European countries. In this case, these preparations are subjected to restrictions and requirements for radio-pharmacies relating to quality assurance, facilities and equipment, quality of starting materials and final radiopharmaceutical products defined in French good preparation practice. Labelled tracers used as magistral preparations have to be prepared under the full responsibility of a radio-pharmacist and used under the responsibility of the prescribing physician. Conditions of sufficient guarantees for the safety of the patient and adherence to pharmaceutical rules must be evaluated individually. However, this form of preparation intends to supply specific medical needs for an individual patient and is not an answer in the framework of development of radiopharmaceuticals. (authors)

77 FR 4052 - National Center for Complementary & Alternative Medicine; Amended Notice of Meeting

Science.gov (United States)

2012-01-26

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Center for Complementary & Alternative Medicine; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Advisory Council for Complementary and Alternative Medicine, February 3, 2012, 8...

Radiation Monitoring in a Newly Established Nuclear Medicine Facility

International Nuclear Information System (INIS)

Afroj, Kamila; Anwar-Ul-Azim, Md.; Nath, Khokon Kumar; Khan, Md. Rezaul Karim

2010-05-01

A study of area monitoring in a nuclear medicine department's new physical facility was performed for 3 months to ascertain the level of radiation protection of the staff working in nuclear medicine and that of the patients and patient's attendants. Exposure to nuclear medicine personnel is considered as occupational exposure, while exposure to patients is considered medical exposure and exposure to patients' attendants is considered public exposure. The areas for the sources of radiation considered were the hot laboratory, where unsealed isotopes, radionuclides, generators are stored and dosages are prepared, the patients' waiting room, where the radioactive nuclides are administered orally and intravenously for diagnosis and treatment and the SPECT rooms, where the patients' acquisition are taken. The monitoring process was performed using the TLD supplied and measured by the Health Physics Division of Bangladesh Atomic Energy Commission. The result shows no over-exposure of radiation from any of the working areas. The environment of the department is safe for work and free from unnecessary radiation exposure risk. (author)

['Judicialization' of public health policy for distribution of medicines].

Science.gov (United States)

Chieffi, Ana Luiza; Barata, Rita Barradas

2009-08-01

The supply of medicines in response to court orders or injunctions has become a common practice in the State of São Paulo, Brazil. This 'judicialization' of the health system clashes with basic principles of the Brazilian Unified National Health System (SUS), such as equal opportunity to access health services. The aim of this paper is to analyze the legal action used to obtain medicines through the São Paulo State Health Department, from two main angles: judicialization of public policies and breach of the equity principle. This is a descriptive study of legal action taken to obtain medicines through the São State Health Department, as listed in the Electronic Court Docket System for the year 2006. Most cases were filed through private attorneys; 47% of the patients had obtained their prescriptions through private care; and 73% of the cases involved patients from the three wealthiest areas in the city of São Paulo. The data demonstrate that such legal action violates key principles of the SUS such as equity, thereby privileging individuals with higher purchasing power and more access to information.

Family medicine practice in Saudi Arabia: The current situation and Proposed Strategic Directions Plan 2020.

Science.gov (United States)

Al-Khaldi, Yahia M; Al-Ghamdi, Essam A; Al-Mogbil, Tariq I; Al-Khashan, Hesham I

2017-01-01

The objectives of this study were to assess the current situation of the teaching and training of undergraduate and postgraduate programs in family medicine in KSA, assess the current practice of family medicine, and draw a roadmap to achieve Saudi vision 2020. This study was conducted with the support and collaboration of the Primary Health Care Department of the Ministry of Health, Saudi Arabia, and World Health Organization (EMRO) in November 2015. Based on the literature review of previous studies conducted for similar purposes, relevant questionnaires were developed. These consisted of four forms, each of which was directed at a different authority to achieve the above-mentioned objectives. Data of all questionnaires were coded, entered, and analyzed using SPSS version 16. There are 2282 primary health-care centers (PHCCs), 60% of which are in rural areas. More than half of the PHCCs have a laboratory and more than one-third have a Radiology Department. Out of the 6107 physicians, 636 are family physicians (10%). All medical colleges have a family medicine department with a total staff of 170 medical teachers. Thirteen departments run family medicine courses of 4-8 weeks' duration for students. Fourteen colleges have internship programs in family medicine and four colleges have postgraduate centers for family medicine (27%). There are 95 training centers for Saudi Board (Saudi Board of Family Medicine [SBFM]) and 68 centers for Saudi Diploma (Saudi Diploma of Family Medicine [SDFM]). The total number of trainers was 241, while the total trainees were 756 in SBFM and 137 in SDFM. This survey showed that there is a shortage of qualified family physicians in all health sectors in Saudi Arabia as a result of the lack of a strategic plan for the training of family physicians. A national strategic plan with specific objectives and an explicit budget are necessary to deal with this shortage and improve the quality of health-care services at PHCCs.

Directory of computer users in nuclear medicine

Energy Technology Data Exchange (ETDEWEB)

Erickson, J.J.; Gurney, J.; McClain, W.J. (eds.)

1979-09-01

The Directory of Computer Users in Nuclear Medicine consists primarily of detailed descriptions and indexes to these descriptions. A typical Installation Description contains the name, address, type, and size of the institution and the names of persons within the institution who can be contacted for further information. If the department has access to a central computer facility for data analysis or timesharing, the type of equipment available and the method of access to that central computer is included. The dedicated data processing equipment used by the department in its nuclear medicine studies is described, including the peripherals, languages used, modes of data collection, and other pertinent information. Following the hardware descriptions are listed the types of studies for which the data processing equipment is used, including the language(s) used, the method of output, and an estimate of the frequency of the particular study. An Installation Index and an Organ Studies Index are also included. (PCS)

Directory of computer users in nuclear medicine

International Nuclear Information System (INIS)

Erickson, J.J.; Gurney, J.; McClain, W.J.

1979-09-01

The Directory of Computer Users in Nuclear Medicine consists primarily of detailed descriptions and indexes to these descriptions. A typical Installation Description contains the name, address, type, and size of the institution and the names of persons within the institution who can be contacted for further information. If the department has access to a central computer facility for data analysis or timesharing, the type of equipment available and the method of access to that central computer is included. The dedicated data processing equipment used by the department in its nuclear medicine studies is described, including the peripherals, languages used, modes of data collection, and other pertinent information. Following the hardware descriptions are listed the types of studies for which the data processing equipment is used, including the language(s) used, the method of output, and an estimate of the frequency of the particular study. An Installation Index and an Organ Studies Index are also included

Venous thromboembolism: the prevailing approach to diagnosis, prevention and treatment among Internal Medicine practitioners.

Science.gov (United States)

Markel, Arie; Gavish, Israel; Kfir, Hila; Rimbrot, Sofia

2017-02-01

Venous thromboembolism (VTE) is the third most common cause of death and the leading cause of sudden death in hospitalized medical patients. Despite the existence of guidelines for prevention and treatment of this disorder, their implementation in everyday life is not always accomplished. We performed a survey among directors of Internal Medicine departments in our country in order to evaluate their attitude and approach to this issue. A questionnaire with pertinent questions regarding prevention and treatment of VTE, including deep vein thrombosis (DVT) and pulmonary embolism (PE) was sent to each one of the directors of Internal Medicine Departments around the country. Sixty-nine out of 97 (71%) of the Internal Medicine departments directors responded the questionnaire. We found that several of the current guidelines were followed in a reasonable way. On the other hand, heterogeneity of responses was also present and the performance of current guidelines was imperfectly followed, and showed to be deficient in several aspects. An effort should be done in order to reemphasize and put in effect current guidelines for the prevention and treatment of VTE among hospitalists and Internal Medicine practitioners.

Nuclear medicine and the pregnant patient

International Nuclear Information System (INIS)

Collins, L.

1988-01-01

Estimates of the risks of exposing an embryo or fetus to radiation are discussed. Recommendations are made about the policies a nuclear medicine department should develop for handling cases of accidental irradiation of an embryo or fetus. The choices available where a known pregnancy is involved and diagnostic radiology is required are outlined. Only necessary examinations should be performed and care taken to avoid or minimise irradiation of the fetus. The nuclear medicine physician must be prepared to make (and defend if necessary) an informed decision on whether to proceed with an examination and must also be in a position to discuss the risks with anxious parents

Results of a 2-Week Inpatient Stay at the Department for Internal and Integrative Medicine: An Observational Study

Directory of Open Access Journals (Sweden)

Romy Lauche

2012-01-01

Full Text Available Introduction. The Department for Internal and Integrative Medicine in Essen utilizes mind/body medical elements in order to empower patients with chronic diseases to better cope with their symptoms and to adopt a healthy lifestyle. This study explored the influence and predictors of a 2-week integrative treatment program on patients’ quality of life. Methods. This observational study was conducted with inpatients as part of the quality assurance program. Patients’ quality of life, psychological symptoms, and health locus of control were measured on admission and discharge and again 3, 6, and 12 months after discharge. Regression analyses were conducted to determine the factors predicting improved quality of life. Results. Data from 2486 inpatients treated in 2001–2004 were included (80% female, mean age 53.9 ± 14.3 years. Response rates decreased to 50% at 12 months. Small-to-moderate effects were found on patients’ quality of life, anxiety, and depression. Patients’ internal locus of control significantly increased. Improved quality of life was mainly predicted by lower baseline scores. Conclusion. Results of this study suggest that a 2-week inpatient treatment might sustainably reduce patients’ symptoms and increase their quality of life; however, conclusions are only preliminary. More research is needed to enable the effectiveness to be judged conclusively.

[Shortage of physicians in anaesthesiology and intensive care medicine - Causes, consequences and solutions].

Science.gov (United States)

Papenfuß, Tim; Roch, Carmen

2012-05-01

74% of all hospitals had vacant positions in 2011, also departments of anaesthesiology and intensive care medicine. More than 50% of these departments work with locums. There are couple of reasons for the shortage of physicians. The consequences in anaesthesiology and intensive care medicine can result in qualitative and financial loss. To solve the shortage of physicians one has to solve the reasons. Main reasons are increasing feminization of medical profession and part-time-work, work-life-balance and a poor specialised education. © Georg Thieme Verlag Stuttgart · New York.

Gender differences in acute and chronic pain in the emergency department: results of the 2014 Academic Emergency Medicine consensus conference pain section.

Science.gov (United States)

Musey, Paul I; Linnstaedt, Sarah D; Platts-Mills, Timothy F; Miner, James R; Bortsov, Andrey V; Safdar, Basmah; Bijur, Polly; Rosenau, Alex; Tsze, Daniel S; Chang, Andrew K; Dorai, Suprina; Engel, Kirsten G; Feldman, James A; Fusaro, Angela M; Lee, David C; Rosenberg, Mark; Keefe, Francis J; Peak, David A; Nam, Catherine S; Patel, Roma G; Fillingim, Roger B; McLean, Samuel A

2014-12-01

Pain is a leading public health problem in the United States, with an annual economic burden of more than $630 billion, and is one of the most common reasons that individuals seek emergency department (ED) care. There is a paucity of data regarding sex differences in the assessment and treatment of acute and chronic pain conditions in the ED. The Academic Emergency Medicine consensus conference convened in Dallas, Texas, in May 2014 to develop a research agenda to address this issue among others related to sex differences in the ED. Prior to the conference, experts and stakeholders from emergency medicine and the pain research field reviewed the current literature and identified eight candidate priority areas. At the conference, these eight areas were reviewed and all eight were ratified using a nominal group technique to build consensus. These priority areas were: 1) gender differences in the pharmacological and nonpharmacological interventions for pain, including differences in opioid tolerance, side effects, or misuse; 2) gender differences in pain severity perceptions, clinically meaningful differences in acute pain, and pain treatment preferences; 3) gender differences in pain outcomes of ED patients across the life span; 4) gender differences in the relationship between acute pain and acute psychological responses; 5) the influence of physician-patient gender differences and characteristics on the assessment and treatment of pain; 6) gender differences in the influence of acute stress and chronic stress on acute pain responses; 7) gender differences in biological mechanisms and molecular pathways mediating acute pain in ED populations; and 8) gender differences in biological mechanisms and molecular pathways mediating chronic pain development after trauma, stress, or acute illness exposure. These areas represent priority areas for future scientific inquiry, and gaining understanding in these will be essential to improving our understanding of sex and gender

THE TEACHING OF COMPREHENSIVE MEDICINE 1938· 1969*

African Journals Online (AJOL)

In the teaching and training field my personal thinking had been very ... Professor of Physic at the University of Cambridge in. 1936-1937. ... This thinking was later crystallized in his .... Department of Medicine as a full-time academic phy ician.

Radiopharmacy contamination in nuclear medicine - a survey report

International Nuclear Information System (INIS)

Ghai, Anchal; Mardi, Somnath; Kumar, Pradeep; Sarika; Mittal, B.R.; Singh, B.

2011-01-01

To conduct the radiation survey of the category IV Nuclear Medicine department and to further measure and compare the level of loose contamination in areas with high levels of exposure at two different time points (morning and evening) using wipe test

Evaluation of radiation shielding rate of lead aprons in nuclear medicine

International Nuclear Information System (INIS)

Han, Sang Hyun; Han, Beom Heui; Lee, Sang Ho; Hong, Dong Heui; Kim, Gi Jin

2017-01-01

Considering that the X-ray apron used in the department of radiology is also used in the department of nuclear medicine, the study aimed to analyze the shielding rate of the apron according to types of radioisotopes, thus γ ray energy, to investigate the protective effects. The radioisotopes used in the experiment were the top 5 nuclides in usage statistics "9"9"mTc, "1"8F, "1"3"1I, "1"2"3I, and "2"0"1Tl, and the aprons were lead equivalent 0.35 mmPb aprons currently under use in the department of nuclear medicine. As a result of experiments, average shielding rates of aprons were "9"9"mTc 31.59%, "2"0"1Tl 68.42%, and "1"2"3I 76.63%. When using an apron, the shielding rate of "1"3'1I actually resulted in average dose rate increase of 33.72%, and "1"8F showed an average shielding rate of –0.315%, showing there was almost no shielding effect. As a result, the radioisotopes with higher shielding rate of apron was in the descending order of "1"2"3I, "2"0"1Tl, "9"9"mTc, "1"8F, "1"3"1I. Currently, aprons used in the nuclear medicine laboratory are general X-ray aprons, and it is thought that it is not appropriate for nuclear medicine environment that utilizes γ rays. Therefore, development of nuclear medicine exclusive aprons suitable for the characteristics of radioisotopes is required in consideration of effective radiation protection and work efficiency of radiation workers

[Rationalization in 20th-century czechoslovak pharmacy practice - commission for rationalization and standardization in medicine, veterinary medicine and pharmacy - part 2*].

Science.gov (United States)

Babica, Jan; Rusek, Václav

2014-08-01

In interwar Czechoslovakia health care, an increased attention paid to the new ideas of scientific management (Taylorism), work rationalization and standardization led to the establishment of the Commission for Rationalization and Standardization in Medicine, Veterinary Medicine and Pharmacy (RANOK) within the Department of Natural Science and Medicine of the Masaryk Academy of Work. Within RANOK, the group for pharmacy worked between 1928 and 1932. The first part of the paper described the scientific management and standardization movement in interwar Czechoslovakia, the establishment of Masaryk Academy of Work and RANOK, and work objectives of RANOK and its group for pharmacy. The second part deals with the work results, relative failure and importance of the group for pharmacy.

Estudos de atmosfera

OpenAIRE

Carlos Eduardo Riccioppo

2016-01-01

Joker e Estudos de balística possuíam formas distintas dos cadernos ou livros quando foram exibidos pela primeira vez, na mostra Dual Overdrive. De algum modo, o flagrante das imagens dos cartazes da campanha política parisiense e daquelas cusparadas sobre o asfalto era preservado no modo como eram mostrados os trabalhos, que repunham não apenas a orientação espacial dos objetos fotografados, mas, igualmente, sua escala: Joker apresentava-se na parede, em dimensões relativamente próximas às d...

Residents' views about family medicine specialty education in Turkey

Directory of Open Access Journals (Sweden)

Uzuner Arzu

2010-04-01

Full Text Available Abstract Background Residents are one of the key stakeholders of specialty training. The Turkish Board of Family Medicine wanted to pursue a realistic and structured approach in the design of the specialty training programme. This approach required the development of a needs-based core curriculum built on evidence obtained from residents about their needs for specialty training and their needs in the current infrastructure. The aim of this study was to obtain evidence on residents' opinions and views about Family Medicine specialty training. Methods This is a descriptive, cross-sectional study. The board prepared a questionnaire to investigate residents' views about some aspects of the education programme such as duration and content, to assess the residents' learning needs as well as their need for a training infrastructure. The questionnaire was distributed to the Family Medicine Departments (n = 27 and to the coordinators of Family Medicine residency programmes in state hospitals (n = 11 by e-mail and by personal contact. Results A total of 191 questionnaires were returned. The female/male ratio was 58.6%/41.4%. Nine state hospitals and 10 university departments participated in the study. The response rate was 29%. Forty-five percent of the participants proposed over three years for the residency duration with either extensions of the standard rotation periods in pediatrics and internal medicine or reductions in general surgery. Residents expressed the need for extra rotations (dermatology 61.8%; otolaryngology 58.6%; radiology 52.4%. Fifty-nine percent of the residents deemed a rotation in a private primary care centre necessary, 62.8% in a state primary care centre with a proposed median duration of three months. Forty-seven percent of the participants advocated subspecialties for Family Medicine, especially geriatrics. The residents were open to new educational methods such as debates, training with models, workshops and e

Veterinary Medicine and Animal Health Technology Handbook.

Science.gov (United States)

New York State Education Dept., Albany. Office of the Professions.

The laws, rules, and regulations of the New York State Education Department that govern professional veterinary medicine and animal health technology practice in the state are presented. Licensure requirements are described, and complete application forms and instructions for obtaining license and first registration as a licensed veterinarian and…

Radiation protection in nuclear medicine

Energy Technology Data Exchange (ETDEWEB)

Volodin, V; Hanson, G P

1993-12-31

The goal of this Chapter is to give a general outline of the essential principles and procedures for radiation protection in a nuclear medicine department where radionuclides are used for diagnosis and therapy. More detailed recommendations regarding radiation protection in nuclear medicine are given in the publications of the International Commission on Radiation Protection (ICRP, publications 25, 57, 60) and in ILO/IAEA/WHO Manual on Radiation Protection in Hospitals and General Practice (Volume 2: Unsealed Sources, WHO, Geneva, 1975), on which this Chapter is based. This chapter is not intended to replace the above-mentioned international recommendations on radiation protection, as well as existing national regulations on this subject, but intended only to provide guidance for implementing these recommendations in clinical practice

Radiation protection in nuclear medicine

International Nuclear Information System (INIS)

Volodin, V.; Hanson, G.P.

1992-01-01

The goal of this Chapter is to give a general outline of the essential principles and procedures for radiation protection in a nuclear medicine department where radionuclides are used for diagnosis and therapy. More detailed recommendations regarding radiation protection in nuclear medicine are given in the publications of the International Commission on Radiation Protection (ICRP, publications 25, 57, 60) and in ILO/IAEA/WHO Manual on Radiation Protection in Hospitals and General Practice (Volume 2: Unsealed Sources, WHO, Geneva, 1975), on which this Chapter is based. This chapter is not intended to replace the above-mentioned international recommendations on radiation protection, as well as existing national regulations on this subject, but intended only to provide guidance for implementing these recommendations in clinical practice

Especialidades médicas: estudo psicossocial Medical specialisations: a psychosocial study

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Maria Luiza de Mattos Fiore

2005-08-01

Full Text Available Estudo exploratório sobre fatores psicológicos e sociais envolvidos na escolha e prática das diversas especialidades médicas, com base na formulação sociológica de Bourdieu e nas considerações de Dejours a respeito do encontro do homem com seu trabalho. O estudo é baseado na análise de conteúdo de entrevistas livres, seguidas de questionário de levantamento social aplicados em 40 médicos atuantes, de ambos os sexos, de diferentes faixas etárias e várias especialidades na cidade de São Paulo. O exame, em profundidade, das entrevistas revela que: a os conflitos psicológicos inerentes à formação da identidade médica e a sua prática são influenciados por aspectos sócio-econômicos interiorizados e decorrentes do estrato social de origem do médico; b as experiências vividas e influenciadas pelo estrato sócio-econômico de origem de cada indivíduo determinaram a organização e a complexidade do espaço subjetivo e, portanto, de suas percepções e de seu comportamento prático; e, c a hierarquia de valores na Medicina pode ser considerada como defesa coletiva contra ansiedades resultantes da tarefa médica e do constante lidar com situações de impotência.This paper presents an exploratory study of the psychological and social factors related to the choice and practice of the various medical specialities, based on the sociological formulation of Bourdieu and the considerations of Dejours concerning man's encounter with his work. The study was based on the analysis of an open interview and social survey questionnaire applied on 40 active medical doctors of both sexes, different ages, and several specialities, in the city of Sao Paulo, Brazil. The results of a thorough analysis of the interviews reveals that: a the psychological conflicts inherent in the formation of a medical identity and the practice of medicine are influenced by acquired socio-economic elements that lead to differing practical solutions and results

Part-time careers in academic internal medicine: a report from the association of specialty professors part-time careers task force on behalf of the alliance for academic internal medicine.

Science.gov (United States)

Linzer, Mark; Warde, Carole; Alexander, R Wayne; Demarco, Deborah M; Haupt, Allison; Hicks, Leroi; Kutner, Jean; Mangione, Carol M; Mechaber, Hilit; Rentz, Meridith; Riley, Joanne; Schuster, Barbara; Solomon, Glen D; Volberding, Paul; Ibrahim, Tod

2009-10-01

To establish guidelines for more effectively incorporating part-time faculty into departments of internal medicine, a task force was convened in early 2007 by the Association of Specialty Professors. The task force used informal surveys, current literature, and consensus building among members of the Alliance for Academic Internal Medicine to produce a consensus statement and a series of recommendations. The task force agreed that part-time faculty could enrich a department of medicine, enhance workforce flexibility, and provide high-quality research, patient care, and education in a cost-effective manner. The task force provided a series of detailed steps for operationalizing part-time practice; to do so, key issues were addressed, such as fixed costs, malpractice insurance, space, cross-coverage, mentoring, career development, productivity targets, and flexible scheduling. Recommendations included (1) increasing respect for work-family balance, (2) allowing flexible time as well as part-time employment, (3) directly addressing negative perceptions about part-time faculty, (4) developing policies to allow flexibility in academic advancement, (5) considering part-time faculty as candidates for leadership positions, (6) encouraging granting agencies, including the National Institutes of Health and Veterans Administration, to consider part-time faculty as eligible for research career development awards, and (7) supporting future research in "best practices" for incorporating part-time faculty into academic departments of medicine.

Behavioral medicine: treatment and organizational issues.

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McKegney, F P; Schwartz, C E

1986-09-01

Behavioral medicine is a newly emerging field dating back to the early 1970s. In this short time, a great deal of controversy and confusion has arisen as to even the definition of the term. Similarly, there are now a variety of different operational applications of this concept in patient care, research, and health care system organizations. It is proposed that the title "behavioral medicine" be used in the most general way, consistent with the definition developed by the Institute of Medicine meeting in 1978. In it, behavioral medicine is a term designating a very large field and is not analogous to a profession, medical specialty, or discipline. This term denotes a body of psychologic and social knowledge and a set of techniques applied to research, prevention, and treatment of medical illness, including psychiatric illness. By this definition, behavioral medicine treatment techniques would include psychotherapy, hypnosis, relaxation, behavior therapy, behavior modification, biofeedback, and pharmacotherapy. One of the cardinal principles of behavioral medicine as a field is that well-defined treatment techniques are used for specific target symptoms or signs of illness. It is proposed that individual behavioral medicine treatment programs be called by the name of either the specific treatment utilized or of the target(s) of the intervention. It is important to ensure collaboration between the variety of treatment and research programs that would fall under this general definition of behavioral medicine, which includes consultation-liaison psychiatry. An organizational model is proposed that would combine all such programs within a multidisciplinary division of a department of psychiatry. This division might be entitled with one or both names, e.g., "consultation-liaison psychiatry and behavioral medicine." Perhaps most importantly, this new field should not promise more than it may be able to provide, particularly in trying to achieve the biopsychosocial model

The generation and gender shifts in medicine: an exploratory survey of internal medicine physicians

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Lemaire Jane

2006-05-01

Full Text Available Abstract Background Two striking demographic shifts evident in today's workforce are also apparent in the medical profession. One is the entry of a new generation of physicians, Gen Xers, and the other is the influx of women. Both shifts are argued to have significant implications for recruitment and retention because of assumptions regarding the younger generation's and women's attitudes towards work and patient care. This paper explores two questions regarding the generations: (1 How do Baby Boomer and Generation X physicians perceive the generation shift in work attitudes and behaviours? and (2 Do Baby Boomer and Generation X physicians differ significantly in their work hours and work attitudes regarding patient care and life balance? Gen Xers include those born between 1965 and 1980; Baby Boomers are those born between 1945 and 1964. We also ask: Do female and male Generation X physicians differ significantly in their work hours and work attitudes regarding patient care and life balance? Methods We conducted exploratory interviews with 54 physicians and residents from the Department of Medicine (response rate 91% and asked about their perceptions regarding the generation and gender shifts in medicine. We limit the analyses to interview responses of 34 Baby Boomers and 18 Generation Xers. We also sent questionnaires to Department members (response rate 66%, and this analysis is limited to 87 Baby Boomers' and 65 Generation Xers' responses. Results The qualitative interview data suggest significant generation and gender shifts in physicians' attitudes. Baby Boomers generally view Gen Xer physicians as less committed to their medical careers. The quantitative questionnaire data suggest that there are few significant differences in the generations' and genders' reports of work-life balance, work hours and attitudes towards patient care. Conclusion A combined qualitative and quantitative approach to the generation shift and gender shift in

Homicides with corpse dismemberment in the material collected by the Department of Forensic Medicine, Krakow, Poland.

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Konopka, Tomasz; Bolechała, Filip; Strona, Marcin; Kopacz, Paweł

2016-01-01

Aim of the study: To determine the circumstances which can be useful for offenders profiling in homicide cases with victim's body dismemberment. Material and methods: Study of all homicide cases with victim's corpse dismemberment examined in Krakow Department of Forensic Medicine over the last 50 years. Results: Within the past 50 years, a total number of 30 cases of homicides with dismembered bodies were examined in Krakow. 22 cases represent defensive mutilations performed by offender, 3 cases can be classified as offensive muti-lations and 3 cases represent aggressive mutilations - decapitation as a method of committing homicide. In this period the only 1 case of necrophilic mutilations was examined, when the body was dismembered without murder. In most cases the background of homicide was the family conflict, 6 was cause of mental illness of perpetrator and in 3 was sexual motive. Only in 3 cases (from 25 when the offender was known) perpetrator kill a stranger. In the other the offender belonged to the family or friends of the victim. In all cases where the perpetrator was determined, homicide and dismemberment was performed in his place of residence. The findings of the Police investigations indicate that in most cases homicides were not planned, occurred under the influence of emotion, only two have been previously scheduled. Conclusions: Homicides with corpses dismemberment usually are committed by offenders who is in close relationship with victim (family or friend). Dismemberment is almost always performed in the same place as murder - home of perpetrator. This type of homicide usually is not planned.

Pharmacogenetic guidance: individualized medicine promotes enhanced pain outcomes

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Dragic LL

2017-12-01

Full Text Available Lisa Lynn Dragic,1 Erica L Wegrzyn,2 Michael E Schatman,3–5 Jeffrey Fudin2,6 1Central Arkansas Veterans Healthcare System, Little Rock, AR, USA; 2Department of Pharmacy, Albany Stratton VA Medical Center, Albany, NY, USA; 3Research and Network Development, Boston Pain Care, Waltham, MA, USA; 4Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA; 5Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA; 6Scientific and Clinical Affairs, Remitigate, LLC, Delmar, NY, USA Abstract: The use of pharmacogenomics has become more prevalent over the past several years in treating many disease states. Several cytochrome P450 enzymes play a role in the metabolism of many pain medications including opioids and antidepressants. Noncytochrome P450 enzymes such as methylenetetrahydrofolate reductase (MTHFR and catechol-O-methyl transferase (COMT also play a role in the explanation of opioid dosage requirements as well as in response to certain antidepressants. We present the case of a patient with reduced COMT and MTHFR expression treated with leucovorin 10 mg daily for the management of chronic pain. The use of leucovorin in this patient decreased pain scores, which were clinically significant and increased functionality. This case demonstrates the importance of pharmacogenetics testing in patients, as this can help direct providers to better therapeutic options for their patients. Keywords: pharmacogenetic, depression, pain, MTHFR, COMT, methyl tetrahydrofolate reductase, catechol-O-methyltransferase

Staff and patient absorbed doses due to diagnostic nuclear medicine procedures

International Nuclear Information System (INIS)

Tabei, F.; Neshandar Asli, I.; Aghamiri, S.M.; Arbabi, K.

2004-01-01

Background: annual patient effective dose equivalent can be considered as a quantitative physical parameter describing the activities performed in each nuclear medicine department. annual staff dose equivalent could be also considered as a parameter describing the amount of radiation risk for performing the activities. We calculated the staff to patient dose equivalent ratio to be used as a physical parameter for quantification of ALARA law in nuclear medicine department. Materials and methods: as a part of nationwide study, this paper reports the staff and patient absorbed dose equivalents from diagnostic nuclear medicine examinations performed in four nuclear medicine department during 1999-2002. The type and frequency of examinations in each department were determined directly from hospital medical reports. Staff absorbed doses equivalents were calculated from regular personal dosimeter reports. Results: the total number of examinations increased by 16.7 % during these years. Annual patient collective dose equivalent increased about 13.0 % and the mean effective dose equivalent per exam was 3.61 ± 0.07 mSv. Annual total staff absorbed dose equivalent (total of 24 radiation workers) in four departments increased from 40.45 mSv to 47.81 mSv during four years that indicates an increase of about 20.6 %. The average of annual ratios of staff to patient effective dose equivalents in four departments were 1.83 x 10 -3 , 1.04 x 10 -3 , 3.28 x 10 -3 and 3.24 x 10 -3 , respectively, within a range of 0.9 x 10 -3 - 4.17 x 10 -3 . The mean value of ratios in four years was about 2.24 x 10 -3 ± 1.09 x 10 -3 that indicates the staff dose of about two 1000 th of patient dose. Conclusion: The mean value of ratios in four years was about 1.89 x 10 -3 ± 0.95 x 10 -3 indicating the staff dose of about one 1000 th of the patient dose. The staff to patient absorbed dose equivalent ratio could be used as a quantitative parameter for describing ALARA law in radiation protection and

[Key points of poverty alleviation of Chinese herbal medicine industry and classification of recommended Chinese herbal medicines].

Science.gov (United States)

Huang, Lu-Qi; Su, Gang-Qiang; Zhang, Xiao-Bo; Sun, Xiao-Ming; Wu, Xiao-Jun; Guo, Lan-Ping; Li, Meng; Wang, Hui; Jing, Zhi-Xian

2017-11-01

To build a well-off society in an all-round way, eliminate poverty, improve people's livelihood and improve the level of social and economic development in poverty-stricken areas is the frontier issues of the government and science and technology workers at all levels. Chinese herbal medicine is the strategic resource of the people's livelihood, Chinese herbal medicine cultivation is an important part of China's rural poor population income. As most of the production of Chinese herbal medicine by the biological characteristics of their own and the interaction of natural ecological environment factors, showing a strong regional character.the Ministry of Traditional Chinese Medicine and the State Council Poverty Alleviation Office and other five departments jointly issued the "China Herbal Industry Poverty Alleviation Action Plan (2017-2020)", according to local conditions of guidance and planning of Chinese herbal medicine production practice, promote Chinese herbal medicine industry poverty alleviation related work In this paper, based on the relevant data of poverty-stricken areas, this paper divides the areas with priority to the poverty alleviation conditions of Chinese herbal medicine industry, and analyzes and catalogs the list of Chinese herbal medicines grown in poverty-stricken areas at the macro level. The results show that there are at least 10% of the poor counties in the counties where the poverty-stricken counties and the concentrated areas are concentrated in the poverty-stricken areas. There is already a good base of Chinese herbal medicine industry, which is the key priority area for poverty alleviation of Chinese herbal medicine industry. Poverty-stricken counties, with a certain degree of development of Chinese medicine industry poverty alleviation conditions, the need to strengthen the relevant work to expand the foundation and capacity of Chinese herbal medicine industry poverty alleviation; 37% of poor counties to develop Chinese medicine

Estudo multicasos sobre atividades inovativas

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Sonia Regina Hierro Parolin

2013-09-01

Full Text Available Em estudos sobre competitividade argumenta-se que as empresas necessitam de estratégias baseadas em inovações e de capacidades internas em constantes e intensas transformações, não somente nos padrões tecnológicos, mas também no encadeamento do processo de gestão das atividades inovativas, como processos dinâmicos, não lineares e diversificados, em função de múltiplos fatores dos ambientes interno e externo. Para contribuir com essas discussões, neste artigo apresenta-se um estudo multicasos em quatro indústrias de médio e grande portes, de segmentos, densidades tecnológicas e históricos com inovações diferentes entre si. Como principais resultados, salientam-se o encadeamento das atividades inovativas como parte de uma estratégia organizacional para obter resultados com inovação e a afluência de todas as pessoas, e não somente as alocadas em pesquisa e desenvolvimento, para o cumprimento dessa estratégia.

Development of a clinical forensic medicine curriculum for emergency physicians in the USA.

Science.gov (United States)

Smock, W S

1994-06-01

To address the forensic needs of living patients, the Department of Emergency Medicine at the University of Louisville School of Medicine in Louisville, Kentucky, USA initiated the first clinical forensic medicine training programme in the USA. In July 1991, formal training in clinical forensic medicine was incorporated into the core curriculum of the USA's second oldest academic emergency medicine training programme. The University of Louisville, in cooperation with the Kentucky Medical Examiner's Office, developed the curriculum to provide the emergency physician with the knowledge base and technical skills to perform forensic evaluations of living patients. Forensic lectures are given monthly by local and regional forensic experts including: forensic pathologists, prosecuting attorneys, firearm and ballistics examiners, law enforcement officers, forensic chemists and forensic odontologists. Topics which are presented include: forensic pathology, forensic photography, ballistics and firearms analysis, paediatric physical and sexual assault, crime scene investigation, forensic odontology, courtroom and expert testimony and the forensic evaluation of penetrating trauma. As a result of the introduction of clinical forensic medicine into the core curriculum of an emergency medicine training programme the residents are now actively addressing the forensic issues encountered in the Emergency department. Key, often short-lived forensic evidence, which was frequently overlooked or discarded while delivering patient care is now recognized, documented and preserved. The development and introduction of a clinical forensic medicine curriculum into emergency medicine training has greatly enhanced the emergency physician's ability to recognize, document and address the forensic needs of their patients who are victims of violent and non-fatal trauma.

Use and toxicity of traditional and complementary medicine among patients seeking care at an emergency department of a teaching hospital in Malaysia.

Science.gov (United States)

Jatau, Abubakar Ibrahim; Aung, Myat Moe Thwe; Kamauzaman, Tuan Hairulnizam Tuan; Ab Rahman, Ab Fatah

2018-05-01

Traditional and Complementary Medicines (TCM) are widely used worldwide, and many of them have the potential to cause toxicity, interaction with conventional medications and non-adherence to prescribed medications due to patients' preference for the TCM use. However, information regarding their use among patients seeking care at emergency departments (ED) of a healthcare facility is limited. The study aimed to evaluate the TCM use among patients attending the ED of a teaching hospital in Malaysia. A sub-analysis of data from a prevalence study of medication-related visits among patients at the ED of Hospital Universiti Sains Malaysia was conducted. The study took place over a period of six weeks from December 2014 to January 2015 involving 434 eligible patients. Data on demography, conventional medication, and TCM uses were collected from patient interview and the medical folders. Among this cohort, 66 patients (15.2%, 95%CI 12.0, 19.0) reported concurrent TCM use. Sixteen (24.2%) of the TCM users were using more than one (1) type of TCM, and 17 (25.8%) came to the ED for medication-related reasons. Traditional Malay Medicine (TMM) was the most frequently used TCM by the patients. Five patients (7.6%) sought treatment at the ED for medical problems related to use of TCM. Patients seeking medical care at the ED may be currently using TCM. ED-physicians should be aware of these therapies and should always ask patients about the TCM use. Copyright © 2018 Elsevier Ltd. All rights reserved.

Attitudes of Emergency Department Staff towards the Role of Clinical ...

African Journals Online (AJOL)

participation of future Pharm-D graduates in direct patient care in the Saudi health care system. Keywords: Clinical ... errors [3]. According to the findings of the. U.S. Institute of Medicine, ED has the highest ..... human: Building a safer health system. Washington, DC: ... department: A systems approach to minimizing risk.

Pertinencia de la gammagrafía de tiroides en un servicio de medicina nuclear de referencia del oriente colombiano / Pertinence of Thyroid Scan in a Nuclear Medicine Department in Eastern Colombia / Relevância da cintilografia da tireóide em um centro de referência de medicina nuclear no leste colombiano

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Liset Sánchez-Ordúz, MD.

2015-03-01

used in the study of thyroid diseases. It is recommended to perform it in patients presenting thyrotoxicosis, thyroid nodules with indeterminate cytology and when diagnosing ectopic thyroid. Our objective was to determine the pertinence of ordering thyroid scan in a nuclear medicine department in eastern Colombia. Methodology: Observational, retrospective, and cross-sectional descriptive study. Thyroid scans including relevant variables performed in the nuclear medicine department at Carlos Ardila Lulle hospital were evaluated during 3 consecutive months. The indication of the study, academic background of physician requesting the test, patient’s gender, concomitant presence of TSH with its respective value, and intake of Levothyroxine before test. Test results were also taken into account. Results: Out of the 277 performed scans, 244 (88% were women. 67% of them were not correctly indicated, and 32% of these patients were taking hormonal supplements, which was suspended 25 days before performing the test. General practitioners and consultants without specialization in endocrinology have a 9.08 and 9.37 probability respectively, of not indicating correctly the thyroid scan compared to endocrinologists. Conclusions: Two out of 3 thyroid scans performed in a nuclear medicine department in Eastern Colombia are not correctly indicated, producing a big impact in public health. [Sánchez-Orduz L, Wandurraga-Sánchez EA, García RE, Camacho PA. Pertinence of Thyroid Scan in a Nuclear Medicine Department in Eastern Colombia. MedUNAB 2015; 17(3: xx-xx]. Introdução: A cintilografia da tireóide é um teste muito usado no estudo de doenças da glândula tireóide. O monitoramento é recomendado em doentes com tireotoxicose, nódulos de tireóide com citologia indeterminada e suspeita de tireóide ectópica. Objetivo: Nosso objetivo foi determinar a pertinência do pedido de cintilografia da tireóide em um centro de referência de medicina nuclear no leste da Col

Herbal medicine use among patients with chronic diseases.

Science.gov (United States)

Tulunay, Munevver; Aypak, Cenk; Yikilkan, Hulya; Gorpelioglu, Suleyman

2015-01-01

Complementary and alternative medicine (CAM) is commonly used all over the world, and herbal medicines are the most preferred ways of CAM. The aim of this study was to determine the frequency of herbal medicine use among patients with chronic diseases. A cross-sectional descriptive study was conducted from April 2014 to December 2014 among patients who had been diagnosed with diabetes mellitus (DM), hypertension (HT), and hyperlipidemia (HL) in Family Medicine Department of Dışkapı Yıldırım Beyazıt Training and Research Hospital, in Ankara. A questionnaire about herbal drug use was applied by face to face interview to the participants. A total of 217 patients were included in this study. The mean age of the participants was 56.6 ± 9.7 years (55 male and 162 female). The rate of herbal medicine use was 29%. Herbal medicine use among female gender was significantly higher (P = 0.040). Conventional medication use was found to be lower among herbal medicine consumers. There was no relationship between herbal medicine use and type of chronic disease, living area, and occupation or education level. Most frequently used herbs were lemon (39.6%) and garlic (11.1%) for HT, cinnamon (12.7%) for DM, and walnut (6.3%) for HL. In this study, herbal medicine use was found to be higher among patients who had been diagnosed with chronic diseases. Therefore, physicians should be aware of herbal medicine usage of their patients and inform them about the effectivity and side effects of herbal medicines.

ESTUDO FITOQUÍMICO E ANTIMICROBIANO DAS FOLHAS DE EUGENIA ASTRINGENS CAMBESS. (MYRTACEAE

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Bruna Carminate

2017-02-01

Full Text Available O conhecimento sobre plantas medicinais simboliza muitas vezes o único recurso terapêutico de muitas comunidades e grupos étnicos. A tradição popular é a origem de valiosos conhecimentos acerca das plantas, muitas das observações populares sobre a utilização de plantas medicinais contribuem, de forma relevante, para a divulgação das virtudes terapêuticas vegetais. A E. astringens é uma espécie que apresenta casca e folhas aromáticas, adstringentes, anti-reumáticas e diuréticas. Apesar do uso medicinal já relatado, não existem muitos estudos quanto a atividade antimicrobiana. O objetivo do presente trabalho foi a realização da triagem fitoquímica e a avaliação da atividade antimicrobiana do extrato hidroalcoólico das folhas de Eugenia astringens Cambess. Foram encontrados taninos, fenóis, catequinas e ácidos orgânicos e o extrato apresentou atividade antibacteriana para todas as 8 cepas testadas.

78 FR 23742 - Nomination Form of Veterinary Shortage Situations for the Veterinary Medicine Loan Repayment...

Science.gov (United States)

2013-04-22

... DEPARTMENT OF AGRICULTURE National Institute of Food and Agriculture Nomination Form of Veterinary Shortage Situations for the Veterinary Medicine Loan Repayment Program (VMLRP) AGENCY: National Institute... information collection for the Veterinary Medicine Loan Repayment Program (VMLRP). This notice initiates a 30...

[Medicine in the discovery of America].

Science.gov (United States)

Gómez-Gallo, Alvaro

2003-01-01

The present manuscript aims to record some general aspects of science, and in particular from the beginning of anatomic studies, during the discovery of America. We mention by Vesalio, who was the best known anatomist of his time in the Western world. In addition this establishes the legal origins of the medical profession in Spain and America, with emphasis on distinct treatments, for example, those in Peru and Chile. This manuscript contains anecdotes and accounts of the time, the use of medicines of the day, and the relationship these had with the native medicine. Finally, medical department of Chile is described, together with a mention of the first hospitals of the Republic of Chile.

Training and education in nuclear medicine at the Medical Faculty of the University of Zagreb

International Nuclear Information System (INIS)

Ivancevic, D.; Popovic, S.; Simonovic, I.; Vlatkovic, M.

1986-01-01

Training for specialization in nuclear medicine in Yugoslavia includes 12 months of training in departments of clinical medicine and 24 months of training in departments of nuclear medicine. Since 1974 many physicians have passed the specialist examination in Zagreb. A postgraduate study in nuclear medicine began at the Medical Faculty of the University of Zagreb in 1979. It includes four semesters of courses and research on a selected subject leading to the degree of Magister (Master of Science). Most of the training is conducted by the Institute of Nuclear Medicine at the University Hospital, Rebro, in Zagreb, which has the necessary teaching staff, equipment and space. Forty-four students have completed this postgraduate study. Nuclear medicine in a developing country faces several problems. Scarcity of expensive equipment and radiopharmaceuticals calls for modifications of methods, home made products and instrument maintenance. These, mostly economic, factors are given special emphasis during training. Nuclear power generation may solve some of the country's energy problems; therefore, specialists in nuclear medicine must obtain additional knowledge about the medical care and treatment of persons who might be subject to irradiation and contamination in nuclear power plants. Lower economic resources in developing countries require better trained personnel, stressing the need for organized training and education in nuclear medicine. With some support the Institute of Nuclear Medicine will be able to offer various forms of training and education in nuclear medicine for physicians, chemists, physicists, technologists and other personnel from developing countries. (author)

The 2014 Academic College of Emergency Experts in India's Education Development Committee (EDC) White Paper on establishing an academic department of Emergency Medicine in India - Guidelines for Staffing, Infrastructure, Resources, Curriculum and Training.

Science.gov (United States)

Aggarwal, Praveen; Galwankar, Sagar; Kalra, Om Prakash; Bhalla, Ashish; Bhoi, Sanjeev; Sundarakumar, Sundarajan

2014-07-01

Emergency medicine services and training in Emergency Medicine (EM) has developed to a large extent in developed countries but its establishment is far from optimal in developing countries. In India, Medical Council of India (MCI) has taken great steps by notifying EM as a separate specialty and so far 20 medical colleges have already initiated 3-year training program in EM. However, there has been shortage of trained faculty, and ambiguity regarding curriculum, rotation policy, infrastructure, teachers' eligibility qualifications and scheme of examination. Academic College of Emergency Experts in India (ACEE-India) has been a powerful advocate for developing Academic EM in India. The ACEE's Education Development Committee (EDC) was created to chalk out guidelines for staffing, infrastructure, resources, curriculum, and training which may be of help to the MCI and the National Board of Examinations (NBE) to set standards for starting 3-year training program in EM and develop the departments of EM as centers of quality education, research, and treatment across India. This paper has made an attempt to give recommendations so as to provide a uniform framework to the institutions, thus guiding them towards establishing an academic Department of EM for starting the 3-year training program in the specialty of EM.

Recruitment of minority physicians into careers in internal medicine.

Science.gov (United States)

Potts, J T

1992-06-15

Despite some initial success in the early 1970s, the important goal of increasing the numbers of underrepresented minorities in medical school and on medical faculties has stalled short of proportionate representation. To further the current efforts of the Association of Professors in Medicine (APM) and other national medical groups that are devoted to improving the numbers of minorities in medicine, ideas and program information must be shared among institutions. In this spirit, we review our experience at Massachusetts General Hospital. We found that the first step toward this goal must be an institutional commitment based on increased awareness and on special effort focused on housestaff recruitment. Once the numbers of minorities increase, the department chairperson, training program directors, and other involved faculty can work with younger minority physicians; the cooperative relationship thus created can guide the development of a strong minority recruitment program without requiring an undue time commitment from minority trainees and faculty. The APM has a combined goal: to achieve early practical results in individual departments, to play a catalytic role with the community and other national medical organizations, and to increase the number of minorities entering medical school and careers in medicine generally.

Exposure from diagnostic nuclear medicine procedures

International Nuclear Information System (INIS)

Iacob, O.; Diaconescu, C.; Isac, R.

2002-01-01

According to our last national study on population exposures from natural and artificial sources of ionizing radiation, 16% of overall annual collective effective dose represent the contribution of diagnostic medical exposures. Of this value, 92% is due to diagnostic X-ray examinations and only 8% arise from diagnostic nuclear medicine procedures. This small contribution to collective dose is mainly the result of their lower frequency compared to that of the X-ray examinations, doses delivered to patients being, on average, ten times higher. The purpose of this review was to reassess the population exposure from in vivo diagnostic nuclear medicine procedures and to evaluate the temporal trends of diagnostic usage of radiopharmaceuticals in Romania. The current survey is the third one conducted in the last decade. As in the previous ones (1990 and 1995), the contribution of the Radiation Hygiene Laboratories Network of the Ministry of Health and Family in collecting data from nuclear medicine departments in hospitals was very important

The usage of complementary and alternative medicine in gastrointestinal patients visiting the outpatients’ department of a large tertiary care centre-views from Pakistan

Science.gov (United States)

Lail, Ghulamullah; Luck, Nasir; Tasneem, Abbas Ali; Rai, AyeshaAslam; Laeeq, Syed Mudasir; Majid, Zain

2016-01-01

Introduction The use of complementary and alternative medicine (CAM) has increased over the last few years, and an emergent data suggests that some CAM modalities may be helpful in addressing gastrointestinal (GI) conditions. Our aim was to find out the prevalence of such practices for GI condition amongst patients visiting an OPD of a large tertiary care centre of Karachi, Pakistan. Methods Patients visiting outpatient department of Hepatogastroenterology department at SIUT, Pakistan from March 2014 to March 2015, were included in this cross sectional study. A pre designed questionnaire was used that included the demographic data, primary disease of the patient, CAM modality used, reason for the use of CAM therapy and reasons for stopping it. Frequencies of different variables were computed using SPSS version 18. Results 906 patients were interviewed, out of which 52% (471) were males. The mean age at presentation was 39.81±12.4 years. 234 (25.8%) of the participants used one of the CAM modalities; Herbal medicine being most common one, seen in 122 (52.13%) followed by spiritual 61 (26%), and homeopathy 33 (14%). The duration of therapy was limited to six months in 161(68%), whereas 7 patients (2.9%) had prolonged duration of use of more than five years. Reasons for using CAM therapy included advice by family and friends in 66 patients (28%), personal will in 42 (17.94%), no benefit from allopathic treatment in 34 (14.5%), while high cost was the reason of use in 3(5%) of the patients. The most common reason for discontinuation of CAM was no benefit, seen in 113 patients (48.30%), followed by physician's advice in 32 (17%) patients, and side effects in 19 (8%). On the other hand 44 patients (18.80%) reported benefit from the therapy while 14 (5.9%) were still continuing with CAM modality. Among the CAM users 140 (60.09%) were un-educated or had primary education while CAM nonusers had 328 (47%) were either uneducated or had primary education only correlation

[Rationalization in 20th-century Czechoslovak pharmacy practice - commission for rationalization and standardization in medicine, veterinary medicine and pharmacy - part 1].

Science.gov (United States)

Babica, Jan; Rusek, Václav

2014-06-01

In the 1920s Czechoslovakia, an increased attention was paid to the new ideas of scientific management (Taylorism), work rationalization and standardization. This was reflected in the foundation of the Masaryk Academy of Work in 1920. An effort to implement the new principles into health care led to the establishment of the Commission for Rationalization and Standardization in Medicine, Veterinary Medicine and Pharmacy (RANOK) within the Department of Natural Science and Medicine of the Academy. Within RANOK, the group for pharmacy worked between 1928-1932. The first part of the paper describes the scientific management and standardization movement in interwar Czechoslovakia, and the establishment of Masaryk Academy of Work and RANOK, including the group for pharmacy. The paper discusses the work objectives of the commission and presents concise biographies of the group for pharmacy members, too. The second part will be focused on the work results, relative failure and role of the group. Masaryk Academy of Work Comission for Rationalization and Standardization in Medicine Veterinary Medicine and Pharmacy (RANOK) work rationalization standardization pharmacy practice.

Estudos organizacionais, (descolonialidade e estudos da dependência: as contribuições da Cepal

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Sergio Wanderley

Full Text Available O objetivo deste artigo é (revisitar o conceito de dependência como categoria de investigação da (e a partir da América Latina, por meio de uma perspectiva histórica crítica descolonial, a fim de ampliar o espaço de debates em estudos organizacionais e promover alternativas à ordem neoliberal. Este ensaio terá como foco os estudos da dependência realizados pela Comissão Econômica para a América Latina e o Caribe (Cepal durante a década de 1950 e o início dos anos 1960. A perspectiva descolonial é um constructo teórico de autores latino-americanos que se consideram herdeiros da longa tradição do pensamento social crítico da região, na qual a teoria da dependência está inserida. As propostas dos autores da dependência confrontaram as principais teorias ortodoxas do Norte produzidas à época. A partir do conceito de centro-periferia, da denúncia de assimetrias nas relações entre essas regiões, do reconhecimento da interdependência entre desenvolvimento e subdesenvolvimento, o conceito de dependência foi sendo (reelaborado nas décadas de 1950 e 1960 por diversos autores latino-americanos como uma categoria de investigação da realidade da (e a partir da região. Essas investigações tinham por objetivo não somente elaborar constructos teóricos, mas, também, transformar a realidade por meio da criação de diversas organizações e instituições que deveriam servir ao propósito de superar o subdesenvolvimento. A denúncia da historicidade da situação de subdesenvolvimento desnudou o caráter de neutralidade do economicismo das teorias produzidas no Norte e promoveu um encontro teórico entre economia e política que muito tem a contribuir com a área dos estudos organizacionais.

[Opportunity and challenge of post-marketing evaluation of traditional Chinese medicine].

Science.gov (United States)

Du, Xiao-Xi; Song, Hai-Bo; Ren, Jing-Tian; Yang, Le; Guo, Xiao-Xin; Pang, Yu

2014-09-01

Post-marketing evaluation is a process which evaluate the risks and benefits of drug clinical application comprehensively and systematically, scientific and systematic results of post-marketing evaluation not only can provide data support for clinical application of traditional Chinese medicine, but also can be a reliable basis for the supervision department to develop risk control measures. With the increasing demands for treatment and prevention of disease, traditional Chinese medicine has been widely used, and security issues are also exposed. How to find risk signal of traditional Chinese medicine in the early stages, carry out targeted evaluation work and control risk timely have become challenges in the development of traditional Chinese medicine industry.

Survey on lower urinary tract symptoms and sleep disorders in patients treated at urology departments

Directory of Open Access Journals (Sweden)

Shimizu N

2013-01-01

Full Text Available Nobutaka Shimizu,1 Yasuharu Nagai,1 Yutaka Yamamoto,1 Takafumi Minami,1 Taiji Hayashi,1 Hidenori Tsuji,1 Masahiro Nozawa,1 Kazuhiro Yoshimura,1 Tokumi Ishii,1 Hirotsugu Uemura,1 Takashi Oki,2 Koichi Sugimoto,2 Kazuhiro Nose,2 Tsukasa Nishioka21Department of Urology, Kinki University Faculty of Medicine, Osaka, Japan; 2Department of Urology, Sakai Hospital, Kinki University Faculty of Medicine, Osaka, JapanObjectives: This study examined the association between sleep disorders and lower urinary tract symptoms in patients who had visited urology departments.Methods: This was an independent cross-sectional, observational study. Outpatients who had visited the urology departments at the Kinki University School of Medicine or the Sakai Hospital, Kinki University School of Medicine, between August 2011 and January 2012 were assessed using the Athens Insomnia Scale and the International Prostate Symptom Score.Results: In total, 1174 patients (mean age, 65.7 ± 13.7 years, with 895 men (67.1 ± 13.2 years old and 279 women (61.4 ± 14.6 years old, were included in the study. Approximately half of these patients were suspected of having a sleep disorder. With regard to the International Prostate Symptom Score subscores, a significant increase in the risk for suspected sleep disorders was observed among patients with a post-micturition symptom (the feeling of incomplete emptying subscore of ≥1 (a 2.3-fold increase, a storage symptom (daytime frequency + urgency + nocturia subscore of ≥5 (a 2.7-fold increase, a voiding symptom (intermittency + slow stream + hesitancy subscore of ≥2 (a 2.6-fold increase, and a nocturia subscore of ≥2 (a 1.9-fold increase.Conclusion: The results demonstrated that the risk factors for sleep disorders could also include voiding, post-micturition, and storage symptoms, in addition to nocturia.Keywords: lower urinary tract symptoms, sleep disturbance, urological disease

In vitro regenerative potentials of the medicinal plant Abutilon ...

African Journals Online (AJOL)

Nissar Reshi

2016-03-23

Mar 23, 2016 ... Plant Tissue Culture Laboratory, Department of Studies in Botany, University of ... Since the plant has a lot of medicinal importance, it was subjected to culture in vitro. ..... (3%) as compared to the cultures of tomato (van den.

Estudo sobre reciclagem de lâmpadas fluorescentes

OpenAIRE

Bacila,Danniele Miranda; Fischer,Klaus; Kolicheski,Mônica Beatriz

2014-01-01

Lâmpadas fluorescentes (LF) contêm mercúrio em sua composição, um metal pesado que pode causar danos à saúde e ao meio ambiente. As LF são amplamente consumidas no Brasil, porém o descarte correto de LF usadas não é amplamente divulgado e os índices de reciclagem são baixos. O objetivo deste estudo foi demonstrar a relevância do descarte adequado, avaliar as tecnologias de reciclagem e a destinação dos materiais, por meio de estudo comparativo entre Brasil e Alemanha. Através de visitas a rec...

Use of complementary and alternative medicine in head and neck cancer patients.

Science.gov (United States)

Lim, C M; Ng, A; Loh, K S

2010-05-01

To determine the prevalence and profile of patients who use complementary and alternative medicine, within a cohort of head and neck cancer patients. Cross-sectional survey. Ninety-three consecutive head and neck cancer patients being followed up at the department of otolaryngology head and neck surgery were surveyed using an interviewer-administered questionnaire. The prevalence of complementary and alternative medicine use was 67.8 per cent. Patients who used complementary and alternative medicine were more likely to be female, better educated and younger, compared with non-users. A total of 82.5 per cent (52/63) perceived complementary and alternative medicine to be effective, even though they were aware of the lack of research and endorsement by their physician regarding such medicine. The use of complementary and alternative medicine by head and neck cancer patients is common, regardless of efficacy or cost. Clinicians should routinely ask patients about their use of complementary and alternative medicine, to facilitate communication and enable appropriate use of such medicine.

Complementary and alternative medicine use among veterans with chronic noncancer pain

OpenAIRE

Lauren M. Denneson, PhD; Kathryn Corson, PhD; Steven K. Dobscha, MD

2011-01-01

We describe prior use and willingness to try complementary and alternative medicine (CAM) among 401 veterans experiencing chronic noncancer pain and explore differences between CAM users and nonusers. Participants in a randomized controlled trial of a collaborative intervention for chronic pain from five Department of Veterans Affairs (VA) primary care clinics self-reported prior use and willingness to try chiropractic care, massage therapy, herbal medicines, and acupuncture. Prior CAM users ...

Wilderness medicine at high altitude: recent developments in the field

OpenAIRE

Shah, Neeraj M; Hussain, Sidra; Cooke, Mark; O’Hara, John P; Mellor, Adrian

2015-01-01

Neeraj M Shah,1 Sidra Hussain,2 Mark Cooke,3 John P O’Hara,3 Adrian Mellor3,4 1Division of Asthma, Allergy and Lung Biology, King’s College London, UK; 2School of Medicine, University College London, London, UK; 3Research Institute for Sport, Physical Activity and Leisure, Leeds Beckett University, Leeds, UK; 4Academic Department of Military Anaesthesia and Critical Care, Royal Centre for Defence Medicine, Birmingham, UK Abstract: Travel to high altitude is increasingly p...

Os estudos brasileiros e os 'brazilianists'

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José Honório Rodrigues

1976-09-01

Full Text Available (primeiro parágrafo do artigo Quando, em 1943-1944, estive nos Estados Unidos, estudando e pesquisando, conheci muitas bibliotecas públicas e universitárias, e o grande Arquivo Nacional dos Estados Unidos. Nas Universidades já se ofereciam cursos de estudos latino-americanos, centralizados sobretudo no estudo da língua espanhola, portuguesa em menor escala, estenografía em espanhol, e raras propunham o ensino da literatura comparativa, antropologia, economia, geografia, política e história latino-americana, sempre em conjunto; raríssimas, como a Columbia, ofereciam aulas de história social e econômica do Brasil, e tambem do México e da América Central, e ainda da Argentina, Uruguai e Paraguai. Havia pouca especialização por paises e áreas, e se via predominantemente a América Latina como um bloco uno e uniforme.

Homicides with corpse dismemberment in the material collected by the Department of Forensic Medicine, Krakow, Poland

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Tomasz Konopka

2017-06-01

Full Text Available Aim of the study : To determine the circumstances which can be useful for offenders profiling in homicide cases with victim’s body dismemberment. Material and methods: Study of all homicide cases with victim’s corpse dismemberment examined in Krakow Department of Forensic Medicine over the last 50 years. Results : Within the past 50 years, a total number of 30 cases of homicides with dismembered bodies were examined in Krakow. 22 cases represent defensive mutilations performed by offender, 3 cases can be classified as offensive muti­lations and 3 cases represent aggressive mutilations – decapitation as a method of committing homicide. In this period the only 1 case of necrophilic mutilations was examined, when the body was dismembered without murder. In most cases the background of homicide was the family conflict, 6 was cause of mental illness of perpetrator and in 3 was sexual motive. Only in 3 cases (from 25 when the offender was known perpetrator kill a stranger. In the other the offender belonged to the family or friends of the victim. In all cases where the perpetrator was determined, homicide and dismemberment was performed in his place of residence. The findings of the Police investigations indicate that in most cases homicides were not planned, occurred under the influence of emotion, only two have been previously scheduled. Conclusions : Homicides with corpses dismemberment usually are committed by offenders who is in close relationship with victim (family or friend. Dismemberment is almost always performed in the same place as murder – home of perpetrator. This type of homicide usually is not planned.

Development and Validation of a Questionnaire for Evaluation of Students’ Attitudes towards Family Medicine

OpenAIRE

Petek Šter, Marija; Švab, Igor; Klemenc-Ketiš, Zalika; Kersnik, Janko

2015-01-01

The development of the EURACT (European Academy of Teachers in General Practice) Educational Agenda helped many family medicine departments in development of clerkship and the aims and objectives of family medicine teaching. Our aims were to develop and validate a tool for assessment of students’ attitudes towards family medicine and to evaluate the impact of the clerkship on students’ attitudes regarding the competences of family doctor. In the pilot study, experienced family doc...

[Highlights of hospital-based internal medicine in 2010: chief residents' perspective].

Science.gov (United States)

Uhlmann, Marc; Burnard, Jérôme; Cosma Rochat, Monica; Gabus, Vincent; Micheloud, Valérie Geiser; Gobin, Niels; Laurent, Jean-Christophe; Marino, Laura; Méan, Marie; Merz, Laurent; Regamey, Julien; Stadelmann, Raphaël

2011-02-02

Applying knowledge acquired from recent medical studies to patient care poses a daily challenge to physicians. Chief residents from the Department of Internal Medicine at the University Hospital of Lausanne carried out a review of some of the issues they considered important. The conclusions of these various publications may have a significant impact on the daily practice of hospital-based internal medicine. Modern medicine based on scientific studies is a reminder that in spite of the essential importance of clinical experience, it is crucial to confront it with the results of relevant publications from the medical literature.

Quality approach in in vivo nuclear medicine - Certification V2010 - Methodological guide

International Nuclear Information System (INIS)

Abdelmoumene, Nafissa; Ferreol, Dominique; Blondet, Emmanuelle; Bonardel, Gerald; Bourrel, Francois; Broglia, Jean Marc; Guilabert, Nadine; Israel, Jean-Marc; Machacek, Catherine; Martineau, Antoine; Remy, Herve; Rousseliere, Francis; Abelmann, Caroline

2013-01-01

This document first presents the different components of the activity in in-vivo nuclear medicine: techniques (functional imagery, vectorized internal radiotherapy, cases outside the nuclear medicine department), team composition and missions, radiation protection regulations, benefits and risks. Then, it addresses the quality approach: quality management system defined according to a process-oriented approach, documentation. It proposes a sheet to assess the implementation of the quality approach. This sheet contains 129 criteria which are related to management (strategy, activity steering and coordination), to support functions (management of human resources and abilities, management of radioactive sources and wastes, radio-pharmacy within the nuclear medicine department, management of medical devices, information system), to patient taking on (management of appointments and patient identification, imagery examination justification, patient reception, patients presenting risks and peculiar situations, checking before radio-pharmaceutical drug administering, taking on for diagnosis purpose, taking for therapeutic purposes), and to assessment, analysis and improvement (management of undesirable events associated with cares, quality follow-up for continuous improvement)

Department of Energy multiprogram laboratories

International Nuclear Information System (INIS)

1982-09-01

The Panel recommends the following major roles and missions for the laboratories: perform the Department's national trust fundamental research missions in the physical sciences, including high energy and nuclear physics, and the radiobiological sciences including nuclear medicine; sustain scientific staff core capabilities and specialized research facilities for laboratory research purposes and for use by other Federal agencies and the private sector; perform independent scientific and technical assessment or verification studies required by the Department; and perform generic research and development where it is judged to be in the public interest or where for economic or technical reasons industry does not choose to support it. Organizational efficiencies if implemented by the Department could contribute toward optimal performance of the laboratories. The Panel recommends that a high level official, such as a Deputy Under Secretary, be appointed to serve as Chief Laboratory Executive with authority to help determine and defend the research and development budget, to allocate resources, to decide where work is to be done, and to assess periodically laboratory performance. Laboratory directors should be given substantially more flexibility to deploy resources and to initiate or adapt programs within broad guidelines provided by the Department. The panel recommends the following actions to increase the usefulness of the laboratories and to promote technology transfer to the private sector: establish user groups for all major mission programs and facilities to ensure greater relevance for Department and laboratory efforts; allow the laboratories to do more reimbursable work for others (other Federal agencies, state and local governments, and industry) by relaxing constraints on such work; implement vigorously the recently liberalized patent policy; permit and encourage joint ventures with industry

The 2014 Academic College of Emergency Experts in India′s Education Development Committee (EDC White Paper on establishing an academic department of Emergency Medicine in India - Guidelines for Staffing, Infrastructure, Resources, Curriculum and Training

Directory of Open Access Journals (Sweden)

Praveen Aggarwal

2014-01-01

Full Text Available Emergency medicine services and training in Emergency Medicine (EM has developed to a large extent in developed countries but its establishment is far from optimal in developing countries. In India, Medical Council of India (MCI has taken great steps by notifying EM as a separate specialty and so far 20 medical colleges have already initiated 3-year training program in EM. However, there has been shortage of trained faculty, and ambiguity regarding curriculum, rotation policy, infrastructure, teachers′ eligibility qualifications and scheme of examination. Academic College of Emergency Experts in India (ACEE-India has been a powerful advocate for developing Academic EM in India. The ACEE′s Education Development Committee (EDC was created to chalk out guidelines for staffing, infrastructure, resources, curriculum, and training which may be of help to the MCI and the National Board of Examinations (NBE to set standards for starting 3-year training program in EM and develop the departments of EM as centers of quality education, research, and treatment across India. This paper has made an attempt to give recommendations so as to provide a uniform framework to the institutions, thus guiding them towards establishing an academic Department of EM for starting the 3-year training program in the specialty of EM.

Cultura organizacional no setor público: um estudo junto a um departamento administrativo de uma universidade federal brasileira Organizational Culture In The Public Administration: A Study In Administrative Department Of Brazilian Federal University

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Evandro Dotto Dias

2011-12-01

Full Text Available The organizacional culture is a complex subject and that constantly it comes being studied for specialists and researchers of the whole world, for the fact of its relevance in the understanding of the functioning of the organizations. However, this type of study not yet total was spread out in the Brazilian public organizations, mainly in federal universities. Therefore, the present work has as objective generality to identify to the organizacional culture under the personal and institucional points of view in an managemental department of the Federal University of Saint Maria, through a comparison with four deuses Greek (Zeus, Apolo, Atena and Dionísio that they reflect the form as the politics and strategies in an organization are lead, according to Handy study (1994. By means of a survey carried through with the employees of the related department, the gotten results had allowed the conclusion of that it has the predominance of the organizacional culture of the Apolo type in the institucional optics and of the Atena type in the personal optics, where a made comparative degree enter the predominant characteristics in each one of these cultures showed a divergence enter the yearnings of the collaborators and the form as the organization acts day-by-day in its, as the points boarded for the research and presented in the analysis of the results.A cultura organizacional é um tema complexo e constantemente em estudo por especialistas e pesquisadores de todo o mundo, pela sua relevância na compreensão do funcionamento das organizações. No entanto, esse tipo de estudo ainda não foi totalmente difundido nas organizações públicas brasileiras, principalmente em universidades federais. Por isso, este trabalho tem como objetivo geral identificar a cultura organizacional sob os pontos de vista pessoal e institucional em um departamento administrativo da Universidade Federal de Santa Maria, através de uma relação com os quatro deuses gregos

Biomimetics: forecasting the future of science, engineering, and medicine

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Hwang J

2015-09-01

Full Text Available Jangsun Hwang,1 Yoon Jeong,1,2 Jeong Min Park,3 Kwan Hong Lee,1,2,4 Jong Wook Hong,1,2 Jonghoon Choi1,2 1Department of Bionano Technology, Graduate School, Hanyang University, Seoul, 2Department of Bionano Engineering, Hanyang University ERICA, Ansan, Korea; 3Department of Biomedical Engineering, Boston University, 4OpenView Venture Partners, Boston, MA, USA Abstract: Biomimetics is the study of nature and natural phenomena to understand the principles of underlying mechanisms, to obtain ideas from nature, and to apply concepts that may benefit science, engineering, and medicine. Examples of biomimetic studies include fluid-drag reduction swimsuits inspired by the structure of shark’s skin, velcro fasteners modeled on burrs, shape of airplanes developed from the look of birds, and stable building structures copied from the backbone of turban shells. In this article, we focus on the current research topics in biomimetics and discuss the potential of biomimetics in science, engineering, and medicine. Our report proposes to become a blueprint for accomplishments that can stem from biomimetics in the next 5 years as well as providing insight into their unseen limitations. Keywords: biomimicry, tissue engineering, biomaterials, nature, nanotechnology, nanomedicine

Guidelines for starting a nuclear medicine laboratory. Excerpts from a booklet published by Bhabha Atomic Research Centre, India

International Nuclear Information System (INIS)

1992-01-01

A nuclear medicine department caters to the need of all clinical departments, and, therefore, should be located at a central place. At the same time, because of radiation hazard associated with the use of radionuclides, planning of the departments should be done in such a way that there is no radiation exposure to non-radiation workers and the general public, and also that radiation workers handling radioisotopes receive minimum exposure. When a decision to set up a nuclear medicine department is taken, the authorities are faced with a number of questions regarding the location, planning for the premises, equipment needed, availability of trained medical and paramedical personnel and the procedure for obtaining clearance from various authorities

Guidelines for starting a nuclear medicine laboratory. Excerpts from a booklet published by Bhabha Atomic Research Centre, India

Energy Technology Data Exchange (ETDEWEB)

NONE

1993-12-31

A nuclear medicine department caters to the need of all clinical departments, and, therefore, should be located at a central place. At the same time, because of radiation hazard associated with the use of radionuclides, planning of the departments should be done in such a way that there is no radiation exposure to non-radiation workers and the general public, and also that radiation workers handling radioisotopes receive minimum exposure. When a decision to set up a nuclear medicine department is taken, the authorities are faced with a number of questions regarding the location, planning for the premises, equipment needed, availability of trained medical and paramedical personnel and the procedure for obtaining clearance from various authorities

Clinical practice in community medicine: Challenges and opportunities

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Rajesh Kumar

2017-01-01

Full Text Available Clinical practice with community health perspective makes community medicine a unique specialty. In their health centers, community physicians not only implement disease prevention programs, assess community health needs, manage healthcare teams and advocate for health promoting policies but also diagnose and treat diseases. However, participation of community medicine faculty in the delivery of clinical care varies from place to place due to administrative constraints. Health centers attached with medical college are not dependent on community medicine faculty for clinical service as these centers have their own medical and paramedical staff; whereas, other clinical departments in medical colleges depend on their faculty for delivery of clinical care in the hospital. Consequently, a perception is gaining ground that community medicine is a para-clinical specialty. Strategies for a fixed tenured rotation of faculty in the health centers should be evolved. All faculty members of community medicine must also provide clinical care in the health centers and the quantum of clinical services provided by each one of them should be reported widely to all stakeholders. Community medicine residency programs must ensure that trainee community physicians acquire competency to deliver comprehensive primary health care (promotive, preventive, curative, and rehabilitative in a health center.

ESTUDOS NACIONAIS SOBRE O ENSINO PARA CEGOS: UMA REVISÃO BIBLIOGRÁFICA

Directory of Open Access Journals (Sweden)

Rosana Mendes Éleres de FIGUEIREDO

2015-12-01

Full Text Available RESUMO O presente artigo tem como objetivo apresentar uma revisão bibliográfica dos estudos nacionais acerca do ensino curricular para cegos. Foi realizada uma busca sistemática em três bases de dados: Google Acadêmico, Scielo e Lilacs, de estudos publicados no período de 2004 a 2014, que tivessem em seu título um dos seguintes descritores: alunos cegos; alunos deficientes visuais; crianças cegas; crianças deficientes visuais. Foram localizados 188 estudos e 56 selecionados dentro dos critérios estabelecidos. Fez-se a leitura integral desses e definiram-se cinco categorias de análise: tipo de estudo; participantes; tipo de abordagem; tipo de discussão e matrizes curriculares. Para cada categoria, foram estabelecidas subcategorias. Ao total 26 subcategorias foram descritas. Os resultados indicam que o Google Acadêmico é a base de dados com maior número de títulos encontrados (188/156; a Scielo apresenta melhor eficiência na relação encontrado x selecionado (12/10. Nas subcategorias de análise, as maiores frequências são identificadas nos estudos empíricos (22; junto a crianças (19; de análises qualitativas (21; na matriz curricular de Educação Física (sete e na subcategoria relacionamento social (16. Contudo, os estudos são convergentes em apontar que as principais dificuldades no ensino às pessoas cegas se referem a deficiências na formação de professores, onde, normalmente, não são discutidos métodos de ensino e produção de material para trabalhar com essa população específica. Em conclusão, além de realizar um mapeamento dos estudos que têm sido conduzidos junto a alunos cegos nos últimos dez anos, este artigo aponta para lacunas na literatura e direciona futuras investigações na área.

Analyzing Big Data in Medicine with Virtual Research Environments and Microservices

OpenAIRE

Ola, Spjuth

2016-01-01

Presentation by Ola Spjuth, Deputy director at Department of Information Technology, Uppsala Multidisciplinary Centre for Advanced Computational Science, at Big Data in Medicine, Uppsala, Sweden.

Computer applications in nuclear medicine

International Nuclear Information System (INIS)

Lancaster, J.L.; Lasher, J.C.; Blumhardt, R.

1987-01-01

Digital computers were introduced to nuclear medicine research as an imaging modality in the mid-1960s. Widespread use of imaging computers (scintigraphic computers) was not seen in nuclear medicine clinics until the mid-1970s. For the user, the ability to acquire scintigraphic images into the computer for quantitative purposes, with accurate selection of regions of interest (ROIs), promised almost endless computational capabilities. Investigators quickly developed many new methods for quantitating the distribution patterns of radiopharmaceuticals within the body both spatially and temporally. The computer was used to acquire data on practically every organ that could be imaged by means of gamma cameras or rectilinear scanners. Methods of image processing borrowed from other disciplines were applied to scintigraphic computer images in an attempt to improve image quality. Image processing in nuclear medicine has evolved into a relatively extensive set of tasks that can be called on by the user to provide additional clinical information rather than to improve image quality. Digital computers are utilized in nuclear medicine departments for nonimaging applications also, Patient scheduling, archiving, radiopharmaceutical inventory, radioimmunoassay (RIA), and health physics are just a few of the areas in which the digital computer has proven helpful. The computer is useful in any area in which a large quantity of data needs to be accurately managed, especially over a long period of time

Pulmonary explorations in nuclear medicine

International Nuclear Information System (INIS)

Beck, C.

1987-01-01

Ten years ago specialists in Nuclear Medicine from the South of France formed an Association called ACOMEN. The objectives were to create a permanent exchange of ideas between members and a close collaboration with physicians. The group objectives have led to a combination of efforts on the behalf of each one to clarify our techniques for physicians having recourse to this speciality as well as the various categories of students passing through the Nuclear Medicine Departments. Different groups within the ACOMEN were assigned to specific subjects. Each group was in charge of building the framework of a certain topic, which was then illustrated by selected documents contributed by all members. A slide collection, complete with an explanatory booklet is the final result of this collaboration. Thus anyone concerned in any way, with nuclear medicine, is able to quickly become familiar with the techniques of the speciality, to be aware of its possibilities and its limitations and to update his hnowledge. One realizes that the first theme selected was not the easiest; pulmonary radionuclide explorations are, as everyone knows, variable and even personalized. However, the choice was deliberate. The difficulty should stimulate those responsible for the other themes as well as the people working with them. There is already a slide collection available to anyone who wishes to learn about the use of nuclear medicine in the diagnosis of respiratory diseases [fr

Leadership Experiences and Characteristics of Chairs of Academic Departments of Psychiatry

Science.gov (United States)

Keith, Samuel J.; Buckley, Peter F.

2011-01-01

Objective: Effective leadership in academic medicine requires a broad constellation of skills, experiences, and core values. The authors sought to describe and define these. Method: The authors conducted a web-based survey among 132 Chairs of North American departments of psychiatry. Results: Eighty-five Chairs (64%) responded to the survey, the…

78 FR 26053 - Advisory Committee on Training in Primary Care Medicine and Dentistry; Notice of Meeting

Science.gov (United States)

2013-05-03

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Service Administration Advisory Committee on Training in Primary Care Medicine and Dentistry; Notice of Meeting In accordance with section... following meeting: Name: Advisory Committee on Training in Primary Care Medicine and Dentistry (ACTPCMD...

78 FR 48440 - Advisory Committee on Training in Primary Care Medicine and Dentistry; Notice of Meeting

Science.gov (United States)

2013-08-08

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Service Administration Advisory Committee on Training in Primary Care Medicine and Dentistry; Notice of Meeting In accordance with section... following meeting: Name: Advisory Committee on Training in Primary Care Medicine and Dentistry (ACTPCMD...

Extremity exposure in nuclear medicine: Preliminary results of a European study

International Nuclear Information System (INIS)

Merce, M. S.; Ruiz, N.; Barth, I.; Carnicer, A.; Donadille, L.; Ferrari, P.; Fulop, M.; Ginjaume, M.; Gualdrini, G.; Krim, S.; Mariotti, F.; Ortega, X.; Rimpler, A.; Vanhavere, F.; Baechler, S.

2011-01-01

The Work Package 4 of the ORAMED project, a collaborative project (2008-11) supported by the European Commission within its seventh Framework Programme, is concerned with the optimisation of the extremity dosimetry of medical staff in nuclear medicine. To evaluate the extremity doses and dose distributions across the hands of medical staff working in nuclear medicine departments, an extensive measurement programme has been started in 32 nuclear medicine departments in Europe. This was done using a standard protocol recording all relevant information for radiation exposure, i.e. radiation protection devices and tools. This study shows the preliminary results obtained for this measurement campaign. For diagnostic purposes, the two most-used radionuclides were considered: 99m Tc) and 18 F. For therapeutic treatments, Zevalin R and DOTATOC (both labelled with 90 Y) were chosen. Large variations of doses were observed across the hands depending on different parameters. Furthermore, this study highlights the importance of the positioning of the extremity dosemeter for a correct estimate of the maximum skin doses. (authors)

Maternal-child health fellowship: maintaining the rigor of family medicine obstetrics.

Science.gov (United States)

Magee, Susanna R; Radlinski, Heidi; Nothnagle, Melissa

2015-01-01

The United States has a growing shortage of maternity care providers. Family medicine maternity care fellowships can address this growing problem by training family physicians to manage high-risk pregnancies and perform cesarean deliveries. This paper describes the impact of one such program-the Maternal Child Health (MCH) Fellowship through the Department of Family Medicine at Brown University and the careers of its graduates over 20 years (1991--2011). Fellowship graduates were mailed a survey regarding their training, current practice and teaching roles, and career satisfaction. Seventeen of 23 fellows (74%) responded to the survey. The majority of our fellowship graduates provide maternity care. Half of our respondents are primary surgeons in cesarean sections, and the majority of these work in community hospitals. Nearly all of our graduates maintain academic appointments and teach actively in their respective departments of family medicine. Our maternal child health fellowship provides family physicians with the opportunity to develop advanced skills needed to provide maternity care for underserved communities and teaching skills to train the next generation of maternal child health care providers.

Respiratory Medicine at McMaster University, Hamilton, Ontario: 1968 to 2013

Directory of Open Access Journals (Sweden)

Norman L Jones

2014-01-01

Full Text Available The medical school at McMaster University (Hamilton, Ontario was conceived in 1965, and admitted the first class in 1969. John Evans became the founding Dean and he invited EJ Moran Campbell to be the first Chairman of the Department of Medicine. Moran Campbell, already a world figure in respiratory medicine and physiology, arrived at McMaster in September 1968, and he invited Norman Jones to be Coordinator of the Respiratory Programme.

Respiratory Medicine at McMaster University, Hamilton, Ontario: 1968 To 2013

Directory of Open Access Journals (Sweden)

Norman L Jones

2014-01-01

Full Text Available The medical school at McMaster University (Hamilton, Ontario was conceived in 1965 and admitted the first class in 1969. John Evans became the founding Dean and he invited Moran Campbell to be the first Chairman of the Department of Medicine. Moran Campbell, already a world figure in respiratory medicine and physiology, arrived at McMaster in September 1968, and he invited Norman Jones to be Coordinator of the Respiratory Programme.

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)

Family Medicine Global Health Fellowship Competencies: A Modified Delphi Study.

Science.gov (United States)

Rayess, Fadya El; Filip, Anna; Doubeni, Anna; Wilson, Calvin; Haq, Cynthia; Debay, Marc; Anandarajah, Gowri; Heffron, Warren; Jayasekera, Neil; Larson, Paul; Dahlman, Bruce; Valdman, Olga; Hunt, Vince

2017-02-01

Many US medical schools and family medicine departments have responded to a growing interest in global health by developing global health fellowships. However, there are no guidelines or consensus statements outlining competencies for global health fellows. Our objective was to develop a mission and core competencies for Family Medicine Global Health Fellowships. A modified Delphi technique was used to develop consensus on fellowship competencies. A panel, comprised of 13 members with dual expertise in global health and medical education, undertook an iterative consensus process, followed by peer review, from April to December 2014. The panel developed a mission statement and identified six domains for family medicine global health fellowships: patient care, medical knowledge, professionalism, communication and leadership, teaching, and scholarship. Each domain includes a set of core and program-specific competencies. The family medicine global health competencies are intended to serve as an educational framework for the design, implementation, and evaluation of individual family medicine global health fellowship programs.

Caso de estudo: a entrada do azeite Gallo no mercado chinês

OpenAIRE

Costa, Miguel Maria Portugal Martins

2014-01-01

Mestrado em Gestão 7 Classificação JEL: M16; F23 A elaboração desta dissertação consiste na criação de um caso de estudo pedagógico com o objectivo de tirar ilações sobre a entrada da marca “Azeite Gallo” no mercado Chinês. Optamos por desenvolver este caso de estudo através de um estudo qualitativo, suportado por um referencial teórico. O intuito do projecto é de documentar um exemplo paradigmático de um produto consumível de marca portuguesa que sucedeu em ultrapassar as barreiras ...

IMPACTOS MICROCLIMÁTICOS DO DESENHO URBANO: ESTUDOS REALIZADOS EM CURITIBA

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Eduardo KRUGER

2011-04-01

Full Text Available O artigo busca compreender as relações entre atributos da geometria urbana e alterações no microclima. São apresentados dois estudos distintos conduzidos na mesma área central de Curitiba, PR, a partir de medições de campo realizadas em 2009 e de simulações de clima urbano no software ENVI-met. Os estudos, embora utilizem a mesma campanha de coleta de dados, possuem objetivos e metodologias diferentes. O primeiro estudo foca no impacto da geometria urbana, na temperatura ambiente e nos níveis de conforto em ruas de pedestre no período diurno, sendo o fator de visão do céu utilizado como indicador da complexa geometria urbana. O segundo estudo trata do impacto da orientação das vias em relação ao vento dominante, quanto às taxas de ventilação resultantes (velocidade do ar e distribuição espacial, visando à dispersão de poluentes gerados pelo tráfego, no contexto urbano. Os resultados auferidos evidenciam a influência da forma urbana para a determinação do conforto térmico em ruas de pedestres, restringindo-se a um período diurno específico, e para a criação de cenários de poluição.

UK nuclear medicine survey, 1989/90

International Nuclear Information System (INIS)

Elliott, A.T.; Shields, R.A.

1993-01-01

A postal survey of UK nuclear medicine departments was carried out to obtain information on activity during the year 1989/90. A rise of 14% in the number of administrations of radiopharmaceuticals was found compared to 1982: a rise of 22% in imaging studies was offset by a 30% decrease in the number of nonimaging investigations. The estimated total number of administrations in the UK was 430 000. (author)

A guide to medicinal plants of Appalachia

Science.gov (United States)

Arnold Krochmal; Russell S. Walters; Richard M. Doughty

1969-01-01

The Medicinal or therapeutic uses of the plants described in this guide are not to be construed in any way as a recommendation by the authors or the U.S. Department of Agriculture. Some of the dried crude drugs, which must be modified considerably before commercial use, can be extremely poisonous when not used properly. Readers are cautioned against using these plant...

Managing patients with oncologic complications in the emergency department [digest].

Science.gov (United States)

Wacker, David; McCurdy, Michael T; Nusbaum, Jeffrey; Gupta, Nachi

2018-01-22

As the prevalence of cancer continues to increase in the general population and improvements in cancer treatment prolong survival, the incidence of patients presenting to the emergency department with oncologic complications will, similarly, continue to rise. This issue reviews 3 of the more common presentations of oncology patients to the emergency department: metastatic spinal cord compression, tumor lysis syndrome, and febrile neutropenia. Signs and symptoms of these conditions can be varied and nonspecific, and may be related to the malignancy itself or to an adverse effect of the cancer treatment. Timely evidence-based decisions in the emergency department regarding diagnostic testing, medications, and arrangement of disposition and oncology follow-up can significantly improve a cancer patient's quality of life. [Points & Pearls is a digest of Emergency Medicine Practice.].

Cúrcuma: planta medicinal, condimentar e de outros usos potenciais Curcuma: medicinal, spice and of other potential use plant

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Arthur Bernardes Cecilio Filho

2000-03-01

Full Text Available A cúrcuma (Curcuma longa L., espécie originária do sudeste asiático, é considerada uma preciosa especiaria. Com a proibição do uso de pigmentos sintéticos nos principais países da América do Norte e Europa, têm sido procuradas alternativas naturais. A cúrcuma, além de sua principal utilização como condimento, possui substâncias antioxidantes, antimicrobianas e corantes (curcumina que lhe conferem possibilidade de emprego nas áreas de cosméticos, têxtil, medicinal e alimentício. Até o presente momento, poucos estudos foram realizados com a cúrcuma no Brasil, fato que determina baixa produtividade. Entretanto, recentes resultados de pesquisa mostram a possibilidade de obtenção de produtividades semelhantes às de seu país de origem, ainda que maiores estudos sejam necessários para definição de estande, adubação e outras práticas culturais. Os objetivos do presente trabalho são apresentar a versatilidade mercadológica da cúrcuma, caracterizar a espécie quanto a aspectos botânicos, nutricionais e químicos, bem como reunir e discutir informações técnicas para melhoria da produtividade e qualidade dos rizomas.The turmeric (Curcuma longa L., original species of the Asian Southeast, is considered a precious spice. With the prohibition of the use of synthetic pigments in the main countries of North America and Europe, it has natural alternatives have been sought. The turmeric, besides its main use as condiment, has anti-oxidant, anti-microbial and dye (curcumin substances that can be used in the cosmetic, textile, medicinal and food areas. Until the present moment, few studies were accomplished with the turmeric in Brazil, fact this that determines low yield. However, recent research results show the possibility of obtaining of yields similar to the one of its origin country, although larger studies are necessary for stand definition, fertilizer and other cultural practices. The objectives of the present work are

The impact of critical appraisal workshops on residents' evidence based medicine skills and knowledge

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Nasr JA

2018-04-01

Full Text Available Justine A Nasr,1,2 John Falatko,1 Alexandra Halalau1,2 1Internal Medicine Department, Beaumont Hospital, Royal Oak, MI, USA; 2Internal Medicine Department, Oakland University William Beaumont School of Medicine, Rochester, MI, USA Objective: To assess the impact of four evidence based medicine (EBM critical appraisal education workshops in improving residents’ EBM knowledge and skills. Methods: The eligible participants in the workshops were 88 residents-in-training, postgraduate years one through four, rotating through the outpatient internal medicine clinic. Four EBM workshops, consisting of 3 days each (30 minutes daily, were taught by our faculty. Topics covered included critical appraisal of randomized controlled trials, case-control and cohort studies, diagnosis studies, and systematic reviews. Results: As a program evaluation, anonymous pre-workshop and post-workshop tests were administered. Each of the four sets of tests showed improvement in scores: therapy from 58% to 77% (42% response rate, harm from 65% to 73% (38% response rate, diagnosis from 49% to 68% (49% response rate, and systematic review from 57% to 72% (30% response rate. Conclusion: We found that teaching EBM in four short workshops improved EBM knowledge and critical appraisal skills related to the four topics. Keywords: evidence based medicine, medical education, assessment methods, graduate, instructional design, curriculum development, curriculum evaluation